Mark Devlin

Cleft Lip/Palate: Incidence of Prenatal Diagnosis in Glasgow, Scotland, and Comparison With Other Centers in the United Kingdom

Objectives To determine the proportion of children with cleft lip and/or cleft palate diagnosed prenatally between 1999 and 2008 in those referred for treatment to the Royal Hospital for Sick Children in Glasgow, Scotland (RHSC); and to compare the percentage prenatally diagnosed in 2008 versus other cleft treatment centers in the U.K. Method A retrospective study was performed using medical records of the 459 cleft patients born and referred to RHSC between 1999 and 2008. Comparable data for year 2008 were requested from other U.K. units. Results For the period studied, the percentage of all clefts diagnosed prenatally was 15%. This rose to 28% when only the cases of cleft lip with or without cleft palate (CL±P) were considered. An increase was seen in prenatal detection of CL±P from 11% in 1999 to 50% in 2008 (p = .011). Two of the six U.K. units that responded had a significantly higher percentage of CL±P cases diagnosed prenatally compared with RHSC in 2008 (p < .05). Conclusions The percentage of CL±P cases diagnosed prenatally in this study is consistent with the literature and increased between 1999 and 2008. Routine ultrasound anomaly scanning is shown to significantly improve detection rates compared with scanning of high-risk pregnancies only. Cases of CL±P where the alveolus or the palate is involved have significantly higher detection rates than those involving only the lip.

The role of three-dimensional imaging in patients with cleft lip and palate

Three-dimensional (3D) imaging is revolutionising patient assessment, diagnosis, management and treatment planning. Restorative dentistry is using optical scanning such as the computer aided design/computer aided manufacture systems to help with tooth preparation design and construction of fixed prosthodontics. Other specialties in dentistry are frequently employing cone beam computed tomography (CBCT) to facilitate 3D imaging. This article outlines how CBCT and 3D sterophotogrammetry have been used in the management of cleft lip and palate with reference to the cleft team based at Glasgow Dental Hospital.