A Longitudinal Three-Center Study of Dental Arch Relationship in Patients with Bilateral Cleft Lip and Palate

Abstract

Objective To compare and evaluate longitudinally the dental arch relationships from 4.5 to 13.5 years of age with the Bauru-BCLP Yardstick in a large sample of patients with bilateral cleft lip and palate (BCLP). Design Retrospective longitudinal intercenter outcome study. Patients Dental casts of 204 consecutive patients with complete BCLP were evaluated at 6,9, and 12 years of age. All models were identified only by random identification numbers. Setting Three cleft palate centers with different treatment protocols. Main Outcome Measures Dental arch relationships were categorized with the Bauru-BCLP yardstick. Increments for each interval (from 6 to 9 years, 6 to 12 years, and 9 to 12 years) were analyzed by logistic and linear regression models. Results There were no significant differences in outcome measures between the centers at age 12 or at age 9. At age 6, center B showed significantly better results ( p = .027), but this difference diminished as the yardstick score for this group increased over time (linear regression analysis), the difference with the reference category (center C, boys) for the intervals 6 to 12 and 9 to 12 years being 10.4% ( p = .041) and 12.9% ( p = .009), respectively. Conclusions Despite different treatment protocols, dental arch relationships in the three centers were comparable in final scores at age 9 and 12 years. Delaying hard palate closure and employing infant orthopedics did not appear to be advantageous in the long run. Premaxillary osteotomy employed in center B appeared to be associated with less favorable development of the dental arch relationship between 9 and 12 years.