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Fell M, Bradley D, Chadha A, Butterworth S, Davies A, Russell C, Richard B, Wren Y, Lewis S, Chong D. Sidedness in Unilateral Orofacial Clefts: A Systematic Scoping Review. Cleft Palate Craniofac J 2025; 62:730-743. [PMID: 38092732 DOI: 10.1177/10556656231221027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/27/2024] Open
Abstract
ObjectiveAn overview of the literature relating to the sidedness of unilateral cleft lip with or without cleft palate to map current knowledge on the cause and impact of directional asymmetry.DesignScoping review with a systematic search of Medline and Embase from inception to May 2023.Patients, ParticipantsHumans born with a left or right unilateral cleft lip with or without a cleft palate.Main Outcome MeasuresCleft sidedness as a co-occurrence, an outcome or an exposure.ResultsForty studies were eligible for inclusion and confirmed the predilection for the occurrence of left sided cleft lips; 12 studies reported cleft sidedness co-occurring with another phenotype, 11 studies report sidedness as an outcome and 17 studies as an exposure. Phenotypes which were reported to co-occur with either left or right sided clefts included congenital dental anomalies, handedness and additional congenital anomalies. Variables investigated as a potential cause of left or right sided clefts as an outcome included chromosomal anomalies, genetic variants and environmental factors. Outcomes investigated in relation to cleft sidedness as an exposure included facial anatomical features, facial growth, educational attainment, functional and psychological characteristics. More studies showed worse outcomes in right sided clefts versus left sided clefts than vice versa, although studies were inconsistent, and a quality assessment was not performed.ConclusionsThe field of cleft sidedness research is expanding and there are promising early findings to differentiate cause and outcome by sidedness of the cleft.
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Affiliation(s)
- Matthew Fell
- Spires Cleft Centre, John Radcliffe Hospital, Oxford, UK
- The Cleft Collective, Bristol Dental School, University of Bristol, Bristol, UK
| | | | - Ambika Chadha
- Cleft.Net.East, University of Cambridge NHS Hospitals Trust, Cambridge, UK
- Department of Perinatal Imaging and Health, Kings College London & South Thames Cleft Service, St. Thomas Hospital, London, UK
| | - Sophie Butterworth
- Cleft Registry and Audit Network, Clinical Excellence Unit, The Royal College of Surgeons of England, London, UK
| | - Amy Davies
- The Cleft Collective, Bristol Dental School, University of Bristol, Bristol, UK
| | - Craig Russell
- Cleft Care Scotland, Royal Hospital for Children, Queen Elizabeth University Hospital, Glasgow, UK
| | - Bruce Richard
- West Midlands Cleft Service, Birmingham Women and Children's Hospital, Birmingham, UK
| | - Yvonne Wren
- The Cleft Collective, Bristol Dental School, University of Bristol, Bristol, UK
- Speech and language therapy research unit, North Bristol NHS Trust, Bristol, UK
| | - Sarah Lewis
- The Cleft Collective, Bristol Dental School, University of Bristol, UK
| | - David Chong
- Plastic and Maxillofacial Surgery, The Royal Children's Hospital, Melbourne, Australia
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de Farias AL, Rojas-Gualdrón DF, Restrepo M, Zecchin KG, Bussaneli DG, Yupanqui K, Raposo-Amaral CE, Santos-Pinto L. Characterization of hypomineralization second primary molar and molar incisor hypomineralization in patients with orofacial clefts. Clin Oral Investig 2025; 29:269. [PMID: 40278923 DOI: 10.1007/s00784-025-06311-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2024] [Accepted: 03/31/2025] [Indexed: 04/26/2025]
Abstract
AIMS To identify and characterize hypomineralization in the second primary molar (HSPM) and molar incisor hypomineralization (MIH), as well as other developmental defects of enamel (DDE) in patients with clefts considering dentition type, tooth type, phenotype and cleft laterality. MATERIALS AND METHODS In this cross-sectional retrospective study, 6432 deciduous and permanent teeth of 290 patients with clefts aged between 3 and 14 years in a referral hospital were assessed using intraoral photographs. The classification of demarcated hypomineralization was carried out by a calibrated examiner using the MIH index. Statistical analyses were performed using a binomial generalized linear model. RESULTS Deciduous and permanent molars were the most affected by HSPM and MIH, whereas incisors and canines were most affected by hypoplasia, with the upper arch being most affected by DDE. Cleft phenotypes involving the palate were associated with HSPM (OR = 31; 95% CI: 1.0-59.3) and MIH (OR = 31.6; 95% CI: 0.6-53.2). CONCLUSION Patients with clefts had a high prevalence of HSPM and MIH in the upper arch and were associated with more severe cleft phenotypes. CLINICAL RELEVANCE Pediatric dentists who are members of the multidisciplinary teams responsible for caring for patients with clefts need to have a more discerning clinical eye when diagnosing DDE in patients with clefts. Posterior teeth are more susceptible to demarcated hypomineralizations in patients with clefts, while anterior teeth are more susceptible to hypoplasias.
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Affiliation(s)
- Aline Leite de Farias
- Basic and Clinical Research Group in Dentistry, School of Dentistry, CES University, Medellín, Colombia.
- Department of Morphology, Genetics, Orthodontics and Pediatric Dentistry, São Paulo State University (Unesp), Araraquara School of Dentistry, Araraquara, São Paulo, Brazil.
| | | | - Manuel Restrepo
- Basic and Clinical Research Group in Dentistry, School of Dentistry, CES University, Medellín, Colombia
| | | | - Diego Girotto Bussaneli
- Department of Morphology, Genetics, Orthodontics and Pediatric Dentistry, São Paulo State University (Unesp), Araraquara School of Dentistry, Araraquara, São Paulo, Brazil
| | - Kasandra Yupanqui
- Department of Morphology, Genetics, Orthodontics and Pediatric Dentistry, São Paulo State University (Unesp), Araraquara School of Dentistry, Araraquara, São Paulo, Brazil
| | | | - Lourdes Santos-Pinto
- Department of Morphology, Genetics, Orthodontics and Pediatric Dentistry, São Paulo State University (Unesp), Araraquara School of Dentistry, Araraquara, São Paulo, Brazil
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Fonseca-Souza G, Tessari VS, Scariot R, Kirschneck C, Coletta RD, Küchler EC, Feltrin-Souza J. Exploring polymorphisms in genes encoding growth factors associated with non-syndromic cleft lip with or without cleft palate and tooth agenesis. J Appl Oral Sci 2025; 33:e20240501. [PMID: 40105578 PMCID: PMC11978285 DOI: 10.1590/1678-7757-2024-0501] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2024] [Revised: 12/23/2024] [Accepted: 01/13/2025] [Indexed: 03/20/2025] Open
Abstract
OBJECTIVE To evaluate the association between non-syndromic cleft lip with or without cleft palate (NSCL±P) and tooth agenesis (TA), as well as the association of both conditions with polymorphisms in genes encoding growth factors. METHODOLOGY This cross-sectional study included children with NSCL±P and a control group of children without NSCL±P. Permanent teeth TA (excluding third molars) was evaluated using panoramic radiographs by a trained examiner. Only TA located outside the cleft was considered in the NSCL±P group. Genetic polymorphisms in Transforming Growth Factor Beta 1 (TGFB1)-rs1800470 and rs4803455-Transforming Growth Factor Beta Receptor 2 (TGFBR2)-rs3087465 and rs764522-Epidermal Growth Factor (EGF)-rs4444903 and rs2237051-and Epidermal Growth Factor Receptor (EGFR)-rs2227983- were genotyped by real-time PCR allele discrimination from buccal cell samples. Associations were tested by uni and multivariable Poisson regression models (5% significance level). RESULTS A total of 243 children-127 with NSCL±P (mean age = 8.80±2.14 years) and 116 without NSCL±P (mean age = 8.58±2.03 years) were included. TA was more frequent in the NSCL±P group (23.8%) than in the control group (6.2%) (p<0.01). The EGF rs2237051 was significantly associated with NSCL±P, independently of the other variables (PRa=1.41; p=0.042). Regarding TA, only the cleft presence was associated with a higher prevalence of TA regardless of different variables (PRa=3.70; p=0.001). There was no association between TA and the investigated genetic polymorphisms. When TA and NSCL±P were considered together, a borderline association was observed with rs1800470 in TGFB1 (p=0.06). CONCLUSION NSCL±P is associated with TA outside the cleft area. The EGF rs2237051 was associated with NSCL±P. Polymorphisms in genes encoding growth factors are not associated with TA.
