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Escobar-Arregocés F, Eras MA, Bustos A, Suárez-Castillo A, García-Robayo DA, Del Pilar Bernal M. Characterization of the oral microbiota and the relationship of the oral microbiota with the dental and periodontal status in children and adolescents with nonsyndromic cleft lip and palate. Systematic literature review and meta-analysis. Clin Oral Investig 2024; 28:245. [PMID: 38587683 PMCID: PMC11001721 DOI: 10.1007/s00784-024-05624-3] [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: 12/04/2023] [Accepted: 03/18/2024] [Indexed: 04/09/2024]
Abstract
OBJECTIVE To identify the characteristics of the oral microbiota and the relationship of the dental caries and periodontal status in patients aged 0 to 18 years with non-syndromic cleft lip and palate (CLP). MATERIALS AND METHODS A systematic review of the literature was carried out. Five databases were consulted, including publications in English, Spanish and Portuguese. The evaluations of the quality of the observational studies and the experimental studies were carried out with the Newcastle-Ottawa scale and CONSORT guidelines, respectively. The risk of bias of the studies was determined using Rev Manager 5.4, and 5 publications were meta-analyzed. RESULTS The cariogenic microbiota of children and adolescents with cleft lip and palate was similar to that of children without clefts, although with higher counts of Streptococcus mutans and Lactobacillus spp. The periodontopathogenic microbiota was related to the presence of Campylobacter spp, Fusobacterium spp, Fusobacterium nucleatum, Prevotella intermedia/nigrescens, Parvimonas micra and Porphyromonas gingivalis, considered microorganisms with high pathogenic capacity. Heterogeneity was shown in relation to the microbiota and the type of fissure, presenting numerous microorganisms associated with the pre- and post-surgical condition (cheilorrhaphy and palatorrhaphy) such as Staphylococcus aureus, Streptococcus beta hemolyticus, Klebsiella pneumoniae and Klebsiella oxytoca, Moraxella catarrhalis, Candida spp, Candida albicans, Candida krusei and Candida tropicalis. The meta-analysis revealed that patients with cleft lip and palate were 2.03 times more likely to have caries than the control group (p<0.005). CONCLUSION In the microbiota, there was a great diversity of microorganisms that can vary according to the type of fissure and surgical interventions predisposing patients to a greater probability of dental caries, it is important to take into account the technique used to describe the oral microbiota in order to be able to compare the different studies. CLINICAL RELEVANCE Studying the microbiota and the relationship of dental caries and periodontal status in children and adolescents with cleft lip and palate can facilitate the comprehensive care of patients with these conditions.
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Affiliation(s)
- Francina Escobar-Arregocés
- Center of Dental Research, Member of the interdisciplinary team for the care of patients with CLP, Faculty of Dentistry, Pontificia Universidad Javeriana, Bogotá, DC, Colombia.
| | - Mayra-Alexandra Eras
- Pediatric Dentistry, Faculty of Dentistry, Pontificia Universidad Javeriana, Bogotá, DC, Colombia
| | - Andrea Bustos
- Pediatric Dentistry, Faculty of Dentistry, Pontificia Universidad Javeriana, Bogotá, DC, Colombia
| | - Angela Suárez-Castillo
- Public Health, Faculty of Dentistry, Pontificia Universidad Javeriana, Bogotá, DC, Colombia
| | - Dabeiba-Adriana García-Robayo
- Biological Science, Center of Dental Research, Faculty of Dentistry, Pontificia Universidad Javeriana, Bogotá, DC, Colombia
| | - Maria Del Pilar Bernal
- Pediatric Stomatology, Member of the interdisciplinary team for the care of patients with CLP, Faculty of Dentistry, Pontificia Universidad Javeriana, Bogotá, DC, Colombia
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Alansari N, Abed H, Abid M. Oral flora and functional dysbiosis of cleft lip and palate patients: A scoping review. SPECIAL CARE IN DENTISTRY 2024; 44:255-268. [PMID: 37173294 DOI: 10.1111/scd.12872] [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: 11/10/2022] [Revised: 04/23/2023] [Accepted: 04/24/2023] [Indexed: 05/15/2023]
Abstract
AIMS This scoping review aimed to conduct an assessment of the current literature on specific ecological changes in the oral microbiota of individuals living with cleft lip and/or palate. METHODS All studies that assess oral microbiota and ecological changes distinct of individuals living with cleft lip and/or palate were included. Ovid MEDLINE and EMBASE databases were used, using planned search keywords. Included articles were grouped into cohort, cross-sectional, case-control, and retrospective reviews. RESULTS A total of 164 eligible title articles were recognized. Of these, 32 full-text studies were included in the present review. All the included articles were published between 1992 and 2022. These studies were two retrospective studies, two review studies, and the remaining (n = 28) were observational studies. CONCLUSION The oral flora of cleft lip and/or palate patients has been shown in scientific studies to have an increased frequency of potentially pathogenic fungal and bacterial colonization, particularly Candida species, Staphylococcus aureus, Lactobacili and Streptococci mutans. This may influence oral diseases and post-operative repair complications, potentially necessitating further surgical intervention.
