Reliability of the novel cleft lip and palate smile esthetic index (CLP-SEI)

Background/objectives The aim of this research was to determine the reliability of a novel index for the assessment of smile esthetics in patients with cleft lip and/or palate (CL +/- P) at the end of their multidisciplinary treatment, for use in clinical and academic settings. Materials and methods Five orthodontists, five periodontologists, five general practitioners, five dental students, and five laypeople rated the smiles of 10 patients with CL +/- P twice at a 2 weeks interval. The rating scale consisted of four main categories: 1. nasolabial esthetics, 2. gingival esthetics, 3. dental esthetics, and 4. overall esthetics. A total of 15 parameters were rated. Intra- and inter-rater agreements were calculated using SPSS. Results The inter-rater agreement varied between good and excellent whereby the orthodontists, periodontists, general practitioners, dental students, and laypeople obtained agreement scores of 0.86, 0.92, 0.84, 0.90, and 0.89, respectively. The intra-rater agreement was good with agreement scores of 0.78, 0.84, 0.84, 0.80, and 0.79, respectively. Limitations Smile esthetics were rated on static pictures, not in real life or by video recordings in a young adult population. Conclusions/implications The cleft lip and palate smile esthetic index is a reliable tool for the assessment of smile esthetics in patients with CL +/- P.