2007 Volume 32 Issue 1 Pages 34-42
The five categories rating based on dental models has been used in many assessments of dental arch relationships in patients with unilateral cleft lip and palate (UCLP). This study was performed using the 5-Year-Old Index in the Department of Oral-Maxillofacial Surgery, Dentistry and Orthodontics, The University of Tokyo Hospital (UTH). In this study, the usefulness of the index was examined and dental arch relationships in deciduous dentition in patients with UCLP were evaluated. An evaluation of speech was also carried out.
Dental models in late deciduous dentition of 31 patients with complete UCLP were used in this study. The average age was 6 years 0 month and primary surgeries were performed in 13 hospitals. The modified Millard's method with small triangular flap was used for lip closure and the pushback operation was performed for palate closure in 22 patients (M-P group). Eight out of 22 patients were treated in UTH (UTH group). Intra- and inter-examiner agreements were evaluated using the weighted kappa statistics. Speech evaluation was performed on 25 out of 31 patients using clinical records.
Intra- and inter-examiner agreements were high indicating good reliability. The average score was 3.23 in all 31 patients, and 3.36 and 3.00 in the M-P group and in the UTH group respectively. Good dental arch relationships (Group 1 and 2) were found in 16.1% of all patients, in 13.6% of the M-P group and in 37.5% of the UTH group. Poor relationships (Group 4 and 5) were found in 32.3% of all patients, in 36.4% of the M-P group and in 25.0% of the UTH group. Articulation disorder was found in 36.0% of all patients, in 26.3% of the M-P group and in 12.5% of the UTH group. Velopharyngeal insufficiency was found in 4.0% of all patients but was not found in both the M-P and UTH groups.
The 5-Year-Old Index seemed to be a reliable method for the evaluation of dental arch relationships in patients with UCLP. Average dental arch relationships revealed in this study were slightly better than those of our previous studies using the Goslon Yardstick. On the other hand, when compared with other reports from foreign institutions, the proportion of patients with poor dental arch relationship was larger. However, facial appearance, speech ability and racial difference should be taken into consideration when interpreting the results of this study.
