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The Youth Quality of Life­Facial Differences (YQOL-FD), validated in the United States in 2005, was developed at the University of Washington by the Seattle Quality of Life Group (SeaQol), to evaluate quality of life of adolescents with facial deformities. Because no Portuguese version exists, the measure was not viable in Brazil. This study aimed to obtain linguistic and psychometric validation of a version of the YQOL-FD in Portuguese. Twenty-five patients with cleft lip and palate and five without facial deformity participated in Traumatology and Maxillofacial Prosthesis Surgery Clinic, School of Dentistry, University of São Paulo. The linguistic validation of the YQOL-FD was carried out by a team consisting of the researcher, as project manager, two native Portuguese-speaking consultants fluent in English, and one native English-speaking consultant fluent in Portuguese. After translation and back-translation, a Portuguese version was obtained, which was applied in a pilot test (n = 10); after the final adjustments the Seattle Quality of Life Group approved the official version of the YQOL-FD in Portuguese. To obtain the psychometric validation, we requested the participation of 20 patients with cleft lip and palate who answered the questionnaire twice in a range of 7 to 15 days. The Cronbach's alpha test was applied in the 48-item block, showing a high degree of internal consistency (0.949). The Wilcoxon Signal Post Test was applied to verify if the test and retest values were similar; the general agreement was 4/5 = 80%, indicating high reproducibility. It was concluded that the Portuguese version of the YQOL-FD is adequate for evaluating Quality of Life of Brazilian adolescents with craniofacial deformities.

O YQOL-FD (Youth Quality of Life ­ Facial Differences) validado nos EUA em 2005, foi desenvolvido na Universidade de Washington, pelo Seattle Qualitity of Life Group (SeaQol), com a finalidade de avaliar a qualidade de vida de adolescentes com deformidades faciais. Por não apresentar uma versão no idioma português o seu uso não poderia ser viabilizado no Brasil. O objetivo deste trabalho foi conseguir a validação linguística e a validação psicométrica de uma versão do YQOL-FD, no idioma português do Brasil. Participaram deste estudo 25 pacientes com Fissura de Lábio e Palato (FLP) e 5 sem qualquer deformidade facial, em atendimento na Clínica do Departamento de Cirurgia Traumatologia e Prótese Maxilofacial da Faculdade de Odontologia da Universidade de São Paulo. A validação linguística do YQOL-FD foi realizada por uma equipe constituída pelo pesquisador, como gerente de projeto, por 2 consultores nativos da língua portuguesa muito fluentes em inglês e por 1 consultor nativo de língua inglesa com fluência em português. Após a tradução e a retrotradução obteve-se uma versão em português, a qual foi aplicada em um teste piloto, com n = 10, sendo 5 adolescentes com FLP e 5 sem FLP, que após os acertos finais permitiu que o SeaQol aprovasse a versão oficial do YQOL ­ FD em português. Para a obtenção da validação psicométrica solicitou-se a participação de 20 pacientes com FLP que responderam ao questionário por 2 vezes em um intervalo de 7 a 15 dias. O teste de Cronbach foi aplicado no bloco de 48 itens mostrando alto grau de consistência interna (0,949). Na aplicação do Teste dos Postos Sinalizados de Wilcoxon, com o intuito de verificar se os valores do teste (t) e do re-teste (rt) são semelhantes, foi possível observar que a concordância geral é de 4/5 = 80%, portanto uma reprodutibilidade elevada. Concluiu-se que o YQOL­FD na versão em português pode ser utilizado como instrumento adequado para a avaliação da Qualidade de Vida dos adolescentes brasileiros com deformidade carniofacial.

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ABSTRACT: A standardized photographic documentation is reproducible, which facilitates the evaluation of new techniques, treatment planning, and comparison of results. Clinical photography is important to impart scientific education to health professionals, because techniques can be better understood by the listener or reader when they are well illustrated. Documentation of consistent imaging of clinical diagnosis and treatment is also essential in medical-legal cases. Highquality clinical photographs along with radiographs and other medical and dental images should become an integral part of patients' medical records. Variables such as lens selection, camera position, distance, and patient's position should be understood and controlled by healthcare personnel for acquiring accurate photographs. In the case of patients with craniofacial deformities, such as cleft lip and palate, it is important to establish the standardization of photographic records because the patients' aesthetic evaluation is a fundamental clinical indicator in the deformity analysis, besides assisting the planning of patients' multidisciplinary treatment. This article aims to assist health professionals in acquiring standardized facial photographs (front, right profile, left profile, and submental oblique view) of patients with cleft lip and palate.

