This article provides a summary of the main outcome measures currently available and in use within modern cleft care. The fact that there are such a diverse range, including surgical, orthodontic, dental, speech and patient satisfaction measures, is a reflection of the complex, multidisciplinary and longitudinal nature of the care provided. The use of such measures of outcome is essential in the auditing and drive for continued improvements in the standards of care for patients affected with cleft lip and palate.
AgbajeJO, LesaffreE, DeclerckD.Assessment of caries experience in epidemiological surveys: a review. Community Dent Health2012; 29: 14–19.
2.
AinamoJ, BarmesD, BeagrieG, CutressT, MartinJ, Sardo-InfirriJ.Development of the World Health Organization (WHO) community periodontal index of treatment needs (CPITN). Int Dent J1982; 32: 281–291.
3.
Al-OmariI, MillettDT, AyoubAF. Methods of assessment of cleft-related facial deformity: a review. Cleft Palate Craniofac J2005; 42: 145–156.
4.
AltalibiM, SaltajiH, EdwardsR, MajorPW, Flores-MirC.Indices to assess malocclusions in patients with cleft lip and palate. Eur J Orthod2013; 35: 772–782.
5.
Asher-McDadeC, BrattströmV, DahlE, McWilliamJ, MølstedK, PlintDA. A six-center international study of treatment outcome in patients with clefts of the lip and palate: Part 4. Assessment of nasolabial appearance. Cleft Palate Craniofac J1992; 29: 409–412.
6.
Asher-McDadeC, RobertsC, ShawWC, GallagerC.Development of a method for rating nasolabial appearance in patients with clefts of the lip and palate. Cleft Palate Craniofac J1991; 28: 385–390; discussion 390–391.
7.
AssuncaoAG. The V.L.S. classification for secondary deformities in the unilateral cleft lip. Br J Plast Surg1992; 45: 288–292.
8.
AtackN, HathornI, MarsM, SandyJ.Study models of 5 year old children as predictors of surgical outcome in unilateral cleft lip and palate. Eur J Orthod1997a; 19: 165–170.
9.
AtackNE, HathornIS, SembG, DowellT, SandyJR. A new index for assessing surgical outcome in unilateral cleft lip and palate subjects aged five: reproducibility and validity. Cleft Palate Craniofac J1997b; 34: 242–246.
10.
BearnDR, SandyJR, ShawWC. Cephalometric soft tissue profile in unilateral cleft lip and palate patients. Eur J Orthod2002; 24: 277–284.
11.
BerglandO, SembG, AbyholmFE. Elimination of the residual alveolar cleft by secondary bone grafting and subsequent orthodontic treatment. Cleft Palate J1986; 23: 175–205.
12.
BrittonKF, WelburyRR. Dental caries prevalence in children with cleft lip/palate aged between 6 months and 6 years in the West of Scotland. Eur Arch Paediatr Dent2010; 11: 236–241.
13.
BroadbentJM, ThomsonWM. For debate: problems with the DMF index pertinent to dental caries data analysis. Community Dent Oral Epidemiol2005; 33: 400–409.
14.
CostaB, LimaJE, GomideMR, RosaOP. Clinical and microbiological evaluation of the periodontal status of children with unilateral complete cleft lip and palate. Cleft Palate Craniofac J2003; 40: 585–589.
15.
DarziA.High Quality Care for All: NHS Next Stage Review Final Report. London: Department of Health. 2008.
16.
DaskalogiannakisJ, MercadoA, RussellK, HathawayR, DugasG, LongRE. The Americleft study: an inter-center study of treatment outcomes for patients with unilateral cleft lip and palate part 3. Analysis of craniofacial form. Cleft Palate Craniofac J2011; 48: 252–258.
17.
DeaconS, BessantP, RussellJI, HathornI.What are the occlusal outcomes for unilateral cleft lip and palate patients? A national project in the UK. Br Dent J2007; 203: E18.
18.
DeaconS, MukarramS, CopleyL, HorrocksJ, van der MeulenJ.CRANE Database Annual Report 2010. London: Clinical Effectiveness Unit, The Royal College of Surgeons of England. 2010.
19.
DobbynLM, WeirJT, MacfarlaneTV, MosseyPA. Calibration of the modified Huddart and Bodenham scoring system against the GOSLON/5-Year-Olds’ Index for unilateral cleft lip and palate. Eur J Orthod2012; 34: 762–767.
