Objective: To assess the prevalence and patterns of hypodontia in nonsyndromic Pierre Robin sequence (PRS) and compare it with hypodontia in nonsyndromic isolated cleft palates and isolated cleft lips. Design: Retrospective cohort study. Setting: Alder Hey Children’s Hospital, United Kingdom. Patients: Patients with nonsyndromic PRS (group 1), isolated cleft palate (group 2), and isolated cleft lip (group 3). Main Outcome Measures: Hypodontia in the permanent dentition assessed from orthopantomographs. Results: A total of 154 patients were included. Group 1 had the highest incidence of hypodontia with 47% having at least one tooth congenitally absent. Groups 2 and 3 had reduced rates of hypodontia with 27% and 19% of the groups missing teeth, respectively; 93% of cases of hypodontia in group 1 involved the absence of at least one second premolar. Of these patients, there was found to be bilateral agenesis of second premolars in 50% of cases. Conclusions: Patients with PRS and cleft palates are more likely to have hypodontia than those with isolated cleft palates or unilateral cleft lips. Patients with PRS have more severe hypodontia than those with isolated cleft palates or unilateral cleft lips. Bilateral agenesis of lower second premolars is a commonly seen pattern among patients with PRS. In this large UK study, a similar prevalence and pattern of hypodontia to other nonsyndromic PRS populations worldwide has been demonstrated.
‘Neurodiversity’ is a term used to describe people with neurological variation; this includes people with autism, dyspraxia, dyslexia and attention deficit hyperactivity disorder. Studies have shown an increased prevalence of malocclusion and dental trauma in people with these conditions. Unfortunately, a lack of understanding around such neurological differences can create barriers when accessing orthodontic care. The aim of this article is to raise awareness around the subject and to suggest reasonable adjustments to practice which may subsequently be used by the orthodontic team to improve the patient experience. CPD/Clinical Relevance: Recognition of neurodiversity and the need to make reasonable adjustments to orthodontic care may aid compliance and improve outcomes in this group of patients.
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