| dc.description.abstract | Objectives: Children with orofacial clefts have appearance concerns, as well as behavioral and social issues. Phase 1 orthodontic treatment includes maxillary expansion and protraction, and incisor alignment. Desired effects include speech and mastication development, and improvement in nasal geometry and soft tissue profile. The aim of this study was to analyze relationships between quality of life (QoL), orthodontic treatment and burden of care associated with this diagnosis.
Methods: Modification to an IRB approved study allowed patient information access. Filters were applied to the patient database. Retrospective chart reviews resulted in a sample group of 59 subjects with cleft lip with or without cleft palate (CL+/-CP) who had undergone phase 1 orthodontics using RPE with or without the use of facemask. Parent-proxy and child reported QoL data was gathered from times T0 (before orthodontic treatment) and T1 (following RPE with or without facemask). The control group was 12 age-matched subjects with isolated cleft palate, who had not had phase 1 care. Scores from the PedsQL 4.0 and addendum questionnaire were analyzed.
Results: In the sample, child scores differed significantly from parent-proxy psychosocial QoL scores at both time points. Parents tended to perceive a lower QoL than the children themselves (T0: Z= -2.875, p= 0.004, T1: Z= -2.075, p= 0.038).
There was a statistically significant difference between the sample group’s parent-proxy psychosocial QoL scores at T0 to those at T1 (Z= -2.458, p= 0.014); the median score increased from 71.67% to 79.345%. There was no significant difference seen for the same analysis of the control group. The sample group children reported on the statement ‘I am happy with how I look’, and there was a statistically significant difference from T0 to T1 (Z= -3.115, p= 0.002); no child scored lower following orthodontics.
Conclusions: Children with CL+/-CP were happier with their appearance at T1 than T0, although there was no statistically significant difference in their psychosocial QoL over this time. Sample group parents perceived a statistically significant difference in their child’s psychosocial QoL from T0 to T1. Child and parent-proxy reports of psychosocial QoL differed significantly- a finding found in previous literature. | en |
