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  • 1.
    Berggren, Anders
    et al.
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Biomedicine and Surgery, Division of surgery. Östergötlands Läns Landsting, Reconstruction Centre, Department of Plastic Surgery, Hand surgery UHL.
    Abdiu, Avni
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Biomedicine and Surgery, Division of surgery. Östergötlands Läns Landsting, Reconstruction Centre, Department of Plastic Surgery, Hand surgery UHL.
    Marcusson, Agneta
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Neuroscience and Locomotion, Dental Clinic. Östergötlands Läns Landsting, Reconstruction Centre, Department of Oral Surgery UHL.
    Paulin, Gunnar
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Neuroscience and Locomotion, Dental Clinic. Östergötlands Läns Landsting, Reconstruction Centre, Department of Oral Surgery UHL.
    Letter: The nasal alar elevator: An effective tool in the presurgical treatment of infants born with cleft lip2005In: Plastic and reconstructive surgery (1963), ISSN 0032-1052, E-ISSN 1529-4242, Vol. 115, no 6, p. 1785-1787Article in journal (Other academic)
    Abstract [en]

    [No abstract available]

  • 2.
    Bondemark, L.
    et al.
    Faculty of Odontology, Malmoe University, Department of Orthodontics, Malmoe, Sweden, Faculty of Odontology, Malmoe University, Department of Orthodontics, Carl Gustavs väg 34, Scania SE-20506 Malmoe, Sweden.
    Holm, A.-K.
    Umeå University, Department of Odontology, Pediatric Dentistry, Umeå, Sweden.
    Hansen, K.
    University of Gothenburg, Department of Orthodontics, Gothenburg, Sweden.
    Axelsson, S.
    Swedish Council on Technology Assessment in Health Care, Stockholm, Sweden.
    Mohlin, B.
    Sahlgrenska Academy, Goteborg University, Faculty of Odontology, Gothenburg, Sweden.
    Brattstrom, V.
    National Health Service, Uppland County Council, Uppsala, Sweden.
    Paulin, Gunnar
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Neuroscience and Locomotion, Dental Clinic. Linköping University, Department of Neuroscience and Locomotion, Dental Clinic.
    Pietila, T.
    Health Centre of Pori, Pori, Finland.
    Long-term stability of orthodontic treatment and patient satisfaction: A systematic review2007In: Angle orthodontist, ISSN 0003-3219, E-ISSN 1945-7103, Vol. 77, no 1, p. 181-191Article, review/survey (Refereed)
    Abstract [en]

    Objective: To evaluate morphologic stability and patient satisfaction at least 5 years after orthodontic treatment. Materials and Methods: Published literature was searched through the PubMed and Cochrane Library electronic databases from 1966 to January 2005. The search was performed by an information specialist at the Swedish Council on Technology Assessment in Health Care. The inclusion criteria consisted of a follow-up period of at least 5 years postretention, randomized clinical trials, prospective or retrospective clinical controlled studies, and cohort studies, and orthodontic treatment including fixed or removable appliances, selective grinding, or extractions. Two reviewers extracted the data independently and also assessed the quality of the studies. Results: The search strategy resulted in 1004 abstracts or full-text articles, of which 38 met the inclusion criteria. Treatment of crowding resulted in successful dental alignment. However, the mandibular arch length and width gradually decreased, and crowding of the lower anterior teeth reoccurred postretention. This condition was unpredictable at the individual level (limited evidence). Treatment of Angle Class II division 1 malocclusion with Herbst appliance normalized the occlusion. Relapse occurred but could not be predicted at the individual level (limited evidence). The scientific evidence was insufficient for conclusions on treatment of cross-bite, Angle Class III, open bite, and various other malocclusions as well as on patient satisfaction in a long-term perspective. Conclusions: This review has exposed the difficulties in drawing meaningful evidence-based conclusions often because of the inherent problems of retrospective and uncontrolled study design. © 2006 by The EH Angle Education and Research Foundation, Inc.

