Qualitative Assessment of Surgical Repair of Three Types of Unilateral Cleft Lip

Abstract Objective: To assess the effect of the three types of unilateral cleft lip (UCL) [cleft lip only, cleft lip and alveolus, and cleft lip alveolus and palate] on the outcome of the repair. Material and Methods: This study was a case series of effect of types of UCL on the outcome of the repair. Fifteen subjects each were in three UCL phenotypes groups. Evaluation of the scar, lip, and nose was done qualitatively by both parents/guardians and professionals using a modified form of the criteria described by Christofides et al. (2006). Results: In the assessment of the surgical scar, the parents found a difference between the three types of cleft in terms of texture, shape, and width of the scar and presence of columella deviation. The professional assessors, however, only found the three types of cleft to be different in the presence of alar flattening. Conclusion: Differences truly exist in the outcome of surgical repair of the three types of unilateral cleft lip, especially in the aesthetics of the nose and in the width and shape of the residual lip scar. Thus, it is important to consider this in the assessment of UCL repair because putting the subtypes together might have a negative impact on the assessment.

Comparison of operative 'difficulty' with post-operative sequelae in lower third molar surgery

Background: The outcome of studies on the effect of patients' factors, dental factors and operative factors on postoperative sequelae following surgical extraction of lower third molar have been unequivocal. Objective: To determine the effect of surgical difficulty (using Pederson's scale), Body Mass Index (BMI) and operative time on the extent of post-operative pain, swelling and trismus following third molar surgery. Methods: The study was a prospective analytical study of the effect of surgical difficulty, BMI, age and operative time ­ Total Intervention Time (TIT) - on the extent of post-operative pain, swelling and trismus. Eighty-four subjects with surgical extraction of impacted lower third molar were studied. All the subjects had a standard Peri-apical radiograph through which the difficulty index was calculated for all third molars using the Pederson scale. Anthropometric vertical and horizontal facial measurements and pain measurement were taken pre-operatively and post-operatively on days 1, 3, 5 and 7. Results: Of the 84 subjects, 16 (19%) were males, while 68 (81%) were females in the ratio of 1:4.2. BMI showed a positive correlation with all the three variables and was significant for swelling on the post-operative days assessed while TIT showed a negative correlation with most of the variables and was significant for trismus. Conclusion: This study showed that age and operative time might have an inverse relationship with the common post-operative complications after lower third molar surgery and BMI might influence the extent of these complications