Cleft Care India Study: A National Audit on Patients with Non-Syndromic Unilateral Cleft Lip and Palate Patients. Part 1: Background, Skeletal, Dental Arch, and Nasolabial Outcomes
Year: 2026
Type: article
Study design: Observational Study
Abstract: is a multicentric national initiative to assess current treatment outcomes for patients with non-syndromic unilateral CLP for 5-, 12-, and 20-year-old age groups.MethodsFourteen cleft care centers across India participated in this cross-sectional study. Standardized protocols for collecting data were formulated with input from the Study Steering Committee, validated through pilot testing, and employed for data collection. Data collected included intra-oral and extraoral photographs, study models, radiographs, surgical information, oral health assessments, speech recordings, hearing evaluations, psychosocial measures, and the intelligibility in context scale questionnaire. In this paper, we present the dentofacial outcomes. Skeletal relationships were analyzed using ANB, SNA, and SNB angles derived from cephalometric radiographs; dental arch relationships were evaluated using the 5-year or modified GOSLON indices; and nasolabial esthetics were assessed with the Asher-McDade index.ResultsData from 294 non-syndromic unilateral cleft lip and palate (UCLP) patients aged 5 (n = 72), 12 (n = 155), and 20 years (n = 67) were analyzed. Reliability testing showed strong intra and inter-rater agreement for all indices and cephalometric data (class correlation coefficient > 0.9). Nearly half of 12 year olds (46.5%) and more than half of 20 year olds (58.7%) demonstrated a Class III skeletal relationship (ANB < 0). Poor to very poor dental arch relationships (score > 3) were observed in 45%, 48%, and 43% of the 5-, 12-, and 20-year groups, respectively. Nasolabial esthetic outcomes were rated poor to very poor in 24.3% of 5 year olds, 25% of 12 year olds, and 55.4% of 20 year olds.ConclusionThis multicentric cleft outcomes audit in India demonstrated suboptimal skeletal, dental, and nasolabial outcomes when benchmarked against international standards. These findings highlight an urgent need for the centralization of cleft services, implementation of systematic national outcome monitoring, and adoption of standardized multidisciplinary care pathways to improve the quality and consistency of cleft management across India.
Authors: Panchali Batra, Deborah Sybil, Krishnamurthy Bonanthaya, Subodh Kumar Singh, Srinivas Gosla Reddy, Puneet Batra, Suryakant Das, Syed Altaf Hussain, Ravi Kumar Mahajan, Raj Gopal Reddy, Vinay Chugh, Gayatri Moghe, Nandlal Bhojraj, Krishna Shama Rao, Chethana K, Sukhdeep Singh Kahlon, Kamlesh Singh, Ranjit H Kamble, Shruti Bijapur, H. Hari Kishore Bhat, Sakshi Katyal, Manoj Prathap, Karthika Nambiar, Savitha Vadakkanthara Hariharan, Subramaniyan Balasubramaniyan, Jonathan R Sandy, Yvonne Wren, Badri Thiruvenkatachari
Institutions: Sant Parmanand Hospital, Jamia Millia Islamia, Bhagwan Mahaveer Jain Hospital, Jain hospital, JSS Dental College and Hospital, Saraswati Dental College and Hospital, Yenepoya University, Smile Train, University of Bristol, University of Manchester, Balaji Dental & Craniofacial Hospital, Sree Balaji Dental College and Hospital
Language: English
Subfield: Genetics
Domain: Life Sciences
Open Access status: green
Award: G8884232648
OpenAlex ID: W7160954111