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Scandcleft randomised trials of primary surgery for unilateral cleft lip and palate: 7. Occlusion in 5 year-olds according to the Huddart and Bodenham index.
J Plast Surg Hand Surg. 2017 Feb; 51(1):58-63.JP

Abstract

BACKGROUND AND AIM

Good dentofacial development and good occlusion are main goals in the treatment of UCLP. The aim was to evaluate dental occlusion at age 5 years with the Huddart and Bodenham index after four different protocols of primary surgery for UCLP.

DESIGN

Three parallel randomised controlled trials were undertaken as an international multicentre study by 10 cleft teams in five countries: Denmark, Finland, Sweden, Norway, and the UK.

METHODS

Three different surgical procedures for primary palatal repair (Arms B, C, and D) were tested against a common procedure (Arm A) in the total cohort of 448 children born with non-syndromic UCLP. Dental casts of 418 patients (272 boys, 146 girls), at the mean age of 5.1 years (range =4.7-6.9) were blindly assessed by 10 orthodontists with the original Huddart and Bodenham index. The main outcome measure was dental occlusion.

RESULTS

The inter- and intra-examiner reliability was good-to-excellent (0.61-0.94; 0.66-1.0, respectively). The mean total scores (+2 to -18) varied from -5.56 (Trial 2C) to -7.21 (Trial 3D). The mean anterior scores (+2 to -6) varied from -1.66 (Trial 2C) to -2.56 (Trial 3A). The mean posterior cleft-side scores (0 to -6) varied from -3.24 (Trial 3A) to -3.82 (Trial 3D) and the mean non-cleft-side scores (0 to -6) varied from -0.60 (Trial 2C) to -1.30 (Trial 3A); however, no significant differences were found within the trials.

CONCLUSION

There was no statistical evidence of a difference in occlusion between the two surgical methods in each trial.

TRIAL REGISTRATION

ISRCTN29932826.

Authors+Show Affiliations

a Stockholm Craniofacial Team, Division of Orthodontics, Department of Dental Medicine , Karolinska Institutet , Stockholm , Sweden.b Department of Dentofacial Orthopedics, Maxillofacial Unit , University Hospital , Linköping , Sweden.c Cleft Palate and Craniofacial Center, Helsinki University Central Hospital , Helsinki , Finland.c Cleft Palate and Craniofacial Center, Helsinki University Central Hospital , Helsinki , Finland.d Cleft Palate Center , Aarhus , Denmark.e Department of Plastic and Reconstructive Surgery , Oslo University Hospital Rikshospitalet , Oslo , Norway.f Greater Manchester Cleft Lip and Palate Unit, Royal Manchester Childrens' Hospital , Manchester , UK.e Department of Plastic and Reconstructive Surgery , Oslo University Hospital Rikshospitalet , Oslo , Norway.g Dental School, University of Manchester , Manchester , UK.h Copenhagen Cleft Palate Center, University Hospital of Copenhagen , Copenhagen , Denmark.i Oral Health Center of Expertise/Western Norway , Bergen , Norway.i Oral Health Center of Expertise/Western Norway , Bergen , Norway.j Department of Odontology , Sahlgrenska Academy, University of Gothenburg , Gothenburg , Sweden.j Department of Odontology , Sahlgrenska Academy, University of Gothenburg , Gothenburg , Sweden.g Dental School, University of Manchester , Manchester , UK.e Department of Plastic and Reconstructive Surgery , Oslo University Hospital Rikshospitalet , Oslo , Norway. g Dental School, University of Manchester , Manchester , UK.

Pub Type(s)

