Study models of 5 year old children as predictors of surgical outcome in unilateral cleft lip and palate

This study examined features of dental occlusion in patients born with a unilateral cleft lip and palate (UCLP). The intention was to develop a 'Goslon type' index for 5 year old children. The Goslon ranking system was used on longitudinal study models taken at 5 and 10 years of age of the same patients. All patients had UCLP and this had been repaired using a Millard type lip repair and a Veau Wardill or Von Langenbeck palatal closure. There was good intra-examiner agreement for ascribing 5 and 10 year old models to one of five categories (excellent-very poor). Inter-examiner agreement on both sets of models was at worst moderate. Two of the examiners identified up to 93 per cent of 5 year old models which either remained in the same category or deteriorated by 10 years of age. At worse the results demonstrated 70 per cent of cases of 5 years of age remained in the same category or deteriorated by 10 years of age. Consensus agreement has produced five categories of outcome for these 5 year old models. This new index is to be subjected to further validation. This study has therefore provided, for the first time, a mechanism for assessing the results of CLP surgery earlier than indices already available.