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Affiliation(s)
- Nadia Alansari
- Department of Orthodontics, College of Dentistry, University of Baghdad, Baghdad, Iraq
- Department of Orthodontics, Al Rafidain University College, Baghdad, Iraq
| | - Hassan Abed
- Department of Basic and Clinical Oral Sciences, Division of Oral Medicine, Faculty of Dentistry, Umm Al-Qura University, Makkah, Saudi Arabia
| | - Mushriq Abid
- Department of Orthodontics, College of Dentistry, University of Baghdad, Baghdad, Iraq
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Marzouk T, Youssef M, Tsigarida A, McKinney C, Wong C, DeLucia L, Shah R, Wang H, Malmstrom H, Shope E. Association between oral clefts and periodontal clinical measures: A meta-analysis. Int J Paediatr Dent 2022; 32:558-575. [PMID: 34626516 DOI: 10.1111/ipd.12934] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/25/2021] [Revised: 09/21/2021] [Accepted: 10/06/2021] [Indexed: 11/28/2022]
Abstract
AIM To conduct a systematic review and to evaluate the clinical parameters for periodontal diseases in individuals with cleft lip and/or palate (CL/P). DESIGN The authors searched six indexed databases without any linguistic limitation through July 2021. The eligibility criteria were observational studies that compared the periodontal clinical measures of individuals with CL/P to those without CL/P. A meta-analysis was conducted using random-effects models with inverse variance weighting. RESULTS The literature search generated 1277 records, and 40 full-text articles were reviewed. Twenty-three studies comprising 3235 individuals from four continents fulfilled our selection criteria. The meta-analysis revealed a significant difference in mean plaque index scores (MD = 0.31, 95% CI = 0.22, 0.41), gingival index scores (MD = 0.50, 95% CI = 0.24, 0.77), and periodontal pocket depth (MD = 0.64, 95% CI = 0.12, 1.16) between individuals with and without CL/P. A slight increase in clinical attachment loss was detected among individuals with CL/P; however, such an increase may have little clinical significance. CONCLUSIONS As age is positively related to periodontal disease progression, and individuals with CL/P are more likely to present with more plaque accumulation and gingival inflammation, clinicians should reinforce preventive dental care from an early age.
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Affiliation(s)
- Tamer Marzouk
- Department of Dentistry, Eastman Institute for Oral Health, University of Rochester, Rochester, New York, USA.,Division of Pediatric Dentistry, Eastman Institute for Oral Health, University of Rochester, Rochester, New York, USA
| | - Mostafa Youssef
- Department of Dentistry, Eastman Institute for Oral Health, University of Rochester, Rochester, New York, USA
| | - Alexandra Tsigarida
- Division of Periodontology, Eastman Institute for Oral Health, University of Rochester, Rochester, New York, USA
| | - Christy McKinney
- Division of Craniofacial Medicine and Seattle Children's Research Institute, Department of Pediatrics, University of Washington, Seattle, Washington, USA
| | - Cynthia Wong
- Division of Pediatric Dentistry, Eastman Institute for Oral Health, University of Rochester, Rochester, New York, USA
| | - Lisa DeLucia
- Division of Pediatric Dentistry, Eastman Institute for Oral Health, University of Rochester, Rochester, New York, USA
| | - Ritu Shah
- Division of Pediatric Dentistry, Eastman Institute for Oral Health, University of Rochester, Rochester, New York, USA
| | - Hongyue Wang
- Department of Biostatistics and Computational Biology, University of Rochester, Rochester, New York, USA
| | - Hans Malmstrom
- Department of Dentistry, Eastman Institute for Oral Health, University of Rochester, Rochester, New York, USA
| | - Erin Shope
- Division of Pediatric Dentistry, Eastman Institute for Oral Health, University of Rochester, Rochester, New York, USA.,Golisano Cleft and Craniofacial Center, University of Rochester, Rochester, New York, USA
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Wu Q, Li Z, Zhang Y, Peng X, Zhou X. Dental caries and periodontitis risk factors in cleft lip and palate patients. Front Pediatr 2022; 10:1092809. [PMID: 36683789 PMCID: PMC9846248 DOI: 10.3389/fped.2022.1092809] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/08/2022] [Accepted: 12/09/2022] [Indexed: 01/06/2023] Open
Abstract
Cleft lip and palate (CLP) is the most common congenital facial malformation and has a significant developmental, physical, and psychological impact on those with the deformity and their families. Risk factors contributing to CLP may conclude as genetic factors and environmental factors. The anatomical and morphological abnormalities related to CLP are favorable for dental plaque accumulation on the tooth surface. Therefore, patients with CLP undergo poorer oral hygiene and higher susceptibility to dental caries and periodontitis. In this review, we aim to conclude and update probable causes underlying the association between CLP and poor oral health and provide novel ideas of targeted early prevention for such oral diseases.