RESUMEN: Una documentación fotográfica estandarizada es reproducible, lo que facilita la evaluación de nuevas técnicas, la planificación del tratamiento y la comparación de resultados. La fotografía clínica es importante para impartir educación científica a los profesionales de la salud, ya que el oyente o lector puede comprender mejor las técnicas cuando están bien ilustradas. La documentación de imágenes consistentes de diagnóstico clínico y tratamiento también es esencial en casos médico-legales. Las fotografías clínicas de alta calidad junto con las radiografías y otras imágenes médicas y dentales deben convertirse en una parte integral de los registros médicos de los pacientes. El personal de atención médica debe comprender y controlar las variables como la selección de la lente, la posición de la cámara, la distancia y la posición del paciente para obtener fotografías precisas. En el caso de pacientes con deformidades craneofaciales, como labio leporino y paladar hendido, es importante establecer la estandarización de los registros fotográficos porque la evaluación estética de los pacientes es un indicador clínico fundamental en el análisis de la deformidad, además de ayudar en la planificación del tratamiento multidisciplinario del paciente. Este artículo pretende ayudar a los profesionales de la salud a adquirir fotografías faciales estandarizadas (frente, perfil derecho, perfil izquierdo y vista oblicua submental) de pacientes con labio leporino y paladar hendido.

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Esthetic evaluation of cleft lip and palate rehabilitation outcomes may assist in the determination of new surgical interventions and aid in reevaluation of treatment protocols. Our objective was to compare esthetics assessments of the nasolabial region in children with a unilateral cleft lip and palate between healthcare professionals who were experienced in the treatment of cleft lip and palate and those who were inexperienced. The study group included 55 patients between 6 and 12 years of age who had already undergone primary reconstructive surgery for unilateral cleft lip. Standardized digital photographs were obtained, and the esthetic features of the nose, lip, and nasolabial region were evaluated. We used only cropped photographic images in the assessments of healthcare professionals with and without experience in cleft lip and palate. Interrater analysis revealed highly reliable assessments made by both the experienced and inexperienced professionals. There was no statistically significant difference in the esthetic attractiveness of the lip and nose between the experienced and inexperienced professionals. Compared with the inexperienced professionals, the experienced professional evaluators showed higher satisfaction with the esthetic appearance of the nasolabial region; however, no difference was observed in the analysis of the lip or nose alone.

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A saúde bucal é indispensável ao sucesso da reabilitação estética e funcional da criança com fissura labiopalatal. O objetivo desta pesquisa foi conhecer como a doença cárie se expressa em pacientes tratados desde os primeiros dias de nascido no Ambulatório de Prótese Buco Maxilo Facial da FOUSP. Um único pesquisador examinou 255 crianças portadoras de fissura labiopalatal na faixa etária de 6 a 72 meses, das quais 116 eram do gênero feminino e 139 do masculino, classificadas em 145 crianças com Fissura transforame incisivo, 36 com Fissura pré-forame incisivo e 74 com Fissura pós-forame incisivo. O exame clínico, visual e tátil, realizou-se após profilaxia dental, sob luz artificial por meio de espelho clínico e sonda IPC quando necessária. A cárie dentária foi diagnosticada pelos critérios da OMS, a severidade de acordo com a FDI/WHO. A análise estatística utilizou o teste Qui-Quadrado ajustado pela estatística de Fisher ou pela correção de Yates. As 35 crianças acometidas por cárie dentária corresponderam a 13,8% da amostra. Não houve associação da prevalência de cárie com os tipos de fissura (p=0,587) e com o gênero (p=0,736), mas o aumento da idade mostrou relação estatisticamente significante (p=0,001). O ceo-d médio na amostra transversal foi 0,34, com o score de severidade muito baixa. Concluiu-se que portadores de fissura labiopalatal, acompanhados desde o nascimento, apresentaram baixa prevalência de cárie dentária com severidade muito baixa...

Oral health is essential to the success of aesthetic and functional rehabilitation of children with cleft lip and palate. The objective of this research was to explore in greater depth how caries are expressed in patients treated since the early days of FOUSP’s Prosthetic Maxillofacial Ambulatory care. A single researcher examined 255 children with cleft lip and palate between the ages of 6 and 72 months of which 116 were female and 139 were male, which classified 145 children with cleft lip and palate, 36 with cleft lip fissure and 74 with cleft palate fissure. Visual and tactile clinical examinations were held after dental prophylaxis under artificial light through clinical mirror and CPI probes when necessary. Dental caries were diagnosed by WHO criteria, severity according to the FDI / WHO. The tabulated data was statistically analyzed using the chi-square test adjusted for the Fisher statistic or the Yates correction. The 35 children were affected by dental caries which accounted for 13.8% of the sample. There was no association between caries prevalence with cleft types (p = 0.587) and gender (p = 0.736), but increasing age showed a statistically significant correlation (p = 0.001). The mean dmft in the cross-sectional sample was 0.34, with the severity score very low. It was concluded that patients with cleft lip and palate, followed from birth, showed a low prevalence of dental caries with very low severity...

