title: Structural outcomes in the Cleft Care UK study. Part 2: dento-facial outcomes.
abstract: OBJECTIVE
  To compare facial appearance and dento-alveolar relationship outcomes from the CSAG (1998) and CCUK (2013) studies.
  
  
  METHODS
  Five-year-olds born with non-syndromic unilateral cleft lip and palate. Those in the original CSAG were treated in a dispersed model of care with low-volume operators. Those in CCUK were treated in a more centralized, high-volume operator model.
  
  
  METHODS
  We compared facial appearance using frontal view photographs (252 CCUK, 239 CSAG) and dental relationships using study models (198 CCUK, 223 CSAG). Facial appearance was scored by a panel of six assessors using a standardized and validated outcome tool. Dento-alveolar relationships were scored by two assessors using the 5-Year-Olds' Index. Ordinal regression was used to compare results between surveys.
  
  
  RESULTS
  Excellent or good facial appearance was seen in 36.2% of CCUK compared with 31.9% in CSAG. In CCUK, 21.6% were rated as having poor or very poor facial appearance compared with 27.6% in CSAG. The percentage rated as having excellent or good dento-alveolar relationships was 53.0% in CCUK compared with 29.6% in CSAG. In CCUK, 19.2% were rated as having poor or very poor dento-alveolar relationships compared to 36.3% in CSAG. The odds ratios for improved outcome in CCUK compared to CSAG were 1.43 (95% CI 1.03, 1.97) for facial appearance and 2.29 (95% CI 1.47, 3.55) for dento-alveolar relationships.
  
  
  CONCLUSIONS
  Facial and dento-alveolar outcomes were better in CCUK children compared to those in CSAG.
authors.affiliation: School of Oral and Dental Sciences, University of Bristol, Bristol, UK.
authors.forename: R
authors.initials: R
authors.lastname: Al-Ghatam
authors.affiliation: School of Oral and Dental Sciences, University of Bristol, Bristol, UK.
authors.forename: T E M
authors.initials: TE
authors.lastname: Jones
authors.affiliation: School of Oral and Dental Sciences, University of Bristol, Bristol, UK.
authors.forename: A J
authors.initials: AJ
authors.lastname: Ireland
authors.affiliation: School of Oral and Dental Sciences, University of Bristol, Bristol, UK.
authors.forename: N E
authors.initials: NE
authors.lastname: Atack
authors.affiliation: School of Oral and Dental Sciences, University of Bristol, Bristol, UK.
authors.forename: O
authors.initials: O
authors.lastname: Chawla
authors.affiliation: School of Oral and Dental Sciences, University of Bristol, Bristol, UK.|South West Cleft Team, University Hospitals Bristol NHS Trust, Cleft Lip and Palate Team, Bristol, UK.
authors.forename: S
authors.initials: S
authors.lastname: Deacon
authors.affiliation: South West Cleft Team, University Hospitals Bristol NHS Trust, Cleft Lip and Palate Team, Bristol, UK.
authors.forename: L
authors.initials: L
authors.lastname: Albery
authors.affiliation: South West Cleft Team, University Hospitals Bristol NHS Trust, Cleft Lip and Palate Team, Bristol, UK.
authors.forename: A R M
authors.initials: AR
authors.lastname: Cobb
authors.affiliation: South West Cleft Team, University Hospitals Bristol NHS Trust, Cleft Lip and Palate Team, Bristol, UK.
authors.forename: J
authors.initials: J
authors.lastname: Cadogan
authors.affiliation: School of Oral and Dental Sciences, University of Bristol, Bristol, UK.
authors.forename: S
authors.initials: S
authors.lastname: Leary
authors.affiliation: School of Oral and Dental Sciences, University of Bristol, Bristol, UK.
authors.forename: A
authors.initials: A
authors.lastname: Waylen
authors.affiliation: School of Oral and Dental Sciences, University of Bristol, Bristol, UK.
authors.forename: A K
authors.initials: AK
authors.lastname: Wills
authors.affiliation: Birmingham Children's Hospital NHS Trust, Birmingham, UK.
authors.forename: B
authors.initials: B
authors.lastname: Richard
authors.affiliation: Birmingham Children's Hospital NHS Trust, Birmingham, UK.
authors.forename: H
authors.initials: H
authors.lastname: Bella
authors.affiliation: School of Oral and Dental Sciences, University of Bristol, Bristol, UK.|National Institute for Health Research (NIHR) Biomedical Research Unit in Nutrition, Diet and Lifestyle at the University Hospitals Bristol NHS Foundation Trust and the University of Bristol, Bristol, UK.
authors.forename: A R
authors.initials: AR
authors.lastname: Ness
authors.affiliation: School of Oral and Dental Sciences, University of Bristol, Bristol, UK.
authors.forename: J R
authors.initials: JR
authors.lastname: Sandy
mesh_terms: D016025:Bone Transplantation; D002675:Child, Preschool; D002971:Cleft Lip / Q000601:surgery*; D002972:Cleft Palate / Q000601:surgery*; D005145:Face; D005260:Female; D006801:Humans; D008297:Male; D016896:Treatment Outcome
keywords: cleft lip; cleft palate; face; treatment outcome