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Affiliation(s)
- Gabriela Fonseca-Souza
- Universidade Federal do Paraná, Setor de Ciências da Saúde, Departamento de Estomatologia, Curitiba, Paraná, Brasil
| | - Vitória Somma Tessari
- Universidade Federal do Paraná, Setor de Ciências da Saúde, Departamento de Estomatologia, Curitiba, Paraná, Brasil
| | - Rafaela Scariot
- Universidade Federal do Paraná, Setor de Ciências da Saúde, Departamento de Estomatologia, Curitiba, Paraná, Brasil
| | | | - Ricardo Della Coletta
- Universidade Estadual de Campinas, Faculdade de Odontologia de Piracicaba, Departamento de Diagnóstico Oral e Programa de Pós-graduação em Biologia Buco-Dental, Piracicaba, São Paulo, Brasil
| | | | - Juliana Feltrin-Souza
- Universidade Federal do Paraná, Setor de Ciências da Saúde, Departamento de Estomatologia, Curitiba, Paraná, Brasil
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Azevedo SG, de Oliveira LQR, Martelli-Júnior H, Coletta RD, Machado RA. Tooth Anomalies in Patients With Nonsyndromic Orofacial Cleft: A Systematic Review and Meta-Analysis. Oral Dis 2025. [PMID: 39760181 DOI: 10.1111/odi.15226] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2024] [Revised: 11/21/2024] [Accepted: 12/04/2024] [Indexed: 01/07/2025]
Abstract
OBJECTIVE To evaluate the frequency of tooth anomalies (TA) in the deciduous and permanent dentition of patients with nonsyndromic orofacial clefts (NSOC), both inside and outside the cleft area. METHODS The following databases were searched for the relevant literature: Cochrane, OVID, SciELO, Embase, Livivo, PubMed, Scopus, and Web of Science. The risk of bias was analyzed using the Joanna Briggs Institute. Fixed and random-effects meta-analysis was performed comparing the presence and absence of NSOC subtypes. The certainty of evidence was evaluated using the GRADE approach. RESULTS Out of 1939 articles identified, after applying the inclusion and exclusion criteria, a total of 75 articles were included (46 cohort and 29 case-control), including 27,703 patients (16,450 with NSOC and 11,253 healthy controls) from 34 countries. The meta-analyses revealed higher odds for tooth agenesis (ORNSOC: 3.72; p = 0.001) and macrodontia (ORNSOC: 8.04; p = 0.04) across the different cleft subtypes outside the cleft area compared with the control group in the permanent dentition, whereas the frequency of root dilaceration was significantly lower in nonsyndromic cleft lip only (NSCLO) (ORNSCLO: 0.38; p < 0.0001) and in nonsyndromic cleft lip and palate (NSCLP) (ORNSCLP: 0.44; 95% p < 0.0001). The results also demonstrated a higher risk of tooth agenesis (ORNSOC: 16.49; p < 0.0001), microdontia (ORNSOC: 17.14; p < 0.0001), macrodontia (ORNSOC: 10.41; p = 0.02), supernumerary tooth (ORNSOC: 10.03; p < 0.0001), and enamel hypoplasia (ORNSOC: 5.62; p < 0.0001) in the permanent dentition inside the cleft area of patients with NSOC. However, for the deciduous dentition, outside the cleft area, microdontia was the only TA significantly more frequent in patients with NSOC (ORNSOC: 6.24; p = 0.006) and nonsyndromic cleft palate only (NSCPO) (ORNSCPO: 8.45; p = 0.02) compared with the control group. TA associations varied across populations. In Europe, no significant associations were found for NSOC, while in Asia, strong associations were observed for NSCLP and NSCL ± P (ORNSCLP and NSCL±P: 139.19; p < 0.0001). In South America, significant associations were identified for NSCLP (ORNSCLP: 2.16; p < 0.0001), NSCL ± P (ORNSCL±P: 2.48; p < 0.0001), and NSOC (ORNSOC: 2.72; p < 0.0001). In North America, tooth agenesis was more frequent in NSCL ± P (ORNSCL±P: 4.75; p < 0.0001), though no significant associations were found for NSCLP or NSOC. In the cleft area, significant associations were observed in European populations for NSOC, including increased frequencies of tooth agenesis (ORNSOC: 19.57; p = 0.003) and supernumerary teeth (ORNSOC: 9.77; p < 0.0001). Asian populations showed similar patterns (ORNSOC: 19.23; p = 0.002), while no significant associations were noted in South America due to limited data. Root dilaceration remained less frequent in NSCLO (ORNSCLO: 0.38; p < 0.0001) and NSCLP (ORNSCLP: 0.44; p < 0.0001), with no associations identified for microdontia, taurodontism, supernumerary tooth, impacted tooth, or transposition. CONCLUSION The results confirm a higher frequency of TA in the permanent dentition of patients with NSOC compared to controls, regardless of cleft subtype. However, significant differences were observed depending on whether the TA occurred inside or outside the cleft area. Although only a limited number of studies were included, microdontia was the only TA significantly more prevalent in the cleft area of patients with NSOC in the deciduous dentition. Variations in the frequency of TA across populations highlight the complex interplay of genetic, environmental, and methodological factors influencing these associations. Despite these findings, the quality of the existing evidence is moderate, with limitations stemming from small sample sizes, methodological variations, and study heterogeneity. These results emphasize the importance of tailored dental management and early intervention strategies for individuals with different cleft subtypes to effectively address and mitigate the impact of these tooth anomalies on oral health and development.
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Affiliation(s)
- Sara Garcia Azevedo
- Department of Oral Diagnosis, School of Dentistry, University of Campinas, Piracicaba, São Paulo, Brazil
| | | | - Hercílio Martelli-Júnior
- Stomatology Clinic, Dental School, State University of Montes Claros, Montes Claros, Minas Gerais, Brazil
- Center for Rehabilitation of Craniofacial Anomalies, Dental School, University of José Rosario Vellano, Alfenas, Minas Gerais, Brazil
| | - Ricardo D Coletta
- Department of Oral Diagnosis, School of Dentistry, University of Campinas, Piracicaba, São Paulo, Brazil
- Graduate Program in Oral Biology, School of Dentistry, University of Campinas, Piracicaba, São Paulo, Brazil
| | - Renato Assis Machado
- Department of Oral Diagnosis, School of Dentistry, University of Campinas, Piracicaba, São Paulo, Brazil
- Graduate Program in Oral Biology, School of Dentistry, University of Campinas, Piracicaba, São Paulo, Brazil
- Master Program, School of Dentistry, Ingá University Center, Maringá, Paraná, Brazil
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Aung WP, Pungchanchaikul P, Pisek A, Bloch-Zupan A, Morkmued S. Prevalence of tooth agenesis and supernumerary teeth related to different Thai cleft lip and cleft palate populations. BMC Oral Health 2024; 24:960. [PMID: 39153972 PMCID: PMC11330041 DOI: 10.1186/s12903-024-04719-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2023] [Accepted: 08/08/2024] [Indexed: 08/19/2024] Open
Abstract
BACKGROUND Pattern of dental anomalies encountered in cleft patients shows subtle signs of genetic involvement. This study aimed to evaluate the prevalence and pattern of tooth agenesis and supernumerary teeth in Thai cleft population according to the cleft type. METHODS Data collected from patients with cleft lip and palate, who had been treated at Tawanchai Cleft Center, Khon Kaen University, Thailand, available during year 2012-2022, were investigated. Records from 194 patients with non-syndromic clefts met the inclusion criteria. Standard dental records, and at least either orthopantomogram (OPG) or cone beam computed tomography (CBCT), were examined. Statistical analysis was performed using chi-square and binominal test (p ≤ 0.05). RESULTS Prevalence of tooth agenesis was higher (77.3%) than that of supernumerary teeth (5.7%) and was more common in bilateral cleft lip and palate (BCLP) (88.1%) than in unilateral cleft lip and palate (UCLP) (72.6%) (p = 0.017). The upper lateral incisor was more frequently affected (46.4%), followed by the upper second premolar. The number of missing teeth observed on the left side was significantly higher. Patients with left UCLP (ULCLP) had the highest prevalence of tooth agenesis. A total of 41 tooth agenesis code (TAC) patterns was found. The prevalence of supernumerary teeth was comparable with 6.6% of ULCLP, 5.1% of BCLP, and 4.5% of URCLP. Tooth-number anomalies were observed more often in the BCLP and were most likely to occur on the left side of the maxilla. Both types of anomalies could be featured in a small proportion of cleft patients. CONCLUSIONS More than half of the patients with non-syndromic cleft lip and palate in this study, presented with tooth-number anomalies. Tooth agenesis was approximately 10-time more prevalent than supernumerary teeth. Tooth agenesis was likely to appear on the left-side of the maxilla regardless of the laterality of the cleft.
