Agreement of Tracing and Direct Viewing Techniques for Cervical Vertebral Maturation Assessment.

OBJECTIVE: This study aimed to evaluate agreement among three methods for cervical vertebral maturation (CVM) assessment, comprising direct viewing, tracing only, and tracing with digitized points. MATERIAL AND METHOD: Two examiners received training and tests of reliability with each CVM method before evaluation of agreement among methods. The subjects were 96 female-cleft lateral cephalometric radiographs (films of eight subjects for each age ranged from seven to 18 years). The examiners interpreted CVM stages of the subjects with four-week interval between uses of each method. RESULTS: The range of weighted kappa values for paired comparisons among the three methods were: 0.96-0.98 for direct viewing and tracing only comparison; 0.93-0.94 for direct viewing and tracing with digitized points comparison; and 0.96-0.97 for tracing only and tracing with digitized points comparison. The intraclass correlation coefficient (ICC) value among the three methods was 0.95. These results indicated very good agreement among methods. CONCLUSION: Use of direct viewing is suitable for CVM assessment without spending more time for tracing. However, the three methods might be used interchangeably.

Orthodontic Treatment Combined with Orthognathic Surgery and Simultaneous Alveolar Bone Graft of a Unilateral Complete Cleft Lip and Palate Patient: A Case Report.

This article aimed to present a case of 22 year-old Thai female with cleft lip and palate who had malocclusion developed from dental problems, skeletal disharmony and unrepaired alveolar cleft. The treatment was orthodontic combined with one-stage surgical correction which corrected skeletal discrepancy and alveolar cleft in single operation. After treatment, the patient had improved in facial esthetics, attaining good occlusal function and continuous maxillary dental arch. This procedure can reduce morbidity, preclude a second hospitalization and the cost of two-stage surgical correction. However this is only an alternative treatment for adult cleft patients who need late alveolar bone graft and orthognathic surgery.

Pre-surgical nasoalveolar molding technique: a literature review.

Cleft lip and palate patients have many defects particularly nasal deformities. The nasoalveolar molding (NAM) technique is an adjunctive treatment, which not only corrects deviated alveolar segments but also addresses nasal deformity before cheiloplasty. NAM technique is claimed to facilitate primary surgical correction and to provide favorable esthetic outcomes. However, there is limited evidence to confirm the special benefits ofNAM technique since so far there have been no truly long term controlled clinical trials to evaluate outcomes of treatment based on pre-surgical NAM technique. NAM technique can aid surgeons in their primary repairs ofnasal deformities but there should be concern about cost-risk benefits and ability ofparents to manage home care. Further studies based on properly designed and managed long-term clinical trials are still neededfor reaching consensus on special benefits ofNAM technique compared with other treatment protocols.