Prevalence of oral trauma in children with bilateral clefts

Abstract

The main object of this study is to analyze the prevalence of oral trauma in subjects with complete bilateral clefts, with anterior projection of the premaxilla. A total of 106 children aging 6 months to 9 years were analyzed. The caretakers answered a specific questionnaire, in order to report the presence or absence of trauma to the soft and/or hard tissues of the child's mouth. Whenever there was a history of trauma, the patients were submitted to clinical examination. The prevalence of oral trauma was 53%, being 91% of soft tissue lesions, 8.9% of avulsion, 7% of luxation and 1.8% of intrusion. For the males, the prevalence was 56% and for the females it was 47%, with no statistical significance. Regarding the following aspects:period of time spent with the parents and at school, and presence or absence of siblings, no statistical difference could be found. Among the traumatized individuals, 80% aged less than 3 years by the moment of the trauma, 89% suffered the trauma at home, 75% presented lesions in the soft tissue at the premaxilla, 16% in the maxillary incisors, and 8.9% presented lesions in both structures. It was noticed that 45% of the permanent incisors that succeeded the traumatized deciduous teeth presented alterations, being 48% of structure and 52% of structure and position. The prevalence of trauma in this sample was superior to that observed in the literature, without any positive associations between the evaluated aspects. These results suggest that the projection of the premaxilla brings about a higher risk of oral trauma around this area.

Fracture of the Vomero-Premaxillary Junction in a Repaired Bilateral Cleft Lip and Palate Patient

“…5,6 Some authors stated that untreated premaxillary segments may lead to serious problems such as lack of proper anterior occlusion, segment mobility compromising articulation, and oronasal fistulae jeopardizing the maintenance of oral hygiene. 7 While soft tissue and dental trauma in children with protruded premaxillae have been reported in the literature, 1 fractures of the vomero-premaxillary junction seem to be rare.…”

“…Complete bilateral cleft lip and palate (BCLP) patients show a characteristic anterior projection of the premaxilla which often persists even after lip repair. 1 This anatomical feature in BCLP children together with an increased overjet predisposes this region to trauma. Silva et al 1 found that 53% had suffered from oral trauma in their sample of 106 BCLP children, the majority sustained soft tissue lesions (91%) and dental trauma including avulsion, luxation, and intrusion of teeth were observed in the rest.…”

“…1 This anatomical feature in BCLP children together with an increased overjet predisposes this region to trauma. Silva et al 1 found that 53% had suffered from oral trauma in their sample of 106 BCLP children, the majority sustained soft tissue lesions (91%) and dental trauma including avulsion, luxation, and intrusion of teeth were observed in the rest. Most of these events occurred at home and were observed before the age of 3 years; a period where toddlers' attempts to walk and falls are frequent.…”

“…Most of these events occurred at home and were observed before the age of 3 years; a period where toddlers' attempts to walk and falls are frequent. 1 Although dental trauma has been reported widely, to the best of the authors' knowledge, any reports related to bone fractures of the vomero-premaxillary junction in BCLP patients have not been published in English literature. The aim of this report is to illustrate clinical findings and the technique of fracture fixation in a child suffering from a fractured vomero-premaxillary junction as well as subsequent columella lengthening.…”

“…Complete bilateral cleft lip and palate (BCLP) patients show a characteristic anterior projection of the premaxilla which often persists even after lip repair 1. This anatomical feature in BCLP children together with an increased overjet predisposes this region to trauma.…”