  • 3. Lindman, R
    et al.
    Paulin, Gunnar
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Neuroscience and Locomotion, Dental Surgery. Östergötlands Läns Landsting, Reconstruction Centre, Department of Oral Surgery UHL.
    Stål, P
    Morphological characterization of the levator veli palatini muscle in children born with cleft palates2001In: The Cleft Palate-Craniofacial Journal, ISSN 1055-6656, E-ISSN 1545-1569, Vol. 38, p. 438-448Article in journal (Refereed)
  • 4.
    Marcusson, Agneta
    et al.
    Linköping University, Department of Neuroscience and Locomotion, Dental Surgery. Linköping University, Faculty of Health Sciences.
    List, Thomas
    Östergötlands Läns Landsting.
    Paulin, Gunnar
    Linköping University, Department of Neuroscience and Locomotion, Dental Surgery. Linköping University, Faculty of Health Sciences.
    Dworkin, Samuel
    Department of Oral Medicine and Psychiatry and Behavioural Sciences, School of Dentistry and Medicine, University of Washington, Seattle, USA .
    Temporomandibular disorders in adults with repaired cleft lip and palate: a comparison with controls2001In: European Journal of Orthodontics, ISSN 0141-5387, E-ISSN 1460-2210, Vol. 23, no 2, p. 193-204Article in journal (Refereed)
    Abstract [en]

    The purpose of this study was to investigate the prevalence of temporomandibular disorders (TMD), and assess psycho‐social distress in adult subjects with repaired complete cleft lip and palate (CLP). Sixty‐three adults (42 males and 21 females, mean age 24.2 years, range 19.5–29.2) with repaired CLP (CLP group) were compared with a group of 66 adults without cleft (non‐cleft group, 49 males and 17 females, mean age 25.5 years, range 20.2–29.9). All subjects underwent a clinical TMD examination, which followed the guidelines in the Research Diagnostic Criteria for TMD (RDC/TMD). Jaw function was assessed by evaluating answers to the mandibular function impairment questionnaire (MFIQ).

    Tension‐type headache was diagnosed according to the International Headache Society (IHS) classification. Psychological status was assessed using the depression score and the non‐specific physical symptom score with subscales of the Revised Symptom Checklist‐90 (SCL‐90‐R).

    The prevalence of reported pain in the face, jaws and/or TMJs was 14 and 9 per cent for the CLP and non‐cleft group, respectively, and did not differ significantly between the groups. The CLP group exhibited a significantly reduced jaw‐opening pattern (P < 0.001) and a higher frequency of crossbites (P < 0.05) compared with the non‐cleft group. Whilst jaw function was similar in both groups, a few items, e.g. speech and drinking, were significantly more impaired (P < 0.01) in the CLP group than in the non‐cleft group. There were no significant differences between the two groups concerning tension‐type headache or psycho‐social distress.

    The study found that overall TMD pain or psycho‐social distress was not more common in this CLP group than in a non‐cleft group.

  • 5.
    Marcusson, Agneta
    et al.
    Östergötlands Läns Landsting, Reconstruction Centre, Department of Oral Surgery UHL. Östergötlands Läns Landsting, Sinnescentrum.
    List, Thomas
    Östergötlands Läns Landsting.
    Paulin, Gunnar
    Östergötlands Läns Landsting, Reconstruction Centre, Department of Oral Surgery UHL. Östergötlands Läns Landsting, Sinnescentrum.
    Åkerlind, Ingemar
    Linköping University, Department of health and environment. Linköping University, Faculty of Health Sciences.
    Reliability of a multidimensional questionnaire for adults with treated complete cleft lip and palate2001In: Scandinavian Journal of Plastic and Reconstructive Surgery and Hand Surgery, ISSN 2000-656X, E-ISSN 2000-6764, Vol. 35, no 3, p. 271-278Article in journal (Refereed)
    Abstract [en]

