Sandy J, Williams A, Mildinhall S, Murphy T, Bearn D, Shaw B, Sell D, Devlin B, Murray J
Division of Child Dental Health, University of Bristol Dental School, Bristol, U.K.
Br J Orthod. 1998 Feb;25(1):21-30. doi: 10.1093/ortho/25.1.21.
A national study of care and outcomes in children born with a unilateral cleft lip and palate (UCLP) was performed over a 15-month period. Two cohorts of children ('5-year-olds' and '12-year-olds') were examined. There were 57 active cleft teams in the U.K. with 105 consultant orthodontists involved in the care of these children. Only 36 teams could provide basic data such as patients names. Of the patients, 47-51 per cent had neonatal appliances. The dental arch relationships were measured with the Goslon Index and a Five-Year-Old Index, 37-39 per cent of both age groups were either 'poor' or 'very poor'. Seventy per cent of the 12-year-old patients had a Skeletal III relation and 42 per cent of bone grafts were seriously deficient or failed. Dental treatment for active caries was needed by 40 per cent of 5-year-olds and 20 per cent of 12-year-olds. In addition, the training of recently appointed consultant orthodontists involved in the care of these children was scrutinized. As a whole, the results were disappointing with standards of care not significantly raised in the last decade. Recommendations have been made to the Department of Health and the implications for the orthodontic profession are explored. Overall, it seems that fewer orthodontists will need to be involved in a centralized care model for these children.
在15个月的时间里，开展了一项关于单侧唇腭裂（UCLP）患儿护理及治疗结果的全国性研究。对两组儿童（“5岁组”和“12岁组”）进行了检查。英国有57个活跃的腭裂治疗团队，105名正畸专科医生参与了这些儿童的护理工作。只有36个团队能够提供诸如患者姓名等基本数据。在患者中，47%至51%使用了新生儿矫治器。用戈斯隆指数和五岁儿童指数测量牙弓关系，两个年龄组中37%至39%的结果为“差”或“非常差”。12岁患者中有70%存在骨骼III类关系，42%的骨移植严重不足或失败。5岁儿童中有40%、12岁儿童中有20%需要对活动性龋齿进行牙科治疗。此外，还对最近参与这些儿童护理工作的正畸专科医生的培训情况进行了审查。总体而言，结果令人失望，在过去十年中护理标准没有显著提高。已向卫生部提出建议，并探讨了对正畸行业的影响。总体而言，似乎需要参与这些儿童集中护理模式的正畸医生会更少。
