Objetivo: comparar a relação interarcos de 112 indivíduos com FLPUC submetidos a queiloplastia neonatal versus em fase convencional, com e sem ortopedia infantil, aplicando-se o índice oclusal de Goslon/5 anos em fotografias intrabucais, obtidas entre 6 e 12 anos de idade. Desenho: estudo retrospectivo de coorte. Local: dois centros de reabilitação do Brasil. Participantes: três grupos tratados com distintos protocolos: grupo I: queiloplastia neonatal (1 a 15 dias) + OI (ortopedia Infantil); grupo II: queiloplastia (3 a 12 meses) + OI; grupo III: queiloplastia (3 a 6 meses), sem OI. Intervenções: o grupo I (n=35) e grupo III (n=58) foram operados pelo mesmo cirurgião, enquanto que o grupo II (n=19) por 4 cirurgiões. Método: para comparação entre os grupos foi utilizado o teste qui-quadrado e para a comparação dos índices oclusais médio intergrupos foi aplicado o ANOVA, Kruskal Wallis (p<0,05). Resultados: a concordância interexaminadores (acima 0,70) e intra (acima de 0,60) foi dada pela estatística kappa. O grupo I apresentou maior percentual de índice 5. O grupo II apresentou o maior percentual de índice 1 e o grupo III apresentou o menor percentual de índice 5 (p=0,029). As estatísticas com os índices agrupados em 1+2 e 4+5 não demonstraram diferenças entre os 3 grupos (p=0,142). O índice oclusal médio em cada grupo apresentou diferenças significativas entre os grupos I (4,0) e III (3,0) (p=0,022). Conclusão: os resultados demonstraram que em relação ao crescimento maxilomandibular, a queiloplastia em fase neonatal com OI (grupo I) apresentou-se menos favorável quando comparada aos outros dois grupos operados a partir dos três meses. O grupo II, operados mais tardiamente de lábio e palato com OI apresentou crescimento favorável enquanto que o grupo III sem OI presentou a menor quantidade de casos com prognóstico ortodôntico-cirúrgico. Considerando a variabilidade e limitações da amostra sugerimos mais trabalhos que envolvam centros que utilizam os protocolos com e sem ortopedia infantil, de preferência de forma prospectiva e randomizada. / Objective: to compare the outcomes of early versus conventional cheiloplasty with and without infant orthopedics (IO) by assessment of dental arch relationships in individuals with non-syndromic complete UCLP, analyzed by the occlusal index for intraoral photographs rating. Design: retrospective cohort study. Setting: two cleft palate centers from Brazil. Participants: three groups treated by different protocols, as follows; Group I: early cheiloplasty (1 to 15 days) + infant IO; Group II: cheiloplasty (3 to 12 months) + IO; Group III: cheiloplasty (3 to 6 months) without IO and palatoplasty (12 to 18 months). Interventions: Individuals in Group I (n=35) and Group III (n=58) were operated by a single surgeon each, while individuals in group II (n=19) were operated by 4 surgeons. The 112 intraoral photographs of individuals of all groups, obtained between 6 and 12 years of age, were assessed by the occlusal index. Main outcome measures: the groups were compared by the chi-square test, and the mean occlusal indices between groups were compared by ANOVA and Kruskal Wallis tests (p<0.05). Results: intrarater (above 0.70) and interrater (above 0.60) was performed by kappa statistics. Group I presented highest percentage of score 5, Group II exhibited highest percentage of score 1, and Group III presented the lowest percentage of score 5 (p=0.029). Analysis grouping scores 1+2 and 4+5 did not reveal statistically significant differences between the 3 groups (p=0.142). The mean occlusal index for each group showed significant differences between groups I (4.0) and III (3.0) (p=0.022). Conclusions: early cheiloplasty with IO (grupo I) was less favorable for maxilomandibular growth compared to the other two groups operated at later ages. Group II, comprising cheiloplasty and palatoplasty at later stages + IO exhibited favorable growth, while group III without IO showed the least amount of orthodontic surgical cases prognosis. Considering the variability and limitation of the present sample, further prospective and randomized studies are warranted.

The purpose of this study was to evaluate the burden of care (BOC) of two presurgical infant orthopedic (PSIO) protocols used for complete unilateral cleft lip and palate (CUCLP), and to compare aesthetic outcomes with centres not utilizing PSIO. Four samples were collected. Two from the same centre that underwent either traditional infant orthopedics (TIO) or nasoalveolar molding (NAM) and two from centres not employing PSIO. BOC data were collected for the PSIO groups and photos at age 5 were collected for ratings of nasolabial aesthetics. The BOC of NAM was found to be significantly greater than IO for number of visits (9.9 vs. 6.6, (p<0.001)) and days wearing the appliance (127 vs. 112, (p<0.05)). Significant differences in aesthetic ratings were noted amongst the three centres but not between the NAM and TIO groups. Overall, an increased burden of NAM over TIO was detected, without an observable aesthetic improvement.