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Affiliation(s)
- Wai Phyo Aung
- Division of Pediatric Dentistry, Department of Preventive Dentistry, Faculty of Dentistry, Khon Kaen University, Khon Kaen, Thailand
| | - Patimaporn Pungchanchaikul
- Division of Pediatric Dentistry, Department of Preventive Dentistry, Faculty of Dentistry, Khon Kaen University, Khon Kaen, Thailand
- Oral Health Care Center for Geriatrics and Special Needs, Faculty of Dentistry, Khon Kaen University, Khon Kaen, Thailand
| | - Araya Pisek
- Division of Dental Public Health, Department of Preventive Dentistry, Faculty of Dentistry, Khon Kaen University, Khon Kaen, Thailand
| | - Agnès Bloch-Zupan
- Université de Strasbourg, Faculté de Chirurgie Dentaire, Strasbourg, France
- Hôpitaux Universitaires de Strasbourg (HUS), Pôle de Médecine et Chirurgie Bucco-dentaires, Centre de Référence des maladies rares orales et dentaires, CRMR-O-Rares, Filière Santé Maladies rares TETE COU & European Reference Network ERN CRANIO, Strasbourg, France
- Université de Strasbourg, Institut de Génétique et de Biologie Moléculaire et Cellulaire (IGBMC), INSERM U1258, CNRS- UMR7104, Illkirch, France
- Université de Strasbourg, Institut d'études avancées (USIAS), Strasbourg, France
| | - Supawich Morkmued
- Division of Pediatric Dentistry, Department of Preventive Dentistry, Faculty of Dentistry, Khon Kaen University, Khon Kaen, Thailand.
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Wanderley Lacerda RH, Filgueiras VM, Guedes Mendonça AC, Vieira AR. Molar-incisor hypomineralization in a cohort of individuals born with cleft lip and palate. Orthod Craniofac Res 2024; 27 Suppl 1:21-26. [PMID: 37643023 DOI: 10.1111/ocr.12708] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2023] [Revised: 08/07/2023] [Accepted: 08/16/2023] [Indexed: 08/31/2023]
Abstract
OBJECTIVE This study aimed to investigate the frequency of molar-incisor hypomineralization (MIH) in individuals born with cleft lip and or cleft palate. SETTINGS AND SAMPLE Three hundred eighty-six individuals born with cleft lip and/or palate before orthodontic treatment. METHODS All the individuals were submitted to a clinical examination and intraoral standardized photos. The registration of MIH was taken by two orthodontists and analysed in association with the cleft type and laterality. The Kruskal-Wallis test and the regression test were used to compare the frequency of molars and incisors affected according to cleft type and laterality, sex and age. RESULTS We found a frequency of 67.87% of MIH in the studied sample. The frequency varied from 25% (in individuals born with cleft palate) to 77% in individuals born with bilateral cleft lip and palate). The number of affected molars was statistically different depending on cleft type and laterality (P < .001- Kruskal-Wallis test). Differences were found between individuals born with unilateral cleft lip and palate and unilateral cleft lip and alveolus (P = .03), and with isolated cleft palate (P = .03), and between individuals born with bilateral cleft lip and palate and born with unilateral cleft lip and alveolus (P = .01), and cleft palate (P = .01). Sex (P = .21) and age (P = .36) had no influence on the frequency of MIH. A positive correlation was found between the number of molars affected and incisors affected (P < .001). CONCLUSION Individuals born with cleft lip and palate have a higher frequency of MIH, and the complexity of cleft type was associated with the number of affected molars.
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Affiliation(s)
| | - Vitor Marques Filgueiras
- Cleft Lip and Palate Center, University Hospital of Paraiba, Federal University of Paraiba, Paraíba, Brazil
| | | | - Alexandre Rezende Vieira
- Department of Oral and Craniofacial Sciences, School of Dental Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
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Ko J, Rustia S, Alkharafi L, Ganguly R, Yen SLK, Oberoi S. Comparison of Alveolar Bone Grafting Outcomes using CBCT in Individuals with UCLP Based on the Presurgical Orthodontic Treatment Methods. Cleft Palate Craniofac J 2024; 61:791-800. [PMID: 36748327 PMCID: PMC10981178 DOI: 10.1177/10556656221143945] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023] Open
Abstract
OBJECTIVE The purpose is to evaluate outcomes of alveolar bone grafting based on the pre-grafting orthodontic preparation methods. DESIGN Retrospective analysis of individuals with unilateral cleft lip and palate. SUBJECTS AND SETTINGS 28 individuals with non-syndromic UCLP from two craniofacial centers, 14 individuals each from XXXX and XXXX. INTERVENTIONS The alignment group underwent maxillary expansion with incisors alignment while the non-alignment group underwent only maxillary expansion for presurgical orthodontic preparation. METHODS Initial and post-surgical CBCT scans were compared to observe changes in angulation of the incisor adjacent to the cleft site, alveolar bony root coverage, and bone graft outcomes. RESULTS In the alignment group, the buccolingual rotation decreased by 32.35 degrees (p = .0002), the anteroposterior inclination increased by 14.01 degrees (p = .0004), and the mesiodistal angulation decreased by 17.88 degrees (p = .0001). Alveolar bony coverage did not change after bone graft in both groups, and no difference was observed between the groups. Chelsea scale showed satisfactory bone graft outcome (category A, C) in 12 cases (85.71%) in the alignment group and 11 cases (78.51%) in the non-alignment group. The volumetric measurement showed the alignment group had better bone fill of 69.85% versus 51.45% in the non-alignment group (p = .0495). CONCLUSIONS Alveolar bony coverage on the tooth adjacent to cleft sites did not change with alveolar bone grafting surgery in either of the alignment and non-alignment group. Presurgical orthodontic alignment does not induce root exposure nor poorer bone grafting outcome.
