Dental Anomalies as Part of the Cleft Spectrum

2008 ◽  
Vol 45 (4) ◽  
pp. 414-419 ◽  
Author(s):  
Renato Menezes ◽  
Alexandre Rezende Vieira

Objective: The aim of this study was to determine subphenotypes of clefts based on tooth development. Dental phenotypes (tooth agenesis, supernumerary and impacted teeth, transposition, and structural anomalies) outside the cleft area in the permanent dentition of oral cleft individuals were investigated. Design: Evaluation of dental records of cleft patients. Setting: National Museum of Health and Medicine, Washington, D.C. Patients, Participants: A collection of dental casts, radiographic and clinical records of 146 patients with oral clefts was evaluated. Main Outcome Measure: Association of dental anomalies with preferential subtypes of clefts. Results: Forty-seven individuals (32.19%) presented at least one dental anomaly outside the cleft area. Individuals with complete cleft lip and palate (CLP) presented more dental anomalies than individuals with incomplete CLP (p  =  .04). Cleft palate individuals presented more dental anomalies than CLP individuals (p  =  .048). Maxillary lateral incisors and premolars were the most affected teeth. High incidence of maxillary second premolar agenesis was observed in individuals with bilateral CLP (p  =  .04). In cases with unilateral CLP, 12.5% presented dental anomalies of the maxillary lateral incisors on the noncleft side. Cleft palate individuals presented a high incidence of mandibular premolar anomalies (p  =  .004). Conclusion: Future studies should consider the inclusion of a complete dental description to aid in the definition of cleft subphenotypes to be studied.

2015 ◽  
Vol 3 (1) ◽  
pp. 32-37 ◽  
Author(s):  
Mario Rodrigues Melo Filho ◽  
Verônica Oliveira Dias ◽  
Daniella Reis Martelli ◽  
Lívia Ribeiro Paranaíba ◽  
Mário Sérgio Oliveira Swerts ◽  
...  

The purpose of the present study was to evaluate the prevalence of teeth malposition (rotated) in Brazilian patients with oral clefts and to contribute to the definition of subphenotypes. This study included 317 patients with nonsyndromic cleft lip with or without cleft palate. Tooth malposition was assessed clinically, through radiographs, and medical history records for each individual. Only teeth malpositions outside the area of the clefts were included. Comparisons were assessed by cross-tabulation and standard chi-square test, and statistical significance was set at p≤0.05. Cleft lip and palate was more prevalent in males, while cleft palate was more common in females. Regarding the presence of tooth malposition, of the 317 patients, 92 (29.02%) had at least one tooth with the dental anomaly. Tooth malposition was more common in patients with cleft lip and palate (16.1%), followed by, respectively, cleft palate (6.9%) and cleft lip (6%) (p=0.112). The highest occurrence of tooth malposition was in the mandible and involved the canines (p<0.01). Few studies have investigated the prevalence of tooth malposition in individuals with nonsyndromic cleft lip with or without cleft palate. Our results confirmed the highest occurrence of dental anomalies, particularly tooth malposition, in patients with oral clefts. Our findings also highlight that there was a higher occurrence of this condition in the mandible and not the maxilla.


2018 ◽  
Vol 55 (4) ◽  
pp. 582-589 ◽  
Author(s):  
Elaine Li Yen Tan ◽  
Meaw Charm Kuek ◽  
Hung Chew Wong ◽  
Serene Ai Kiang Ong ◽  
Mimi Yow

Objective: Children with cleft lip and palate are reported to be commonly associated with higher prevalence of dental anomalies such as hypodontia, supernumeraries, and abnormalities in tooth size, shape, and position. This study investigated the prevalence of dental anomalies in a longitudinal cohort of children with unilateral cleft lip and palate (UCLP). Design: The study was a retrospective analysis of radiographs, study models, and treatment notes. Patients: Sixty patients with repaired UCLP aged 13 years old with complete dental records dating from 5 years of age were included. Methods: Study casts, dental panoramic, anterior maxillary occlusal, and periapical radiographs of the patients were examined for cleft-sidedness, congenitally missing permanent teeth, supernumerary teeth, microdontic, and macrodontic teeth in the anterior maxillary region, presence of malformed permanent cleft-sided lateral incisor and its morphology (peg-shaped, conical shaped, canine-formed), positions of the permanent lateral incisors relative to the cleft side and presence of rotated cleft-sided central incisors. Results: Of the 60 patients studied, 63.3% had hypodontia, 21.7% had supernumerary teeth, 69.6% had microdontia, and 12.5% had macrodontia. All of the cleft-sided permanent lateral incisors had associated anomalies, with a large proportion (43.1%) missing; and when present in 31 subjects, the majority (90.3%) was positioned distal to the cleft. Most of the cleft-sided permanent central incisors were rotated if present, and prevalent at 86.7%. Conclusion: A high prevalence of dental anomalies was observed in this sample of children with UCLP.