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Affiliation(s)
- Qinrui Wu
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China.,Department of Cariology and Endodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Zhengyi Li
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Yixin Zhang
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China.,Department of Cariology and Endodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Xian Peng
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Xuedong Zhou
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China.,Department of Cariology and Endodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, China
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Escobar Arregocés FM. Mucogingival Surgery in the Interdisciplinary Management of Patients with Palato-alveolar Cleft Defects. Contemp Clin Dent 2020; 11:203-207. [PMID: 33110339 PMCID: PMC7583534 DOI: 10.4103/ccd.ccd_118_18] [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] [Received: 02/22/2018] [Revised: 06/23/2018] [Accepted: 03/11/2020] [Indexed: 11/04/2022] Open
Abstract
Here will present a mucogingival technique for interdisciplinary management in patients with palato-alveolar cleft defect sequelae. Mucogingival continuity is sought in these patients by means of an extended laterally positioned flap. Achieving a mucogingival seal in the cleft area would be of great value in interdisciplinary management, favoring the prognosis of subsequent treatments, such as alveolar bone grafts, orthodontics, and rehabilitation, to achieve more esthetic and functional and harmonious results for the patients' dentogingival complex.
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Affiliation(s)
- Francina Maria Escobar Arregocés
- Department of Periodontal, Faculty of Dentistry, School of Odontology, Pontifical Xavierian University (Pontificia Universidad Javeriana), Bogotá, Colombia
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Huang S, Chen PhD Y, Chen PhD Z. Relationship Between Crown to Root Ratio and Alveolar Bone Support in Patients With Unilateral Cleft Lip and Alveolus. Cleft Palate Craniofac J 2020; 58:215-221. [PMID: 32808559 DOI: 10.1177/1055665620950155] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
OBJECTIVES To evaluate the tooth lengths, crown to root ratios (CRRs), and alveolar bone support (ABS) around cleft-adjacent maxillary central incisors (U1s) in patients with unilateral cleft lip and alveolus (UCLA) and to investigate the relationships between CRR and ABS. DESIGN This is a retrospective study. SETTING Cleft Lip and Palate Care Center of Shanghai Ninth People's Hospital, Shanghai, China. PATIENTS Fifty-eight Chinese patients with UCLA. MAIN OUTCOME MEASURE Cone beam computed tomography data from 58 nonsyndromic patients with UCLA (36 males, 22 females; mean age = 12.65 ± 3.64 years) were evaluated. Crown length and root length, alveolar bone thickness (ABT), and the distances between the cementoenamel junction and alveolar bone crest on 4 surfaces of cleft-adjacent U1 were measured and compared with those of noncleft side in the same patients. Crown to root ratio and frequency of dehiscence were calculated and comparisons were also made between cleft and noncleft sides. Regression analysis was performed to explore the association between CRR and ABS. RESULTS The CRR of cleft-adjacent U1 and alveolar bone crest heights (ACHs) on the 4 surfaces were significantly greater than those of noncleft side (P < .01). A 3 mm labial, all lingual, and apico-distal ABTs decreased on the cleft side (P < .01). A positive correlation was found between lingual ACH and CRR (R = 0.316, P < .05), between the 3 mm (R = 0.417, P < .05) and 6 mm labial (R = 0.448, P < .05) ABT and CRR. A negative correlation was found between the 3 mm and 6 mm labial ABTs and the root length. CONCLUSIONS It can be suggested that the CRR is related to ACH and ABT. The lingual ACH, the 3 mm, and 6 mm labial ABTs tend to increase with the increasing CRR.
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Affiliation(s)
- Sijing Huang
- Department of Orthodontics, Shanghai Ninth People's Hospital, College of Stomatology, 56694Shanghai Jiao Tong University School of Medicine, Huangpu District, Shanghai, China.,National Clinical Research Center for Oral Disease, Shanghai, China.,Shanghai Key Laboratory of Stomatology & Shanghai Research Institute of Stomatology, Shanghai, China
| | - Yang Chen PhD
- National Clinical Research Center for Oral Disease, Shanghai, China.,Shanghai Key Laboratory of Stomatology & Shanghai Research Institute of Stomatology, Shanghai, China.,Department of Oral & Craniomaxillofacial Surgery, 56695Shanghai Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, Huangpu District, Shanghai, China
| | - Zhenqi Chen PhD
- Department of Orthodontics, Shanghai Ninth People's Hospital, College of Stomatology, 56694Shanghai Jiao Tong University School of Medicine, Huangpu District, Shanghai, China.,National Clinical Research Center for Oral Disease, Shanghai, China.,Shanghai Key Laboratory of Stomatology & Shanghai Research Institute of Stomatology, Shanghai, China
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Movahhedian N, Vossoughi M, Hajati-Sisakht M. A Cone-Beam Computed Tomographic Study of Alveolar Bone Morphology in Patients With Unilateral Cleft Lip and Palate. Cleft Palate Craniofac J 2019; 57:273-281. [PMID: 31529996 DOI: 10.1177/1055665619874613] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE To evaluate the bony support around the teeth adjacent to the unilateral cleft lip and palate (ULCLP) using cone-beam computed tomography. METHODS AND MATERIALS Cone-beam computed tomographies of 48 cleft-adjacent teeth (28 anterior and 20 posterior to the cleft) and 48 noncleft control teeth were evaluated. The alveolar bone thickness at 3 and 6 mm apical to the cement-enamel junction (CEJ), the distance between the alveolar crest and CEJ (Alv-CEJ), and the presence of fenestration were assessed in buccal, palatal, and proximal surfaces. RESULTS The alveolar bone on the buccal and palatal sides of the teeth anterior to the cleft was significantly thinner than the noncleft teeth (all P < .05). The Alv-CEJ was significantly greater on the buccal and distal surfaces of the teeth anterior to the cleft (P < .001 and P = .010, respectively) and on the palatal and mesial surfaces of the teeth posterior to the cleft (P = .024 and P = .003, respectively) when compared to the noncleft teeth. The frequency of reduced alveolar bone height (>2 mm) was higher than noncleft side for buccal and distal sides of the teeth anterior to the cleft (P = .016 and .006, respectively) and the buccal and mesial sides of the teeth posterior to the cleft (P = .008 and <.001, respectively). The teeth anterior to the cleft had a higher prevalence of fenestration (P = .004). CONCLUSION Reduced alveolar bone height is more common in the cleft side compared to the control side. The teeth anterior to the ULCLP have thinner alveolar bone support and higher frequency of fenestration.
