Evaluation of facial features in two groups of cleft lip and palate patients receiving centralized and non-centralized treatment regimes

The aims of the present study were: (a) to evaluate facial profile and other findings in a group of cleft lip and palate (CLP) patients receiving centralized services as compared with a group of patients who received non-centralized services and who were not submitted to bone grafting procedures; and (b) to evaluate and compare the outcome of early bone grafting procedures that were included in the centralized treatment regime to the outcome of a non-centralized treatment approach that did not include bone grafting procedures. Forty-three lateral cephalometric radiographs of CLP Greek Caucasian children not receiving centralized treatment and 43 lateral cephalometric radiographs of CLP Swedish Caucasian children receiving centralized treatment, strictly matched for age, sex, and type of cleft, were compared as a total and in two subgroups, according to age. Differences were also evaluated in the unilateral (UCLP) and in the bilateral (BCLP) groups separately, as well as in groups discriminated by age, i.e. in the patients born before 1984 (age 11-19 years) and in those born after 1984 (age 4-10 years), as 1984 was the year when early bone grafting was discontinued in the Stockholm area. The findings of this study revealed the following. The overall difference in facial and dental cephalometric findings between CLP children receiving a centralized treatment approach as compared with those treated without centralization was significant. The Swedish group showed a trend towards better cephalometric values throughout all the age groups. When the early age groups were compared, the early bone grafting procedure that was included in the centralized treatment regime did not seem to be a positive factor, in comparison with the absence of bone grafting in the non-centralized treatment regime.