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Burden of Care of Various Infant Orthopedic Protocols for Improvement of Nasolabial Esthetics in Patients With CUCLP.
Cleft Palate Craniofac J. 2018 10; 55(9):1236-1243.CP

Abstract

OBJECTIVES

1. To evaluate the orthodontic burden of care of nasoalveolar molding (NAM) and modified McNeil for the treatment of patients with complete unilateral cleft lip and palate (CUCLP). 2. To compare the esthetic outcomes of each with those of centers not utilizing infant orthopedics (IO).

DESIGN

Retrospective cohort study.

SETTING

Institutional.

PARTICIPANTS

Four cohorts with repaired CUCLP (n = 149) from 3 centers.

INTERVENTIONS

Two cohorts were treated in the same center and had either traditional infant orthopedics (TIO) or NAM and 2 were treated in centers not employing IO.

MAIN OUTCOME MEASURES

Burden of care data for the IO groups were compared using t tests. Frontal and profile photographs at approximately age 5 were collected for ratings of nasolabial esthetics, using a modification of the Asher-McDade method. Intrarater and interrater reliabilities were determined using weighted κ statistics. Median ratings were compared using a Kruskal-Wallis test.

RESULTS

The burden of care of NAM was significantly greater than TIO for both the number of visits (9.9 vs 6.6, [ P < .001]); and treatment duration (127 vs 112 days, [ P < .05]). Significant differences in nasolabial esthetic ratings were noted among the 3 centers. No significant differences were observed in the nasolabial esthetic outcomes between the NAM and TIO groups.

CONCLUSIONS

1. NAM required more visits and longer overall duration compared with TIO. 2. The center employing IO showed favorable nasolabial esthetics compared to those not utilizing IO. 3. No significant differences were found in the nasolabial esthetics of patients who have received NAM compared with TIO.

Authors+Show Affiliations

1 Department of Orthodontics, University of Toronto, Toronto, Ontario, Canada.1 Department of Orthodontics, University of Toronto, Toronto, Ontario, Canada. 2 Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada.3 Division of Orthodontics, Dalhousie University, Halifax, Nova Scotia, Canada. 4 Cleft Palate Team, IWK Health Centre, Halifax, Nova Scotia, Canada.5 Division of Orthodontics, Ohio State University, Columbus, OH, USA.6 Craniofacial Centre, Peyton Manning Children's Hospital at St. Vincent, Indianapolis, IN, USA.7 Albert Einstein Medical Center, Philadelphia, PA, USA. 8 Lancaster Cleft Palate Clinic, PA, USA.8 Lancaster Cleft Palate Clinic, PA, USA. 9 Department of Surgery, Penn State University College of Medicine, Lancaster, PA, USA.8 Lancaster Cleft Palate Clinic, PA, USA.10 Oslo Cleft Team, Department of Plastic Surgery, University of Oslo, Oslo, Norway. 11 Senior Lecturer in Craniofacial Anomalies, University of Manchester, Manchester, UK.12 Orthodontics and Dentofacial Development, University of Manchester, Manchester, UK. Singer is in private practice, Whitby, ON, Canada. Hathaway is now with Craniofacial and Surgical Orthodontics, Division of Craniofacial Plastic and Reconstructive Surgery, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA. Stoutland is in private practice, Philadelphia, PA, USA.

Pub Type(s)

Journal Article
Multicenter Study

Language

eng

PubMed ID

29624437

Citation

Singer, Emily, et al. "Burden of Care of Various Infant Orthopedic Protocols for Improvement of Nasolabial Esthetics in Patients With CUCLP." The Cleft Palate-craniofacial Journal : Official Publication of the American Cleft Palate-Craniofacial Association, vol. 55, no. 9, 2018, pp. 1236-1243.
Singer E, Daskalogiannakis J, Russell KA, et al. Burden of Care of Various Infant Orthopedic Protocols for Improvement of Nasolabial Esthetics in Patients With CUCLP. Cleft Palate Craniofac J. 2018;55(9):1236-1243.
Singer, E., Daskalogiannakis, J., Russell, K. A., Mercado, A. M., Hathaway, R. R., Stoutland, A., Long, R. E., Fessler, J., Semb, G., & Shaw, W. C. (2018). Burden of Care of Various Infant Orthopedic Protocols for Improvement of Nasolabial Esthetics in Patients With CUCLP. The Cleft Palate-craniofacial Journal : Official Publication of the American Cleft Palate-Craniofacial Association, 55(9), 1236-1243. https://doi.org/10.1177/1055665618766978
Singer E, et al. Burden of Care of Various Infant Orthopedic Protocols for Improvement of Nasolabial Esthetics in Patients With CUCLP. Cleft Palate Craniofac J. 2018;55(9):1236-1243. PubMed PMID: 29624437.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Burden of Care of Various Infant Orthopedic Protocols for Improvement of Nasolabial Esthetics in Patients With CUCLP. AU - Singer,Emily, AU - Daskalogiannakis,John, AU - Russell,Kathy A, AU - Mercado,Ana M, AU - Hathaway,Ronald R, AU - Stoutland,Alicia, AU - Long,Ross E,Jr AU - Fessler,Jennifer, AU - Semb,Gunvor, AU - Shaw,William C, Y1 - 2018/04/06/ PY - 2018/4/7/pubmed PY - 2019/10/31/medline PY - 2018/4/7/entrez KW - esthetics KW - infant orthopedics KW - nasal morphology SP - 1236 EP - 1243 JF - The Cleft palate-craniofacial journal : official publication of the American Cleft Palate-Craniofacial Association JO - Cleft Palate Craniofac J VL - 55 IS - 9 N2 - OBJECTIVES: 1. To evaluate the orthodontic burden of care of nasoalveolar molding (NAM) and modified McNeil for the treatment of patients with complete unilateral cleft lip and palate (CUCLP). 2. To compare the esthetic outcomes of each with those of centers not utilizing infant orthopedics (IO). DESIGN: Retrospective cohort study. SETTING: Institutional. PARTICIPANTS: Four cohorts with repaired CUCLP (n = 149) from 3 centers. INTERVENTIONS: Two cohorts were treated in the same center and had either traditional infant orthopedics (TIO) or NAM and 2 were treated in centers not employing IO. MAIN OUTCOME MEASURES: Burden of care data for the IO groups were compared using t tests. Frontal and profile photographs at approximately age 5 were collected for ratings of nasolabial esthetics, using a modification of the Asher-McDade method. Intrarater and interrater reliabilities were determined using weighted κ statistics. Median ratings were compared using a Kruskal-Wallis test. RESULTS: The burden of care of NAM was significantly greater than TIO for both the number of visits (9.9 vs 6.6, [ P < .001]); and treatment duration (127 vs 112 days, [ P < .05]). Significant differences in nasolabial esthetic ratings were noted among the 3 centers. No significant differences were observed in the nasolabial esthetic outcomes between the NAM and TIO groups. CONCLUSIONS: 1. NAM required more visits and longer overall duration compared with TIO. 2. The center employing IO showed favorable nasolabial esthetics compared to those not utilizing IO. 3. No significant differences were found in the nasolabial esthetics of patients who have received NAM compared with TIO. SN - 1545-1569 UR - https://www.unboundmedicine.com/medline/citation/29624437/Burden_of_Care_of_Various_Infant_Orthopedic_Protocols_for_Improvement_of_Nasolabial_Esthetics_in_Patients_With_CUCLP_ L2 - https://journals.sagepub.com/doi/10.1177/1055665618766978?url_ver=Z39.88-2003&amp;rfr_id=ori:rid:crossref.org&amp;rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -