On 6. September 2019 at 14.00 Van Thai Nguyen will defend his doctoral thesis „The first study of the treatment outcomes of patients with cleft lip and palate in Central Vietnam“.
Associate Professor in Orthodontics, Triin Jagomägi, University of Tartu
professor Toai Nguyen, Vietnam
Pertti Pirttiniemi, University of Oulu, Finland
Cleft lip and/or palate (CL/P) is one of the most common congenital birth defects worldwide. In Vietnam, CL/P affects about 1/677 live births per year. In Central Vietnam, most of the patients with CL/P rely on charitable operating teams to receive free treatment for their cleft. Consequently, the treatment is usually behind the optimal timetable compared to other developed countries. These charity cleft treatments have primarily focused on surgery; other types of treatment such as speech therapy or orthodontic treatment have not been provided. Additionally, the follow-ups for these patients are usually fragmented. For these reasons, the treatment outcomes of these patients have not been investigated comprehensively.
The purpose of this thesis was to evaluate the treatment outcomes of patients with CL/P in Central Vietnam who were operated on by charity operation teams. We evaluated the following treatment outcomes: oral health status, nasolabial aesthetics, speech, dentofacial morphology, maxillary arch dimensions, palatal morphology, upper airway structures, patient and their parent’s satisfaction with the cleft treatment, and maternal experiences of having a child with CL/P.
The study was conducted in Hue, a city in Central Vietnam. A total of 81 patients with repaired CL/P were included in the study. Dental caries experiences and periodontal status were evaluated based on the guidelines of the World Health Organization. Nasolabial aesthetics were assessed by a panel of experienced clinicians using three different methods. The speech of the patients was assessed using the Nasometer II to obtain nasalance scores. Dentofacial morphology and upper airway structures were assessed from lateral cephalograms. Maxillary arch dimensions and palatal morphology were evaluated using digital models. The Cleft Hearing, Appearance, and Speech Questionnaire was used to investigate the satisfaction of patients and their parents with the outcomes of the cleft treatment. A different questionnaire was used to collect information about the experiences of the mother while raising a child with CL/P.
Patients with repaired CL/P in Central Vietnam experienced a very high level of caries and signs of gingivitis. They had a fair appearance of nasolabial aesthetics. The speech outcomes were poor and more than half of the patients had hypernasality. Some patients had Class III malocclusion. The airway space, maxillary arch, and palatal dimensions were reduced in children. The mothers did not report any aggressive or extreme feelings about having a child with CL/P. Both patients and their parents were satisfied with the cleft treatment outcomes.
This study further stresses the need to establish a national cleft registry to record, monitor, and follow-up with patients with CL/P. It is also important to establish a minimum required standard of records for each patient with CL/P. We additionally recommend improving the oral health, speech, and orthodontic treatment for patients with CL/P in Central Vietnam.