AbstractIntroduction: Since the recommendations put forward by the Clinical Standards Advisory Group (CSAG) 1998 have been adopted by the cleft community, training, caseload and cleft team composition have undergone significant change. The improvements in cleft outcomes have been well documented by the subsequent Cleft Care UK (CCUK) study. Whilst the changes in dentoalveolar relationships have been assessed, the transverse dimensional changes are less well reported. The aim of this study was to determine if the transverse dimensions of maxillary unilateral cleft lip and palate affected children has improved since the implementation of the CSAG recommendations.
Methods: Maxillary models from each of the CSAG (114) and CCUK (175) cohorts were digitally scanned and anonymised. Linear and angular measurements were taken including; the intermolar width and intercanine width, the distance to the midline for each of the primary canines (C) and second primary molars (E), anterior depth and posterior depth, arch length and arch form angles between the two populations, CSAG and CCUK. The data was then analysed using Stata statistical software and described with respect to the cohort and the side (cleft affected or not).
Results: Statistically and clinically significant differences were observed between the CSAG and CCUK cohorts for the affected side C, affected side E and posterior width measurements with the means of the CCUK cohort (11.09mm, 20.53mm, 41.19mm respectively) being greater than the CSAG cohort (10.05mm, 19.50mm, 39.96mm respectively). Neither statistically or clinically significant differences were observed for the non-affected side C, non-affected side E, posterior depth, arch length or arch form angles. Differences were seen in the linear and angular measurements when the cleft affected and non-affected sides were compared.
Conclusion: The study has found improvements for the measured outcomes for children born with unilateral cleft lip and palate in more recent years. Although clear differences remain between the cleft affected and not affected sides of the maxilla, within the CCUK cohort the arch widths are closer to the norms for unaffected children.
|Date of Award||26 Nov 2020|
|Supervisor||Anthony J Ireland (Supervisor) & Jonathan Sandy (Supervisor)|