title: Long-term follow-up study of patients with a unilateral complete cleft of lip, alveolus, and palate following the Utrecht treatment protocol: Dental arch relationships.
abstract: OBJECTIVE
  This study sought to evaluate long-term dental arch relationships in adults with a unilateral complete cleft lip and palate (UCLP) treated by the Utrecht protocol and to compare results with the centers from the Eurocleft study.
  
  
  METHODS
  Retrospective analysis of UCLP patients age 17 or older, treated by two-stage palate closure at the Wilhelmina Children's Hospital, a tertiary center for cleft surgery in Utrecht, the Netherlands. Patients were invited to the clinic for a long-term evaluation. Casts were obtained on the day of follow-up and assessed by the modified Goslon Yardstick for permanent dentition. Dental casts were scored twice by 3 different examiners.
  
  
  RESULTS
  Intra-rater agreement varied from 0.743 to 0.844, the inter-rater agreement from 0.552 to 0.718. The mean Goslon Yardstick score was 3.3. Thirty-three percent of the patients had a Goslon score of 1 or 2, 45% had a score of 4 or 5.
  
  
  CONCLUSIONS
  The present study found unfavourable results regarding dental arch relationships after delayed hard palate closure at 3 years old. The mean Goslon Yardstick score was 3.3 (SD 1.4) and 45% of the casts were allocated to group 4 or 5 despite extensive orthodontic treatment. We observed a high number of secondary surgical interventions but no evident benefit regarding dental occlusion following the Utrecht treatment protocol, which includes a two-stage palatoplasty. Other factors than the timing of palate closure are likely of influence.
authors.affiliation: Department of Plastic Surgery, University Medical Center Utrecht, Heidelberglaan 100, PO Box 85090, 3584 CX Utrecht, The Netherlands. Electronic address: isabellekappen@me.com.
authors.forename: Isabelle Francisca Petronella Maria
authors.initials: IFPM
authors.lastname: Kappen
authors.affiliation: Department of Maxillofacial Surgery, University Medical Center Utrecht, Heidelberglaan 100, PO Box 85090, 3584 CX Utrecht, The Netherlands.
authors.forename: Gerhard Koendert Pieter
authors.initials: GKP
authors.lastname: Bittermann
authors.affiliation: Department of Maxillofacial Surgery, University Medical Center Utrecht, Heidelberglaan 100, PO Box 85090, 3584 CX Utrecht, The Netherlands.
authors.forename: Dirk
authors.initials: D
authors.lastname: Bitterman
authors.affiliation: Department of Plastic Surgery, University Medical Center Utrecht, Heidelberglaan 100, PO Box 85090, 3584 CX Utrecht, The Netherlands.
authors.forename: Aebele Barber
authors.initials: AB
authors.lastname: Mink van der Molen
authors.affiliation: School of Dentistry, University of Manchester, Higher Cambridge St, Manchester M15 6FH, United Kingdom.
authors.forename: William
authors.initials: W
authors.lastname: Shaw
authors.affiliation: Department of Plastic Surgery, University Medical Center Utrecht, Heidelberglaan 100, PO Box 85090, 3584 CX Utrecht, The Netherlands.
authors.forename: Corstiaan Cornelis
authors.initials: CC
authors.lastname: Breugem
mesh_terms: D000293:Adolescent; D000539:Alveolar Process / Q000002:abnormalities* / Q000601:surgery; D002971:Cleft Lip / Q000601:surgery*; D002972:Cleft Palate / Q000601:surgery*; D002985:Clinical Protocols; D003724:Dental Arch / Q000473:pathology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D012189:Retrospective Studies; D016896:Treatment Outcome; D055815:Young Adult
keywords: Adult; Cleft lip; Cleft palate; Dental arch; Dental occlusion