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J Plast Surg Hand Surg ; 51(1): 58-63, 2017 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-28218557

RESUMEN

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.


Asunto(s)
Labio Leporino/cirugía , Fisura del Paladar/cirugía , Maloclusión/etiología , Niño , Preescolar , Labio Leporino/diagnóstico , Fisura del Paladar/diagnóstico , Femenino , Estudios de Seguimiento , Humanos , Lactante , Internacionalidad , Masculino , Maloclusión/terapia , Variaciones Dependientes del Observador , Complicaciones Posoperatorias/fisiopatología , Complicaciones Posoperatorias/terapia , Ensayos Clínicos Controlados Aleatorios como Asunto , Recuperación de la Función , Medición de Riesgo , Índice de Severidad de la Enfermedad , Factores de Tiempo , Resultado del Tratamiento
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