Does relative maxillary arch constriction worsen with growth in patients with cleft lip and palate? A pilot study

Abstract

Objective: To evaluate relative maxillary arch constriction in patients with unilateral cleft lip and palate (UCLP) and isolated cleft palate (CP) during growth and the reproducibility of a commercial three-dimensional (3D) small object scanner. Design and Setting: Retrospective longitudinal study, University Dental Hospital. Materials and Methods: Plaster models at age 5, 10, and 15 years of ten patients with UCLP and CP were scanned using a commercial 3D small object scanner (http://www.NextEngine.com). Three observers scored the plaster and digital models using the 5-year-old/GOSLON and modified Huddart/Bodenham (MHB) indices and again 3 weeks later. Two-way ANOVA (P 0.05). For plaster models, intra- and inter-observer reproducibility were good to very good (0.74-0.84 and 0.84-0.86) using 5-year-old/GOSLON indices compared with good to very good (0.72-0.85) and very good (0.84-0.86) for the MHB index. For digital models, there was moderate to good intra- (0.46-0.79) and inter-observer (0.44-0.67) reproducibility for the 5-year-old/GOSLON indices compared with good intra- (0.66-0.75) and interobserver reproducibility (0.68-0.71) with the MHB index. Conclusions: There was no progressive worsening of relative maxillary arch constriction with growth in UCLP and CP. The reproducibility of the 5-year-old/GOSLON and MHB indices was acceptable with digital models produced using the commercial 3D small object scanner but good to very good for plaster models. Longitudinal evaluation of maxillary growth in patients with repaired orofacial clefts using these methods is both informative for the care of the individual patient and an important step in refining surgical protocols in countries such as India.

Keywords

• digital model
• plaster model
• relative maxillary arch constriction
• surgical outcome