Secondary Dentition Characteristics in Children With Nonsyndromic Unilateral Cleft Lip and Palate: A Retrospective Study.

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.

Dental maturation of unilateral cleft lip and palate.

Cleft lip and palate (CLP) is the most common craniofacial abnormality and the fourth most common birth defect in Singapore. Many reports suggest that CLP children have delayed dental development and asymmetrical timing of tooth-pair formation. The aim of this study was to investigate the timing of development of permanent teeth in unilateral CLP (UCLP) children and to compare the findings with non-CLP children in Singapore. A total of 60 UCLP children aged between 5 and 9 years (mean 6.64 ± 0.90 years) and a non-CLP control group matched for age, gender, and race were investigated and compared. Dental records and radiographs were studied and the dental maturation was determined using the Demirjian's method (1973). The dental maturation of UCLP children were delayed compared with non-CLP children by a mean of 0.55 ± 0.75 years and the delay was statistically significant (P < 0.001). The UCLP group also had significantly higher risk of asymmetrically developing tooth pairs than the control group (P < 0.001). The most commonly delayed tooth in development was the maxillary cleft-sided lateral incisor. In conclusion, the UCLP children in Singapore demonstrated delayed dental maturation and a higher occurrence of asymmetrical tooth-pair formation than the non-CLP children.