title: Scandcleft randomised trials of primary surgery for unilateral cleft lip and palate: 7. Occlusion in 5 year-olds according to the Huddart and Bodenham index.
abstract: OBJECTIVE
  Good dentofacial development and good occlusion are main goals in the treatment of UCLP. The aim was to evaluate dental occlusion at age 5 years with the Huddart and Bodenham index after four different protocols of primary surgery for UCLP.
  
  
  METHODS
  Three parallel randomised controlled trials were undertaken as an international multicentre study by 10 cleft teams in five countries: Denmark, Finland, Sweden, Norway, and the UK.
  
  
  METHODS
  Three different surgical procedures for primary palatal repair (Arms B, C, and D) were tested against a common procedure (Arm A) in the total cohort of 448 children born with non-syndromic UCLP. Dental casts of 418 patients (272 boys, 146 girls), at the mean age of 5.1 years (range =4.7-6.9) were blindly assessed by 10 orthodontists with the original Huddart and Bodenham index. The main outcome measure was dental occlusion.
  
  
  RESULTS
  The inter- and intra-examiner reliability was good-to-excellent (0.61-0.94; 0.66-1.0, respectively). The mean total scores (+2 to -18) varied from -5.56 (Trial 2C) to -7.21 (Trial 3D). The mean anterior scores (+2 to -6) varied from -1.66 (Trial 2C) to -2.56 (Trial 3A). The mean posterior cleft-side scores (0 to -6) varied from -3.24 (Trial 3A) to -3.82 (Trial 3D) and the mean non-cleft-side scores (0 to -6) varied from -0.60 (Trial 2C) to -1.30 (Trial 3A); however, no significant differences were found within the trials.
  
  
  CONCLUSIONS
  There was no statistical evidence of a difference in occlusion between the two surgical methods in each trial.
  
  
  BACKGROUND
  ISRCTN29932826.
authors.affiliation: a Stockholm Craniofacial Team, Division of Orthodontics, Department of Dental Medicine , Karolinska Institutet , Stockholm , Sweden.
authors.forename: Agneta
authors.initials: A
authors.lastname: Karsten
authors.affiliation: b Department of Dentofacial Orthopedics, Maxillofacial Unit , University Hospital , Linköping , Sweden.
authors.forename: Agneta
authors.initials: A
authors.lastname: Marcusson
authors.affiliation: c Cleft Palate and Craniofacial Center, Helsinki University Central Hospital , Helsinki , Finland.
authors.forename: Kirsti
authors.initials: K
authors.lastname: Hurmerinta
authors.affiliation: c Cleft Palate and Craniofacial Center, Helsinki University Central Hospital , Helsinki , Finland.
authors.forename: Arja
authors.initials: A
authors.lastname: Heliövaara
authors.affiliation: d Cleft Palate Center , Aarhus , Denmark.
authors.forename: Annelise
authors.initials: A
authors.lastname: Küseler
authors.affiliation: e Department of Plastic and Reconstructive Surgery , Oslo University Hospital Rikshospitalet , Oslo , Norway.
authors.forename: Pål
authors.initials: P
authors.lastname: Skaare
authors.affiliation: f Greater Manchester Cleft Lip and Palate Unit, Royal Manchester Childrens' Hospital , Manchester , UK.
authors.forename: Haydn
authors.initials: H
authors.lastname: Bellardie
authors.affiliation: e Department of Plastic and Reconstructive Surgery , Oslo University Hospital Rikshospitalet , Oslo , Norway.
authors.forename: Elisabeth
authors.initials: E
authors.lastname: Rønning
authors.affiliation: g Dental School, University of Manchester , Manchester , UK.
authors.forename: William
authors.initials: W
authors.lastname: Shaw
authors.affiliation: h Copenhagen Cleft Palate Center, University Hospital of Copenhagen , Copenhagen , Denmark.
authors.forename: Kirsten
authors.initials: K
authors.lastname: Mølsted
authors.affiliation: i Oral Health Center of Expertise/Western Norway , Bergen , Norway.
authors.forename: Paul
authors.initials: P
authors.lastname: Sæle
authors.affiliation: i Oral Health Center of Expertise/Western Norway , Bergen , Norway.
authors.forename: Eli
authors.initials: E
authors.lastname: Brinck
authors.affiliation: j Department of Odontology , Sahlgrenska Academy, University of Gothenburg , Gothenburg , Sweden.
authors.forename: Sara
authors.initials: S
authors.lastname: Rizell
authors.affiliation: j Department of Odontology , Sahlgrenska Academy, University of Gothenburg , Gothenburg , Sweden.
authors.forename: Midia
authors.initials: M
authors.lastname: Najal Chalier
authors.affiliation: g Dental School, University of Manchester , Manchester , UK.
authors.forename: Philip
authors.initials: P
authors.lastname: Eyres
authors.affiliation: e Department of Plastic and Reconstructive Surgery , Oslo University Hospital Rikshospitalet , Oslo , Norway.|g Dental School, University of Manchester , Manchester , UK.
authors.forename: Gunvor
authors.initials: G
authors.lastname: Semb
mesh_terms: D002648:Child; D002675:Child, Preschool; D002971:Cleft Lip / Q000175:diagnosis / Q000601:surgery*; D002972:Cleft Palate / Q000175:diagnosis / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D038622:Internationality; D008297:Male; D008310:Malocclusion / Q000209:etiology* / Q000628:therapy; D015588:Observer Variation; D011183:Postoperative Complications / Q000503:physiopathology / Q000628:therapy; D016032:Randomized Controlled Trials as Topic; D020127:Recovery of Function; D018570:Risk Assessment; D012720:Severity of Illness Index; D013997:Time Factors; D016896:Treatment Outcome
keywords: Scandcleft; Unilateral cleft lip and palate; dental occlusion at 5 years; randomised controlled trials; the original Huddart and Bodenham index