20.
EdlerR, AgarwalP, WertheimD, GreenhillD.The use of anthropometric proportion indices in the measurement of facial attractiveness. Eur J Orthod2006; 28: 274–281.
21.
EdlerR, RahimMA, WertheimD, GreenhillD.The use of facial anthropometrics in aesthetic assessment. Cleft Palate Craniofac J2010; 47: 48–457.
22.
FarkasL, MunroI.Anthropometric Facial Proportions in Medicine. Springfield, IL: Charles C Thomas Pub Ltd. 1987.
23.
FarkasLG, HajnisK, PosnickJC. Anthropometric and anthroposcopic findings of the nasal and facial region in cleft patients before and after primary lip and palate repair. Cleft Palate Craniofac J1993; 30: 1–12.
24.
FitzsimonsK, CopleyL, DeaconS, van der MeulenJ.CRANE Database Annual Report 2012. London: Clinical Effectiveness Unit, The Royal College of Surgeons of England. 2012.
25.
FlinnW, LongRE, GarattiniG, SembG.A multicenter outcomes assessment of five-year-old patients with unilateral cleft lip and palate. Cleft Palate Craniofac J2006; 43: 253–258.
26.
FudalejP, KatsarosC, BongaartsC, DudkiewiczZ, Kuijpers-JagtmanAM. Dental arch relationship in children with complete unilateral cleft lip and palate following one-stage and three-stage surgical protocols. Clin Oral Investig2011; 15: 503–510.
27.
GrayD, MosseyPA. Evaluation of a modified Huddart/Bodenham scoring system for assessment of maxillary arch constriction in unilateral cleft lip and palate subjects. Eur J Orthod2005; 27: 507–511.
28.
GussyM, KilpatrickN.The self-concept of adolescents with cleft lip and palate: a pilot study using a multidimensional/hierarchical measurement instrument. Int J Paediatr Dent2006; 16: 335–341.
29.
HasslöfP, TwetmanS.Caries prevalence in children with cleft lip and palate — a systematic review of case–control studies. Int J Paediatr Dent2007; 17: 313–319.
30.
HathawayR, DaskalogiannakisJ, MercadoA, RussellK, LongRE, CohenM.The Americleft study: an inter-center study of treatment outcomes for patients with unilateral cleft lip and palate. Part 2. Dental arch relationships. Cleft Palate Craniofac J2011; 48: 244–251.
31.
HathornI, Roberts-HarryD, MarsM.The Goslon yardstick applied to a consecutive series of patients with unilateral clefts of the lip and palate. Cleft Palate Craniofac J1996; 33: 494–496.
32.
HathornIS, AtackNE, ButcherG, DicksonJ, DurningP, HammondM.Centralization of services: standard setting and outcomes. Cleft Palate Craniofac J2006; 43: 401–405.
33.
HeidbuchelKL, Kuijpers-JagtmanAM. Maxillary and mandibular dental-arch dimensions and occlusion in bilateral cleft lip and palate patients form 3 to 17 years of age. Cleft Palate Craniofac J1997; 34: 21–26.
34.
HodgkinsonP, BrownS, DuncanD, GrantC, McNaughtonA, ThomasP.Management of children with cleft lip and palate: a review describing the application of multidisciplinary team working in this condition based upon the experiences of a regional cleft lip and palate centre in The United Kingdom. Fet Matern Med Rev2005; 16: 1–27.
35.
HowellsDJ, ShawWC. The validity and reliability of ratings of dental and facial attractiveness for epidemiologic use. Am J Orthod1985; 88: 402–408.
36.
HuddartAG, BodenhamRS. The evaluation of arch form and occlusion in unilateral cleft palate subjects. Cleft Palate J1972; 9: 194–209.
37.
HuntO, BurdenD, HepperP, JohnstonC.The psychosocial effects of cleft lip and palate: a systematic review. Eur J Orthod2005; 27: 274–285.
38.
InmanDS, ThomasP, HodgkinsonPD, ReidCA. Oro-nasal fistula development and velopharyngeal insufficiency following primary cleft palate surgery — an audit of 148 children born between 1985 and 1997. Br J Plast Surg2005; 58: 1051–1054.
39.
