Supernumerary Lateral Incisor Teeth

A sample of 62 cases of supernumerary teeth found in the lateral incisor area was selected and analysed. The great majority of these teeth were supplemental teeth, with deciduous precedents. Both teeth (the normal incisor and supernumerary) showed reduction in size as compared to the unaffected side. Differences were found between the mesial unit and the distal—the mesial being larger and having an incisor shape and the distal smaller and resembling a canine. Many of the pairs were similar to supernumerary teeth found in cleft lip and palate and there were also effects upon the other teeth particularly central incisors. Stigmata of cleft were observed in the alveolus, nasal floor and hard palate in a significant proportion of cases. It is concluded that supernumerary laterals arise by gemination or failure of development of normal odontogenic material. The anomaly fulfils the hypothetical criteria for a microform of cleft and may be the result of a minor error in embryonic fusion.

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Combined Bone Grafting and Delayed Closure of the Hard Palate in Patients with Unilateral Cleft Lip and Palate: Facilitation of Lateral Incisor Eruption and Evaluation of Indicators for Timing of the Procedure

The Cleft Palate-Craniofacial Journal ◽

10.1597/1545-1569_2000_037_0098_cbgadc_2.3.co_2 ◽

2000 ◽

Vol 37 (1) ◽

pp. 98-105 ◽

Cited By ~ 17

Author(s):

Jan Lilja ◽

Amin Kalaaji ◽

Hans Friede ◽

Anna Elander

Keyword(s):

Bone Grafting ◽

Hard Palate ◽

Cleft Lip ◽

Cleft Lip And Palate ◽

Lateral Incisor ◽

Delayed Closure

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Combined Bone Grafting and Delayed Closure of the Hard Palate in Patients with Unilateral Cleft Lip and Palate: Facilitation of Lateral Incisor Eruption and Evaluation of Indicators for Timing of the Procedure

The Cleft Palate-Craniofacial Journal ◽

10.1597/1545-1569(2000)037<0098:cbgadc>2.3.co;2 ◽

2000 ◽

Vol 37 (1) ◽

pp. 98-105 ◽

Cited By ~ 33

Author(s):

Jan Lilja ◽

Amin Kalaaji ◽

Hans Friede ◽

Anna Elander

Keyword(s):

Bone Grafting ◽

Hard Palate ◽

Cleft Lip ◽

Cleft Lip And Palate ◽

Lateral Incisor ◽

Delayed Closure

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Histologic Aspect of the Curved Vomerine Mucosa in Cleft Lip and Palate

The Cleft Palate-Craniofacial Journal ◽

10.1177/10556656211031419 ◽

2021 ◽

pp. 105566562110314

Author(s):

Benito K. Benitez ◽

Andrzej Brudnicki ◽

Prasad Nalabothu ◽

Jeannette A. von Jackowski ◽

Elisabeth Bruder ◽

...

Keyword(s):

Nasal Mucosa ◽

Cleft Lip ◽

Cleft Lip And Palate ◽

Squamous Metaplasia ◽

Periodic Acid ◽

Surgical Techniques ◽

Basal Cells ◽

Periodic Acid Schiff ◽

Tissue Samples ◽

Nasal Floor

Background: Common surgical techniques aim to turn the entire vomerine mucosa with vomer flaps either to the oral side or to the nasal side. The latter approach is widely performed due to the similarity in color to the nasal mucosa. However, we lack a histologic description of the curved vomerine mucosa in cleft lip and palate malformations. Methods: We histologically examined an excess of curved vomerine mucosa in 8 patients using hematoxylin–eosin, periodic acid–Schiff, Elastin van Gieson, and Alcian blue stains. Tissue samples were obtained during surgery at 8 months of age. Results: Our histological analysis of the mucoperiosteum overlying the curved vomer revealed characteristics consistent with those of an oral mucosa or a squamous metaplasia of the nasal mucosa, as exhibited by a stratified squamous epithelium containing numerous seromucous glands. Some areas showed a palisaded arrangement of the basal cells compatible with metaplasia of respiratory epithelium, but no goblet cells or respiratory cilia were identified. Abundant fibrosis and rich vascularity were present. Conclusion: The vomer mucosa showed no specific signs of nasal mucosa. These findings should be considered in presurgical cleft orthopedics and palatal surgery for further refinement. Shifting the vomer mucosa according to a fixed physiologic belief should not overrule other important aspects of cleft repair such as primary healing and establishing optimal form and function of palatal roof and nasal floor.

