J Med Assoc Thai 2011; 94 (12):9

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Prediction of Final Treatment for Class III Malocclusion of Patients with Oral Clefts
Wangsrimongkol T Mail, Manosudprasit M , Godfrey K , Kuratchatchaval C , Surakunprapha P

Objective: To evaluate the value of predicted treatment plans interpreted from a previously developed Formula for Orthodontics and Surgery Prediction (FOSP) in patients with cleft lip and/or palate (CLP).
Material and Method: Orthodontic treatment records were collected of 105 non-syndromic CLP patients between the ages of 5 and 29 years, having Class III malocclusions of varying severity. Three cephalometric values from pre-treatment lateral cephalometric radiographs were determined for use with the FOSP. A receiver operating curve (ROC) was used to identify the optimal cut-off score for classifying predicted treatment needs, whether orthodontics alone or orthognathic surgery. The clinical merit of using the FOSP was determined by comparing predicted plans with actual treatments.
Results: The predictive value using a cut-off score of 0.6475 from the FOSP-for recommending the final treatment provided was correctly classified for 79 subjects (75.2%). Sensitivity and specificity of the FOSP for prediction of the need for orthognathic surgery were 68.1% (52.9%-80.9%) and 81.0% (68.6%-90.1%), respectively.
Conclusion: The FOSP can be used for early treatment prediction and counseling, and for more objectively specifying the type of orthodontic treatment for CLP patients. Other sources of information-such as evaluation of psychological and
socioeconomic status, and patient’s wishes-are still necessary for finalizing the treatment plan.

Keywords: Cleft lip-palate, Orthognathic surgery prediction

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