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Affiliation(s)
- Jaemin Ko
- Craniofacial and Special Care Orthodontics, Division of Dentistry, Children's Hospital Los Angeles, Los Angeles, CA, USA
| | - Samantha Rustia
- School of Dentistry, University of California, San Francisco, CA, USA
| | - Lateefa Alkharafi
- Program in Craniofacial Biology and Division of Craniofacial Anomalies, Department of Orofacial Sciences, University of California, San Francisco, CA, USA
| | - Rumpa Ganguly
- Oral and Maxillofacial Radiology, Department of Orofacial Sciences, University of California, San Francisco, CA, USA
| | - Stephen L-K Yen
- Craniofacial and Special Care Orthodontics, Division of Dentistry, Children's Hospital Los Angeles, Los Angeles, CA, USA
| | - Snehlata Oberoi
- Program in Craniofacial Biology and Division of Craniofacial Anomalies, Department of Orofacial Sciences, University of California, San Francisco, CA, USA
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Defabianis P, Guagnano R, Romano F. A Cross-Sectional Study of the Dental Arch Relationship and Palatal Morphology after Cleft Surgery in Italian Children with Unilateral Cleft and Lip Palate. CHILDREN (BASEL, SWITZERLAND) 2023; 10:1559. [PMID: 37761520 PMCID: PMC10528838 DOI: 10.3390/children10091559] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Revised: 09/06/2023] [Accepted: 09/13/2023] [Indexed: 09/29/2023]
Abstract
Dental arch relationships (DARs) and palatal morphology (PM) were evaluated in in non-syndromic complete unilateral cleft lip and palate (UCLP) Italian patients after surgery. Pre- and postnatal factors affecting the results were investigated. Sixty-six children with UCLP (40 boys and 26 girls, with a mean age of 10.1 ± 2.9 years), predominantly Caucasian (77%), were consecutively enrolled in this cross-sectional study. Twenty children had received a one-stage protocol consisting of an early periosteal palate surgical repair and lip closure and forty-six were submitted to a staged surgical protocol with delayed palate repair (DPR). A single clinician collected data on their medical history and carried out a dental examination. The DAR and PM were graded on dental casts according to the Eurocran index and dichotomised as favourable and unfavourable based on the treatment outcome. Multiple logistic regression analyses demonstrated that female sex (OR = 6.08, 95% CI: 1.47-25.23, p = 0.013), DPR (OR = 4.77, 95% CI: 1.14-19.93, p = 0.032) and the use of a neonatal plate (OR = 4.68, 95% CI: 1.27-17.16, p = 0.020) increased the odds of having favourable DAR, while only DPR (OR = 9.76, 95% CI: 2.40-39.71, p = 0.001) was significantly associated with a favourable PM. Based on these findings, only DPR had a significantly favourable effect on both DAR and DM in Italian children with complete UCLP.
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Affiliation(s)
- Patrizia Defabianis
- Department of Surgical Sciences, C.I.R. Dental School, University of Turin, 10126 Turin, Italy;
| | | | - Federica Romano
- Department of Surgical Sciences, C.I.R. Dental School, University of Turin, 10126 Turin, Italy;
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Mäntynen P, Laurila M, Strausz T, Mauno J, Leikola J, Suojanen J. Use of Individually Designed CAD/CAM Suprastructures for Dental Reconstruction in Patients with Cleft Lip and Palate. Dent J (Basel) 2023; 11:212. [PMID: 37754332 PMCID: PMC10528161 DOI: 10.3390/dj11090212] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2023] [Revised: 09/01/2023] [Accepted: 09/07/2023] [Indexed: 09/28/2023] Open
Abstract
This patient series reports the outcomes of CAD/CAM prosthetic reconstructions in patients with cleft lip and palate (n = 9, aged 27 to 76) who have experienced significant failure with conventional restorative and fixed prosthodontic treatments. The objective of the protocol is to establish a functional and patient-friendly prosthetic structure for individuals with unilateral/bilateral cleft lip and palate (UCLP/BCLP) while minimising the requirement for specialised follow-up care in the cleft unit. The study data were obtained from a retrospective cohort at Helsinki University Hospital. Prosthetic reconstructions were performed using CAD/CAM bar structures by the Atlantis 2in1 system or Createch removable telescope structures, supported by four to eight maxillary dental implants. Out of the nine patients, seven experienced no complications. One prosthesis fracture occurred after 16 months due to a design error in the original framework, and one patient experienced failure of osseointegration in a dental fixture (specifically, one fixture out of the eight maxillary implants in this patient). In total, 56 implants were successfully placed. The maxillary dentition of elderly patients with cleft lip and palate often poses challenges due to periodontal and reconstructive issues. An implant-supported CAD/CAM bar with a removable telescope suprastructure offers an easily maintained and functional solution for dental rehabilitation.
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Affiliation(s)
- Pilvi Mäntynen
- Päijät-Häme Joint Authority for Health and Wellbeing, Department of Oral and Maxillofacial Surgery, Lahti Central Hospital, 15850 Lahti, Finland; (M.L.); (J.S.)
- Clinicum, Faculty of Medicine, University of Helsinki, 00014 Helsinki, Finland
| | - Marisa Laurila
- Päijät-Häme Joint Authority for Health and Wellbeing, Department of Oral and Maxillofacial Surgery, Lahti Central Hospital, 15850 Lahti, Finland; (M.L.); (J.S.)
| | - Tommi Strausz
- Institute for Molecular Medicine Finland, Helsinki Institute of Life Science, University of Helsinki, 00014 Helsinki, Finland
| | - Jari Mauno
- Cleft Palate and Craniofacial Centre, Department of Plastic Surgery, HUS Helsinki University Hospital and University of Helsinki, 00029 Helsinki, Finland; (J.M.); (J.L.)
| | - Junnu Leikola
- Cleft Palate and Craniofacial Centre, Department of Plastic Surgery, HUS Helsinki University Hospital and University of Helsinki, 00029 Helsinki, Finland; (J.M.); (J.L.)
| | - Juho Suojanen
- Päijät-Häme Joint Authority for Health and Wellbeing, Department of Oral and Maxillofacial Surgery, Lahti Central Hospital, 15850 Lahti, Finland; (M.L.); (J.S.)
- Clinicum, Faculty of Medicine, University of Helsinki, 00014 Helsinki, Finland
- Cleft Palate and Craniofacial Centre, Department of Plastic Surgery, HUS Helsinki University Hospital and University of Helsinki, 00029 Helsinki, Finland; (J.M.); (J.L.)
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10
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de Andrade RS, Oliveira FESD, Martelli DRB, de Barros LM, Martelli Júnior H. Maternal consumption of caffeine and second-hand tobacco smoke as risk factors for the development of oral clefts. Clinics (Sao Paulo) 2023; 78:100266. [PMID: 37567043 PMCID: PMC10432903 DOI: 10.1016/j.clinsp.2023.100266] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/11/2023] [Revised: 07/18/2023] [Accepted: 07/24/2023] [Indexed: 08/13/2023] Open
Abstract
OBJECTIVE The aim of this case-control study was to investigate environmental factors, such as caffeine, folic acid, nutritional iron supplementation, multivitamin complexes, alcohol, and tobacco (second-hand smoking), which have been described as risk factors for the development of oral clefts. METHODS This case-control study employed convenience sampling and included 409 mothers: 132 with children with oral clefts (cases) and 277 with children without oral clefts (controls). The age range of the children in both groups was 0 to 2 years. A questionnaire was administered to each mother to inquire about their habits and food consumption during the first trimester of pregnancy. RESULTS Folic acid supplementation was observed in 116 (87.8%) of the case group (p < 0.001) and 271 (97.8%) of the control group. Regarding the use of ferrous sulfate, 114 (86.3%) of the case group and 271 (97.8%) of the control group reported using it. In the case group, 84 (63.6%) mothers reported being exposed to second-hand smoke, and 5 (3.7%) reported alcohol consumption (p = 0.797). In terms of caffeine consumption, 127 mothers (95.4%) in the case group consumed it (p = 0.13), while 247 (88.8%) reported consumption in the control group. CONCLUSIONS The results suggest a direct relationship between secondhand smoke, alcohol consumption, and the lack of maternal supplementation with oral clefts.
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Affiliation(s)
| | - Fabrício Emanuel Soares de Oliveira
- Postgraduate Program in Primary Health Care, Unimontes, Montes Claros, Minas Gerais, Brazil; Postgraduate Program in Health Sciences, Unimontes, Montes Claros, Minas Gerais, Brazil.
| | | | - Letízia Monteiro de Barros
- José do Rosário Vellano University, Institute of Dentistry and Health Sciences, Periodontics, Alfenas, Minas Gerais, Brazil
| | - Hercílio Martelli Júnior
- Postgraduate Program in Primary Health Care, Unimontes, Montes Claros, Minas Gerais, Brazil; Postgraduate Program in Health Sciences, Unimontes, Montes Claros, Minas Gerais, Brazil
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11
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May J, Smallridge J, Collard M, Vaidyanathan M, Bhujel N. Challenges for dental care of the paediatric patient born with cleft lip and/or palate. Br Dent J 2023; 234:867-871. [PMID: 37349433 DOI: 10.1038/s41415-023-5995-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2023] [Revised: 05/05/2023] [Accepted: 05/09/2023] [Indexed: 06/24/2023]
Abstract
This paper forms part of a series on the management of patients with cleft lip and/or palate (CLP). Children with CLP have a higher incidence of dental caries and dental anomalies. This paper explains the important roles of both the general dental practitioner and specialist paediatric dentist on the cleft team in managing these children alongside the multidisciplinary team.
