Indiacran: An Inter-Center Assessment of Dental Arch Relationship for Patients with Repaired Complete Unilateral Cleft Lip and Palate

Abstract

Objective: To conduct an intercenter outcome assessment of maxillomandibular relationships for patients with repaired complete unilateral cleft lip and palate between the ages of 8 and 14 using the GOSLON Yardstick index. Design: Retrospective cohort study. Setting: Ten Comprehensive Cleft Care Centers across India. Subjects: A total of 397 subjects with repaired unilateral cleft lip and palate. Methods: Using GOSLON Yardstick, 397 study models of patients with complete unilateral cleft lip and palate were assessed. The intra-rater and inter-rater reliabilities were assessed using weighted kappa statistics. One-way analysis of variance test was performed to determine if there were any statistically significant differences in GOSLON ratings among the centers. Significance levels were set at P < .05. Results: The inter-rater and intra-rater reliability values of GOSLON ratings were 0.882 and 0.836. The GOSLON ratings across ten different centers range from 3.1 to 3.9. The center with the best score, that is, Center G, with 37.5% of its patients with a GOSLON 4 and 5 combined, whereas Center A with the worst score, that is, 57.5% of its patients with a GOSLON 5. Conclusions: The outcomes vary from fair to poor GOSLON scores among Indiacran centers. Continued efforts to share best practices and improve standardization across centers may enhance the quality of care and decrease the burden of care for patients with cleft lip and palate and their parents.

Keywords: GOSLON Yardstick; UCLP; cleft lip and palate; dental arch relationship; inter-center study; study model; treatment outcome measures; unilateral cleft lip and palate.