Predictive factors for canine position in patients with unilateral cleft lip and palate

Abstract

Summary Objectives The aims were to compare cleft and non-cleft canine position, to find predictive factors for canine position and to assess surgically exposed canines. Materials/Methods One hundred forty-eight individuals, born 1978–2005, with total unilateral cleft lip and palate (including Simonart’s band <5 mm) treated in Gothenburg, were included. Canine angulation as well as vertical and horizontal position were assessed on panoramic radiographs (PAN) taken at the age of 10. Plausible predictive factors were registered from PAN, cast models and medical records. Data on spontaneous eruption or surgical exposure were available for 88 patients. Cleft- and non-cleft side was compared using paired t-test and Fisher’s exact test. Multiple stepwise regression analysis and logistic regression analysis were used to detect possible predictors for cleft canine position. Results The cleft canine angulation was 29.3 ± 13.1 degrees (mean ± standard deviation) versus 7.6 ± 8.2 degrees on the non-cleft side (p < 0.001). Cleft canines were higher positioned and located closer to the midline compared to non-cleft canines (p < 0.001). Age for both hard palate closure and bone grafting, cleft lateral agenesis as well as transposition were associated with canine position. Cleft canines that required surgical exposure (28%) had an increased angulation and were higher positioned than spontaneously erupted canines (p < 0.001). Limitations The shortcomings were the retrospective design and incomplete assessment of the buccal–palatal canine position on 2D images. Conclusions/Implications With increased age for bone grafting, decreased age for hard palate closure and transposition, an association with abnormal canine position was found. A rigorous monitoring of cleft canine eruption is, therefore, advocated.

Outcomes of permanent canines on the cleft side after secondary alveolar grafting using different materials in complete unilateral cleft lip and palate

“…In agreement with previous studies that showed that late alveolar bone grafting may be associated with an increased canine angulation and a higher canine position in the horizontal and vertical sectors, 5 , 11 a time interaction was found in intergroup and intragroup comparisons for PCCS angulation, PCCS height, and root formation stage in this study. An increased mesiodistal angulation and greater height were also observed as predictors of canine impaction, confirming a previous study.…”

Three‐dimensional evaluation of secondary alveolar bone grafting in patients with unilateral cleft lip and palate: A 2–3 year post‐operative follow‐up

“…In the present study, a landmark‐based method similar to that of Oberoi was used, although Alqahtani relied on a more accurate surface‐based technique. Previous 2D studies reported higher vertical position of maxillary canines in CLP patients, which were also closer to the midline and were more angulated towards it 16 . However, in our study, the canines on the cleft side were positioned significantly higher from the occlusal plane than those in the non‐cleft side 1–2 years after SABG.…”

“…Previous 2D studies reported higher vertical position of maxillary canines in CLP patients, which were also closer to the midline and were more angulated towards it. 16 However, in our study, the canines on the cleft side were positioned significantly higher from the occlusal plane than those in the non-cleft side 1-2 years after SABG. Furthermore, SABG resorption presented no direct influence on the horizontal position nor on the angulation of the maxillary canines towards the midpalatal plane.…”

“…13 However, higher prevalence of maxillary canine impaction has been observed in patients with UCLAP (82%) compared to the general population (0.9%-2.2%), 14 and the eruption of upper canines in CLP patients can be affected by variables other than SABG, such as the presence of supernumerary teeth, tooth agenesis or premature loss of deciduous teeth. 15,16 Different methods have been described to define the bone graft volume (or region of interest) on CBCT scans, such as the use of anatomical landmarks, manual delineation or semi-automatic segmentation. 17 In order to calculate bone resorption and define success, pre-and post-operative scans can be compared.…”

“…Another parameter often used to evaluate the success of SABG is the position and subsequent eruption of the permanent maxillary canine 13 . However, higher prevalence of maxillary canine impaction has been observed in patients with UCLAP (82%) compared to the general population (0.9%–2.2%), 14 and the eruption of upper canines in CLP patients can be affected by variables other than SABG, such as the presence of supernumerary teeth, tooth agenesis or premature loss of deciduous teeth 15,16 …”