2020 ◽  
Vol 20 (1) ◽  
pp. 257-263
Author(s):  
Adriana Boeri Freire Tamburini ◽  
Ygor Henrique Pereira Rodrigues ◽  
Daniella Reis Barbosa Martelli ◽  
Letízia Monteiro de Barros ◽  
Rodrigo Soares de Andrade ◽  
...  

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.


2016 ◽  
Vol 10 (02) ◽  
pp. 254-258 ◽  
Author(s):  
Wendy Nicholls

ABSTRACT Objective: The purpose of this paper was to describe the prevalence and type of dental anomalies in the primary and permanent dentition in children with a cleft condition at Princess Margaret Hospital in Perth, Western Australia. Materials and Methods: The details of 162 current dental patients extracted from the main dental database through their year of birth for the period 1998–2001 were selected consecutively. Dental records and X-rays were examined by one examiner (WN) and verified by a second examiner (RB) to determine dental development. The mean age of the subjects was 10.8 years with equal numbers of males and females. Subjects were further divided into cleft type; unilateral cleft lip (UCL) and palate, bilateral cleft lip (BCL) and palate, UCL, BCL, and cleft palate. Results: One hundred sixty-two subjects were grouped into 21 categories of anomaly or abnormality. Prevalence rates for the categories were calculated for the overall group and for gender and cleft type. Conclusion: Overall, 94% of patients were found to have at least one dental anomaly, with fifty-six (34%) patients having more than one anomaly or abnormality.


2019 ◽  
Vol 8 (1) ◽  
Author(s):  
David Sainsbury ◽  
◽  
Caroline Williams ◽  
Catherine de Blacam ◽  
Joanne Mullen ◽  
...  

Abstract Background This systematic review aims to inform the development of a screening tool which pre-operatively predicts which children are likely to develop velopharyngeal insufficiency, one of the causes of poor speech outcomes, following cleft palate repair. This would be highly beneficial as it would inform pre-operative counselling of parents, allow targeted speech and language therapy, and enable meaningful comparison of outcomes between surgeons, techniques, and institutions. Currently, it is unclear which factors influence speech outcomes. A systematic review investigating the non-interventional factors which potentially influence speech outcomes following cleft palate repair is warranted. This may be illuminating in itself or provide foundations for future studies. Methods A systematic review will be carried out according to Cochrane methodology and reported according to PRISMA guidelines (PLoS Med 6: e1000097, 2009). Systematic review software will be used to facilitate three-stage screening by two independent reviewers experienced in cleft lip and palate. Thereafter, data extraction and GRADE assessment will be performed in duplicate by five independent reviewers experienced in cleft lip and palate. Studies reporting the proportion of patients who were recommended or underwent secondary speech surgery for velopharyngeal insufficiency following primary surgery for cleft palate will be included. The study findings will be tabulated and summarised. The primary outcome measure will be further speech surgery (either recommended or performed). The secondary outcome measure will be perceptual speech assessment for the presence of velopharyngeal insufficiency. A meta-analysis is planned. However, if this is not possible, due to the anticipated marked heterogeneity of study characteristics, pre-operative assessment, and the recorded outcome measures, a narrative synthesis will be undertaken. Discussion This systematic review may provide sufficient data to inform the development of a screening tool to predict the risk of velopharyngeal insufficiency prior to cleft palate repair. However, it is anticipated that these findings will provide the foundation for future studies in this area. Systematic review registration Registered on 19 December 2016 with PROSPERO CRD42017051624


2015 ◽  
Vol 2015 ◽  
pp. 1-5 ◽  
Author(s):  
Seunghee Ha ◽  
Kyung S. Koh ◽  
Heewon Moon ◽  
Seungeun Jung ◽  
Tae Suk Oh

This study presents clinical outcomes of primary cleft palate surgery, including rate of oronasal fistula development, rate of velopharyngeal insufficiency (VPI) requiring secondary surgery, and speech outcomes. We examined the effect of cleft type on the clinical outcomes. Retrospective analysis was performed using clinical records of all patients who received a primary palatoplasty at the Cleft Palate Clinic at Seoul Asan Medical Center, South Korea, between 2007 and 2012. The study included 292 patients with nonsyndromic overt cleft palate (±cleft lip). The results revealed that the rate of oronasal fistula was 7.9% and the incidence of VPI based on the rate of secondary palatal surgery was 19.2%. The results showed that 50.3% of all the patients had received speech therapy and 28.8% and 51.4% demonstrated significant hypernasality and articulatory deficits, respectively. The results of the rate of VPI and speech outcomes were significantly different in terms of cleft type. Except for the rate of oronasal fistula, patients with cleft palate generally exhibited better clinical outcomes compared to those with bilateral or unilateral cleft lip and palate. This study suggests that several factors, including cleft type, should be identified and comprehensively considered to establish an optimal treatment regimen for patients with cleft palate.


