Dental Anomalies in Maxillary Incisors and Canines among Patients with Total Cleft Lip and Palate

Abstract

Cleft lip and palate is the most common asymmetric congenital condition of the orofacial region, which also finds its reflection in dental anomalies. The aim of the study was to present the dental asymmetries of the front region of the maxilla in cleft patients. Materials and Methods: We analyzed plaster casts and panoramic X-rays of 154 patients with total clefts and 151 healthy individuals. The cleft patients’ age ranged between 7.1 and 20 years (mean 13.18). The control group had a similar age range (7.1 and 20 years, mean 13.44). The digital caliper was used to measure the width of the teeth. Each measurement was performed three times each. Results: Most of the dental anomalies among cleft patients referred to the lateral incisors and were focused on the cleft side. The asymmetry of the incisors is reflected both in the number of teeth in the cleft region and their width. The lateral incisor was missing twice as frequently on the cleft side of the individual. If present, the lateral incisor was usually ±1.5 mm narrower than the incisor on the opposite side. In bilateral clefts, dental anomalies occurred more frequently on the left side. Conclusions: Dental problems occurred more frequently in patients with total cleft lip and palate than in healthy individuals. The most commonly affected teeth were the lateral incisors. The width of the lateral incisors was reduced in cleft patients—showing a smaller mesiodistal dimension on the cleft side.

Correlation Between Maxillary Anterior Teeth and Common Facial Measurements

“…39 Females recorded a higher psychological impact than males in relation to maxillary anterior teeth symmetry and this reflected on their quality of life in Polish subpopulation. 40 BZW was significantly correlated with summation width. This finding aligns with a previous finding 12 that showed BZ distance and age acting as predictors of central incisor and maxillary anterior teeth widths.…”

Sociodemographic Factors Associated with Knowledge About Management of Cleft Lip and Palate Patients in Peruvian Dental Students: A Logistic Regression Analysis

“…The dependent variable considered was knowledge about the management of patients with cleft lip and palate. The independent variables were sex (X1) [10][11][12][13][14][15][16][17][18][19][20][21][22][23] and age (X2). 24 The possible confounding variables were academic year of study (X3), 25 marital status (X4), 18 place of origin (X5), 23 area of residence (X6) and relationship with CLP persons (X7).…”

“…This plays a crucial role in cell adhesion and could result in the failure of palatal ridges fusion during intrauterine life between the 5th and 12th week. 8,11 It is also important to consider other genes involved in this malformation such as MSX1, GLI2, JAG2, SATB2, LHX8, SKI, ERBB2, TGFA, TGFβ2, TGFβ3, FGF, SPRY2, TBX10 and MSX2. 7,8,12,13 Other possible factors include physical, chemical or environmental factors (drugs, smoking, alcohol) (Paradowska), diseases during the first trimester of pregnancy, eg rubella, influenza, gestational diabetes, radiation according to its intensity, duration and frequency of exposure, maternal age, use of teratogenic agents such as cortisone, carbamazepine, phenytoin, valproate, diazepam, diets low in riboflavin and folic acid, organic solvents, and stress.…”

“…8 They may also present with dental problems such as delayed tooth eruption, enamel hypoplasia, dental caries, dilacerations, anodontia, crowding, supernumerary teeth, ectopic teeth, hypodontia and severe G4 and G5 malocclusions according to the Goslon index (Great Ormond Street, London and Oslo) caused mainly by maxillary hypoplasia, among others. 11,14,16,17 To mitigate the consequences of this malformation, a series of protocols have been recommended for the feeding and maintenance of oral hygiene of these patients, especially in the early stages of development, as they are usually surgically intervened in the first months after birth. 1,6,15 However, it is important that the dentist and the dental student about to graduate know how to identify, classify and timely diagnose this malformation in order to carry out activities that may allow the development of an orientation plan, consultation with the head and neck surgeon, and orthodontic treatment that will contribute to improve the health of these patients and allow them to have a better quality of life.…”

Prevalence of Dental Anomalies in Patients with Non-syndromic Cleft Lip with or without Cleft Palate

“…Since other genetic variants associated with syndromes may have influences on dental anomalies, they can interfere with the detection of direct associations between dental anomalies and orofacial clefts[25].The excluded subjects included those with Goldenhar syndrome, ectodermal dysplasia, CHARGE syndrome, Down syndrome, and Treacher Collins syndrome. Typically, around 70% of patients with orofacial clefts present as non-syndromic cases with isolated clefts, whereas the remaining 30% exhibit syndromic features with multiple congenital defects[26]. The limited 5 number of syndromic cases in the present study could be attributed to several factors, including that patients registered only with a syndromic diagnosis were filtered during the data collection process or patients with severe syndromic complications being unable to receive dental management, thereby contributing to a lack of research data.…”