Twenty-Year Follow-Up of 50 Consecutive Patients Born with Unilateral Complete Cleft Lip and Palate Treated by the Oslo Cleft Team, Norway

Long-term follow-up of patients with complete clefts provides a more certain indication of treatment outcome than short-term studies. Relatively few published reports, however, describe outcomes at age 20 years or beyond. This retrospective cohort study involved 50 patient (17 female, 33 male) born with complete unilateral cleft lip and palate who were consecutively treated by the Oslo Cleft Team. The data were analyzed by internal and external observers with the use of standardized procedures, ie, for assessment of dental arch relationship, the late adolescent version of the original Goslon Yardstick; for facial growth, standardized cephalometry; and an extension of the Bergland scale for rating alveolar bone grafting success. The kappa statistic was used to evaluate interrater reliability. The burden of care in numbers of operations and duration of orthodontic treatment was calculated. Results for dental arch relationship were as follows: 40% had excellent, 32% good, 18% fair, and 10% had poor outcome. The cephalometric measurements are comparable with other published results. A completely normal interdental septum after bone grafting was observed in 80%, a slightly reduced septum in 18%, and a failed graft in 2%. Long-term follow-up suggests that the Oslo treatment protocol for unilateral cleft lip and palate achieves a satisfactory balance between the burden of care and dentofacial outcome.