Prediction of Final Treatment for Class III Malocclusion of Patients with Oral Clefts
Tasanee Wangsrimongkol DDS, MS, PhD*, Montian Manosudprasit DDS, MDS*, Keith Godfrey AM, MDS, Dr Dent*, Chutinart Kuratchatchaval DDS*, Palakorn Surakunprapha MD**
Affiliation : * Department of Orthodontics, Faculty of Dentistry, Khon Kaen University, Khon Kaen, Thailand ** Department of Surgery, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
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