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Affiliation(s)
- Joanna May
- North West North Wales Cleft Network, Alder Hey Children´s Hospital, Liverpool, United Kingdom.
| | | | - Mechelle Collard
- South West South Wales Cleft Network, Cardiff, Wales, United Kingdom
| | | | - Nabina Bhujel
- Evelina London Cleft Service, London, United Kingdom
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12
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Aboujaoude S, Rizk C, Sokhn S, Moukarzel C, Aoun G. Dental Anomalies in a Sample of Lebanese Children: a Retrospective Study. Mater Sociomed 2023; 35:319-324. [PMID: 38380282 PMCID: PMC10875945 DOI: 10.5455/msm.2023.35.319-324] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2023] [Accepted: 12/15/2023] [Indexed: 12/28/2023] Open
Abstract
BACKGROUND Dental anomalies (DAs) represent a significant chapter in pediatric dentistry with a lot of practical relevance. Both primary and permanent dentitions may be affected. OBJECTIVE The main objective of our study was to evaluate, using digital panoramic radiographs, the prevalence, distribution, and patterns of DAs in a sample of Lebanese children aged between 8 and 15 years old. METHODS 112 digital panoramic radiographs of patients aged between 8 and 15 years (60 males and 52 females) from the year 2017 till 2022 attending the department of Pediatric Dentistry and Dental Public Health at the Faculty of Dental Medicine at the Lebanese University were assessed for DAs of number (hypodontia, oligodontia, hyperdontia), of size (microdontia, macrodontia), of shape (fusion, gemination, dilaceration, taurodontism), of position (transposition, ectopia, impaction), and of structure (dentin dysplasia, amelogenesis imperfecta, dentinogenesis imperfecta). The data were analyzed statistically using Chi-square and Fisher's exact tests. RESULTS Out of 112 patient radiographs, 84 showed at least one DA, which suggests a very high prevalence (75%). Among them, 36.9% exhibited multiple types of anomalies. These 84 patients showed a total of 274 DAs, distributed equally among males and females. CONCLUSION Dentists should be alerted to the presence of DAs. Their high prevalence requires careful clinical and radiological examinations for early detection. Regular monitoring is mandatory and could guide preventive approaches to minimize associated dental complications.
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Affiliation(s)
- Samia Aboujaoude
- Department of Pediatric Dentistry and Dental Public Health, Faculty of Dental Medicine, Lebanese University, Beirut, Lebanon
| | - Charline Rizk
- Department of Pediatric Dentistry and Dental Public Health, Faculty of Dental Medicine, Lebanese University, Beirut, Lebanon
| | - Sayde Sokhn
- Department of Oral Medicine and Maxillofacial Radiology, Faculty of Dental Medicine, Lebanese University, Beirut, Lebanon
| | - Carla Moukarzel
- Department of Pediatric Dentistry and Dental Public Health, Faculty of Dental Medicine, Lebanese University, Beirut, Lebanon
| | - Georges Aoun
- Department of Oral Medicine and Maxillofacial Radiology, Faculty of Dental Medicine, Lebanese University, Beirut, Lebanon
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13
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Herrera-Atoche JR, Huerta-García NA, Escoffié-Ramírez M, Aguilar-Pérez FJ, Aguilar-Ayala FJ, Lizarraga-Colomé EA, Colomé-Ruiz GE, Zúñiga-Herrera ID. Dental anomalies in cleft lip and palate: A case-control comparison of total and outside the cleft prevalence. Medicine (Baltimore) 2022; 101:e29383. [PMID: 35945732 PMCID: PMC9351879 DOI: 10.1097/md.0000000000029383] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
Abstract
This study's objective was to compare the total and outside the cleft prevalence of dental anomalies (DA) between patients with cleft lip and palate (CLP) and a control group. This retrospective cross-sectional study was done under a case-control design. The case group consisted of 192 non-syndromic patients with complete CLP, while the control group included 411 patients. All subjects had orthopantomography, intra, and extraoral photographs. The prevalence of dental agenesis, supernumerary teeth, impacted teeth, dental transposition, and microdontia were compared using a chi-squared test (P < .05). Next, a second test was made, but only the anomalies outside the cleft were considered for this study. Total prevalence was 89.1% for cases, and 20.9% for controls (P < .01). The prevalence of each DA was significantly higher for the case group. In the analysis of DAs outside the cleft, the total prevalence was still significantly associated (P < .01); however, only dental agenesis was statistically significant (P < .01). Further analysis found that a high rate of upper premolar absence (P < .01) could explain this event. Patients with CLP have a higher prevalence of DAs compared to controls. After considering only the DAs outside the cleft, the total prevalence remains significantly higher. However, this phenomenon is explained mainly by the elevated prevalence of upper premolars' agenesis. This study's results suggest that environmental factors are behind the high prevalence of DAs in subjects with CLP.
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Affiliation(s)
| | - Nieves Aime Huerta-García
- Paediatric Dentistry Department, School of Dentistry, Universidad Autónoma de Yucatán, Mérida, Mexico
| | | | | | - Fernando Javier Aguilar-Ayala
- Paediatric Dentistry Department, School of Dentistry, Universidad Autónoma de Yucatán, Mérida, Mexico
- *Correspondence: Fernando Javier Aguilar-Ayala, Universidad Autónoma de Yucatán, Mérida, Mexico (e-mail: )
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14
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Tooth abnormalities associated with non-syndromic cleft lip and palate: systematic review and meta-analysis. Clin Oral Investig 2022; 26:5089-5103. [PMID: 35729285 DOI: 10.1007/s00784-022-04540-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2021] [Accepted: 05/05/2022] [Indexed: 11/03/2022]
Abstract
OBJECTIVE To evaluate the association between orofacial clefts (OFC) and tooth abnormalities (TA). METHODS We searched PubMed, Scopus, Web of Science, Cochrane Library, LILACS, and BBO, and in the gray literature and selected observational studies that evaluated the association between TA and OFC. The risk of bias was analyzed using the Newcastle-Ottawa Scale. A random-effects meta-analysis was performed comparing the presence and absence of OFC, cleft type-cleft palate (CP) and cleft lip with or without palate (CL/P)-and cleft laterality-unilateral and bilateral. The certainty of evidence was evaluated using the GRADE approach. RESULTS A total of 99 studies were included in the qualitative analysis, and 37 were included in the meta-analysis. Only four studies were classified as low risk of bias. Significant associations were observed between the presence of OFC and tooth agenesis (OR = 19.46; 95%CI = 4.99-75.96), supernumerary teeth (OR = 4.04; 95%CI = 1.26-12.99), developmental defects of enamel (OR = 3.15; 95%CI = 1.28-7.80), microdontia (OR = 15.57; 95%CI = 1.06-228.51), and taurodontism (OR = 1.74; 95%CI = 1.74-2.86). Individuals with CP had a lower frequency of supernumerary teeth (OR = 0.22; 95%CI = 0.08-0.64), peg-shaped tooth (OR = 0.31; 95%CI = 0.12-0.80), and morphological TA (OR = 0.13; 95%CI = 0.04-0.45) than individuals with CL/P. No TA was significantly associated with cleft laterality (p > 0.05). The quality of the evidence was very low in all analyses. CONCLUSION Individuals with OFC had a higher frequency of TA than those without OFC. Individuals with CP had a lower frequency of TA than individuals with CL/P. No TA was associated to cleft laterality. CLINICAL RELEVANCE Help to identify the treatment needs of individuals affected by OFC, improving the services provided to this population.
