scholarly journals Supernumerary teeth in patients with cleft lip and palate: the tooth germs do not separate

2021 ◽  
Vol 26 (4) ◽  
Author(s):  
Alberto CONSOLARO ◽  
Maria Carolina Malta MEDEIROS ◽  
Dario Augusto Oliveira MIRANDA ◽  
Ingrid Araújo de OLIVEIRA

ABSTRACT Introduction: Supernumerary teeth in cases of cleft lip and palate do not result from the division of normal germs before the formation of hard tissue. Deciduous and permanent teeth odontogenesis begins after the face has formed, either with or without the cleft. Discussion: The most acceptable hypothesis to enable understanding of the presence of supernumerary teeth on one or both sides of the cleft palate is hyperactivity of the dental lamina in its walls. This hyperactivity, with the formation of more tooth germs, must be attributed to mediators and genes related to tooth formation, under strong influence of local epigenetic factors, whose developmental environment was affected by the presence of the cleft. Conclusion: The current concepts of embryology no longer support the fusion of embryonic processes for the formation of the face, but rather the leveling of the grooves between them. All human teeth have a dual embryonic origin, as they are composed of ectoderm and mesenchyme/ectomesenchyme, but this does not make it easy for them to be duplicated to form supernumerary teeth.

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.


2019 ◽  
Vol 57 (1) ◽  
pp. 73-79 ◽  
Author(s):  
Salomón Yezioro-Rubinsky ◽  
Javier H. Eslava-Schmalbach ◽  
Liliana Otero ◽  
Sara A. Rodríguez-Aguirre ◽  
Ángela M. Duque ◽  
...  

Objectives: To assess the risk of dental anomaly presentation in permanent teeth in a group of Colombian children with nonsyndromic cleft lip and palate (NSCLP) and to determine the frequency of the anomalies according to the cleft type. Methods: An analytical matched case–control study was conducted with 210 controls and 210 patients with NSCLP. The patients were classified into 3 groups: complete right unilateral cleft lip and palate (RCLP), complete left unilateral cleft lip and palate (LCLP), and complete bilateral cleft lip and palate (BCLP). Univariate and multivariate Poisson regression models were used to analyze paired samples (Bonferroni adjustment, P ≤ .002). Results: A high risk of finding agenesis of the maxillary lateral incisors, supernumerary teeth, microdontia of the maxillary lateral incisors, and rotation of the maxillary central incisors adjacent to the cleft ( P < .0001) was observed in the patients with NSCLP. One or more dental anomalies were found in 98% of patients with BCLP, in 96% of those with LCLP, and in 87% of those with RCLP. Most of the anomalies were located on the cleft area. The incidence relative risk (IRR) of anomalies was highest in patients with BCLP (IRR: 10.5; 95% confidence interval [CI]: 6.76-16.3), followed by in those with LCLP (IRR: 8.51; 95% CI: 5.64-12.8). Conclusions: Most dental anomalies were found in the cleft area; this was expected because the cleft area was the most affected in the patients included in this study.


2021 ◽  
pp. 105566562110277
Author(s):  
Agnieszka Lasota ◽  
Weronika Siebieszuk ◽  
Przemysław Pastuszak ◽  
Adrianna Mostowska

Introduction: Cleft lip with or without cleft palate (CL/P) is congenital deformity associated with hyperdontia. Objective: To determine the prevalence and characteristics of supernumerary teeth in patients with CL/P. Design: Retrospective descriptive and correlation clinical study. Patients: One hundred thirteen children with cleft (age ranged 9.3-19.2; 67 males and 46 females) treated in Clinic of Congenital Facial Deformities Medical University of Lublin were included in the study. Methods: Records evaluation was conducted regarding age, gender, cleft type (Q36, Q37— International Classification of Diseases 10th revision), cleft side, and incidence of supernumeraries. In all supernumerary teeth, size, shape, and developmental degree were analyzed and correlation between the incidence of hyperdontia with different variables was checked. Correlations were detected using chi-square and the Yates correction. Results: The majority of the examined group were males—59.29% with Q37 (67.26%) and the cleft on the left side (62.83%). Hyperdontia was noted in 26.55%. Only upper lateral incisors were affected. They usually had atypical shape (56.67%), reduced size (83.33%), and delayed development (56.67%). Conclusions: The prevalence of supernumerary permanent teeth in patients with cleft was higher than in the general population. Anomaly was more frequent in male patients and occurred mainly on the cleft side. The severity of the cleft did not influenced the frequency of supernumerary teeth, their shape, size, and developmental degree. Supernumerary teeth were characterized by reduced crown size, abnormal structure, incorrect inclination, and delayed development phase.


Author(s):  
O. V. Dudnik ◽  
Ad. A. Mamedov ◽  
O. I. Admakin ◽  
A. A. Skakodub ◽  
Y. O. Volkov ◽  
...  

