Dental anomalies and their therapeutic implications: retrospective assessment of a frequent finding in patients with cleft lip and palate

Abstract

Background Orofacial clefts are characterized by a frequent occurrence of dental anomalies. Numerous studies demonstrate the high prevalence of dental aplasia, supernumerary teeth, and hypoplastic teeth in patients with cleft lip with/without cleft palate (CL/P), yet the therapeutic consequences are rarely discussed. This study explores prevalence, localization, and association between primary and secondary dentition in a large European collective and begins to evaluate the significance of dental anomalies in the therapeutic course of patients with CL/P. Methods The medical reports of 1070 patients with different entities of CL/P who presented to our clinic within a 15-year investigation period were evaluated retrospectively. Dental anomalies were classified into three different diagnostic groups: dental aplasia, supernumerary teeth and hypoplastic teeth. The statistical analyses included studies of the frequency and localization of dental anomalies in different cleft entities as well as of the association between primary and secondary dentition and the therapeutic consequences. Results Uni- or bilateral cleft lip and palate (CLP) (47.5%) occurred most frequently, followed by cleft palate only (CPO) (32.9%) and cleft lip with or without alveolus (CL ± A) (19.6%). Dental anomalies were found significantly more often on the side of the cleft. Aplastic permanent teeth were mostly found in patients with CLP (54.8%), while supernumerary permanent teeth occurred primarily in patients with CL ± A (21.7%). Patients with CPO presented dental aplasia but no patient with CPO showed supernumerary teeth. The occurrence of dental aplasia in the primary dentition significantly increases the probability of aplastic teeth in the permanent dentition. Dental anomalies, in particular dental aplasia, significantly increase patients’ need for subsequent orthodontic therapy and orthognathic surgery. Conclusion Dental aplasia and hypoplasia are common in patients with CL/P not only in the cleft area but in the whole dentition. In the event of dental aplasia in the primary dentition, the frequency of aplastic teeth in the permanent dentition is significantly higher. Additionally, the need for therapeutic interventions, especially concerning orthognathic surgery, seems to be significantly higher in patients with CL/P who are affected by dental anomalies. Clinicians should take this into account when creating long-term treatment plans.

The application of zebrafish model in the study of cleft lip and palate development: A systematic review

“…Therefore, utilization of the zebrafish model to study the development of genetic mechanisms involved in craniofacial abnormalities is recommended for future studies. Because dental anomalies are highly associated with cleft lip and palate, well-designed studies on zebrafish dentition may offer new findings in the dental field [ 44 , 45 ]. It has been reported that zebrafish tooth structures are similar to mammalian teeth, which justifies their use to study human dental abnormalities ( Fig.…”

A Cross-Sectional Study of the Dental Arch Relationship and Palatal Morphology after Cleft Surgery in Italian Children with Unilateral Cleft and Lip Palate

“…Surprisingly, we observed that agenesis of the non-cleft lateral incisor reduced the odds of achieving favourable treatment outcomes in terms of the PM but not the DAR, even if the association approached statistical significance. Missing lateral incisors were found to predispose UCLP children to maxillary hypoplasia and to increase the need for orthodontic treatment and orthognathic surgery [ 19 , 57 , 58 ]; the main problem is the maxillary asymmetry favouring the development of cross-bite.…”

Dental and skeletal maturation of Chinese male children with unilateral cleft lip and palate

“…However, children with CL/P are likely to possess dental and jaw deformities; this may lead to inaccurate estimation. The prevalence of dental anomalies has been shown to vary significantly depending on the type and severity of the cleft, including numeric abnormalities such as missing and supernumerary teeth, morphological abnormalities, such as microdontia and fusing teeth, and tooth replacement abnormalities [11,12]. Furthermore, it has been reported that enamel defects are more common in CL/P patients than in non-CL/P individuals [13].…”