    The purpose of this study was to evaluate the reliability of a multidimensional questionnaire for Swedish adults with treated complete unilateral or bilateral cleft lip and palate (CLP). The questionnaire was designed to be used in the evaluation of adults with treated CLP after treatment. Before any conclusions were drawn from the results of the study we assessed the test-retest reliability of the questionnaire. The questionnaire included 168 questions and assessed the following domains: aesthetics, functions associated with CLP, satisfaction with treatment and perceived need for treatment, quality of life, depression and non-specific physical symptoms, body image, and jaw function. The subjects answered the questionnaire twice at a 2-3-week interval. Sixty-one adults (38 men, 23 women) mean age 24 years (range 20-29) participated in the study. The response rate for the questionnaire was acceptable at 75%. The test-retest reliability varied among the different domains. The reliability of questions regarding aesthetics, functions associated with CLP, and treatment satisfaction was good to excellent (intraclass correlation coefficient (ICC) = 0.51 to 0.89). Good to excellent (ICC = 0.61 to 1.0) reliability was also found for the quality of life in various life domains and the wellbeing scales. The reliability of the body image scale was moderate (kappa = 0.43-0.60) for most items and lower than that of other scales used in this study. The reliability of the mean depression symptom score (ICC = 0.93) and the mean non-specific physical symptoms score (ICC = 0.85) were excellent. The reliability of the mandibular function impairment was good (ICC = 0.67). The conclusion of the study is that an overall reliability was good for the multidimensional questionnaire.

  • 6.
    Marcusson, Agneta
    et al.
    Linköping University, Department of Neuroscience and Locomotion, Dental Surgery. Linköping University, Faculty of Health Sciences.
    Paulin, Gunnar
    Linköping University, Department of Neuroscience and Locomotion, Dental Surgery. Linköping University, Faculty of Health Sciences.
    Alterations in occlusion and maxillary dental arch dimensions in adults with treated unilateral complete cleft lip and palateManuscript (preprint) (Other academic)
    Abstract [en]

    The purpose of this stndy was to evaluate the occlusion and maxillary dental arch dimensions in adults with repaired complete unilateral cleft lip and palate (UCLP) and to investigate the patterns of change in early adulthood. Study models from 39 subjects (25 men, 14 women) (mean age 24.7 years, range 20.2-29.3) with the diagnosis complete UCLP taken at a follow-up examination were analysed and compared with the study models taken at baseline examination (mean age 19.1 years, range 16.0-20.6). Lip closure was made according to the Millard technique and palatal closure according to the Wardill-Kilner technique. All subjects had received orthodontic treatment with fixed appliances. The subjects were divided into three groups according to the type of retention in the upper jaw: no retention (n = 15), retention with bonded twisted retainer (n = 13), onlay or fixed bridge (n = 11).

    Occlusion was evaluated according to a scoring system (Huddart and Bodenham, 1972). The maxillary dental arch dimensions were measured with a video imaging system. In the total sample there was a significant deterioration in the total occlusal score during the follow-up period. The impairment was larger on the cleft side than on the non-cleft side. There were no significant differences in the frontal scores. A comparison of the transversal and sagittal maxillary arch dimensions revealed significant differences in all measurements during the follow-up interval. The reduction was largest for the maxillary second premolar width, followed by the first molar width. The oveijet differed significantly between the registrations. The occlusal score and the maxillary arch dimensions were reduced in all of the three subgroups, but there were no differences between the groups. No gender differences were found.

  • 7.
    Marcusson, Agneta
    et al.
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Neuroscience and Locomotion, Dental Clinic. Östergötlands Läns Landsting, Reconstruction Centre, Department of Oral Surgery UHL.
    Paulin, Gunnar
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Neuroscience and Locomotion, Dental Clinic. Östergötlands Läns Landsting, Reconstruction Centre, Department of Oral Surgery UHL.
    Changes in occlusion and maxillary dental arch dimensions in adults with treated unilateral complete cleft lip and palate2005In: 10 International congress on cleft Palate and Related Craniofacial Anomalies,2005, 2005, p. 119-119Conference paper (Refereed)
    Abstract [en]

       

  • 8.
    Marcusson, Agneta
    et al.
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Neuroscience and Locomotion, Dental Clinic. Östergötlands Läns Landsting, Reconstruction Centre, Department of Oral Surgery UHL.
    Paulin, Gunnar
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Neuroscience and Locomotion, Dental Clinic. Östergötlands Läns Landsting, Reconstruction Centre, Department of Oral Surgery UHL.
    Changes in occlusion and maxillary dental arch dimensions in adults with treated unilateral complete cleft lip and palate: A follow-up study2004In: European Journal of Orthodontics, ISSN 0141-5387, E-ISSN 1460-2210, Vol. 26, no 4, p. 385-390Article in journal (Refereed)
    Abstract [en]

