Analysis of dental arch relationships in Swedish unilateral cleft lip and palate subjects: 20-year longitudinal consecutive series treated with delayed hard palate closure. 2006

Jan Lilja, and Michael Mars, and Anna Elander, and Lars Enocson, and Catharina Hagberg, and Emma Worrell, and Puneet Batra, and Hans Friede
Sahlgrenska University Hospital, Goteborg, Sweden.

OBJECTIVE To evaluate the dental arch relationships for a consecutive series from Goteborg, Sweden, who had delayed hard palate closure. METHODS Retrospective study. METHODS Sahlgrenska University Hospital, Goteborg, Sweden. METHODS The dental study models of 104 consecutive unilateral cleft lip and palate subjects. The study cohort was born between 1979 and 1994. Longitudinal records were available at ages 5 (n = 94), 10 (n = 97), 16 (n = 59), and 19 years (n = 46). Five assessors rated models according to the GOSLON Yardstick on two separate occasions each. METHODS These patients had been operated upon according to the Goteborg protocol of delayed hard palate closure (at age 8 years). RESULTS 85% of subjects were rated in groups 1 and 2 (excellent or very good outcome), 12% were rated in group 3 (satisfactory), and 3% were assigned to group 4 (poor). No patients presented in Group 5 (very poor). Weighted kappa statistics for double determination of Yardstick allocation for five assessors demonstrated values between .65 and .90 for interrater agreement (good/very good) and between .70 and .90 for intrarater agreement (very good). CONCLUSIONS Delayed hard palate closure as practiced in Goteborg since 1979 has produced the best GOSLON Yardstick ratings in a consecutive series of patients ever recorded worldwide, since the Yardstick was first used in 1983. However, it is noteworthy that a new protocol has been introduced in Goteborg since 1994, in which hard palate closure is done at 3 years due to concerns regarding speech.

UI MeSH Term Description Entries
D008310 Malocclusion Such malposition and contact of the maxillary and mandibular teeth as to interfere with the highest efficiency during the excursive movements of the jaw that are essential for mastication. (Jablonski, Illustrated Dictionary of Dentistry, 1982) Angle's Classification,Crossbite,Tooth Crowding,Cross Bite,Angle Classification,Angles Classification,Bite, Cross,Bites, Cross,Classification, Angle's,Cross Bites,Crossbites,Crowding, Tooth,Crowdings, Tooth,Malocclusions
D002648 Child A person 6 to 12 years of age. An individual 2 to 5 years old is CHILD, PRESCHOOL. Children
D002675 Child, Preschool A child between the ages of 2 and 5. Children, Preschool,Preschool Child,Preschool Children
D002971 Cleft Lip Congenital defect in the upper lip where the maxillary prominence fails to merge with the merged medial nasal prominences. It is thought to be caused by faulty migration of the mesoderm in the head region. Harelip,Cleft Lips,Harelips,Lip, Cleft,Lips, Cleft
D002972 Cleft Palate Congenital fissure of the soft and/or hard palate, due to faulty fusion. Cleft Palate, Isolated,Cleft Palates,Palate, Cleft,Palates, Cleft
D003765 Models, Dental Presentation devices used for patient education and technique training in dentistry. Dental Models,Dental Model,Model, Dental
D003766 Dental Occlusion The relationship of all the components of the masticatory system in normal function. It has special reference to the position and contact of the maxillary and mandibular teeth for the highest efficiency during the excursive movements of the jaw that are essential for mastication. (From Jablonski, Dictionary of Dentistry, 1992, p556, p472) Canine Guidance,Occlusal Guidance,Occlusal Plane,Occlusion, Dental,Dental Occlusions,Guidance, Canine,Guidance, Occlusal,Occlusal Guidances,Occlusal Planes,Occlusions, Dental,Plane, Occlusal,Planes, Occlusal
D004812 Epidemiologic Methods Research techniques that focus on study designs and data gathering methods in human and animal populations. Epidemiologic Method,Epidemiological Methods,Methods, Epidemiologic,Epidemiological Method,Method, Epidemiologic,Method, Epidemiological,Methods, Epidemiological
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000293 Adolescent A person 13 to 18 years of age. Adolescence,Youth,Adolescents,Adolescents, Female,Adolescents, Male,Teenagers,Teens,Adolescent, Female,Adolescent, Male,Female Adolescent,Female Adolescents,Male Adolescent,Male Adolescents,Teen,Teenager,Youths

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