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Dental Arch Relationship Outcomes in One- and Two-Stage Palatoplasty for Japanese Patients with Complete Unilateral Cleft Lip and Palate

2014; SAGE Publishing; Volume: 52; Issue: 3 Linguagem: Inglês

10.1597/13-285

1545-1569

Tadashi Mikoya, Toyoko Shibukawa, Takafumi Susami, Yoshiaki Sato, Toshimoto Tengan, Hirotaka Katashima, Akihiko Oyama, Yusuke Matsuzawa, Yumi Ito, Emi Funayama,

Tracheal and airway disorders

To compare dental arch relationship outcomes following one- and two-stage palatal repair.Nonrandomized, clinical trial with concurrent control.Hokkaido University Hospital.Sixty-eight consecutively treated Japanese patients with complete unilateral cleft lip and palate.Thirty-one of the 68 patients underwent two-stage palatoplasty with delayed hard palate closure, and 37 patients underwent one-stage pushback palatoplasty.Dental casts were taken at 4.9 to 6.3 (mean: 5.2) years of age in the two-stage group and at 4.0 to 6.3 (mean: 5.1) years of age in the one-stage group, and dental arch relationships were assessed using the 5-Year-Olds' Index (5-Y) by four raters and the Huddart/Bodenham Index (HB) by two raters.Intrarater and interrater reliabilities evaluated using weighted kappa statistics were good or better for the 5-Y and HB ratings. The mean 5-Y score was 2.94 in the two-stage group and 3.13 in the one-stage group (P value was not significant). However, there was a significant difference in distributions between the groups (P < .05). The HB scores of molars were significantly greater in the two-stage group than in the one-stage group (P < .05). The rank correlation coefficients between the 5-Y and total HB score (ρ = -0.840, P < .01) and between the 5-Y and the score of the incisors in the HB (ρ = -0.814, P < .01) were significantly increased.These results suggest that the anteroposterior relationship was not significantly different between the groups, but the transversal relationship was better in the two-stage group than in the one-stage group.