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Dual embryonic origin of maxillary lateral incisors: clinical implications in patients with cleft lip and palate

Dental Press Journal of Orthodontics ◽

10.1590/2177-6709.20.5.118-125.sar ◽

2015 ◽

Vol 20 (5) ◽

pp. 118-125 ◽

Cited By ~ 5

Author(s):

Daniela Gamba Garib ◽

Julia Petruccelli Rosar ◽

Renata Sathler ◽

Terumi Okada Ozawa

Keyword(s):

Cleft Lip ◽

Cleft Lip And Palate ◽

Lateral Incisor ◽

Craniofacial Anomalies ◽

Nasal Process ◽

Embryonic Origin ◽

Maxillary Lateral Incisor ◽

To Come ◽

Dual Origin ◽

Research Analysis

Introduction:Cleft lip and palate are craniofacial anomalies highly prevalent in the overall population. In oral clefts involving the alveolar ridge, variations of number, shape, size and position are observed in maxillary lateral incisors. The objective of this manuscript is to elucidate the embryonic origin of maxillary lateral incisors in order to understand the etiology of these variations.Contextualization: The hypothesis that orofacial clefts would split maxillary lateral incisor buds has been previously reported. However, recent studies showed that maxillary lateral incisors have dual embryonic origin, being partially formed by both the medial nasal process and the maxillary process. In other words, the mesial half of the lateral incisor seems to come from the medial nasal process while the distal half of the lateral incisor originates from the maxillary process. In cleft patients, these processes do not fuse, which results in different numerical and positional patterns for lateral incisors relating to the alveolar cleft. In addition to these considerations, this study proposes a nomenclature for maxillary lateral incisors in patients with cleft lip and palate, based on embryology and lateral incisors position in relation to the alveolar cleft.Conclusion:Embryological knowledge on the dual origin of maxillary lateral incisors and the use of a proper nomenclature for their numerical and positional variations renders appropriate communication among professionals and treatment planning easier, in addition to standardizing research analysis.

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Secondary Dentition Characteristics in Children With Nonsyndromic Unilateral Cleft Lip and Palate

The Cleft Palate-Craniofacial Journal ◽

10.1177/1055665617750489 ◽

2018 ◽

Vol 55 (4) ◽

pp. 582-589 ◽

Cited By ~ 3

Author(s):

Elaine Li Yen Tan ◽

Meaw Charm Kuek ◽

Hung Chew Wong ◽

Serene Ai Kiang Ong ◽

Mimi Yow

Keyword(s):

Cleft Lip ◽

Cleft Lip And Palate ◽

Permanent Teeth ◽

Tooth Size ◽

Dental Anomalies ◽

Supernumerary Teeth ◽

High Prevalence ◽

Dental Records ◽

Congenitally Missing ◽

Maxillary Region

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.

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Cleft Maxillary Hypoplasia

Oral and Maxillofacial Surgery for the Clinician ◽

10.1007/978-981-15-1346-6_75 ◽

2021 ◽

pp. 1675-1702

Author(s):

Philip Mathew ◽

Mustafa. K ◽

Paul Mathai

Keyword(s):

Treatment Planning ◽

Hard Palate ◽

Cleft Lip ◽

Cleft Lip And Palate ◽

Clinical Problem ◽

Congenital Defect ◽

Individualized Treatment ◽

Maxillary Hypoplasia ◽

Surgical Interventions ◽

Detailed Evaluation

AbstractCleft lip and palate patients are born with a challenging deformity that requires multiple surgical interventions in order to reach functional and esthetic harmony. Mid face deficiency in cleft patients is a challenging clinical problem very often encountered in the management of this congenital defect. Cleft maxillary hypoplasia can be attributed to the inherited traits, acquired traits and Induced traits. CLP patients usually present with symptoms varying from malocclusion, retrusion of midface, and a narrow hard palate. A detailed evaluation and individualized treatment planning is of utmost importance in dealing with these patients. Treatment involves the contribution from both the orthodontist and the craniofacial team. The goals for the treatment for cleft maxillary hypoplasia are improvement of aesthetic deficits as well as correction of malocclusion.

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Hard Palate Repair Timing and Facial Growth in Unilateral Cleft Lip and Palate: A Longitudinal Study

The Cleft Palate-Craniofacial Journal ◽

10.1597/05-119 ◽

2006 ◽

Vol 43 (5) ◽

pp. 547-556 ◽

Cited By ~ 53

Author(s):

Yu-Fang Liao ◽

Timothy J. Cole ◽

Michael Mars

Keyword(s):

Longitudinal Study ◽

Hard Palate ◽

Cleft Lip ◽

Cleft Lip And Palate ◽

Sri Lankan ◽

Facial Morphology ◽

Facial Growth ◽

Clinical Notes ◽

Timing Effect ◽

Palate Repair

Objective: To investigate whether timing of hard palate repair had a significant effect on facial growth in patients with unilateral cleft lip and palate (UCLP). Design: Retrospective longitudinal study. Setting: Sri Lankan Cleft Lip and Palate Project. Patients: A total of 104 patients with nonsyndromic UCLP who had hard palate repair by age 13 years, with their 290 cephalometric radiographs taken after lip and palate repair. Main Outcome Measures: Clinical notes were used to record surgical treatment histories. Cephalometry was used to determine facial morphology and growth rate. Results: Timing of hard palate repair had a significant effect on the length and protrusion of the alveolar maxilla (PMP-A and SNA, respectively) and the anteroposterior alveolar jaw relation (ANB) at age 20 years but not on their growth rates. Conclusion: Timing of hard palate repair significantly affects the growth of the maxilla in patients with UCLP. Late hard palate repair has a smaller adverse effect than does early hard palate repair on the growth of the maxilla. This timing effect primarily affects the anteroposterior development of the maxillary dentoalveolus and is attributed to the development being undisturbed before closure of the hard palate.