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15
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Savoldelli C, Bailleux S, Chamorey E, Vandersteen C, Lerhe B, Afota F. Impact of a new combined preoperative cleft assessment on dental implant success in patients with cleft and palate: a retrospective study. BMC Oral Health 2022; 22:73. [PMID: 35291983 PMCID: PMC8925145 DOI: 10.1186/s12903-022-02040-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2021] [Accepted: 11/30/2021] [Indexed: 11/17/2022] Open
Abstract
Background Bone height assessment alone is frequently used to guide rehabilitation choice, without consideration for soft tissues or adjacent teeth. This study aimed to evaluate the impact of different preoperative cleft assessments on implant success and patient satisfaction. Methods The study involved a retrospective assessment of records from 40 patients with cleft lip and palate (CLP). The alveolar cleft score (ACS; clinical criteria), interdental alveolar bone height (IABH) score (radiological criteria), patient compliance score (dental hygiene, medical visit observance, and smoking), and a novel combined score (IABH-ACS-Compliance) were assessed from patient records. Patients who required prosthetic tooth rehabilitation in the cleft dental arch space were included. Twenty-six patients (Group 1) were treated with dental implants, and 14 patients (Group 2) selected another prosthetic option (fixed prosthodontics, removal prosthesis), orthodontic space closure, or no rehabilitation. The main outcomes measured were relative implant success (no implant loss involving marginal bone loss ≤ 1.9 mm) for patients treated with dental implant therapy (Group 1) and patient satisfaction for all patients (Groups 1 and 2). Results Forty dental implants were placed in the patients in Group 1. Four implants in four patients (Group 1 relative failure, RF) were lost (implant survival rate of 90%) after 36 (± 12.4) months of follow-up. Twenty-two patients who received implants belonged to the relative implant success group (Group 1 RS). The average “IABH-ACS-Compliance” scores were significantly different (p < 0.05): 16.90 ± 2.35 and 12.75 ± 0.43 for the Group 1 RS and RF groups, respectively. Conclusions Preoperative cleft parameters have an impact on relative implant success and patient satisfaction. The new cleft assessment combined-score (“IABH-ACS-Compliance”) allows an accurate selection of cleft cases eligible for dental implants, thereby improving postoperative outcomes.
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Affiliation(s)
- Charles Savoldelli
- Oral and Maxillo-Facial Surgery Department, Head and Neck Institute, University Hospital of Nice, 30 Avenue Valombrose, 06100, Nice, France. .,Paediatric Maxillofacial Surgery and ENT Department, Lenval Hospital, Nice, France.
| | - Sonanda Bailleux
- Paediatric Maxillofacial Surgery and ENT Department, Lenval Hospital, Nice, France
| | - Emmanuel Chamorey
- Clinical Research, Innovation and Statistics Department, Centre Antoine Lacassagne, Nice, France
| | - Clair Vandersteen
- Oral and Maxillo-Facial Surgery Department, Head and Neck Institute, University Hospital of Nice, 30 Avenue Valombrose, 06100, Nice, France
| | - Barbara Lerhe
- Oral and Maxillo-Facial Surgery Department, Head and Neck Institute, University Hospital of Nice, 30 Avenue Valombrose, 06100, Nice, France.,Paediatric Maxillofacial Surgery and ENT Department, Lenval Hospital, Nice, France
| | - Franck Afota
- Oral and Maxillo-Facial Surgery Department, Head and Neck Institute, University Hospital of Nice, 30 Avenue Valombrose, 06100, Nice, France
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16
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Stasiak M, Wojtaszek-Słomińska A, Racka-Pilszak B. Alveolar bone heights of maxillary central incisors in unilateral cleft lip and palate patients using cone-beam computed tomography evaluation. J Orofac Orthop 2021; 82:198-208. [PMID: 33544175 PMCID: PMC8076140 DOI: 10.1007/s00056-020-00276-w] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2019] [Accepted: 12/02/2020] [Indexed: 11/26/2022]
Abstract
PURPOSE The aims of this retrospective cross-sectional study were to measure and compare labial and palatal alveolar bone heights of maxillary central incisors in unilateral cleft lip and palate patients, following STROBE (Strengthening the Reporting of Observational Studies in Epidemiology) guidelines. PATIENTS AND METHODS The study group consisted of 21 patients with a mean age of 16 years. High-resolution cone-beam computed tomography was performed at least one year after secondary alveolar bone grafting. The experimental side was the cleft side and the contralateral side without congenital cleft was the control. Measurements were performed on incisors' midsagittal cross-sections. The Wilcoxon signed-rank test was used for intergroup comparisons. RESULTS The labial and palatal distances between alveolar bone crests and cementoenamel junctions were significantly greater on the cleft side than on the noncleft side. Mean differences were 0.75 and 1.41 mm, respectively. The prevalence of dehiscences at the cleft side maxillary central incisors was 52% on the labial surface and 43% on the palatal surface. In the controls, it was 19% and 14%, respectively. CONCLUSION The cleft-adjacent maxillary central incisors had more apically displaced alveolar bone crests on the labial and palatal sides of the roots than the controls. Higher prevalence of dehiscences was found on the cleft side. Bone margin differences predispose to gingival height differences of the central incisors. These differences could increase the demands of patients to obtain more esthetic treatment results with orthodontic extrusion and periodontal intervention on the cleft side.
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Affiliation(s)
- Marcin Stasiak
- Department of Orthodontics, Faculty of Medicine, Medical University of Gdańsk, Aleja Zwycięstwa 42c, 80-210, Gdańsk, Poland.
| | - Anna Wojtaszek-Słomińska
- Department of Orthodontics, Faculty of Medicine, Medical University of Gdańsk, Aleja Zwycięstwa 42c, 80-210, Gdańsk, Poland
| | - Bogna Racka-Pilszak
- Department of Orthodontics, Faculty of Medicine, Medical University of Gdańsk, Aleja Zwycięstwa 42c, 80-210, Gdańsk, Poland
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17
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Antonarakis GS, Ghislanzoni LH, Fisher DM. Sella Turcica Bridging and Tooth Agenesis in Children With Unilateral Cleft Lip and Palate. Cleft Palate Craniofac J 2020; 58:1382-1388. [PMID: 33375837 DOI: 10.1177/1055665620984649] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
AIM To investigate differences in sella turcica size and bridging in children with unilateral cleft lip and palate (UCLP) with or without concomitant dental anomalies. PATIENTS AND METHODS A cross-sectional study was carried out looking at 56 children with nonsyndromic UCLP. Lateral cephalograms, taken before alveolar bone grafting, were used to assess sella turcica height, width, area, and bridging. Panoramic radiographs were used to evaluate the presence of dental anomalies in the cleft area including agenesis, supernumerary, and peg-shaped lateral incisors. Differences between sella turcica measurements in the presence or absence of dental anomalies were assessed using t tests. Differences between the prevalence of dental anomalies and sella turcica bridging were assessed using χ2 and Fisher exact tests. Multinomial logistic regression was used to investigate potential associations between sella measurements and dental anomalies. RESULTS Twenty-six of the 56 children presented with agenesis of the cleft-side lateral incisor, while 7 had a supernumerary, and 19 had a peg-shaped lateral incisor. With regard to sella turcica bridging, 27 children had no calcification, 25 partial and 4 complete calcification. Children with agenesis of the cleft-side lateral incisor showed a shorter sella maximum height (P = .010) and a smaller area (P = .019). When looking at sella turcica bridging, 100% of children with complete calcification showed agenesis of the cleft-side lateral incisor, compared with 52% and 33% of children with partial calcification and no calcification, respectively (P = .034). CONCLUSIONS Children with UCLP and sella turcica bridging are more likely to present with agenesis of the cleft-side maxillary lateral incisor.