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Affiliation(s)
- Najmeh Movahhedian
- Oral and Maxillofacial Radiology Department, School of Dentistry, Shiraz University of Medical Sciences, Iran
| | - Mehrdad Vossoughi
- Oral and Dental Disease Research Center, Department of Dental Public Health, School of Dentistry, Shiraz University of Medical Sciences, Iran
| | - Mahtab Hajati-Sisakht
- Student Research Committee, School of Dentistry, Shiraz University of Medical Sciences, Iran
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Bittermann GKP, van Es RJJ, de Ruiter AP, Frank MH, Bittermann AJN, van der Molen ABM, Koole R, Rosenberg AJWP. Incidence of complications in secondary alveolar bone grafting of bilateral clefts with premaxillary osteotomy: a retrospective cohort study. Clin Oral Investig 2019; 24:915-925. [PMID: 31250194 DOI: 10.1007/s00784-019-02977-y] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2017] [Accepted: 06/11/2019] [Indexed: 10/26/2022]
Abstract
OBJECTIVE To evaluate factors affecting incidence of complications after secondary alveolar bone grafting with premaxillary osteotomy (SABG + PO) in children with complete bilateral cleft of lip and palate (BCLP). MATERIALS AND METHODS Data were collected from children with BCLP treated with SABG + PO from 2004 to 2014 at our institute. Preoperative parameters included age, donor site, race, gingival health, bone quality around cleft-related teeth, premaxilla position, graft timing, presence of canines in the cleft, and presence of deciduous teeth around the cleft area. Logistic regression and the chi-squared test were used to assess correlations and the incidence of complications. RESULTS In the 64 patients, a significant correlation was found between complication rate and timing of bone grafting with respect to early versus late SABG + PO (p = 0.041), age > 12 years (p = 0.011; odds ratio (OR) 5.9; 95% confidence interval (CI) 1.49-23.93), malposition of the premaxilla (p = 0.042; OR 3.3; 95% CI 1.04-10.13), and preoperative bone quality around cleft-related teeth (p = 0.005; OR 5.3; 95% CI 1.6-17.2). CONCLUSIONS The timing of SABG + PO is essential, as early SABG + PO is associated with fewer complications. A malpositioned premaxilla and poor bone quality around cleft-related teeth are associated with more complications. Therefore, preoperative orthodontic repositioning of the malpositioned premaxilla before SABG + PO should be considered. CLINICAL RELEVANCE Analysis of treatment protocols and complications for BCLP patients underscores that proper timing of SABG + PO and correct premaxilla repositioning help reduce complications.
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Affiliation(s)
- Gerhard K P Bittermann
- Department of Oral and Maxillofacial Surgery, Wilhelmina Children's Hospital Cleft Team, University Medical Centre Utrecht, Utrecht University, Heidelberglaan 100, PO Box 85500, 3508 AB, Utrecht, The Netherlands.