    The purpose of this study was to evaluate the occlusion and maxillary dental arch dimensions in adults with repaired complete unilateral cleft lip and palate (UCLP) and to investigate the patterns of change in early adulthood. Study models from 39 patients (25 men, 14 women, mean age 24.7 years, range 20.2-29.3 years) with a diagnosis of complete UCLP taken at a follow-up examination were analysed and compared with the study models taken at baseline examination (mean age 19.1 years, range 16.0-20.6 years). Lip closure was carried out according to the Millard technique and palatal closure according to the Wardill-Kilner technique. All patients had received orthodontic treatment with fixed appliances. The patients were divided into three groups according to the type of retention in the upper arch: no retention (n = 15), retention with a bonded twisted retainer (n = 13), an onlay or fixed bridge (n = 11). Occlusion was evaluated according to a scoring system. The maxillary dental arch dimensions were measured with a video imaging system. There was a significant deterioration in the total occlusal score during the follow-up period and this was larger on the cleft than on the non-cleft side. There were no significant differences in the anterior scores. A comparison of the transversal and sagittal maxillary arch dimensions revealed significant differences in all measurements during the follow-up interval. The reduction was largest for the maxillary second premolar width, followed by the first molar width. The overjet differed significantly between the registrations. The occlusal score and the maxillary arch dimensions were reduced in all of the three subgroups, but there were no differences between the groups.

  • 9.
    Marcusson, Agneta
    et al.
    Linköping University, Department of Neuroscience and Locomotion, Dental Clinic. Linköping University, Faculty of Health Sciences.
    Paulin, Gunnar
    Linköping University, Department of Neuroscience and Locomotion, Dental Clinic. Linköping University, Faculty of Health Sciences.
    Östrup, Leif
    Linköping University, Department of Biomedicine and Surgery, Plastic Surgery, Hand Surgery and Burns. Linköping University, Faculty of Health Sciences.
    Facial appearance in adults who had cleft lip and palate treated in childhood2002In: Scandinavian Journal of Plastic and Reconstructive Surgery and Hand Surgery, ISSN 2000-656X, E-ISSN 2000-6764, Vol. 36, no 1, p. 16-23Article in journal (Refereed)
    Abstract [en]

    Sixty-eight adults (44 men and 24 women) with treated total cleft lip and palate were compared with a group of 66 adults (49 men and 17 women) without clefts, matched by sex and age. The outcome measures included a self-report questionnaire about body image, quality of life in general, health-related quality of life, somatisation, and depression. The group with clefts were also asked if they had further need of treatment. They reported significantly more dissatisfaction with their facial appearance (nose, lips, mouth, profile, and overall facial appearance) than the group without clefts. Satisfaction with facial appearance was significantly correlated with a better quality of life in both groups, and significantly correlated with a better health-related quality of life and a lower grade of somatisation in the group with clefts. Dissatisfaction with facial appearance was the most significant predictor of depression in both groups. A panel of four professionals from a cleft lip and palate treatment team judged the outcome of treatment in 64 of the subjects on colour slides. The professionals and the subjects with clefts were generally not very satisfied with the results of the surgical outcome. Thirty of the subjects with clefts (47%) wished to have more operations. The professional group recommended further operations in 38 of the cases (59%), in particular, rhinoplasties. We conclude that the subjects with treated clefts were not satisfied with their facial appearance, although they seem to be psychosocially well-adjusted to their disability.

  • 10.
    Marcusson, Agneta
    et al.
    Östergötlands Läns Landsting, Reconstruction Centre, Department of Oral Surgery UHL. Östergötlands Läns Landsting, Sinnescentrum.
    Åkerlind, Ingemar
    Östergötlands Läns Landsting, Local Health Care Services in the West of Östergötland, Unit of Research and Development in Local Health Care, County of Östergötland.
    Paulin, Gunnar
    Östergötlands Läns Landsting, Reconstruction Centre, Department of Oral Surgery UHL. Linköping University, Faculty of Health Sciences.
    Quality of life in adults with repaired complete cleft lip and palate2001In: The Cleft Palate-Craniofacial Journal, ISSN 1055-6656, E-ISSN 1545-1569, Vol. 38, no 4, p. 379-385Article in journal (Refereed)
    Abstract [en]

    Objective: This study evaluated the quality of life in adult Swedish subjects with repaired complete cleft lip and palate (CLP).

