Aesthetic Assessment of Infants With Different Cleft Types Before, During, and After Orthopedic Treatment

J Craniofac Surg. 2018 Nov;29(8):2081-2087. doi: 10.1097/SCS.0000000000004888.


Objective: The aim of the present study is to compare the aesthetic assessments of infants with different types of cleft before (T1), during (T2), and after (T3) orthopedic therapy (OT) by orthodontists, dentists, and laypersons.

Methods: Photographs of 3 patients (incomplete lip [C1], complete unilateral [C2], and complete bilateral cleft [C3]) at T1 (C1, C2, C3 chronologic age: 5, 2, 2 days), T2 (C1, C2, C3 chronologic age: 32, 28, 35 days; using forehead anchoraged nasal stent or conventional nasoalveolar therapy plates), and T3 (C1, C2, C3 chronologic age: 80, 91, 105 days) were collected from the archive. The nasolabial region at stage T3 were masked and also added to the evaluation form (T4). Fifty-one evaluators (17 orthodontists, 17 dentists, and 17 laypersons; mean age = 30.1 ± 3.63) assessed 21 frontal photographs using Asher-McDade et al's 5-point scale.

Results: The scores of the orthodontists for T1 photographs were statistically lower than the dentists and laypersons (P < 0.05). The scores of T3 and T4 were similar in all groups (P > 0.05). The assessment scores progressively decreased from T1 to T3 (P > 0.05). The scores of both treatment methods were similar in the orthodontist group (P > 0.05), whereas the scores were lower for forehead anchored nasal stent in the other groups (P < 0.05).

Conclusion: Orthodontists are familiar with cleft patients. Therefore, the aesthetic of infants at any therapy stage with different treatment methods was not categorized as poor. The enhanced scores at post-OT stage and the similar scores of masked and nonmasked post-OT photographs may underline the recognition of the rehabilitation period by not only specialists but also laypersons.

MeSH terms

  • Adult
  • Cleft Lip / surgery*
  • Cleft Palate / surgery*
  • Dentistry*
  • Esthetics*
  • Female
  • Humans
  • Infant
  • Infant, Newborn
  • Male
  • Orthodontics
  • Photography
  • Plastic Surgery Procedures / instrumentation
  • Plastic Surgery Procedures / methods
  • Postoperative Period
  • Preoperative Period
  • Stents