Treatment of Dental Anomalies in Children with Complete Unilateral Cleft Lip and Palate at Sickkids Hospital, Toronto
Bibliographic record
Abstract
OBJECTIVE: To quantify dental anomalies in permanent dentition associated with complete unilateral cleft lip and palate and to survey treatment modalities used to address these problems. METHOD: Retrospective study of 116 children with complete unilateral cleft lip and palate treated at SickKids since birth. Presence and morphology of lateral incisors and second premolars were determined. Orthodontic, surgical, and/or prosthetic procedures were analyzed. RESULTS: The cleft-side lateral incisor was absent in 93.1% of finished cases. The lateral incisor mesial to the cleft was present in 4.3%, absent due to agenesis in 75.9%, and extracted in 19.8% of cases. The lateral distal to the cleft was present in 2.6%, absent due to agenesis in 33.6%, and extracted in 63.8% of cases. Of 105 lateral incisors, only one had normal morphology. Noncleft-side lateral incisors were absent in 16% of finished cases. Absence was due to agenesis in 12.1% of cases and extraction in 4.3%. When the lateral incisor was missing, closure of the dental space occurred by orthodontic tooth movement after alveolar bone grafting (45%); surgical closure with simultaneous alveolar bone grafting (35%); prosthetic closure (17%); and 3% were failures. Agenesis of premolars occurred in 12.1% of cleft-side and 10.3% of noncleft-side maxillary second premolars. CONCLUSIONS: The cleft-side lateral incisor is rarely present at the conclusion of orthodontic and surgical treatment of complete unilateral cleft lip and palate. Often absent due to agenesis, when present it is typically abnormal in size and bone support and is commonly extracted in favor of canine substitution.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.001 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".