    Design/Patients: Sixty-eight adults with repaired CLP were compared with a group of 66 adults without cleft matched by gender and age.

    Outcome Measures: The outcome measures included a self-report questionnaire concerning quality of life in general, well-being, and health-related quality of life.

    Results: The CLP group rated their quality of life significantly lower than did the control group in the areas of life meaning (p < .05), family life (p < .0001), and private economy (p < .01). There were no significant differences between the groups concerning well-being. In the CLP group, the health-related quality of life was significantly lower concerning global life (p < .0001), disturbance to life (p < .01), well-being (p < .0001), social contacts (p < .0001), and family life (p < .05) but significantly higher concerning ability to make the most of leisure time (p < .001) and to be active (p < .001).

    Conclusions: The CLP group perceived a marked impact of the handicap on their lives concerning global aspects, well-being, and social life. More practical and tangible aspects of their daily living, however, were not affected, and only some minor aspects of their quality of life in general were poor in comparison with the control group, which indicates a fairly good life adjustment in spite of the handicap.

  • 11.
    Mohlin, Bengt
    et al.
    Department of Orthodontics, The Sahlgrenska Academy at Göteborg University, Faculty of Odontology, Göteborg, Sweden.
    Axelsson, Susanna
    Department of Occlusion, The Swedish Council on Technology Assessment in Health Care, Stockholm, Sweden.
    Paulin, Gunnar
    Linköping University, Department of Neuroscience and Locomotion, Dental Clinic. Linköping University, Faculty of Health Sciences.
    Pietila, Terttu
    Department of Orthodontics, Health Centre of Pori, Pori, Finland.
    Bondemark, Lars
    Department of Orthodontics, Faculty of Odontology, Malmo University, Malmo, Sweden.
    Brattstrom, Viveca
    Department of Orthodontics, National Health Service Uppland County Council, Uppsala, Sweden.
    Hansen, Ken
    Department of Orthodontics, University of Göteborg, Göteborg, Sweden.
    Holm, Anna-Karin
    Department of Odontology, Pediatric Dentistry, Umeå University, Umeå, Sweden.
    TMD in Relation to Malocclusion and Orthodontic Treatment2007In: Angle orthodontist, ISSN 0003-3219, E-ISSN 1945-7103, Vol. 77, no 3, p. 542-548Article, review/survey (Refereed)
    Abstract [en]

    Objective: The aim of this systematic literature review was to evaluate associations between different malocclusions, orthodontic treatment, and signs and symptoms of temporomandibular disorders (TMD).

    Materials and Methods: This review was part of a project at the Swedish Council on Technology Assessment in Health Care focusing on malocclusion and orthodontic treatment from a health perspective. As a first step, the literature was searched in the Medline and Cochrane Library databases from 1966 to May 2003. A later update was made in January 2005. Human studies in English or in Scandinavian languages were included.

    Results: Associations between certain malocclusions and TMD were found in some studies, whereas the majority of the reviewed articles failed to identify significant and clinically important associations. TMD could not be correlated to any specific type of malocclusion, and there was no support for the belief that orthodontic treatment may cause TMD. Obvious individual variations in signs and symptoms of TMD over time according to some longitudinal studies further emphasized the difficulty in establishing malocclusion as a significant risk factor for TMD. A considerable reduction in signs and symptoms of TMD between the teenage period and young adulthood has been shown in some recent longitudinal studies.

    Conclusions: Associations between specific types of malocclusions and development of significant signs and symptoms of TMD could not be verified. There is still a need for longitudinal studies.

