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Early detection of differences in surgical outcome for cleft lip and palate
N E Atack1, I Hathorn, T Dowell
1Division of Child Dental Health, University of Bristol Dental School, UK.
Insights
This study compared surgical outcomes for children with cleft lip and palate in Bristol and Oslo. Oslo showed better dento-alveolar results at age five, indicating surgical technique differences.
Area of Science:
- Craniofacial surgery
- Pediatric dentistry
- Plastic surgery
Background:
- Unilateral cleft lip and palate (CLP) significantly impacts dento-alveolar development.
- Primary surgical repair aims to correct the defect and optimize facial growth.
- Variations in surgical techniques and centers may influence long-term outcomes.
Purpose of the Study:
- To compare dento-alveolar outcomes at age five between children with unilateral CLP surgically repaired in Bristol and Oslo.
- To assess the efficacy of a new 5-year-old index in detecting differences in surgical results.
Main Methods:
- Retrospective analysis of study models from 46 children in Bristol and 54 children in Oslo.
- Utilized a novel 5-year-old index to categorize dento-alveolar relationships.
- Compared the distribution of cases within ideal and poor outcome groups between the two centers.
Main Results:
- The Oslo sample showed a higher percentage (57%) in ideal dento-alveolar outcome groups (1 and 2) compared to Bristol (35%).
- Bristol had a significantly higher percentage (46%) in the worst outcome groups (4 and 5) versus Oslo (15%).
- The 5-year-old index effectively differentiated outcomes between the surgical centers.
Conclusions:
- Surgical repair of unilateral cleft lip and palate can yield different dento-alveolar outcomes depending on the center.
- The 5-year-old index is a valuable tool for assessing early surgical results in pediatric CLP patients.
- Differences in surgical protocols between centers may explain the observed variations in outcomes.
Abstract:
This study examined the dento-alveolar relationships of 5-year-old children born with a unilateral cleft lip and palate with primary surgical repair performed in one of two centres (Bristol or Oslo). The Bristol sample comprised 46 sets of study models and the Oslo CLP Growth Archive provided 54 cases with a very similar sex distribution. We used a recently developed 5-year-old index to measure differences in outcome between the two centres. The Oslo sample were assessed as having up to 57 per cent in the ideal groupings (1 and 2), in the Bristol group this was only 35 per cent. Bristol had up to 46 per cent of cases assessed in the worst groups (4 and 5). The comparative figure from the Oslo group was 15 per cent. These results suggest that it is possible to detect differences in surgical outcome at 5 years of age.
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