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A retrospective intercenter comparison of two surgical protocols through the dental arch relationship of 5- to 6-year-old unilateral cleft patients

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Abstract

Objectives

The objectives of this retrospective equivalence trial were to assess the dental arch relationship of 5- to 6-year-old patients with unilateral cleft lip and palate (UCLP) treated in two specialized cleft centers with a different surgical protocol using the 5-Year-Olds’ Index and the modified Huddart/Bodenham scoring system, and to determine the correlation between these two scoring indices.

Materials and methods

The dental arch relationship of seventy-three 5- to 6-year-old patients with complete UCLP was evaluated on plaster casts using the 5-Year-Olds’ Index and the modified Huddart/Bodenham scoring system. The sagittal occlusion, overbite, and overjet were also recorded. Inter- and intra-examiner agreement was determined using Intraclass Correlation Coefficients.

Results

A good to very good inter- and intra-examiner agreement was found. No significant mean difference in outcome based on the 5-Year-Olds’ Index, the modified Huddart/Bodenham scoring system, overjet, or overbite was detected. For mean difference in sagittal occlusion, the hypothesis that both centers are clinically equivalent was confirmed. A strong negative correlation (rs = − 0.832) between the 5-Year-Olds’ Index and the modified Huddart/Bodenham scoring system was found.

Conclusions

The dental arch relationship of 5- to 6-year-old unilateral cleft patients treated in two Belgian cleft centers is clinically equivalent based on sagittal occlusion, despite substantial differences in their treatment protocol. Clinical equivalence for other parameters was not confirmed. There is a strong correlation between the 5-Year-Olds’ Index and the modified Huddart/Bodenham scoring system.

Clinical relevance

A well-implemented treatment protocol for cleft patients is of the utmost importance, but case load and skill of the surgeon are also important factors for the quality of the results.

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Acknowledgements

The authors wish to thank Ms. V. Thienpont for the data collection and support in this study; Dr. K. Bonte, Dr. N. Roche, Dr. J. Schoenaers, Dr. V. Vander Poorten, and Dr. G. Hens for their contribution in the surgical interventions; Dr. Stefanie De Buyser for the statistical analyses; and in extent, all the members of the cleft teams of Ghent University Hospital and University Hospitals Leuven.

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Authors and Affiliations

  1. Oral Health Sciences, Department of Orthodontics, Ghent University, C. Heymanslaan 10, 9000, Ghent, Belgium

    Laurent AM Thierens, Liesbeth Temmerman, Noëmi MC De Roo & Guy AM De Pauw

  2. Centre for Congenital Facial Anomalies, Ghent University Hospital, C. Heymanslaan 10, 9000, Ghent, Belgium

    Laurent AM Thierens & Guy AM De Pauw

  3. Department of Oral Health Sciences-Orthodontics, KU Leuven and Dentistry, University Hospitals Leuven, Kapucijnenvoer 7, 3000, Leuven, Belgium

    Arianne Lewyllie, An Verdonck, Maria Cadenas de Llano Perula & Guy Willems

  4. Leuven Cleft Lip and Palate Team, University Hospitals Leuven, Kapucijnenvoer 7, 3000, Leuven, Belgium

    An Verdonck & Maria Cadenas de Llano Perula

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  1. Laurent AM Thierens
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  2. Arianne Lewyllie
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  3. Liesbeth Temmerman
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  4. Noëmi MC De Roo
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  5. An Verdonck
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  6. Maria Cadenas de Llano Perula
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  7. Guy Willems
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Correspondence to Laurent AM Thierens.

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Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

The study design was evaluated and approved by the Ethical Committees of the Ghent University Hospital (21 August 2014) and the University Hospitals Leuven (14 November 2014) under registration number B670201420725 and is in accordance with the Declaration of Helsinki. All procedures were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Informed consent was obtained from all individual participants included in the study.

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Thierens, L.A., Lewyllie, A., Temmerman, L. et al. A retrospective intercenter comparison of two surgical protocols through the dental arch relationship of 5- to 6-year-old unilateral cleft patients. Clin Oral Invest 23, 1777–1784 (2019). https://doi.org/10.1007/s00784-018-2601-0

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