  • 12.
    Semb, Gunvor
    et al.
    Division of Dentistry, University of Manchester , Manchester , UK; Department of Plastic and Reconstructive Surgery , Oslo University Hospital Rikshospitalet , Oslo , Norway; Department of Speech and Language Disorders , Statped sørøst , Oslo , Norway..
    Enemark, Hans
    Cleft Palate Center , Aarhus , Denmark.
    Friede, Hans
    Department of Orthodontics , Sahlgrenska Academy, University of Gothenburg , Sweden.
    Paulin, Gunnar
    Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Maxillofacial Unit.
    Lilja, Jan
    Department of Plastic Surgery , Sahlgrenska Academy, University of Gothenburg , Sweden.
    Rautio, Jorma
    Cleft Palate and Craniofacial Center, Helsinki University Central Hospital , Helsinki , Finland.
    Andersen, Mikael
    Copenhagen Cleft Palate Center, University Hospital of Copenhagen , Denmark.
    Åbyholm, Frank
    Department of Plastic and Reconstructive Surgery , Oslo University Hospital Rikshospitalet , Oslo , Norway.
    Lohmander, Anette
    Division of Speech and Language Pathology , Karolinska Institute, and Karolinska University Hospital , Stockholm , Sweden.
    Shaw, William
    Division of Dentistry, University of Manchester , Manchester , UK.
    Mølsted, Kirsten
    Copenhagen Cleft Palate Center, University Hospital of Copenhagen , Denmark.
    Heliövaara, Arja
    Cleft Palate and Craniofacial Center, Helsinki University Central Hospital , Helsinki , Finland.
    Bolund, Stig
    Copenhagen Cleft Palate Center, University Hospital of Copenhagen , Denmark.
    Hukki, Jyri
    Cleft Palate and Craniofacial Center, Helsinki University Central Hospital , Helsinki , Finland.
    Vindenes, Hallvard
    Centre for Cleft Lip and Palate, Bergen University Hospital Haukeland , Bergen , Norway.
    Davenport, Peter
    Greater Manchester Cleft Lip and Palate Unit , Royal Manchester Childrens' Hospital , Manchester , UK.
    Arctander, Kjartan
    Department of Plastic and Reconstructive Surgery , Oslo University Hospital Rikshospitalet , Oslo , Norway.
    Larson, Ola
    Stockholm Craniofacial Team , Karolinska University Hospital , Stockholm , Sweden.
    Berggren, Anders
    Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Department of Hand and Plastic Surgery.
    Whitby, David
    Greater Manchester Cleft Lip and Palate Unit , Royal Manchester Childrens' Hospital , Manchester , UK.
    Leonard, Alan
    The Royal Hospital for Sick Children , Belfast , N. Ireland.
    Neovius, Erik
    Stockholm Craniofacial Team , Karolinska University Hospital , Stockholm , Sweden.
    Elander, Anna
    Department of Plastic Surgery , Sahlgrenska Academy, University of Gothenburg , Sweden.
    Willadsen, Elisabeth
    Department of Nordic Studies and Linguistics , University of Copenhagen , Denmark.
    Bannister, R. Patricia
    Greater Manchester Cleft Lip and Palate Unit , Royal Manchester Childrens' Hospital , Manchester , UK.
    Bradbury, Eileen
    Private Practitioner , Manchester , UK.
    Henningsson, Gunilla
    Stockholm Craniofacial Team , Karolinska University Hospital , Stockholm , Sweden.
    Persson, Christina
    Institute of Neuroscience and Physiology, Speech and Language; Division for Speech and Language Pathology , Sahlgrenska University Hospital , Gothenburg , Sweden Pathology Unit , Sahlgrenska Academy, University of Gothenburg , Sweden; .
    Eyres, Philip
    Division of Dentistry, University of Manchester , Manchester , UK.
    Emborg, Berit
    Cleft Palate Center , Aarhus , Denmark.
    Kisling-Møller, Mia
    Division of Dentistry, University of Manchester , Manchester , UK.
    Küseler, Annelise
    Division of Dentistry, University of Manchester , Manchester , UK.
    Granhof Black, Birthe
    Division of Dentistry, University of Manchester , Manchester , UK.
    Schöps, Antje
    Copenhagen Cleft Palate Center, University Hospital of Copenhagen , Denmark.
    Bau, Anja
    Copenhagen Cleft Palate Center, University Hospital of Copenhagen , Denmark.
    Boers, Maria
    Copenhagen Cleft Palate Center, University Hospital of Copenhagen , Denmark.
    Søgaard Andersen, Helene
    Copenhagen Cleft Palate Center, University Hospital of Copenhagen , Denmark.
    Jeppesen, Karin
    Copenhagen Cleft Palate Center, University Hospital of Copenhagen , Denmark.
    Marxen, Dorte
    Copenhagen Cleft Palate Center, University Hospital of Copenhagen , Denmark.
    Paaso, Marjukka
    Cleft Palate and Craniofacial Center, Helsinki University Central Hospital , Helsinki , Finland.
    Hölttä, Elina
    Cleft Palate and Craniofacial Center, Helsinki University Central Hospital , Helsinki , Finland.
    Alaluusua, Suvi
    Cleft Palate and Craniofacial Center, Helsinki University Central Hospital , Helsinki , Finland.
    Turunen, Leena
    Cleft Palate and Craniofacial Center, Helsinki University Central Hospital , Helsinki , Finland.
    Humerinta, Kirsti
    Cleft Palate and Craniofacial Center, Helsinki University Central Hospital , Helsinki , Finland.
    Elfving-Little, Ulla
