A collaborative survey on occlusion after orthodontic treatment in patients with unilateral cleft lip and palate in Japan. Issue 2 (1st June 2018) - Mano, Mikiko
Abstract: Purpose: A nationwide collaborative survey was performed in Japan to evaluate the recent treatment outcomes on occlusion after orthodontic/orthognathic treatment for patients with unilateral cleft lip and palate (UCLP). Methods: A retrospective collaborative survey was performed. Twenty-five facilities, including 14 university hospitals, examined their orthodontic records and cast models of patients with UCLP. Using common format, information of 492 non-syndromic UCLP cases were reported. Patients with syndromic UCLP or congenital missing maxillary central incisors were excluded. Basically, each facility reported their most recent 30 cases. Results: Of 492 cases, 330 cases (67.1%) were reported from 11 facilities, suggesting that orthodontic treatment for patients with CL/P was not fully centralized in Japan. Secondary alveolar bone grafting and orthognathic surgery were performed in 92.7% and 22.5% of cases, respectively. A significantly higher rate of orthognathic surgery was seen in cases reported from university hospitals (27.5%) than other facilities (14.8%). Average age at the end of active orthodontic/orthognathic treatment was 18.5 years. The lateral incisors on cleft sides were congenitally missing in 50.2% and displayed microdontia in 42.9% of cases. After orthodontic treatment, the central incisors and the canines were aligned without interdental spaces in 55.3% of cases. The positive anterior overjet was seen in 88.2%, and the centerline discrepancies between maxillary and mandibular incisors within 1/4 of mandibular incisor width was in 74.8% of cases. Conclusions: The final occlusion after orthodontic treatment was satisfactory in most cases. Findings of this study are referable for improving standard Japanese orthodontic care for patients with CL/P.