Dental anomalies in individuals with cleft lip and/or palate
ABSTRACT Significant heterogeneity has previously been reported but with no consensus on the prevalence of dental anomalies in subjects with a cleft lip and palate (CLP), thus, the purpose of this study was to investigate the frequency of various dental anomalies in the upper dental arch in different cleft groups. Diagnostic records, i.e., panoramic, occlusal and periapical films, dental casts, and intra-oral photographs, of 122 subjects (mean age: 14 +/- 5 years; 67 males and 55 females) were grouped as either unilateral left cleft lip and palate (ULCLP), unilateral right cleft lip and palate (URCLP), bilateral cleft lip and palate (BCLP), or cleft palate (CP). Prevalence rates of 15 different dental anomalies were calculated for each group. Wilcoxon's test was used to determine if there was a statistically significant difference in the number of missing teeth between the right and left sides, in each cleft group. Overall, 96.7 percent of patients were found to have at least one dental anomaly. The most prevalent was agenesis in the anterior region on the cleft side (70.8-97.1 percent). There was a statistically significant difference in the prevalence of agenesis by cleft and non-cleft sides but only in the ULCLP group (P < 0.001). Significantly higher rates of impaction were observed in the anterior and premolar regions in the CLP groups (2.9-29.2 percent), with the highest rates in the anterior region on the cleft sides. A very high proportion of subjects were found to have at least one dental anomaly. Thus, the management of dental anomalies should be central to the treatment planning process of individuals with a cleft.
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ABSTRACT: Fusion, an uncommon anomaly of the hard dental tissues, is potentially the cause of clinical problems related to esthetics, tooth spacing, and other periodontal complications. This paper describes a multidisciplinary approach involving surgical, endodontic, restorative, and orthodontic attention for the successful, functional, and esthetic rehabilitation of a maxillary left lateral incisor fused with a supernumerary tooth in unilateral cleft lip adolescence in contralateral side. After clinical and radiographic examinations, a fusion between the left maxillary lateral incisor and a supernumerary tooth was diagnosed in the patient, and a small connection was detected between the pulp systems of the two root canals. The case reported in this paper presents the successful resolution of a fused maxillary lateral incisor with a supernumerary tooth, using endodontic, surgical, restorative, and orthodontic management. The decision made in extracting or retaining the fused tooth depends on the arch discrepancy and esthetic needs. Future studies, with long-term followup, will be helpful in evaluating the long-term efficacy of the different treatment options.01/2014; 2014:459416. DOI:10.1155/2014/459416
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ABSTRACT: The absence of a maxillary permanent lateral incisor in patients with unilateral cleft lip and palate (UCLP) may affect the dental arch relationship. An analysis is performed to investigate the relationship between the maxillary-mandibular dental relationship and the status of the maxillary permanent lateral incisor. Patients with non-syndromic UCLP were analysed using the GOSLON Yardstick to assess maxillary-mandibular dental relationship on pre-expansion orthodontic study models. Absence of the permanent upper lateral incisor on the cleft side was assessed from medical records and dental radiographs. A total of 83 subjects were identified: 54 males and 29 females, with 54 having a missing lateral incisor on the cleft side. There was a significant relationship between the GOSLON Yardstick score and the absence of the maxillary permanent lateral incisor on the cleft side (p<0.05). Of those in GOSLON categories 4 and 5, 78% had a missing lateral incisor compared to 42.3% in GOSLON 1 and 2. Missing lateral incisor may be an indicator of severity of dental arch discrepancy. Copyright © 2015 Elsevier Inc. All rights reserved.Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, and Endodontology 12/2014; DOI:10.1016/j.oooo.2014.12.011 · 1.46 Impact Factor
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ABSTRACT: Background Cleft lip and/or palate is the most frequent congenital abnormality occurring in the craniofacial region and is often associated with numerous dental defects such as tooth agenesis, supernumerary teeth, microdontia, taurodontism, crown malformations, or delay in eruption. The prevalence of hypodontia in cleft-affected patients is much higher in comparison with a healthy population. The aim of this study was to evaluate the prevalence of second premolar hypodontia in patients with cleft lip and/or palate. Material and Methods We performed a retrospective, evaluation of panoramic radiographs and dental casts in the Department of Dentofacial Orthopeadics and Orthodontics, Wroclaw Medical University. Two independent observers evaluated the records of 469 patients with various types of clefts and analyzed dental casts and panoramic radiographs. Results 202 individuals met inclusion criteria. The sample comprised 120 UCLP patients, 38 BCLP patients, 28 CP patients, and 17 CLA patients. Hypodontia in the premolar region was observed in 39 individuals (19.3%). A total number of 58 second premolars were missing, of which 35 were maxillary second premolars (U5) and 23 were mandibular second premolars (L5). Conclusions Estimated hypodontia in the Polish CL/P sample was considerably higher than the hypodontia in permanent dentition reported for a European healthy population. The number of congenitally missing second premolars was higher in the maxillary arch than in the mandibular.Medical science monitor: international medical journal of experimental and clinical research 03/2014; 20:355-60. DOI:10.12659/MSM.890386 · 1.22 Impact Factor