The purpose of this study was to evaluate the burden of care (BOC) of two presurgical infant orthopedic (PSIO) protocols used for complete unilateral cleft lip and palate (CUCLP), and to compare aesthetic outcomes with centres not utilizing PSIO. Four samples were collected. Two from the same centre that underwent either traditional infant orthopedics (TIO) or nasoalveolar molding (NAM) and two from centres not employing PSIO. BOC data were collected for the PSIO groups and photos at age 5 were collected for ratings of nasolabial aesthetics. The BOC of NAM was found to be significantly greater than IO for number of visits (9.9 vs. 6.6, (p<0.001)) and days wearing the appliance (127 vs. 112, (p<0.05)). Significant differences in aesthetic ratings were noted amongst the three centres but not between the NAM and TIO groups. Overall, an increased burden of NAM over TIO was detected, without an observable aesthetic improvement.

Objetivo: comparar a relação interarcos de 112 indivíduos com FLPUC submetidos a queiloplastia neonatal versus em fase convencional, com e sem ortopedia infantil, aplicando-se o índice oclusal de Goslon/5 anos em fotografias intrabucais, obtidas entre 6 e 12 anos de idade. Desenho: estudo retrospectivo de coorte. Local: dois centros de reabilitação do Brasil. Participantes: três grupos tratados com distintos protocolos: grupo I: queiloplastia neonatal (1 a 15 dias) + OI (ortopedia Infantil); grupo II: queiloplastia (3 a 12 meses) + OI; grupo III: queiloplastia (3 a 6 meses), sem OI. Intervenções: o grupo I (n=35) e grupo III (n=58) foram operados pelo mesmo cirurgião, enquanto que o grupo II (n=19) por 4 cirurgiões. Método: para comparação entre os grupos foi utilizado o teste qui-quadrado e para a comparação dos índices oclusais médio intergrupos foi aplicado o ANOVA, Kruskal Wallis (p<0,05). Resultados: a concordância interexaminadores (acima 0,70) e intra (acima de 0,60) foi dada pela estatística kappa. O grupo I apresentou maior percentual de índice 5. O grupo II apresentou o maior percentual de índice 1 e o grupo III apresentou o menor percentual de índice 5 (p=0,029). As estatísticas com os índices agrupados em 1+2 e 4+5 não demonstraram diferenças entre os 3 grupos (p=0,142). O índice oclusal médio em cada grupo apresentou diferenças significativas entre os grupos I (4,0) e III (3,0) (p=0,022). Conclusão: os resultados demonstraram que em relação ao crescimento maxilomandibular, a queiloplastia em fase neonatal com OI (grupo I) apresentou-se menos favorável quando comparada aos outros dois grupos operados a partir dos três meses. O grupo II, operados mais tardiamente de lábio e palato com OI apresentou crescimento favorável enquanto que o grupo III sem OI presentou a menor quantidade de casos com prognóstico ortodôntico-cirúrgico. Considerando a variabilidade e limitações da amostra sugerimos mais trabalhos que envolvam centros que utilizam os protocolos com e sem ortopedia infantil, de preferência de forma prospectiva e randomizada. / Objective: to compare the outcomes of early versus conventional cheiloplasty with and without infant orthopedics (IO) by assessment of dental arch relationships in individuals with non-syndromic complete UCLP, analyzed by the occlusal index for intraoral photographs rating. Design: retrospective cohort study. Setting: two cleft palate centers from Brazil. Participants: three groups treated by different protocols, as follows; Group I: early cheiloplasty (1 to 15 days) + infant IO; Group II: cheiloplasty (3 to 12 months) + IO; Group III: cheiloplasty (3 to 6 months) without IO and palatoplasty (12 to 18 months). Interventions: Individuals in Group I (n=35) and Group III (n=58) were operated by a single surgeon each, while individuals in group II (n=19) were operated by 4 surgeons. The 112 intraoral photographs of individuals of all groups, obtained between 6 and 12 years of age, were assessed by the occlusal index. Main outcome measures: the groups were compared by the chi-square test, and the mean occlusal indices between groups were compared by ANOVA and Kruskal Wallis tests (p<0.05). Results: intrarater (above 0.70) and interrater (above 0.60) was performed by kappa statistics. Group I presented highest percentage of score 5, Group II exhibited highest percentage of score 1, and Group III presented the lowest percentage of score 5 (p=0.029). Analysis grouping scores 1+2 and 4+5 did not reveal statistically significant differences between the 3 groups (p=0.142). The mean occlusal index for each group showed significant differences between groups I (4.0) and III (3.0) (p=0.022). Conclusions: early cheiloplasty with IO (grupo I) was less favorable for maxilomandibular growth compared to the other two groups operated at later ages. Group II, comprising cheiloplasty and palatoplasty at later stages + IO exhibited favorable growth, while group III without IO showed the least amount of orthodontic surgical cases prognosis. Considering the variability and limitation of the present sample, further prospective and randomized studies are warranted.