Analysis of dental arch relationships in Swedish unilateral cleft lip and palate subjects: 20-year longitudinal consecutive series treated with delayed hard palate closure

Cleft Palate Craniofac J. 2006 Sep;43(5):606-11. doi: 10.1597/05-069.


Objective: To evaluate the dental arch relationships for a consecutive series from Goteborg, Sweden, who had delayed hard palate closure.

Design: Retrospective study.

Setting: Sahlgrenska University Hospital, Goteborg, Sweden.

Patients: The dental study models of 104 consecutive unilateral cleft lip and palate subjects. The study cohort was born between 1979 and 1994. Longitudinal records were available at ages 5 (n = 94), 10 (n = 97), 16 (n = 59), and 19 years (n = 46). Five assessors rated models according to the GOSLON Yardstick on two separate occasions each.

Interventions: These patients had been operated upon according to the Goteborg protocol of delayed hard palate closure (at age 8 years).

Results: 85% of subjects were rated in groups 1 and 2 (excellent or very good outcome), 12% were rated in group 3 (satisfactory), and 3% were assigned to group 4 (poor). No patients presented in Group 5 (very poor). Weighted kappa statistics for double determination of Yardstick allocation for five assessors demonstrated values between .65 and .90 for interrater agreement (good/very good) and between .70 and .90 for intrarater agreement (very good).

Conclusions: Delayed hard palate closure as practiced in Goteborg since 1979 has produced the best GOSLON Yardstick ratings in a consecutive series of patients ever recorded worldwide, since the Yardstick was first used in 1983. However, it is noteworthy that a new protocol has been introduced in Goteborg since 1994, in which hard palate closure is done at 3 years due to concerns regarding speech.

MeSH terms

  • Adolescent
  • Adult
  • Child
  • Child, Preschool
  • Cleft Lip / pathology*
  • Cleft Lip / surgery
  • Cleft Palate / pathology*
  • Cleft Palate / surgery
  • Dental Models
  • Dental Occlusion
  • Epidemiologic Methods
  • Humans
  • Malocclusion / etiology
  • Malocclusion / pathology
  • Palate, Hard / pathology
  • Palate, Hard / surgery
  • Time Factors
  • Treatment Outcome