Hospital-based Costs to the National Health Service (UK) for Children and Adolescents Born with Cleft from Birth to 20 Years.

Objective: The primary aim was to assess the cost (£) to the National Health Service (NHS) of hospital treatment for individuals born with bilateral cleft lip and palate (BCLP), unilateral cleft lip and palate (UCLP), and cleft palate (CP), from birth to 20 years. The secondary aim was to assess the number of scheduled clinical outpatient and inpatient/outpatient surgical visits for this cohort.

Design: Retrospective micro-costing analysis.

Association of Perioperative Antibiotics with the Prevention of Postoperative Fistula after Cleft Palate Repair.

Background: There is debate amongst surgeons regarding the use of antibiotics to prevent fistulae after palatoplasty. Prescribing should be evidence based, as antibiotic stewardship is integral to reducing antibiotic resistance. Our aim was to determine whether differing perioperative regimens affect the prevalence of postoperative fistulae.

Longitudinal educational attainment among children with isolated oral cleft: a cohort study.

Objectives: (1) To explore differences in educational attainment between children born with isolated clefts and the general population at ages 5, 7 and 11 years; (2) to describe longitudinal changes in attainment among children with cleft through primary education.

Design: Analysis of Cleft Registry and Audit Network data linked to national educational outcomes.

Setting: English state schools.

Syndromes associated with Robin sequence: a national prospective cohort study.

Objectives: To determine the prevalence of syndromic Robin sequence (RS) in the UK and if this group of patients had an increased need for airway and feeding management compared with a non-syndromic RS cohort.

Design: A prospective national multicentre study of cases submitted to the Cleft Collective cohort studies.

Setting: Specialist cleft services in the UK.

Exploring the Relationship Between Palatal Cleft Type and Width With the Use of Relieving Incisions in Primary Repair.

Objective: The mainstay of palatal repair in the United Kingdom is the intravelar veloplasty (IVVP). It is not always possible to align the oral mucosa in the midline to achieve tension-free repair. The addition of lateral relieving incisions may aid transposition of the oral mucosa to allow closure.

The Relationship Between Maxillary Growth and Speech in Children With a Unilateral Cleft Lip and Palate at 5 Years of Age.

Objective: This study sought to investigate the association between maxillary growth and speech outcomes for children with a repaired unilateral cleft lip and palate (UCLP) at 5 years of age.

Participants: In all, 521 children (180 females and 341 males) with a nonsyndromic complete UCLP, born between 2007 and 2012 in England, Wales, and Northern Ireland were included in this study.

Outcome Measures: Maxillary growth was analyzed using dental models scored by the 5-Year-Olds' index, and perceptual speech analyses were scored by the Cleft Audit Protocol for Speech - Augmented rating.

Reliability and Predictive Validity of Dental Arch Relationships Using the 5-Year-Olds' Index and the GOSLON Yardstick to Determine Facial Growth.

Aims: To determine reliability and predictive validity of the 5-year-olds'(5YO) Index and GOSLON Yardstick in 119 patients born with unilateral cleft lip and palate at 5, 7/8, 10, 15/16, and 19 years.

Methods: Five hundred thirty-four dental study models were appraised by 2 teams in 2 centers, twice in each center. Intrateam and interteam reliability in scoring the models was calculated using κ.

School absence and achievement in children with isolated orofacial clefts.

Objectives: To examine school absence and academic achievement among 7-year-old children with isolated orofacial clefts in England.

Design: Analysis of educational data linked to national cleft registry and administrative hospital data.

Setting: English state schools.

Is There a Correlation Between Nasolabial Appearance and Dentoalveolar Relationships in Patients With Repaired Unilateral Cleft Lip and Palate?

Objective: To determine whether a relationship exists between the aesthetic scores given to photographic records of the nasolabial region of patients with repaired unilateral cleft lip and palate (UCLP) and the 5-Year Olds' Index scores of study models for the same participants.

Design: Retrospective study.

Setting: University of Bristol Dental Hospital, United Kingdom.

Outcome Measures in UCLP: The Modified 5-Year-Olds'-Index-Development and Reliability.

Objective: Can we reliably discriminate severity within the existing categories of the 5-Year-Olds' Index?

Design: Retrospective method comparison and development study.

Setting: School of Oral and Dental Science, University of Bristol.

Methods: Dental study models of 5-year-olds with unilateral cleft lip and palate (UCLP) were collected from the archives of 2 national cleft surveys (n = 351).

Early academic achievement in children with isolated clefts: a population-based study in England.

Objectives: We used national data to study differences in academic achievement between 5-year-old children with an isolated oral cleft and the general population. We also assessed differences by cleft type.

Methods: Children born in England with an oral cleft were identified in a national cleft registry.

Chewing gum vs. ibuprofen in the management of orthodontic pain, a multi-centre randomised controlled trial - the effect of anxiety.

Objectives: Pain is a common side effect of orthodontic treatment. An objective of this study, part of a large previously reported RCT on pain and analgesic use, was to determine the effect of anxiety on perceived pain and use of analgesia.

Methods: 1000 patients aged 11-17 years, undergoing upper and lower fixed appliance treatment in nine hospital departments were recruited into this two-arm parallel design randomised controlled trial.

Comparative assessment of chewing gum and ibuprofen in the management of orthodontic pain with fixed appliances: A pragmatic multicenter randomized controlled trial.