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The aim of this study was to assess the prevalence of caries in children with cleft lip and∕or palate aged 6-36 months of life. This study was conducted at the University of São Paulo School of Dentistry, Brazil. A total of 143 children were selected (73 male, 70 female), all of whom had at least two erupted teeth. The children were distributed as follows: 88 had cleft lip and palate, 35 had cleft palate, 20 had cleft lip. Dental caries disease was diagnosed according to criteria set by the World Health Organization. It was observed that 18.9% of the study children had caries. No correlation between prevalence of caries and gender or type of cleft was observed. Mean dmf-t was 0.47. The prevalence of caries was higher in the upper arch, and the most affected tooth was the central incisor (p = 0.001). Children with cleft lip and∕or palate did not have high caries indices.

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The aim of this study was to assess the prevalence of caries in children with cleft lip and∕or palate aged 6-36 months of life. This study was conducted at the University of São Paulo School of Dentistry, Brazil. A total of 143 children were selected (73 male, 70 female), all of whom had at least two erupted teeth. The children were distributed as follows: 88 had cleft lip and palate, 35 had cleft palate, 20 had cleft lip. Dental caries disease was diagnosed according to criteria set by the World Health Organization. It was observed that 18.9% of the study children had caries. No correlation between prevalence of caries and gender or type of cleft was observed. Mean dmf-t was 0.47. The prevalence of caries was higher in the upper arch, and the most affected tooth was the central incisor (p=0.001). Children with cleft lip and∕or palate did not have high caries indices.

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Objetivo: Avaliar a condição oclusal dos arcos dentários de crianças com fissura labiopalatina bilateral completa (FLPb), em acompanhamento na Faculdade de Odontologia da Universidade de São Paulo (Fousp), por meio de análise de modelos em gesso. Material e Método: A amostra selecionada constituiu-se de modelos das arcadas dentárias de 30 pacientes com FLPb (8 do gênero feminino e 22 do masculino), com idade média de 6 anos e 2 meses, submetidos a cirurgias reparadoras primárias. Após exame clínico, realizaram-se fotos intra/extraorais e moldagem para obtenção dos modelos de trabalho, que foram classificados pelo índice de Bilateral, por três examinadores calibrados. O Teste Alfa de Cronbach e a Análise de Correlação de Spearman mostraram elevado grau de confiabilidade (p<0,001) e reprodutibilidade (p

Objective: Assess the condition of occlusal dental arches of children with complete bilateral cleft lip and palate (FLPb), followed at the School of Dentistry, USP by analysis of dental casts. Material and method: The sample consisted of models of the dental arches of 30 patients with FLPb (8 females and 22 males) with mean age of 6 years and 2 months underwent primary repair surgeries. After clinical examination, there were pictures intra I extra oral and molding to obtain the working models, which were classified by the Index of Bilateral, by three calibrated examiners. The Cronbach's alpha test and Spearman correlation analysis showed a high degree of reliability (p <0001) and reproducibility (p <0.001). The study of the correlation between prognosis and Gender, and prognosis and rehabilitation hospital for surgery was done only with the rates determined by the researcher, which were grouped into good regular and poor prognosis. Results: Of the 30 patients analyzed, classified by the Index of Bilateral resulted in 10% grade 1,36.6% grade 2, 36.6% grade 3, 13.33% grade 4 and 3.33% grade 5. Only 16% had a poor prognosis, and prognosis associated with the gender showed no statistically significant difference (p = 0.207) during the ap- plication of the Likelihood Ratio Test. Likewise, no relationship was found between the prognosis and rehabilitation hospitais (p = 0.788). Conclusions: There was a high concentration of patients in good and regular forecasts, without regard to gender or the rehabilitation hospital for surgery.

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Cleft lip and palate is one of the most common deformities of the craniofacial region, and treatment of this deformity is essential for social reintegration. One of the major goals of surgery and treatment of craniofacial deformities is to improve the aesthetic appearance of the face, and thereby improve the patient's social acceptability. Here, we present a critical review of the criteria for aesthetic evaluation of the nasolabial region in cleft patients by assessing publications with the highest level of evidence, including professional evaluation, and patient satisfaction. The findings indicate treatment of this condition represents a major challenge for multidisciplinary team care.