Comparative Study
Journal Article
Multicenter Study
Review

Language

eng

PubMed ID

28218557

Citation

Karsten, Agneta, et al. "Scandcleft Randomised Trials of Primary Surgery for Unilateral Cleft Lip and Palate: 7. Occlusion in 5 Year-olds According to the Huddart and Bodenham Index." Journal of Plastic Surgery and Hand Surgery, vol. 51, no. 1, 2017, pp. 58-63.
Karsten A, Marcusson A, Hurmerinta K, et al. Scandcleft randomised trials of primary surgery for unilateral cleft lip and palate: 7. Occlusion in 5 year-olds according to the Huddart and Bodenham index. J Plast Surg Hand Surg. 2017;51(1):58-63.
Karsten, A., Marcusson, A., Hurmerinta, K., Heliövaara, A., Küseler, A., Skaare, P., Bellardie, H., Rønning, E., Shaw, W., Mølsted, K., Sæle, P., Brinck, E., Rizell, S., Najal Chalier, M., Eyres, P., & Semb, G. (2017). Scandcleft randomised trials of primary surgery for unilateral cleft lip and palate: 7. Occlusion in 5 year-olds according to the Huddart and Bodenham index. Journal of Plastic Surgery and Hand Surgery, 51(1), 58-63. https://doi.org/10.1080/2000656X.2016.1265529
Karsten A, et al. Scandcleft Randomised Trials of Primary Surgery for Unilateral Cleft Lip and Palate: 7. Occlusion in 5 Year-olds According to the Huddart and Bodenham Index. J Plast Surg Hand Surg. 2017;51(1):58-63. PubMed PMID: 28218557.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Scandcleft randomised trials of primary surgery for unilateral cleft lip and palate: 7. Occlusion in 5 year-olds according to the Huddart and Bodenham index. AU - Karsten,Agneta, AU - Marcusson,Agneta, AU - Hurmerinta,Kirsti, AU - Heliövaara,Arja, AU - Küseler,Annelise, AU - Skaare,Pål, AU - Bellardie,Haydn, AU - Rønning,Elisabeth, AU - Shaw,William, AU - Mølsted,Kirsten, AU - Sæle,Paul, AU - Brinck,Eli, AU - Rizell,Sara, AU - Najal Chalier,Midia, AU - Eyres,Philip, AU - Semb,Gunvor, PY - 2017/2/21/entrez PY - 2017/2/22/pubmed PY - 2017/12/16/medline KW - Scandcleft KW - Unilateral cleft lip and palate KW - dental occlusion at 5 years KW - randomised controlled trials KW - the original Huddart and Bodenham index SP - 58 EP - 63 JF - Journal of plastic surgery and hand surgery JO - J Plast Surg Hand Surg VL - 51 IS - 1 N2 - BACKGROUND AND AIM: Good dentofacial development and good occlusion are main goals in the treatment of UCLP. The aim was to evaluate dental occlusion at age 5 years with the Huddart and Bodenham index after four different protocols of primary surgery for UCLP. DESIGN: Three parallel randomised controlled trials were undertaken as an international multicentre study by 10 cleft teams in five countries: Denmark, Finland, Sweden, Norway, and the UK. METHODS: Three different surgical procedures for primary palatal repair (Arms B, C, and D) were tested against a common procedure (Arm A) in the total cohort of 448 children born with non-syndromic UCLP. Dental casts of 418 patients (272 boys, 146 girls), at the mean age of 5.1 years (range =4.7-6.9) were blindly assessed by 10 orthodontists with the original Huddart and Bodenham index. The main outcome measure was dental occlusion. RESULTS: The inter- and intra-examiner reliability was good-to-excellent (0.61-0.94; 0.66-1.0, respectively). The mean total scores (+2 to -18) varied from -5.56 (Trial 2C) to -7.21 (Trial 3D). The mean anterior scores (+2 to -6) varied from -1.66 (Trial 2C) to -2.56 (Trial 3A). The mean posterior cleft-side scores (0 to -6) varied from -3.24 (Trial 3A) to -3.82 (Trial 3D) and the mean non-cleft-side scores (0 to -6) varied from -0.60 (Trial 2C) to -1.30 (Trial 3A); however, no significant differences were found within the trials. CONCLUSION: There was no statistical evidence of a difference in occlusion between the two surgical methods in each trial. TRIAL REGISTRATION: ISRCTN29932826. SN - 2000-6764 UR - https://www.unboundmedicine.com/medline/citation/28218557/Scandcleft_randomised_trials_of_primary_surgery_for_unilateral_cleft_lip_and_palate:_7__Occlusion_in_5_year_olds_according_to_the_Huddart_and_Bodenham_index_ L2 - http://www.tandfonline.com/doi/full/10.1080/2000656X.2016.1265529 DB - PRIME DP - Unbound Medicine ER -