Relevance. Cleft lip and palate is one of the severe malformations of the face and jaw, requiring a comprehensive approach to the rehabilitation of the patients, including doctors of various specialties, one of which is orthodontists. A feature of orthodontic treatment is difficulty of fixing bracket systems, as well as lowering the level of oral hygiene, caused by deformation and displacement of fragments of the maxillofacial region.Purpose. Improving the effectiveness of orthodontic treatment and hygiene of the oral caviti in patients with cleft lip and palate in permanent bite period.Materials and methods. A comparison was made of the effetctiveness of fixing brackets systmes with direct and indirect bonding techniques and the effectiveness of oral hygiene during orthodontic treatment using irrigators.Results. The results of the study showed a difference in the effectiveness of using direct and indirect methods of fixing bracket systems in patients with cleft and palate. The use of irrigators as additional means of oral hygiene has demonstrated a positive dynamic of hygiene indices.Conclusions. Results of the study demonstrate the advantages of fixation the brackets by indirect bonding and use additional hygiene products irrigator for improving of oral hygiene.


2009 ◽  
Vol 46 (5) ◽  
pp. 529-531 ◽  
Author(s):  
Mahmoud Al-Dajani

Objective: To evaluate the prevalence of dental caries in patients with cleft lip and/or palate and their cleft-free sibling controls. Methods: The two subject groups (patient and control) comprised 106 participants. The former group consisted of 53 patients with cleft lip and/or palate, aged 12 to 29 years, who visited the Oral and Maxillofacial Surgery Hospital at Damascus University of Syria. The control group consisted of the patients’ siblings who had no clefts, and they were sex matched to the patient group. Dental caries were examined clinically and were reported using the decayed, missing, and filled permanent teeth (DMFT) index. The DMFT scores were compared between the two groups. Results: The author found an overall association of dental caries with the presence of cleft lip and/or palate (odds ratio  =  2.52; 95% confidence interval  =  1.389–4.574; p < .05). The DMFT index scores were proportionally higher in patients with cleft lip and/or palate compared with the control group (p < .001). Conclusion: Subjects with cleft lip and palate are susceptible to dental caries independently of socioeconomic status.


2015 ◽  
Vol 20 (5) ◽  
pp. 118-125 ◽  
Author(s):  
Daniela Gamba Garib ◽  
Julia Petruccelli Rosar ◽  
Renata Sathler ◽  
Terumi Okada Ozawa

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.


1992 ◽  
Vol 29 (4) ◽  
pp. 380-384 ◽  
Author(s):  
Akira Suzuki ◽  
Mieko Watanabe ◽  
Masayuki Nakano ◽  
Yasuhide Takahama

Maxillary lateral incisors on the alveolar cleft were investigated in 431 cleft children registered in the Department of Orthodontics, Kyushu University Dental Hospital. The majority of primary maxillary lateral incisors were located on the distal side of the alveolar cleft in both unilateral cleft lip and alveolus (UCLA) and unilateral cleft lip and palate (UCLP) subjects. Permanent teeth in UCLA tend to be located distally, but in UCLP they tend to be congenially absent (p < .01). The majority of primary teeth had normal shapes; the majority of permanent teeth were of intermediate type or were missing congenially. One third of the UCLA and one half of the UCLP subjects who had primary maxillary lateral incisors were not followed by permanent replacements. The location of the majority of permanent maxillary lateral incisors tallied with that of the primary ones except in four UCLA, ten UCLP, and two bilateral cleft lip and palate (BCLP) subjects. Four UCLA and ten UCLP subjects who had primary lateral incisors on the distal side were followed by their permanent successors on the mesial side. Three UCLP and one BCLP subjects had permanent maxillary lateral incisors even though they had no temporary predecessors.


1996 ◽  
Vol 33 (5) ◽  
pp. 436-439 ◽  
Author(s):  
Peter J. Anderson ◽  
Anthony L.H., Moss

The incidence of dental abnormalities in the cleft lip and palate population has been reported to be much higher than in the normal population. The role of genes in the production of a cleft lip and palate, and dental anomalies is thought to be complex, with autosomal dominant, recessive, and x-linked genes all playing a role. Noncleft parents can carry some of the cleft lip and palate genes, which produce clinically subtle manifestations in their facial skeleton. The purpose of this study was to look for evidence of increased dental anomalies in the non-cleft parents of cleft lip and palate children. The dentitions of the parents of 60 children with different types of cleft lip and palate were examined prospectively to see whether or not they exhibited features found more readily in the cleft lip and palate rather than did the normal population. Their dentitions were studied to record the following dental features: congenitally missing teeth, supernumerary teeth, or morphologic changes of the crowns of the permanent teeth. The number and position of any frenal attachments were also recorded. The results of this study did not show any differences in incidence of dental anomalies from the noncleft population. There was no evidence to support the hypothesis that congenital absence of lateral incisors is a microform of cleft lip and palate. Further, these results also failed to reveal any consistent pattern in the number and position of frenal attachments.


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