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. 2015 Nov;18 Suppl 2(Suppl 2):14-24.
doi: 10.1111/ocr.12109.

Structural outcomes in the Cleft Care UK study. Part 2: dento-facial outcomes

R Al-Ghatam  1 , T E M Jones  1 , A J Ireland  1 , N E Atack  1 , O Chawla  1 , S Deacon  1   2 , L Albery  2 , A R M Cobb  2 , J Cadogan  2 , S Leary  1 , A Waylen  1 , A K Wills  1 , B Richard  3 , H Bella  3 , A R Ness  1   4 , J R Sandy  1
Affiliations

Structural outcomes in the Cleft Care UK study. Part 2: dento-facial outcomes

R Al-Ghatam et al. Orthod Craniofac Res. 2015 Nov.

Abstract

Objectives: To compare facial appearance and dento-alveolar relationship outcomes from the CSAG (1998) and CCUK (2013) studies.

Setting and sample population: 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.

Materials and 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.

Keywords: cleft lip; cleft palate; face; treatment outcome.

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Figures

Figure 1
Figure 1
Photographs were cropped so that the final image in each case included both medial canthi, a small portion of sclera, all of the upper lip and lower lip and the oral commissures.
Figure 2
Figure 2
Categorization of photographic assessment of facial appearance from frontal views in the CCUK and CSAG groups, pooling data from the six observers.
Figure 3
Figure 3
Categorization of assessment of dental relationships from the study models in CCUK and CSAG groups.
See this image and copyright information in PMC

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