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Affiliation(s)
- Gregory S Antonarakis
- Division of Orthodontics, University Clinics of Dental Medicine, University of Geneva, Switzerland
| | - Luis Huanca Ghislanzoni
- Division of Orthodontics, University Clinics of Dental Medicine, University of Geneva, Switzerland
| | - David M Fisher
- Division of Plastic and Reconstructive Surgery, The Hospital for Sick Children, Toronto, Ontario, Canada
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18
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da Cas NV, Machado RA, Coletta RD, Carrinho Ayroza Rangel AL. Patterns of dental anomalies in patients with nonsyndromic oral cleft. BRAZILIAN JOURNAL OF ORAL SCIENCES 2020. [DOI: 10.20396/bjos.v19i0.8658729] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Abstract
Aim: To characterize the patterns of dental anomalies (DA) in the mixed and permanent dentitions of patients with nonsyndromic oral cleft (NSOC). Methods: This cross-sectional, observational, case-control study included 173 patients, 61 with mixed dentition (NSOC=29 and control=32) and 112 with permanent dentition (NSOC=57 and control=55). All subjected were submitted to clinical and radiographic examination. Dental anomalies of eruption, number, size and shape outside the cleft area were considered. Results: Although there was no statistical significance among patients with mixed dentition, dental agenesis was the anomaly more common in this group. In patients with permanent dentition, a higher prevalence of DA in NSOC group compared to control group was observed (p=0.02). Gyroversion and dental agenesis were the DA more frequently observed in the permanent dentition and the second premolar was the tooth more affected (p=0.003). Mandible and the left side were more involved, and dental agenesis was more frequently found in patients with unilateral cleft lip with or without cleft palate (NSCL±P). Conclusion: Our findings show a higher frequency of DA in NSOCs than in the control group in patients with permanent dentition, mainly due to a higher occurrence of agenesis of second premolars in patients with unilateral NSCL±P.
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19
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A novel method for alveolar bone grafting assessment in cleft lip and palate patients: cone-beam computed tomography evaluation. Clin Oral Investig 2020; 25:1967-1975. [PMID: 32803441 PMCID: PMC7966225 DOI: 10.1007/s00784-020-03505-z] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2020] [Accepted: 08/05/2020] [Indexed: 11/28/2022]
Abstract
Objectives This retrospective cross-sectional study aimed to present a new method for secondary alveolar bone grafting (SABG) assessment and to qualitatively evaluate the SABG results in unilateral cleft lip and palate patients. Materials and methods Research was conducted according to the STROBE guidelines. The study group consisted of 21 patients with a mean age of 16 years. High-resolution cone-beam computed tomography (CBCT) was performed at least 1 year after grafting. The experimental side was the cleft side, and the contralateral side without a congenital cleft was the control. Measurements were performed at four levels of the maxillary central incisors’ roots according to the new scale with scores from 0 to 3. The sum of the scores provided a general assessment of bone architecture. The Wilcoxon signed-rank test was used for intergroup comparisons, and a Kappa coefficient was used for reproducibility measurements. Results High individual variability was found, and the bone architecture was significantly worse on the cleft side than on the noncleft side. The results showed 28.57% failure, 33.33% poor, 19.05% moderate, and 19.05% good results from the surgical procedure. Kappa coefficients produced results from 0.92 to 1.00 for intra-rater and from 0.81 to 1.00 for inter-rater reproducibility. Conclusions CBCT provides detailed information about alveolar bone morphology. The new assessment method is useful at every treatment stage and provides excellent repeatability. SABG did not provide good bone morphology, in most cases. Clinical relevance This research presents a new universal alternative for the assessment of SABG by utilizing CBCT. Electronic supplementary material The online version of this article (10.1007/s00784-020-03505-z) contains supplementary material, which is available to authorized users.
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20
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Tamburini ABF, Rodrigues YHP, Martelli DRB, Barros LMD, Andrade RSD, Machado RA, Coletta RD, Martelli-Júnior H, Flório FM. Dental anomalies in the deciduous dentition of non-syndromic oral clefts patients. REVISTA BRASILEIRA DE SAÚDE MATERNO INFANTIL 2020. [DOI: 10.1590/1806-93042020000100014] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Abstract Objectives: to investigate the prevalence of dental anomalies in complete deciduous dentition of children with NSCL/P. Methods: this study included 75 children with NSCL/P and 286 healthy control. In both groups the children had deciduous dentition with ages varying from 4 to 6 years. Clinical examination, panoramic and periapical radiographies were performed and dental anomalies of number and shape were considered. Results: there was a higher prevalence of dental anomalies in the case group, compared to the control group. In all, 42 dental anomalies were identified, 25.33% in the case group and 8.04% in control group (p<0.001). Therewas a higher frequency of dental anomalies in NSCL/P (47.36%), followed by non-syndromic cleft lip (31.57%) and non-syndromic cleft palate (21.05%). The occurrence of agenesis (p= 0.005) and twinning (p = 0.029) were higher in the case group. Conclusions: the occurrence of agenesis and dental twinning was more frequent in the case group and may contribute to the definition of oral cleft subphenotype.
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21
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Elhoseiny YO, B Mostafa RA, Elkassaby MA, Abou-El-Fotouh MM. Tooth Agenesis in Patients with Complete Bilateral Cleft Lip and Palate. Ann Maxillofac Surg 2020; 9:359-363. [PMID: 31909016 PMCID: PMC6933966 DOI: 10.4103/ams.ams_34_19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Aim The aim of this study was to compare the number of teeth in the premaxilla (cleft area) and to assess the presence of tooth agenesis with the ultimate goal of finding whether differences existed in the two suggested subtypes of nonsyndromic bilateral cleft lip and palate (BCLP) patients. Settings and Design A retrospective comparative study was conducted, where cone- beam computed tomography (CBCT) images of 22 BCLP patients (10 males and 12 females, with age range 8 to 14, mean age 9.6 years) obtained from archive of Cleft Clinic, affiliated to the Oral and Maxillofacial Surgery department, Ain-Shams University, Cairo, Egypt were assessed. Subjects and Methods CBCT images were divided into two subtypes: Group (P) - this represents BCLP characterized by well-developed (P) prominent premaxilla and SNA >80 ± 2 and Group (R) - this represents BCLP characterized by ill-developed (R) rudimentary premaxilla and SNA <80 ± 2. The number of teeth in the premaxilla was evaluated, and the presence of agenesis in the premaxilla and posterior segments was documented. Statistical Analysis Used Unpaired-Student's t-test was used to compare the number of teeth among the two groups and to test significance at P < 0.05. Intraobserver agreement was assessed using alpha (Cronbach) reliability analysis. A descriptive analysis using percentages was performed to characterize tooth agenesis. Results A significant difference was found in the number of teeth in the premaxilla among Group R and Group P. Maxillary lateral incisor showed the highest percentage of agenesis in the two groups followed by the maxillary second premolar. Conclusions The number of teeth might be useful in differentiating different subtypes of nonsyndromic BCLP.
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Affiliation(s)
- Yomna O Elhoseiny
- Department of Oral and Maxillofacial Radiology, Faculty of Dentistry, Ain Shams University, Cairo, Egypt
| | - Raghdaa A B Mostafa
- Department of Oral and Maxillofacial Radiology, Faculty of Dentistry, Ain Shams University, Cairo, Egypt
| | - Marwa A Elkassaby
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Ain Shams University, Cairo, Egypt
| | - Mona M Abou-El-Fotouh
- Department of Oral and Maxillofacial Radiology, Faculty of Dentistry, Ain Shams University, Cairo, Egypt
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Saint-Surin I, Roman T, Touzet-Roumazeille S, Ferri J, Lauwers L. Implant-borne rehabilitation for alveolar dental cleft: Retrospective analysis of thirty-nine cases. JOURNAL OF STOMATOLOGY, ORAL AND MAXILLOFACIAL SURGERY 2019; 121:339-343. [PMID: 31672683 DOI: 10.1016/j.jormas.2019.10.007] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/23/2019] [Revised: 10/15/2019] [Accepted: 10/17/2019] [Indexed: 11/17/2022]
Abstract
INTRODUCTION Dental rehabilitation of patients with alveolar-dental cleft sequelae is a crucial issue in the final stages of functional and aesthetic management of these patients. The objectives of this study are to establish the success of implant-supported rehabilitations for patients with alveolar dental cleft sequelae followed in the Department of Maxillofacial Surgery and Stomatology of Lille University Hospital and the reasons for not using this type of rehabilitation for others. MATERIALS AND METHOD Patients treated between January 2009 and December 2018 with implant-supported prostheses at an alveolar dental cleft site were included. Dental implants were placed after a complementary alveolar bone graft. Clinical and radiological criteria regarding periodontal, occlusal and prosthetic status were studied. RESULTS A total of 12 implants in 8 patients were placed. One of these implants was lost, resulting in an implant survival rate of 91.7%. All patients were able to benefit from functional rehabilitation. DISCUSSION The present results demonstrate the interest and reliability of implant rehabilitation in these patients. They furthermore highlight financial factors as a barrier to using this solution among the majority of patients in care.
