Retrospective Evaluation of Treatment Outcome in Japanese Children with Complete Unilateral Cleft Lip and Palate. Part 1: Five-Year-Olds’ Index for Dental Arch Relationships

Objective: To evaluate the dental arch relationships of Japanese children with complete unilateral cleft lip and palate (UCLP) and to examine the 5-year-olds’ index for its validity. Design: Retrospective study and comparison with previous reports. Subjects: One hundred thirty-six children with complete UCLP who received primary cheiloplasty and palatoplasty in the Kyushu University Hospital from 1966 to 1999. Materials: Dental models taken from children 53 to 67 months of age and their cephalograms. Methods: Study models were assessed using five scores; 1 = excellent, 2 = good, 3 = fair, 4 = poor, and 5 = very poor, in accordance with the 5-year-olds’ index and also evaluated using Huddart and Bodenham's numerical classification. Dental arch widths, three-dimensional maxillary dental arch form, and lateral cephalograms were traced and measured. The outcome by 5-year-olds’ index was compared with Huddart and Bodenham's numerical classification, dental arch dimensions, and cephalometric measurements. Results: Occlusal outcome evaluated by the 5-year-olds’ index was rated 2.95, which was classified as fair. This index rating showed a significant relationship with numerical classification and dental arch length, but not with dental arch width. The index showed a relationship with mandibular form and position, but not with maxillary position. Conclusion: The occlusal outcome of the cases with UCLP was fair as evaluated using the 5-year-olds’ index. The index evaluates the anteroposterior relationship of maxillary/mandibular dental arches but does not evaluate the collapse of maxillary segments.