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Oronasal Transfixion Suture to Prevent Uplifted Nasal Floor Deformity in Cleft Lip and Palate Patients: A 5-Year Follow-Up

The Cleft Palate-Craniofacial Journal ◽

10.1177/1055665618774027 ◽

2018 ◽

Vol 56 (3) ◽

pp. 390-394

Author(s):

Yuta Nakajima ◽

Shunsuke Yuzuriha ◽

Fumio Nagai ◽

Kenya Fujita ◽

Masahiko Noguchi

Keyword(s):

Private Practice ◽

Cleft Lip ◽

Chart Review ◽

Outcome Measure ◽

Cleft Lip And Palate ◽

Tertiary Care ◽

University Hospital ◽

Nasal Floor ◽

Orbicularis Oris Muscle

Objective: In unilateral cleft lip and palate, the reconstructed nasal floor is sometimes uplifted regardless of the reconstructive method used. We used a 5-0 absorbable anchoring suture, the oronasal transfixion suture (ONT suture), to fasten the reconstructed nasal floor to the orbicularis oris muscle to prevent this deformity. This study was performed to evaluate the effects of the ONT suture. Design: Blind retrospective study of photography and chart review. Setting: Shinshu University Hospital, tertiary care, Nagano, Japan. Private practice. Patients: Ninety-three consecutive patients with unilateral complete cleft lip and palate who had undergone primary nasolabial repair in our department and affiliated hospitals between 1999 and 2011 participated in this study. Finally, 45 patients were included. Interventions: The ONT suture was put in place at the time of primary nasolabial repair. Main Outcome Measure: The height of the nasal floor was evaluated on submental view photographs at 5 years old. Results: The ONT suture was applied in 21 patients. The height of the nasal floor on the cleft side was significantly closer to that on the noncleft side with the ONT suture than without the ONT suture ( P = .008). Conclusions: The ONT suture is effective to prevent uplifted nasal floor deformity on the cleft side// in unilateral complete cleft lip and palate at the time of primary nasolabial repair.

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Cranial Base in Newborns with Complete Cleft Lip and Palate: Radiographic Study

The Cleft Palate-Craniofacial Journal ◽

10.1597/1545-1569_1995_032_0199_cbinwc_2.3.co_2 ◽

1995 ◽

Vol 32 (3) ◽

pp. 199-205 ◽

Cited By ~ 6

Author(s):

Kirsten Mølsted ◽

Inger Kjær ◽

Erik Dahl

Keyword(s):

Temporal Bone ◽

Cleft Lip ◽

Cleft Lip And Palate ◽

Test Group ◽

Cranial Base ◽

Sphenoid Bone ◽

Control Group ◽

Petrous Portion ◽

A Minor ◽

Base Width

In a 1993 study, Mølsted and colleagues found an increased width of the sphenooccipital synchondrosis in newborns with complete clefts of the lip, alveolus, and palate compared with newborns with incomplete clefts. As the spheno-occipital synchondrosis represents remnants of the early chondrocranium that later ossifies and incorporates in the cranial base, it is possible that an inborn alteration, such as a deviant growth of cartilage, or a delayed maturation in the early development of the cartilaginous cranial base, can affect not only the length and the width of the cranial base, but also the petrous portion of the temporal bone and the nasal septum, as these structures also have a cartilaginous origin. The purpose of the present study was to measure the cranial base width, including the width of the maxilla, and to measure the bilateral angulation of the petrous portion of the temporal bone and the sphenoid bone in 3-month-old children with complete clefts and in 3-month-old children with an incomplete cleft of the lip, and to compare the two groups. Fifty-two children with complete clefts (CLP) without associated malformations comprised the test group. Forty-eight children with a minor, incomplete cleft lip (CL) constituted the control group. The results of the comparison showed marked differences between the CLP and CL groups. In the CLP children, the cranial base width and the bilateral angulation of the sphenoid bone increased. An increased angulation was also seen between left and right sides of the pars petrosa. Furthermore, increased maxillary width was found. This confirms that cleft lip and palate is not an isolated malformation localized to the jaws but a malformation, which also involves the cartilaginous cranial base.

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