2020 ◽  
Vol 12 (2) ◽  
pp. 80-86
Author(s):  
Argemiro Alves da Silva Junior ◽  
Caroline Brandão Pires de Almeida

Cleft lip and palate are considered the most frequently studied facial changes in recent decades, due to their high incidence. The aim of this study was to identify the application of the nursing process applied to patients with cleft lip and/or palate, described in the literature. It is an integrative review of a qualitative approach focused on the search for results for evidence-based practice. From the combination of the descriptors, 38 productions were located. After applying the established criteria, the final sample consisted of seven articles. the implementation of a care protocol for patients with cleft, in different institutional contexts, and the results found in this review may also inspire the realization of future studies that demonstrate the impact that nursing care has on the rehabilitation of these patients.


Author(s):  
Dr. Minti Kumari ◽  
Dr. Madhuri Kumari ◽  
Dr Anurag Rai ◽  
Dr. Navin Kumar

It is evident that hyperdontia is more common in the permanent dentition than in the primary. There is a considerable difference between males and females in the prevalence of these teeth in permanent dentition; hyperdontia is twice as common in males as in females. However, this approximation varies in terms of location, other associating syndromes that may be present, and the ethnicity of the individual. In terms of ethnicity, it can be seen that hyperdontia is in fact less common in Caucasian than in Asian populations. There is evidence to show that an individual is more likely to have hyperdontia if other members of their family also have the condition. Hence the present study was planned for evaluation of occurrence of hyperdontia in non-syndromic  population from Bihar Region. The present study was planned in Public Health Dentistry, Patna Dental College and Hospital, Patna, Bihar. Total 195 patients referred to Department of Dentistry were evaluated in the present study. Panoramic radiographs and clinical records of patients above the age of 18 years and without any syndromic features were selected for the study.  All the radiographs were examined for the presence of supernumerary teeth, their location, morphology, and number. Morphologically, teeth were classified as conical, tuberculate, supplemental, and odontoma. Early diagnosis of dental anomalies can prevent some esthetic, orthodontic, and periodontal problems, and knowledge of the prevalence and distribution of the anomalies may help clinicians to the detection of these anomalies at early stages. Our study evaluated the prevalence of selected dental anomalies; future studies should investigate the prevalence of dental anomalies of all types. Keywords: Hyperdontia, non-syndromic, panoramic radiograph, supernumerary teeth, etc.


2017 ◽  
Vol 13 (2) ◽  
pp. 293-295
Author(s):  
Deepika Kapoor ◽  
Deepanshu Garg

Orofacial clefts (OFC) are one of the most common congenital problems seen with a very high incidence. It imparts a negative effect on the overall health of the child by hindering in his feeding practices, normal facial growth, development of dentition and hence speech. Infants born with orofacial clefts have oronasal communication which creates a problem with the creation of negative pressure inside the oral cavity required for suckling.The treatment for such patients is with the multidisciplinary approach but the preliminary  concern for the neonate is to help with the feeding for which a feeding appliance is given. This case report presents a case of a 3-day old infant to whom a feeding appliance was given to aid in suckling. 


2020 ◽  
pp. 105566562098024
Author(s):  
Kim Bettens ◽  
Laura Bruneel ◽  
Cassandra Alighieri ◽  
Daniel Sseremba ◽  
Duncan Musasizib ◽  
...  

Objective: To provide speech outcomes of English-speaking Ugandan patients with a cleft palate with or without cleft lip (CP±L). Design: Prospective case–control study. Setting: Referral hospital for patients with cleft lip and palate in Uganda. Participants: Twenty-four English-speaking Ugandan children with a CP±L (15 boys, 9 girls, mean 8.4 years) who received palatal closure prior to 6 months of age and an age- and gender-matched control group of Ugandan children without cleft palate. Interventions: Comparison of speech outcomes of the patient and control group. Main Outcome Measures: Perceptual speech outcomes including articulation, resonance, speech understandability and acceptability, and velopharyngeal composite score (VPC-sum). Information regarding speech therapy, fistula rate, and secondary surgery. Results: Normal speech understandability was observed in 42% of the patients, and 38% were judged with normal speech acceptability. Only 16% showed compensatory articulation. Acceptable resonance was found in 71%, and 75% of the patients were judged perceptually to present with competent velopharyngeal function based on the VPC-sum. Additional speech intervention was recommended in 25% of the patients. Statistically significant differences for all these variables were still observed with the control children ( P < .05). Conclusions: Overall, acceptable speech outcomes were found after early primary palatal closure. Comparable or even better results were found in comparison with international benchmarks, especially regarding the presence of compensatory articulation. Whether this approach is transferable to Western countries is the subject for further research.


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