JackHC, AntounJS, FowlertPV. Evaluation of primary surgical outcomes in New Zealand patients with unilateral clefts of the lip and palate. Aust Orthod J2011; 27: 23–27.
40.
JohnA, SellD, SweeneyT, Harding-BellA, WilliamsA.The cleft audit protocol for speech-augmented: a validated and reliable measure for auditing cleft speech. Cleft Palate Craniofac J2006; 43: 272–288.
41.
JohnsonN, SandyJ.An aesthetic index for evaluation of cleft repair. Eur J Orthod2003; 25: 243–249.
42.
JohnsonN, WilliamsAC, SingerS, SouthallP, AtackN, SandyJR. Dentoalveolar relations in children born with a unilateral cleft lip and palate (UCLP) in Western Australia. Cleft Palate Craniofac J2000; 37: 12–16.
43.
KasemS.Assessing Orthodontic Treatment in Patients with Unilateral Cleft Lip and Palate. Manchester: University of Manchester. 2003.
44.
KindelanJD, NashedRR, BromigeMR. Radiographic assessment of secondary autogenous alveolar bone grafting in cleft lip and palate patients. Cleft Palate Craniofac J1997; 34: 195–198.
45.
KlassenA, TsangarisE, ForrestC, WongK, PusicA, CanoS.Quality of life of children treated for cleft lip and/or palate: a systematic review. J Plast Reconstr Aesthet Surg2012; 65: 547–557.
46.
LagesEM, MarcosB, PordeusIA. Oral health of individuals with cleft lip, cleft palate, or both. Cleft Palate Craniofac J2004; 41: 59–63.
47.
LoeH, SilnessJ.Periodontal disease in pregnancy. I. Prevalence and severity. Acta Odontol Scand1963; 21: 533–551.
48.
LongR, SpanglerB, YowM.Cleft width and secondary alveolar bone graft success. Cleft Palate Craniofac J1995; 32: 420–427.
49.
LongR, PaternoM, VinsonB.Effect of cuspid positioning in the cleft at the time of secondary alveolar bone grafting on eventual graft success. Cleft Palate Craniofac J1996; 33: 225–230.
50.
MarsM, PlintDA, HoustonWJ, BerglandO, SembG.The Goslon Yardstick: a new system of assessing dental arch relationships in children with unilateral clefts of the lip and palate. Cleft Palate J1987; 24: 314–322.
51.
McMullanRE, DoubledayB, MuirJD, HarradineNW, WilliamsJK. Development of a treatment outcome standard as a result of a clinical audit of the outcome of fixed appliance therapy undertaken by hospital-based consultant orthodontists in the UK. Br Dent J2003; 194: 81–84.
52.
MercadoA, RussellK, HathawayR, DaskalogiannakisJ, SadekH, LongRE. The Americleft study: an inter-center study of treatment outcomes for patients with unilateral cleft lip and palate part 4. Nasolabial aesthetics. Cleft Palate Craniofac J2011; 48: 259–64.
53.
MosseyPA, ClarkJD, GrayD.Preliminary investigation of a modified Huddart/Bodenham scoring system for assessment of maxillary arch constriction in unilateral cleft lip and palate subjects. Eur J Orthod2003; 25: 251–257.
54.
MølstedK, Asher-McDadeC, BrattströmV, DahlE, MarsM, McWilliamJ.A six-center international study of treatment outcome in patients with clefts of the lip and palate: Part 2. Craniofacial form and soft tissue profile. Cleft Palate Craniofac J1992; 29: 398–404.
55.
NightingaleC, WitherowH, ReidFD, EdlerR.Comparative reproducibility of three methods of radiographic assessment of alveolar bone grafting. Eur J Orthod2003; 25: 35–41.
56.
NoverrazAE, Kuijpers-JagtmanAM, MarsM, van't HofMA. Timing of hard palate closure and dental arch relationships in unilateral cleft lip and palate patients: a mixed-longitudinal study. Cleft Palate Craniofac J1993; 30: 391–396.
57.
OberoiS, ChigurupatiR, GillP, HoffmanWY, VargervikK.Volumetric assessment of secondary alveolar bone grafting using cone beam computed tomography. Cleft Palate Craniofac J2009; 46: 503–511.
58.
OhannessianP, BerggrenA, AbdiuA.The cleft lip evaluation profile (CLEP): a new approach for postoperative nasolabial assessment in patients with unilateral cleft lip and palate. J Plast Surg Hand Surg2011; 45: 8–13.
