Active Presurgical Infant Orthopedics for Unilateral Cleft Lip and Palate: Intercenter Outcome Comparison of Latham, Modified McNeil, and Nasoalveolar Molding.

Autor:	Kornbluth M; 1 Department of Dentistry, The Hospital for Sick Children, Toronto, Ontario, Canada., Campbell RE; 2 Division of Pediatric Dentistry, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, United States., Daskalogiannakis J; 1 Department of Dentistry, The Hospital for Sick Children, Toronto, Ontario, Canada.; 3 Department of Orthodontics, University of Toronto, Toronto, Ontario, Canada., Ross EJ; 4 Department of Dentistry, Boston Children's Hospital, Boston, MA, USA., Glick PH; 5 Barrow Cleft and Craniofacial Center, Phoenix, AZ, USA., Russell KA; 6 Division of Orthodontics, Dalhousie University, Halifax, Nova Scotia, Canada., Doucet JC; 7 Division of Oral and Maxillofacial Science, Dalhousie University, Halifax, Nova Scotia, Canada., Hathaway RR; 8 Division of Craniofacial Plastic and Reconstructive Surgery, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA., Long RE Jr; 9 Lancaster Cleft Palate Clinic, Lancaster, PA, USA., Sitzman TJ; 10 Division of Plastic Surgery, Phoenix Children's Hospital, Phoenix, AZ, USA.
Jazyk:	angličtina
Zdroj:	The Cleft palate-craniofacial journal : official publication of the American Cleft Palate-Craniofacial Association [Cleft Palate Craniofac J] 2018 May; Vol. 55 (5), pp. 639-648. Date of Electronic Publication: 2018 Feb 20.
DOI:	10.1177/1055665618757367
Abstrakt:	Objective: To compare dental arch relationship, craniofacial form, and nasolabial aesthetic outcomes among cleft centers using distinct methods of presurgical infant orthopedics (PSIO). Design: Retrospective cohort study. Setting: Four cleft centers in North America. Patients: One hundred ninety-one children with repaired complete unilateral cleft lip and palate (CUCLP). Main Outcome Measures: Dental arch relationship was assessed using the GOSLON Yardstick. Craniofacial form was assessed by 12 cephalometric measurements. Nasolabial aesthetics were assessed using the Asher-McDade system. Assessments were performed between 6 and 12 years of age. Results: The center that used no PSIO achieved the most favorable dental arch relationship and maxillomandibular relationship, with a median GOSLON score of 2.3 ( P < .01) and an ANB angle of 5.1° ( P < .05). The proportion of children assigned a GOSLON score of 4 or 5, predictive of the need for orthognathic surgery in adolescence, was 16% at the center that used no PSIO and no secondary surgery, compared to 76% at the centers that used the Latham appliance and early secondary lip and nose surgery ( P < .01). The center that used no PSIO and no secondary surgery achieved significantly less favorable nasolabial aesthetic outcomes than the centers using Latham appliance or nasoalveolar molding (NAM) ( P < .01). Conclusions: Effects of active PSIO are multifaceted and intertwined with use of revision surgery. In our study, centers using either the Latham appliance combined with early revision surgery or the NAM appliance without revision surgery achieved better nasolabial aesthetic outcomes but worse maxillary growth, compared to a center using no PSIO and secondary surgery.
Databáze:	MEDLINE
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