Complete unilateral cleft lip and palate: validity of the five-year index and the Goslon yardstick in predicting long-term dental arch relationships

Cleft Palate Craniofac J. 2006 Sep;43(5):557-62. doi: 10.1597/05-074.


Objective: To assess the validity of the 5-year index by subjecting study models at the age of 5 years to both the 5-year index and the Goslon yardstick, and then relating these results to the Goslon ratings at 10 years.

Design: Retrospective study.

Setting: Sahlgrenska University Hospital, Gothenburg, Sweden.

Patients: Study models of 94 patients with unilateral cleft lip and palate (UCLP) were evaluated at the ages of 5 and 10 years. The dental arch relationships were judged and categorized by using the Goslon yardstick for the 10-year models and both the Goslon yardstick and the 5-year index for the 5-year models.

Results: When used for 5- and 10-year models, the Goslon yardstick showed a kappa score of 0.539 (weighted kappa = 0.579) with a moderate strength of agreement. However, 5-year index scores at 5 years compared with the Goslon scores at 10 years showed a kappa score of only 0.043 (weighted kappa = 0.090), showing poor strength of agreement. Goslon scores at 10 years showed improvement in 14 cases when graded by the same Goslon yardstick at 5 years, whereas there was improvement in 23 cases when the 5-year models were graded by the 5-year index (actual improvement in scores in UCLP cases is highly unlikely).

Conclusions: Although use of the Goslon yardstick at 5 years has demonstrated some inherent flaws in its use at that age, these drawbacks are fewer than those when the 5-year index is used at 5 years of age.

Publication types

  • Validation Study

MeSH terms

  • Child
  • Child, Preschool
  • Cleft Lip / pathology*
  • Cleft Palate / pathology*
  • Dental Arch / growth & development*
  • Dental Arch / pathology
  • Dental Models
  • Humans
  • Longitudinal Studies
  • Malocclusion / diagnosis*
  • Malocclusion / etiology
  • Observer Variation
  • Reproducibility of Results
  • Retrospective Studies