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Affiliation(s)
- I Saint-Surin
- Chirurgie orale, Hôpital Salengro, centre Abel-Caumartin, CHRU de Lille, Lille, France.
| | - T Roman
- Médecine bucco-dentaire, centre Abel-Caumartin, CHRU de Lille, Lille, France
| | - S Touzet-Roumazeille
- Université Lille 2 Droit et Santé, 59000, Lille, France; Oral and Maxillofacial Department, Roger Salengro Hospital, CHU de Lille, 59000, Lille, France
| | - J Ferri
- Université Lille 2 Droit et Santé, 59000, Lille, France; Oral and Maxillofacial Department, Roger Salengro Hospital, CHU de Lille, 59000, Lille, France; Inserm, U1008, Controlled Drug Delivery Systems and Biomaterials, 59000, Lille, France
| | - L Lauwers
- Université Lille 2 Droit et Santé, 59000, Lille, France; Oral and Maxillofacial Department, Roger Salengro Hospital, CHU de Lille, 59000, Lille, France
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Dindaroğlu F, Duran GS, Doğan S. Dental crown symmetry in unilateral cleft lip and palate patients: A three‐dimensional analysis on digital dental models. Orthod Craniofac Res 2019; 22:281-288. [DOI: 10.1111/ocr.12330] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2019] [Revised: 06/11/2019] [Accepted: 06/12/2019] [Indexed: 11/26/2022]
Affiliation(s)
- Furkan Dindaroğlu
- Ege University Faculty of Dentistry Department of Orthodontics İzmir Turkey
| | | | - Servet Doğan
- Ege University Faculty of Dentistry Department of Orthodontics İzmir Turkey
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Shen CA, Guo R, Li W. Enamel defects in permanent teeth of patients with cleft lip and palate: a cross-sectional study. J Int Med Res 2019; 47:2084-2096. [PMID: 30913937 PMCID: PMC6567767 DOI: 10.1177/0300060519832165] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
OBJECTIVE This study investigated the prevalence, type, and location of enamel defects in the permanent teeth of patients with complete unilateral or bilateral cleft lip and palate (CLP), and compared the prevalence and characteristics of defects between CLP patients and non-CLP individuals. METHODS We examined completely erupted permanent dentition, except for third molars, of CLP patients and non-CLP individuals of both sexes, 9-36 years of age, and analyzed corresponding panoramic radiographs. Two independent examiners performed clinical examinations in accordance with the Modified Developmental Defects of Enamel index. RESULTS A total of 210 (87.9%) CLP patients and 194 (41.4%) non-CLP individuals had at least one enamel defect; these were more prevalent in the CLP group than in the non-CLP group. Upper teeth were primarily affected by enamel defects associated with the cleft; defects were most prevalent on the cleft side in CLP patients, followed by the non-cleft side in CLP patients, and then by non-CLP individuals. CONCLUSION Enamel defects were more common in CLP patients than in non-CLP individuals. Among CLP patients, enamel defects were more prevalent in the cleft side of the maxilla; the central incisor was the most commonly affected tooth in this quadrant.
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Affiliation(s)
- Chia-An Shen
- Department of Orthodontics, Peking University School and Hospital of Stomatology, Beijing, P.R. China
| | - Runzhi Guo
- Department of Orthodontics, Peking University School and Hospital of Stomatology, Beijing, P.R. China
| | - Weiran Li
- Department of Orthodontics, Peking University School and Hospital of Stomatology, Beijing, P.R. China
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Nicot R, Rotten D, Opdenakker Y, Kverneland B, Ferri J, Couly G, Levaillant JM. Fetal dental panorama on three-dimensional ultrasound imaging of cleft lip and palate and other facial anomalies. Clin Oral Investig 2018; 23:1561-1568. [PMID: 30132143 DOI: 10.1007/s00784-018-2586-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2017] [Accepted: 08/17/2018] [Indexed: 12/28/2022]
Abstract
OBJECTIVES Craniofacial deformities have a high psychosocial impact. The aim of this paper is to improve obstetric ultrasonography and prenatal detection of facial anomalies by providing a new fetal dental panorama. MATERIAL AND METHODS The present study describes a new modality to visualize the fetal tooth germs and an easy step-by-step diagnostic approach. Image acquisition was performed between 23 and 32 weeks of gestation using a Voluson E10 GE ultrasound machine with an RM6C transducer (GE Medical Systems, Zipf, Austria). Reconstruction was performed using Omniview from the axial image. Volume contrast imaging (VCI) was used with a thickness of 20 mm, and a render mode that combined "Rx mode" and "surface texture." RESULTS The resulting imaging allows a more precise visualization of the fetal dental arch and can be obtained between 14 and 28 weeks of gestation. The presence of dental anomalies can be a clue for the diagnosis of various congenital defects, in particular conditions with a shortage of other physical abnormalities, such as ectodermal dysplasia and Binder syndrome. CONCLUSIONS The creation of a precise fetal dental panorama allows an improved detection of facial deformities. CLINICAL RELEVANCE With the current paper, we want to increase prenatal diagnostics facial anomalies, and help to establish a tailored multidisciplinary treatment plan. This paper should be of interest to readers who are currently treating patients with craniofacial malformations and readers who are performing diagnostic prenatal sonography.
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Affiliation(s)
- Romain Nicot
- Center for Woman and Fetal Imaging, F-59800, Lille, France. .,Department of Oral and Maxillofacial Surgery and Stomatology, CHU Lille, F-59000, Lille, France.
| | - Daniel Rotten
- Department of Gynecology and Obstetrics, Hôpital Delafontaine, F-93200, Saint-Denis, France
| | - Yasmin Opdenakker
- Department of Oral and Maxillofacial Surgery, University Hospital Ghent, B-9000, Ghent, Belgium
| | - Bothild Kverneland
- Department of Maxillofacial Surgery, Necker Enfants Malades University Hospital, F-75015, Paris, France
| | - Joël Ferri
- Department of Oral and Maxillofacial Surgery and Stomatology, CHU Lille, F-59000, Lille, France.,International Association of Oral and Maxillofacial Medicine (IAOMM), F-59650, Villeneuve dAscq, France
| | - Gérard Couly
- Center for Woman and Fetal Imaging, F-59800, Lille, France
| | - Jean-Marc Levaillant
- Center for Woman and Fetal Imaging, F-59800, Lille, France.,Hôpital Privé Armand Brillard, Groupe Ramsay Générale de Santé, F-94130, Nogent-sur-Marne, France
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Hereman V, Cadenas De Llano-Pérula M, Willems G, Coucke W, Wyatt J, Verdonck A. Associated parameters of canine impaction in patients with unilateral cleft lip and palate after secondary alveolar bone grafting: a retrospective study. Eur J Orthod 2018; 40:575-582. [DOI: 10.1093/ejo/cjy011] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Affiliation(s)
- Valérie Hereman
- Department of Oral Health Sciences—Orthodontics, KU Leuven and Dentistry, University Hospitals Leuven
| | | | - Guy Willems
- Department of Oral Health Sciences—Orthodontics, KU Leuven and Dentistry, University Hospitals Leuven
| | | | - Jan Wyatt
- Department of Oral Health Sciences—Children and Special Care Dentistry, KU Leuven and Dentistry, University Hospitals Leuven, Belgium
| | - Anna Verdonck
- Department of Oral Health Sciences—Orthodontics, KU Leuven and Dentistry, University Hospitals Leuven
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