Scandcleft randomized trials of primary surgery for unilateral cleft lip and palate: comparison of dental arch relationships and dental indices at 5, 8, and 10 years.


Journal

European journal of orthodontics
ISSN: 1460-2210
Titre abrégé: Eur J Orthod
Pays: England
ID NLM: 7909010

Informations de publication

Date de publication:
24 05 2022
Historique:
pubmed: 4 9 2021
medline: 26 5 2022
entrez: 3 9 2021
Statut: ppublish

Résumé

The Scandcleft intercentre study evaluates the outcomes of four surgical protocols (common method Arm A, and methods B, C, and D) for treatment of children with unilateral cleft lip and palate (UCLP) in a set of three randomized trials of primary surgery (Trials 1, 2, and 3). To evaluate and compare dental arch relationships of 5-, 8-, and 10-year-old children with UCLP after four different protocols of primary surgery and to compare three dental indices. The results are secondary outcomes of the overall trial. Study models taken at the ages of 5 (n = 418), 8 (n = 411), and 10 years (n = 410) were analysed by a blinded panel of orthodontists using the Eurocran index, the 5-year-olds' (5YO) index, and the GOSLON Yardstick. Student's t-test, Pearson's correlation, chi-square test, and kappa statistics were used in statistical analyses. The reliability of the dental indices varied between moderate and very good, and those of the Eurocran palatal index varied between fair and very good. Significant correlations existed between the dental indices at all ages. No differences were found in the mean 5-, 8-, and 10-year index scores or their distributions within surgical trials. Comparisons between trials detected significantly better mean index scores in Trial 2 Arm C (at all ages) and in Trial 1 Arm B (at 5 and 10 years of age) than in Trial 3 Arm D. The mean Eurocran dental index scores of the total material at 5, 8, and 10 years of age were 2.50, 2.60, and 2.26, and those of the 5YO index and GOSLON Yardstick were 2.77, 2.90, and 2.54, respectively. At age 10 years, 75.8% of the patients had had orthodontic treatment. The results of these three trials do not provide evidence that one surgical method is superior to the others. The reliabilities of the dental indices were acceptable, and significant correlations existed between the indices at all ages. The reliability of the Eurocran palatal index was questionable. ISRCTN29932826.

Sections du résumé

BACKGROUND AND TRIAL DESIGN
The Scandcleft intercentre study evaluates the outcomes of four surgical protocols (common method Arm A, and methods B, C, and D) for treatment of children with unilateral cleft lip and palate (UCLP) in a set of three randomized trials of primary surgery (Trials 1, 2, and 3).
OBJECTIVES
To evaluate and compare dental arch relationships of 5-, 8-, and 10-year-old children with UCLP after four different protocols of primary surgery and to compare three dental indices. The results are secondary outcomes of the overall trial.
METHODS
Study models taken at the ages of 5 (n = 418), 8 (n = 411), and 10 years (n = 410) were analysed by a blinded panel of orthodontists using the Eurocran index, the 5-year-olds' (5YO) index, and the GOSLON Yardstick. Student's t-test, Pearson's correlation, chi-square test, and kappa statistics were used in statistical analyses.
RESULTS
The reliability of the dental indices varied between moderate and very good, and those of the Eurocran palatal index varied between fair and very good. Significant correlations existed between the dental indices at all ages. No differences were found in the mean 5-, 8-, and 10-year index scores or their distributions within surgical trials. Comparisons between trials detected significantly better mean index scores in Trial 2 Arm C (at all ages) and in Trial 1 Arm B (at 5 and 10 years of age) than in Trial 3 Arm D. The mean Eurocran dental index scores of the total material at 5, 8, and 10 years of age were 2.50, 2.60, and 2.26, and those of the 5YO index and GOSLON Yardstick were 2.77, 2.90, and 2.54, respectively. At age 10 years, 75.8% of the patients had had orthodontic treatment.
CONCLUSIONS
The results of these three trials do not provide evidence that one surgical method is superior to the others. The reliabilities of the dental indices were acceptable, and significant correlations existed between the indices at all ages. The reliability of the Eurocran palatal index was questionable.
TRIAL REGISTRATION
ISRCTN29932826.

Identifiants

pubmed: 34476476
pii: 6363503
doi: 10.1093/ejo/cjab055
pmc: PMC9127717
doi:

Banques de données

ISRCTN
['ISRCTN29932826']

Types de publication

Journal Article Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

258-267

Informations de copyright

© The Author(s) 2021. Published by Oxford University Press on behalf of the European Orthodontic Society.

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Auteurs

Arja Heliövaara (A)

Cleft Palate and Craniofacial Center, Department of Plastic Surgery, Helsinki University Hospital and Helsinki University, Finland.

Annelise Küseler (A)

Cleft Palate Center and University Hospital Aarhus and University of Aarhus, Denmark.

Pål Skaare (P)

Department of Plastic and Reconstructive Surgery, Oslo University Hospital Rikshospitalet, Norway.

Haydn Bellardie (H)

Dental School, University of Manchester, UK.
University of the Western and Cape, Cape Town, South Africa.

Kirsten Mølsted (K)

Copenhagen Cleft Palate Center, University Hospital of Copenhagen, Denmark.

Agneta Karsten (A)

Section for Orthodontics, Division of Orthodontics and Pedodontics, Department of Dental Medicine, Karolinska Institutet and Stockholm Craniofacial Team, Sweden.

Agneta Marcusson (A)

Maxillofacial Unit and Department of Clinical and Experimental Medicine, Linköping University, Sweden.

Sara Rizell (S)

Specialist Clinic for Orthodontics, University Clinics of Odontology, Public Dental Health Service, Västra Götaland Region, Sweden.

Eli Brinck (E)

Department of Plastic and Reconstructive Surgery, Oslo University Hospital Rikshospitalet, Norway.

Paul Sæle (P)

Oral Health Center of Expertise/Western Norway, Bergen, Norway.

Midia Najar Chalien (MN)

Specialist Clinic for Orthodontics, University Clinics of Odontology, Public Dental Health Service, Västra Götaland Region, Sweden.

Jeanette Mooney (J)

Dental School, University of Manchester, UK.

Phil Eyres (P)

Dental School, University of Manchester, UK.

William Shaw (W)

Dental School, University of Manchester, UK.

Gunvor Semb (G)

Department of Plastic and Reconstructive Surgery, Oslo University Hospital Rikshospitalet, Norway.
Dental School, University of Manchester, UK.

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