| | - Robert J J van Es
- Department of Oral and Maxillofacial Surgery, Wilhelmina Children's Hospital Cleft Team, University Medical Centre Utrecht, Utrecht University, Heidelberglaan 100, PO Box 85500, 3508 AB, Utrecht, The Netherlands
| | - Adrianus P de Ruiter
- Department of Oral and Maxillofacial Surgery, Wilhelmina Children's Hospital Cleft Team, University Medical Centre Utrecht, Utrecht University, Heidelberglaan 100, PO Box 85500, 3508 AB, Utrecht, The Netherlands
| | - Michael H Frank
- Department of Oral and Maxillofacial Surgery, Haaglanden Medical Centre, PO Box 432, 2501 CK, The Hague, The Netherlands
| | - Arnold J N Bittermann
- Department of Pediatric Otorhinolaryngology, Wilhelmina Children's Hospital, University Medical Center Utrecht, 3508 AB, Utrecht, The Netherlands
| | - Aebele B Mink van der Molen
- Department of Plastic Surgery, Wilhelmina Children's Hospital Cleft Team, University Medical Centre Utrecht, Utrecht University, Lundlaan 6, PO Box 85090, 3508 AB, Utrecht, The Netherlands
| | - Ron Koole
- Department of Oral and Maxillofacial Surgery, Wilhelmina Children's Hospital Cleft Team, University Medical Centre Utrecht, Utrecht University, Heidelberglaan 100, PO Box 85500, 3508 AB, Utrecht, The Netherlands
| | - Antoine J W P Rosenberg
- Department of Oral and Maxillofacial Surgery, Wilhelmina Children's Hospital Cleft Team, University Medical Centre Utrecht, Utrecht University, Heidelberglaan 100, PO Box 85500, 3508 AB, Utrecht, The Netherlands
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Pan Y, Zeng Y, Zhang Z, Liu Y, Jing Y, Xiao L. Evaluation of alveolar bone support around incisors in patients with unilateral cleft lip, alveolus, and palate in late mixed dentition using cone beam computed tomography. Angle Orthod 2018; 88:299-305. [PMID: 29384701 DOI: 10.2319/071517-472.1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
OBJECTIVES To evaluate alveolar bone support around cleft-adjacent maxillary central incisors (U1) in patients with unilateral cleft lip, alveolus and palate (UCLAP) in the late mixed dentition and to investigate the correlation between the alveolar bone thickness (ABT) and tooth inclination. MATERIALS AND METHODS Cone beam computed tomography scans of 45 subjects with UCLAP (29 boys, 16 girls; mean age = 10.74 ± 1.08 years) were assessed. The distance between the cementoenamel junction (CEJ) and alveolar bone crest (AC), and the ABTs at 3 mm, 6 mm, and the apex were measured on the labial, lingual and distal surfaces of U1. The cleft and normal sides were compared using a paired t-test and Pearson's χ2 test. Pearson's correlation was used to explore the association between the ABT and tooth inclination of cleft-adjacent U1 in the labiolingual and mesiodistal dimensions. RESULTS The CEJ-AC distances were significantly greater in cleft-adjacent U1 ( P < .01), with more bone height reduction observed labially and distally ( P < .001). The labial, lingual, and apico-distal ABTs were decreased on the cleft side ( P < .01). A positive correlation was found between the apico-labial ABT and the labiolingual inclination ( r = 0.568, P < .01). CONCLUSIONS Patients with UCLAP have reduced alveolar bone support around the cleft-adjacent U1, and the apico-labial ABT tends to decrease with increasing lingual tooth inclination; however, the correlation was weak.
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Sundell AL, Ullbro C, Dahlén G, Marcusson A, Twetman S. Salivary microbial profiles in 5-year old children with oral clefts: a comparative study. Eur Arch Paediatr Dent 2018; 19:57-60. [DOI: 10.1007/s40368-018-0326-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2017] [Accepted: 01/10/2018] [Indexed: 11/24/2022]
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Stec M, Szczepańska J, Pypeć J, Hirschfelder U. Periodontal Status and Oral Hygiene in Two Populations of Cleft Patients. Cleft Palate Craniofac J 2017; 44:73-8. [PMID: 17214530 DOI: 10.1597/05-137] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Objective: To evaluate and compare the oral hygiene and periodontal status in children with unilateral and bilateral cleft lip and palate treated in Łódź, Poland, and Erlangen, Germany. Design: Oral health was assessed by the presence of dental plaque, pocket depth, clinical attachment levels, and pathologic teeth mobility. Subjects and Methods: Thirty-seven Polish and 63 German patients participated in this study. Results: Poor oral hygiene was found in 57% of all subjects. In Erlangen, 60% of patients had optimal oral hygiene, compared to 19% in Łódź. The highest scores for dental plaque were noted in both groups in the cleft region. Healthy periodontium was significantly more frequent among German patients, whereas gingival bleeding was significantly more frequent among Polish patients. Pocket depths greater than 6 mm occurred only in German subjects. No statistically significant difference was observed between the amount of tooth areas with gingival recessions and the country of origin. Periodontal pockets deeper than 3.5 mm occurred more frequently during active orthodontic treatment. Conclusions: The oral hygiene regimens in Germany and Poland were not comparable, as more plaque was found in the Polish than in the German population. Plaque accumulation seems not to be a key factor in causing periodontal destruction in the cleft area. Factors other than oral hygiene should be considered of major importance in relation to the development of gingival recession on teeth in cleft areas.
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Affiliation(s)
- Magdalena Stec
- Department of Orthodontics, University of Erlanger-Nuremberg, Erlanger, Germany.
