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

Journal article
Authors Jan Lilja
Michael Mars
Anna Elander
Lars Enocson
Catharina Hagberg
Emma Worrell
Puneet Batra
Hans Friede
Published in The Cleft palate-craniofacial journal : official publication of the American Cleft Palate-Craniofacial Association
Volume 43
Issue 5
Pages 606-11
ISSN 1055-6656
Publication year 2006
Published at Institute of Odontology
Institute of Clinical Sciences
Pages 606-11
Language en
Links dx.doi.org/10.1597/05-069
Keywords Adolescent, Adult, Child, Child, Preschool, Cleft Lip, pathology, surgery, Cleft Palate, pathology, surgery, Dental Models, Dental Occlusion, Epidemiologic Methods, Humans, Malocclusion, etiology, pathology, Palate, Hard, pathology, surgery, Time Factors, Treatment Outcome
Subject categories Plastic surgery, Orthodontics

Abstract

OBJECTIVE: To evaluate the dental arch relationships for a consecutive series from Goteborg, Sweden, who had delayed hard palate closure. DESIGN: Retrospective study. SETTING: Sahlgrenska University Hospital, Goteborg, Sweden. PATIENTS: 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. INTERVENTIONS: 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.

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