|Title||Risk of Malocclusion Among Patients Undergoing Single-Stage Versus Two-Stage Cleft Palate Repair.|
|Publication Type||Journal Article|
|Year of Publication||2022|
|Authors||McCrary H, Torrecillas V, Pollard SHatch, Collingridge DS, Yamashiro D, Skirko JR|
|Journal||Cleft Palate Craniofac J|
|Date Published||2022 10|
|Keywords||Child, Child, Preschool, Cleft Lip, Cleft Palate, Humans, Malocclusion, Malocclusion, Angle Class III, Retrospective Studies, Treatment Outcome|
OBJECTIVE: Evaluate impact of single-stage versus staged palate repair on the risk of developing malocclusion among patients with cleft palate (CP).
DESIGN: Retrospective cohort study 2000-2016.
SETTING: Academic, tertiary children's hospital.
PATIENTS: Patients undergoing CP repair between 1999-2015.
INTERVENTIONS: CP repair, categorized as either single-stage or staged.
MAIN OUTCOME MEASURE: Time to development of Class III malocclusion.
RESULTS: 967 patients were included; 60.1% had a two-stage CP repair, and 39.9% had single-stage. Malocclusion was diagnosed in 28.2% of patients. In the model examining all patients at ≤5 years ( = 659), patients who were not white had a higher risk of malocclusion (HR 2.46, = 0.004) and staged repair was not protective against malocclusion (HR 0.98, = 0.91). In all patients >5 years ( = 411), higher Veau classification and more recent year of birth were significantly associated with higher hazard rates ( < 0.05). Two-staged repair was not protective against developing malocclusion (HR 0.86, = 0.60). In the model examining patients with staged repair ≤5 years old ( = 414), higher age at hard palate closure was associated with reduced malocclusion risk (HR 0.67, < 0.001) and patients who were not white had increased risk (HR 2.56, = 0.01). In patients with staged repair >5 years old, more recent birth year may be associated with a higher risk of malocclusion (HR 1.06, = 0.06) while syndrome may be associated with lower risk of malocclusion diagnosis (HR 0.46, = 0.07).
CONCLUSION: Our data suggests that staged CP repair is not protective against developing Class III malocclusion.
|Alternate Journal||Cleft Palate Craniofac J|
Risk of Malocclusion Among Patients Undergoing Single-Stage Versus Two-Stage Cleft Palate Repair.
Jonathan Skirko, MD, MHPA, MPH