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Stelzle F, Rohde M, Oetter N, Krug K, Riemann M, Adler W, Neukam FW, Knipfer C. Gingival esthetics and oral health-related quality of life in patients with cleft lip and palate. Int J Oral Maxillofac Surg 2017; 46:993-999. [PMID: 28396130 DOI: 10.1016/j.ijom.2017.03.020] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2016] [Revised: 02/02/2017] [Accepted: 03/14/2017] [Indexed: 10/19/2022]
Abstract
While the oral health-related quality of life (OHRQoL) is known to be reduced in patients with cleft lip and palate (CLP), its inter-dependency with the soft tissue characteristics of the CLP area remains unclear. This study aimed to evaluate the soft tissue characteristics in the treated cleft area in order to investigate whether gingival esthetics correlate with OHRQoL. Thirty-six patients with unilateral or bilateral CLP (46 cleft areas) were investigated after secondary/tertiary alveolar bone grafting and orthodontic/prosthetic implant treatment using an adapted score to rate gingival esthetics (clinical esthetic score, CES). The patient's OHRQoL was determined using the German short version of the Oral Health Impact Profile questionnaire (OHIP-G14). The results showed a significantly better rating in patients with their own teeth in situ (12.05±1.10) than in patients with implants (6.95±4.78) or prosthetics (4.00±3.58). The best OHRQoL values were achieved by patients with their own teeth integrated into the cleft area (1.32±2.31), followed by patients with implants (2.33±2.33) and prosthetics (3.75±5.87). A significant (P=0.017) correlation was found between OHIP-G14 and CES scores, suggesting an increased OHRQoL in cases with higher oral esthetics in the cleft area. The therapeutic strategy contributes to both gingival esthetics and OHRQoL. The patient's subjective perception of OHRQoL can be attributed to objective gingival esthetic ratings.
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Affiliation(s)
- F Stelzle
- Department of Oral and Maxillofacial Surgery, Friedrich-Alexander-University Erlangen-Nürnberg (FAU), University Hospital Erlangen, Erlangen, Germany.
| | - M Rohde
- Department of Oral and Maxillofacial Surgery, Friedrich-Alexander-University Erlangen-Nürnberg (FAU), University Hospital Erlangen, Erlangen, Germany
| | - N Oetter
- Department of Oral and Maxillofacial Surgery, Friedrich-Alexander-University Erlangen-Nürnberg (FAU), University Hospital Erlangen, Erlangen, Germany
| | - K Krug
- Department of Oral and Maxillofacial Surgery, Friedrich-Alexander-University Erlangen-Nürnberg (FAU), University Hospital Erlangen, Erlangen, Germany
| | - M Riemann
- Department of Oral and Maxillofacial Surgery, Friedrich-Alexander-University Erlangen-Nürnberg (FAU), University Hospital Erlangen, Erlangen, Germany
| | - W Adler
- Department of Medical Informatics, Biometry and Epidemiology, Friedrich-Alexander-University Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - F W Neukam
- Department of Oral and Maxillofacial Surgery, Friedrich-Alexander-University Erlangen-Nürnberg (FAU), University Hospital Erlangen, Erlangen, Germany
| | - C Knipfer
- Department of Oral and Maxillofacial Surgery, Friedrich-Alexander-University Erlangen-Nürnberg (FAU), University Hospital Erlangen, Erlangen, Germany
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Ercan E, Celikoglu M, Buyuk SK, Sekerci AE. Assessment of the alveolar bone support of patients with unilateral cleft lip and palate: a cone-beam computed tomography study. Angle Orthod 2015; 85:1003-8. [PMID: 25650761 DOI: 10.2319/092614-691.1] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVE To assess the bone support of the teeth adjacent to a cleft using cone-beam computed tomography (CBCT). MATERIALS AND METHODS The CBCT scans of 31 patients with unilateral cleft lip and palate (UCLP) were assessed. The data for teeth neighboring the cleft were compared with those of contralateral noncleft teeth. For each tooth analyzed, the distance between the cementoenamel junction (CEJ) and the bone crest (AC) at the buccal side was measured as was the thickness of the buccal bone level at 0, 1, 2, and 4 mm. RESULTS The bone thicknesses of the central teeth at the cleft region at the crest and 2 mm apically were statistically significantly thinner than that of the central incisor at a noncleft region. The CEJ-AC distance for central teeth at the cleft region was higher than that for central teeth in a noncleft region. CONCLUSIONS Subjects with UCLP showed reduced bone support at teeth neighboring the cleft compared with controls. This may cause some problems during orthodontic treatment.