    Cleft Palate and Craniofacial Center, Helsinki University Central Hospital , Helsinki , Finland.
    Tørdal, Inger Beate
    Department of Speech and Language Disorders , Statped sørøst , Oslo , Norway.
    Kjøll, Lillian
    Department of Speech and Language Disorders , Statped sørøst , Oslo , Norway.
    Aukner, Ragnhild
    Department of Speech and Language Disorders , Statped sørøst , Oslo , Norway.
    Hide, Øydis
    Department of Speech and Language Disorders , Statped sørøst , Oslo , Norway.
    Feragen, Kristin Billaud
    Department of Speech and Language Disorders , Statped sørøst , Oslo , Norway.
    Rønning, Elisabeth
    Department of Plastic and Reconstructive Surgery , Oslo University Hospital Rikshospitalet , Oslo , Norway.
    Skaare, Pål
    Department of Plastic and Reconstructive Surgery , Oslo University Hospital Rikshospitalet , Oslo , Norway.
    Brinck, Eli
    Department of Plastic and Reconstructive Surgery , Oslo University Hospital Rikshospitalet , Oslo , Norway.
    Semmingsen, Ann-Magritt
    Department of Plastic and Reconstructive Surgery , Oslo University Hospital Rikshospitalet , Oslo , Norway.
    Lindberg, Nina
    Department of Plastic and Reconstructive Surgery , Oslo University Hospital Rikshospitalet , Oslo , Norway.
    Bowden, Melanie
    Greater Manchester Cleft Lip and Palate Unit , Royal Manchester Childrens' Hospital , Manchester , UK.
    Davies, Julie
    Greater Manchester Cleft Lip and Palate Unit , Royal Manchester Childrens' Hospital , Manchester , UK.
    Mooney, Jeanette
    Greater Manchester Cleft Lip and Palate Unit , Royal Manchester Childrens' Hospital , Manchester , UK.
    Bellardie, Haydn
    Greater Manchester Cleft Lip and Palate Unit , Royal Manchester Childrens' Hospital , Manchester , UK.
    Schofield, Nina
    Greater Manchester Cleft Lip and Palate Unit , Royal Manchester Childrens' Hospital , Manchester , UK.
    Nyberg, Jill
    Stockholm Craniofacial Team , Karolinska University Hospital , Stockholm , Sweden.
    Lundberg, Maria
    Stockholm Craniofacial Team , Karolinska University Hospital , Stockholm , Sweden.
    Linder-Aronson Karsten, Agneta
    Stockholm Craniofacial Team, Department of Dental Medicine , Karolinska Institute , Stockholm , Sweden.
    Larson, Margareta
    Eastman Institute, Stockholms Läns Landsting , Stockholm , Sweden.
    Holmefjord, Anders
    Statped vest , Bergen , Norway.
    Reisæter, Sigvor
    Statped vest , Bergen , Norway.
    Pedersen, Nina-Helen
    Statped vest , Bergen , Norway.
    Rasmussen, Therese
    Statped vest , Bergen , Norway.
    Tindlund, Rolf
    Dental School, University of Bergen , Bergen , Norway.
    Sæle, Paul
    Oral Health Center of Expertise/Western Norway , Bergen , Norway.
    Blomhoff, Reidunn
    Centre for Cleft Lip and Palate, Bergen University Hospital Haukeland , Bergen , Norway.
    Jacobsen, Gry
    Centre for Cleft Lip and Palate, Bergen University Hospital Haukeland , Bergen , Norway.
    Havstam, Christina
    Division for Speech and Language Pathology , Sahlgrenska University Hospital , Gothenburg , Sweden.
    Rizell, Sara
    Department of Orthodontics , Sahlgrenska Academy, University of Gothenburg , Sweden.
    Enocson, Lars
    Department of Orthodontics , Sahlgrenska Academy, University of Gothenburg , Sweden.
    Hagberg, Catharina
    Department of Orthodontics , Sahlgrenska Academy, University of Gothenburg , Sweden.
    Najar Chalien, Midia
    Department of Orthodontics , Sahlgrenska Academy, University of Gothenburg , Sweden.
    Paganini, Anna
    Department of Plastic Surgery , Sahlgrenska Academy, University of Gothenburg , Sweden.
    Lundeborg, Inger
    Linköping University, Department of Clinical and Experimental Medicine, Division of Speech language pathology, Audiology and Otorhinolaryngology. Linköping University, Faculty of Medicine and Health Sciences.
    Marcusson, Agneta
    Linköping University, Department of Clinical and Experimental Medicine, Division of Surgery, Orthopedics and Oncology. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Maxillofacial Unit.
    Mjönes, Anna-Britta
    Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Department of Otorhinolaryngology in Linköping.
    Gustavsson, Annica
    Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Maxillofacial Unit.
    Hayden, Christine
    The Royal Hospital for Sick Children , Belfast , N. Ireland.
    McAleer, Eilish
    The Royal Hospital for Sick Children , Belfast , N. Ireland.
    Slevan, Emma
    The Royal Hospital for Sick Children , Belfast , N. Ireland.
    Gregg, Terry
    The Royal Hospital for Sick Children , Belfast , N. Ireland.
    Worthington, Helen
    Division of Dentistry, University of Manchester , Manchester , UK.
    A Scandcleft randomised trials of primary surgery for unilateral cleft lip and palate: 1. Planning and management.2017In: Journal of Plastic Surgery and Hand Surgery, ISSN 2000-656X, E-ISSN 2000-6764, Vol. 51, no 1, p. 2-13Article in journal (Refereed)
    Abstract [en]