59.
PepperH, RevingtonP, DeaconS, ThomasS.Impact of secondary alveolar bone grafting on the symptomaticity of reflux in oronasal fistulas: a patient related outcome study. Cleft Palate Craniofac J2013; to be published.
60.
RevingtonPJ, McNamaraC, MukarramS, PereraE, ShahHV, DeaconSA. Alveolar bone grafting: results of a national outcome study. Ann R Coll Surg Engl2010; 92: 643–646.
61.
RichmondS, ShawWC, O'BrienKD, BuchananIB, JonesR, StephensCD. The development of the PAR Index (Peer Assessment Rating): reliability and validity. Eur J Orthod1992a; 14: 125–139.
62.
RichmondS, ShawWC, RobertsCT, AndrewsM.The PAR Index (Peer Assessment Rating): methods to determine outcome of orthodontic treatment in terms of improvement and standards. Eur J Orthod1992b; 14: 180–187.
63.
RobertsCT, SembG, ShawWC. Strategies for the advancement of surgical methods in cleft lip and palate. Cleft Palate Craniofac J1991; 28: 141–149.
64.
RossRB. The clinical implications of facial growth in cleft lip and palate. Cleft Palate J1970; 7: 37–47.
65.
SagheriD, Ravens-SiebererU, BraumannB, von MackensenS.An Evaluation of Health-Related Quality of Life (HRQoL) in a group of 4–7 year-old children with cleft lip and palate. J Orofac Orthop2009; 70: 274–284.
SellD, HardingA, GrunwellP.A screening assessment of cleft palate speech (Great Ormond Street Speech Assessment). Eur J Disord Commun1994; 29: 1–15.
68.
SellD, HardingA, GrunwellP.GOS.SP.ASS.’98: an assessment for speech disorders associated with cleft palate and/or velopharyngeal dysfunction (revised). Int J Lang Commun Disord1999; 34: 17–33.
69.
SharmaVP, BellaH, CadierMM, PigottRW, GoodacreTE, RichardBM. Outcomes in facial aesthetics in cleft lip and palate surgery: a systematic review. J Plast Reconstr Aesthet Surg2012; 65: 1233–1245.
70.
ShawWC, DahlE, Asher-McDadeC, BrattströmV, MarsM, McWilliamJ.A six-center international study of treatment outcome in patients with clefts of the lip and palate: Part 5. General discussion and conclusions. Cleft Palate Craniofac J1992; 29: 413–418.
71.
ShawWC, ReesG, DaweM, CharlesCR. The influence of dentofacial appearance on the social attractiveness of young adults. Am J Orthod1985; 87: 21–26.
72.
SheahanP, MillerI, SheahanJN, EarleyMJ, BlayneyAW. Incidence and outcome of middle ear disease in cleft lip and/or cleft palate. Int J Pediatr Otorhinolaryngol2003; 67: 785–793.
73.
SouthallP, WaltersM, SingerS.The influence of orthodontic treatment on the GOSLON score of unilateral cleft lip and palate patients. Cleft Palate Craniofac J2012; 49: 215–220.
74.
TothillC, MosseyPA. Assessment of arch constriction in patients with bilateral cleft lip and palate and isolated cleft palate: a pilot study. Eur J Orthod2007; 29: 193–197.
75.
TureskyS, GilmoreND, GlickmanI.Reduced plaque formation by the chloromethyl analogue of victamine C. J Periodontol1970; 41: 41–43.
76.
TurnerSR, RumseyN, SandyJR. Psychological aspects of cleft lip and palate. Eur J Orthod1998; 20: 407–415.
77.
WilliamsAC, BearnD, MildinhallS, MurphyT, SellD, ShawWC. Cleft lip and palate care in the United Kingdom — the Clinical Standards Advisory Group (CSAG) Study. Part 2: Dentofacial outcomes and patient satisfaction. Cleft Palate Craniofac J2001; 38: 24–29.
78.
WitherowH, CoxS, JonesE, CarrR, WaterhouseN.A new scale to assess radiographic success of secondary alveolar bone grafts. Cleft Palate Craniofac J2002; 39: 255–260.
79.
WongFW, KingNM. The oral health of children with clefts — a review. Cleft Palate Craniofac J1998; 35: 248–254.