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Affiliation(s)
- Esra Ercan
- a Assistant Professor, Department of Periodontology, Karadeniz Technical University, Trabzon, Turkey
| | - Mevlut Celikoglu
- b Associate Professor, Department of Orthodontics, Akdeniz University, Antalya, Turkey
| | | | - Ahmet Ercan Sekerci
- d Assistant Professor, Department of Oral and Maxillofacial Radiology, Erciyes University, Kayseri, Turkey
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Geisinger ML, Abou-Arraj RV, Souccar NM, Holmes CM, Geurs NC. Decision making in the treatment of patients with malocclusion and chronic periodontitis: Scientific evidence and clinical experience. Semin Orthod 2014. [DOI: 10.1053/j.sodo.2014.06.006] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Mutthineni RB, Nutalapati R, Kasagani SK. Comparison of oral hygiene and periodontal status in patients with clefts of palate and patients with unilateral cleft lip, palate and alveolus. J Indian Soc Periodontol 2011; 14:236-40. [PMID: 21731249 PMCID: PMC3118074 DOI: 10.4103/0972-124x.76928] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2009] [Accepted: 09/15/2010] [Indexed: 11/04/2022] Open
Abstract
Aim: This study was conducted to analyze and compare the oral hygiene and periodontal status in patients with clefts of palate (CP) and patients with unilateral cleft lip, palate and alveolus (UCLPA). Materials and Methods: The study group consisted of 120 cleft patients. Subjects were divided into two groups of 60 each. Group I - patients with UCLPA and Group II - patients with CP. For comparison, all the four quadrants were defined, Q1-right upper quadrant, Q2-left upper quadrant, Q3-left lower quadrant and Q4-right lower quadrant, in both groups and the following parameters were recorded: Plaque Index (PI, Silness and Loe), Sulcus Bleeding Index (SBI, Muhlemann and Son), Probing Pocket Depth (PPD), Clinical Attachment Level (CAL), Mobility Index (Miller) and Radiographic Amount of Bone Loss. Results: The periodontal destruction was seen to be higher in UCLPA patients compared with CP patients. The poor oral hygiene status, as indicated by higher values of PI, and the periodontal status, evaluated by SBI, PPD, CAL, mobility and Radiographic Amount of Bone Loss, were higher in patients with UCLPA than in patients with CP. Conclusion: In this study, patients with cleft lip, palate and alveolus had poor oral hygiene and periodontal status compared with patients with cleft palate.
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Affiliation(s)
- Ramesh Babu Mutthineni
- Department of Periodontics, Mamata Dental College and Hospital, Khammam, Andhra Pradesh, India
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Rawashdeh MA, Ayesh JA, Darwazeh AMG. Oral Candidal Colonization in Cleft Patients as a Function of Age, Gender, Surgery, Type of Cleft, and Oral Health. J Oral Maxillofac Surg 2011; 69:1207-13. [DOI: 10.1016/j.joms.2010.02.044] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2009] [Revised: 02/01/2010] [Accepted: 02/18/2010] [Indexed: 11/29/2022]
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Boloor V, Thomas B. Comparison of periodontal status among patients with cleft lip, cleft palate, and cleft lip along with a cleft in palate and alveolus. J Indian Soc Periodontol 2010; 14:168-72. [PMID: 21760670 PMCID: PMC3100859 DOI: 10.4103/0972-124x.75911] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2010] [Accepted: 06/17/2010] [Indexed: 11/04/2022] Open
Abstract
BACKGROUND AND OBJECTIVES A healthy periodontium is an important prerequisite for unhindered dentition and long-term oral health. In cleft subjects, especially in those with cleft lip, alveolus and palate (CLAP), maintenance of oral hygiene is a difficult task for the patients because of the patent oro-nasal communication. Crowding of teeth in cleft patients is a common finding, especially in those with CLAP and those with cleft palate (CP). In the case of multiple tooth-malpositions, transverse deficiency, arch length deficiency and primary cross-bite; periodontal trauma increases and is detrimental to periodontal health. According to literature, a critical periodontal situation was found in patients with CLAP. Hence a study was conducted to analyze the periodontal status of patients with cleft lip (CL); those with cleft palate; and those with cleft lip, alveolus and palate. MATERIALS AND METHODS The present study consisted of 60 cleft subjects divided into 3 groups: those with cleft lip; those with cleft palate; and those with cleft lip, alveolus and palate. Subjects with permanent dentition were selected, and the clinical examination included determination of oral hygiene status using Oral Hygiene Index - Simplified (OHI-S) index and periodontal status using community periodontal index (CPI). RESULTS Statistically significant increase in the periodontal disease in the CLAP group as compared with the other 2 groups, and the oral hygiene was seen to be generally poor with the CLAP group. INTERPRETATION AND CONCLUSION Individuals with clefts are more prone to periodontal disease due to the presence of cleft, which causes retention of food in the defect sites and inability to maintain good oral hygiene; but the severity of periodontal disease is more if the defect is large and involving the lip, alveolus and palate.