    BACKGROUND AND AIMS: Longstanding uncertainty surrounds the selection of surgical protocols for the closure of unilateral cleft lip and palate, and randomised trials have only rarely been performed. This paper is an introduction to three randomised trials of primary surgery for children born with complete unilateral cleft lip and palate (UCLP). It presents the protocol developed for the trials in CONSORT format, and describes the management structure that was developed to achieve the long-term engagement and commitment required to complete the project.

    METHOD: Ten established national or regional cleft centres participated. Lip and soft palate closure at 3-4 months, and hard palate closure at 12 months served as a common method in each trial. Trial 1 compared this with hard palate closure at 36 months. Trial 2 compared it with lip closure at 3-4 months and hard and soft palate closure at 12 months. Trial 3 compared it with lip and hard palate closure at 3-4 months and soft palate closure at 12 months. The primary outcomes were speech and dentofacial development, with a series of perioperative and longer-term secondary outcomes.

    RESULTS: Recruitment of 448 infants took place over a 9-year period, with 99.8% subsequent retention at 5 years.

    CONCLUSION: The series of reports that follow this introductory paper include comparisons at age 5 of surgical outcomes, speech outcomes, measures of dentofacial development and appearance, and parental satisfaction. The outcomes recorded and the numbers analysed for each outcome and time point are described in the series.

    TRIAL REGISTRATION: ISRCTN29932826.

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