The aim of this study was to test the reliability of using digital photographs of study models as an alternative to the use of plaster study models in the assessment of surgical treatment outcome in 5-year-old children with unilateral cleft lip and palate (UCLP). Fifty-six dental study models available from the Managed Clinical Network for Cleft Services in Scotland (CLEFTSiS) database of patients aged 5-years with non-syndromic UCLP were employed. An experienced examiner scored the plaster

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... y models using the modifi ed Huddart/Bodenham system. A set of digital photographs stored in the CLEFTSiS electronic patient record database of fi ve different views of the same study models were scored by three examiners to allow calculation of interexaminer reliability. The same examiners repeated the scoring 1 month later under similar conditions to determine intraexaminer reliability and minimize the infl uence of memory bias on the results. The mean kappa () value for the application of the modifi ed Huddart/Bodenham system on photographs of 5-year-old UCLP study models was 0.65 ± 0.05. The mean value for the measurement of overjet on the digital photographs was 0.68 ± 0.07. Using the interpretation suggested by Altman, good agreement for both scoring systems was found. Therefore, digital photographs of study models are a reliable alternative to measuring treatment outcome using study models of 5-year-old children with UCLP.