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Affiliation(s)
- Vinita Boloor
- Department of Periodontics, Yenepoya Dental College, Deralakatte, Mangalore - 575 018, India
| | - Biju Thomas
- A B Shetty Memorial Institute of Dental Sciences, Deralakatte, Mangalore - 575 018, India
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Perdikogianni H, Papaioannou W, Nakou M, Oulis C, Papagiannoulis L. Periodontal and microbiological parameters in children and adolescents with cleft lip and /or palate. Int J Paediatr Dent 2009; 19:455-67. [PMID: 19732188 DOI: 10.1111/j.1365-263x.2009.01020.x] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Objective. To evaluate the oral hygiene and the periodontal condition of children and adolescents with cleft lip and/or palate (CLP). Methods. Forty-one children and adolescents, 4-18 years, with CLP and 41 normal controls participated. Clinical parameters examined were the plaque and gingival index and Community Periodontal Index of Treatment Needs. For teeth in the cleft area, probing pocket depth, bleeding on probing, and tooth mobility were also evaluated. Samples of subgingival plaque were collected from 21 randomly selected patients of each group. Results. The CLP group had generally poorer oral hygiene (plaque index significantly higher) compared with the control. Children in both groups presented mild degree of gingivitis. Teeth in the cleft area had significantly higher pocket probing depth and tooth mobility, compared with corresponding teeth in the control group. The microbial analysis did not reveal significant differences in the composition of the subgingival microbiota between groups. Teeth in the cleft presented higher isolation frequencies and mean percentages of periodontopathic bacteria. Conclusion. Youngsters with CLP showed poor oral hygiene and worse periodontal condition, compared with controls. The above results advocate their participation in an intensive preventive dental programme that should start at an early age, possibly decreasing the risk of future periodontal disease.
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Stec-Slonicz M, Szczepańska J, Hirschfelder U. Comparison of caries prevalence in two populations of cleft patients. Cleft Palate Craniofac J 2007; 44:532-7. [PMID: 17760485 DOI: 10.1597/06-121.1] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE To assess and compare the oral and dental status and the level of oral health care among Polish and German patients with cleft lip and palate treated in Łódź and Erlangen, followed by an assessment of the level of realization of oral care procedures. DESIGN Oral and dental status were assessed by the presence of dental plaque and caries lesions. Parents of each patient completed a questionnaire related to frequency of tooth brushing, frequency of dental visits, and the use of means with increased fluoride content. SETTING Department of Dentistry for Developmental Ages, Medical University of Łódź, Łódź, Poland, and Department of Orthodontics, University of Erlangen-Nuremburg, Erlangen, Germany. PATIENTS AND INTERVENTION Thirty-seven Polish patients were examined between February and April 2004. Sixty-three German patients were examined between October 2004 and August 2005. RESULTS In Erlangen, decayed teeth = 1.625, missing teeth = 0.014, and filled teeth = 2.39. In Łódź, decayed teeth = 2.5, missing teeth = 0.09, and filled teeth = 0.75. Among the subjects with Approximal Plaque Index scores <40%, the Decayed-Missing-Filled-Teeth Index was significantly higher in Polish than in German patients. In the total population of patients, a positive correlation between the value of the API Index and caries intensity was recorded. Declared parents' answers did not copy the actual oral cavity status. CONCLUSIONS Caries prevalence in each group was much higher than in the general population and significantly higher among Polish than German cleft patients. Programs for cleft children promoting oral health, especially aimed at plaque control, are recommended in the early stages of the children's lives.
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Dewinter G, Quirynen M, Heidbüchel K, Verdonck A, Willems G, Carels C. Dental abnormalities, bone graft quality, and periodontal conditions in patients with unilateral cleft lip and palate at different phases of orthodontic treatment. Cleft Palate Craniofac J 2003; 40:343-50. [PMID: 12846599 DOI: 10.1597/1545-1569_2003_040_0343_dabgqa_2.0.co_2] [Citation(s) in RCA: 53] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVES To evaluate the dental and periodontal condition of patients with unilateral cleft lip and palate (UCLP) before orthodontic treatment and evaluate whether the dental and periodontal condition of these patients during and after orthodontic treatment was jeopardized by the duration of the orthodontic and surgical treatment. DESIGN Seventy-five individuals with UCLP (52 males, 23 females), between ages 8 and 20 years, participated in a retrospective study during their final follow-up visit with regard to dental abnormalities, such as hypodontia, external root resorption, crown and root malformation, and supernumerary teeth. Alveolar bone height and periodontal attachment loss on the cleft side were also screened before or after bone grafting and at different stages of orthodontic treatment. RESULTS Hypodontia of the lateral incisor was found in more than 50% of the patients on the cleft side. Second premolars and/or lateral incisors outside the cleft area were missing in 27.2% of the patients. In 32%, malformations of the teeth near the cleft were noticed. In general, the teeth around and in the cleft of the patients showed normal septal bone heights and a healthy periodontium. Sixty of the 75 patients received a bone graft to restore the interrupted alveolar process. In 93.3% of these patients, the cleft was grafted before the eruption of the canine. CONCLUSION The periodontium of the teeth in and around the cleft in patients with UCLP observed during and after orthodontic treatment can cope relatively well with the long orthodontic treatment and combined surgical interventions. The children, who had not yet started treatment, also showed enough bone support and no periodontal problems of the teeth besides the cleft. Early secondary bone grafting seems to give optimal periodontal results.
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Affiliation(s)
- G Dewinter
- Department of Orthodontics, Faculty of Medicine, Katholieke Universiteit Leuven, Leuven, Belgium
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