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Rigshospitalet - a part of Copenhagen University Hospital
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Do Infant Cleft Dimensions Have an Influence on Occlusal Relations? A Subgroup Analysis Within an RCT of Primary Surgery in Patients With Unilateral Cleft Lip and Palate

Research output: Contribution to journalJournal articleResearchpeer-review

DOI

  1. Spatially Detailed 3D Quantification of Improved Facial Symmetry After Surgery in Children With Unicoronal Synostosis

    Research output: Contribution to journalJournal articleResearchpeer-review

  2. Facial Asymmetry in Children with Unicoronal Synostosis Who Have Undergone Craniofacial Reconstruction in Infancy

    Research output: Contribution to journalJournal articleResearchpeer-review

  3. Lexical selectivity in danish toddlers with cleft palate

    Research output: Contribution to journalJournal articleResearchpeer-review

  1. Scandcleft trial of primary surgery for unilateral cleft lip and palate: Craniofacial cephalometrics at 8 years

    Research output: Contribution to journalJournal articleResearchpeer-review

  2. Scandcleft randomized trials of primary surgery for unilateral cleft lip and palate: dental anomalies in 8-year olds

    Research output: Contribution to journalJournal articleResearchpeer-review

  3. Scandcleft randomized trials of primary surgery for unilateral cleft lip and palate: maxillary growth at eight years of age

    Research output: Contribution to journalJournal articleResearchpeer-review

  • Susanna Botticelli
  • Annelise Küseler
  • Agneta Marcusson
  • Kirsten Mølsted
  • Sven E Nørholt
  • Paolo M Cattaneo
  • Thomas K Pedersen
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AIM: To investigate whether infant cleft dimensions, in a surgical protocol with early or delayed hard palate closure, influence occlusion before orthodontics.

DESIGN: Subgroup analysis within a randomized trial of primary surgery (Scandcleft).

SETTING: Tertiary health care. One surgical centre.

PATIENTS AND METHODS: A total of 122 unilateral cleft lip and palate infants received primary cheilo-rhinoplasty and soft palate closure at age 4 months and were randomized for hard palate closure at age 12 versus 36 months. A novel 3D analysis of cleft size and morphology was performed on digitized presurgical models. Occlusion was scored on 8-year models using the modified Huddarth-Bodenham (MHB) Index and the Goslon Yardstick.

MAIN OUTCOME MEASUREMENTS: Differences in MHB and Goslon scores among the 2 surgical groups adjusted for cleft size.

RESULTS: The crude analysis showed no difference between the 2 surgical groups in Goslon scores but a better MHB (P = .006) for the group who received delayed hard palate closure. When adjusting for the ratio between cleft surface and palatal surface (3D Infant Cleft Severity Ratio) and for posterior cleft dimensions at tuberosity level, the delayed hard palate closure group received 3.65 points better for MHB (confidence interval: 1.81; 5.48; P < .001) and showed a trend for reduced risk of receiving a Goslon of 4 or 5 (P = .052). For posterior clefts larger than 9 mm, the Goslon score was better in the delayed hard palate closure group (P = .033).

CONCLUSIONS: Seen from an orthodontic perspective, when the soft palate is closed first, and the cleft is large, the timing of hard palate closure should be planned in relation to posterior cleft size.

Original languageEnglish
JournalCleft Palate-Craniofacial Journal
Volume57
Issue number3
Pages (from-to)378-388
Number of pages11
ISSN1055-6656
DOIs
Publication statusPublished - Mar 2020

    Research areas

  • Cleft Lip, Cleft Palate, Dental Arch, Humans, Infant, Palate, Hard, Palate, Soft, Treatment Outcome

ID: 61797970