Introduction: The aim of this randomized trial was to investigate the effect of the use of a sugar-free chewing gum vs ibuprofen on reported pain in orthodontic patients.

Methods: This was a 2-arm parallel design randomized controlled trial in 9 sites in the southwest of England. Patients about to undergo orthodontic treatment with maxillary and mandibular fixed appliances were recruited and randomly allocated to an experimental chewing gum group or a control ibuprofen group.

Grommet Surgery in Children With Orofacial Clefts in England.

Objective: To assess grommet insertion practice in the first 5 years of life among children with an orofacial cleft in England.

Design: Analysis of national administrative data of hospital admissions.

Setting: National Health Service hospitals, England.

Powered versus manual toothbrushing for oral health.

Background: Removing dental plaque may play a key role maintaining oral health. There is conflicting evidence for the relative merits of manual and powered toothbrushing in achieving this. This is an update of a Cochrane review first published in 2003, and previously updated in 2005.

A review of outcome measures used in cleft care.

This article provides a summary of the main outcome measures currently available and in use within modern cleft care. The fact that there are such a diverse range, including surgical, orthodontic, dental, speech and patient satisfaction measures, is a reflection of the complex, multidisciplinary and longitudinal nature of the care provided. The use of such measures of outcome is essential in the auditing and drive for continued improvements in the standards of care for patients affected with cleft lip and palate.

Hospital care of children with a cleft in England.

Objective: To analyse hospital admissions in the first 2 years of life among children with cleft lip and/or palate in England.

Design: Analysis of national administrative data of hospital admissions.

Setting: National Health Service hospitals.

Hospital admissions for dental treatment among children with cleft lip and/or palate born between 1997 and 2003: an analysis of Hospital Episode Statistics in England.

Background: Children with clefts have an increased tendency for dental anomalies and caries.

Aim: To determine the pattern of hospital admissions for dental treatment during primary dentition among children with clefts.

Design: Cohort study based on Hospital Episode Statistics, an administrative database of all admissions to National Health Service hospitals in England.

Impact of secondary alveolar bone grafting on the symptoms of reflux in oronasal fistulas: a patient-related outcome study.

Objective : To establish for the first time the prevalence of fistula symptoms and the effectiveness of secondary alveolar bone grafting to treat these symptoms in a single surgeon cohort in Bristol, United Kingdom. Design : Direct questioning of 233 consecutive patients with cleft before and after secondary alveolar bone grafting as to the presence of fistula symptoms. Setting : Southwest and South Wales Cleft Centre, Frenchay Hospital, Bristol, United Kingdom.

Centralisation of services for children with cleft lip or palate in England: a study of hospital episode statistics.

Background: In 1998, a process of centralisation was initiated for services for children born with a cleft lip or palate in the UK. We studied the timing of this process in England according to its impact on the number of hospitals and surgeons involved in primary surgical repairs.

Methods: All live born patients with a cleft lip and/or palate born between April 1997 and December 2008 were identified in Hospital Episode Statistics, the database of admissions to English National Health Service hospitals.

Secondary bone grafting for alveolar cleft in children with cleft lip or cleft lip and palate.

Background: Secondary alveolar bone grafting has been widely used to reconstruct alveolar cleft. However, there is still some controversy.

Objectives: To compare the effectiveness and safety of different secondary bone grafting methods.

Different powered toothbrushes for plaque control and gingival health.

Background: Powered brushes were first introduced commercially in the 1960s. A recent systematic review suggested the superiority of certain modes of powered over manual toothbrushing for plaque and gingivitis reduction. That review did not allow for direct comparison between different modes of powered toothbrush.

Alveolar bone grafting: results of a national outcome study.

Introduction: In 1998, the Clinical Standards Advisory Group (CSAG) report demonstrated a successful radiographic outcome of 58%, for alveolar bone grafting, from 157 cases of unilateral cleft lip and palate (UCLP) in children aged 12 years. No further national studies have assessed the current level of radiographic outcome following the re-organisation of cleft services since the recommendations from the CSAG report.

Patients And Methods: In 2008, radiographic images were requested for alveolar bone grafts performed in calendar year 2006 from each of the now established UK cleft centres.

The outcome for secondary alveolar bone grafting in the South West UK region post-CSAG.

Objective: In 1998 the delivery of cleft care in the United Kingdom was examined by the Clinical Standards Advisory Group, the outcomes of which led to the wide restructuring of cleft services in the United Kingdom. We present a retrospective study evaluating the radiographic outcome of 53 consecutively performed alveolar bone grafts following the regional centralization of secondary alveolar bone grafting to the South West Cleft Centre between 2004 and 2006.

Methods: A retrospective audit of one surgeon's outcome of 53 consecutively performed alveolar bone grafts, assessed radiographically using the Kindelan method.

Quality of trials in a systematic review of powered toothbrushes: suggestions for future clinical trials.

Background: This study aimed to assess the quality of reports of randomized controlled trials (RCTs) comparing manual and powered toothbrushes and provide advice on how future trials might be improved.

Methods: Studies were identified in the Cochrane systematic review of RCTs comparing powered versus manual toothbrushes. Reports were assessed against predefined criteria on the design of the studies to determine the effectiveness of the brushes in everyday home use and on their methodological quality.