The maxillary lateral incisor in the rehabilitation of cleft lip and palate

Abstract

ObjectiveThis study analyzed the maintenance of lateral incisors in the dental rehabilitation of individuals with cleft lip and palate.Material and MethodsThe study was conducted on a tertiary craniofacial center and comprised retrospective analysis of panoramic and periapical radiographs of Caucasoid individuals with non-syndromic complete unilateral cleft lip and palate, analyzing all radiographs available on the records of each individual, from the first to the last up to 12 years of age. Overall, 2,826 records were reviewed to achieve a sample of 1,000 individuals. Among these, 487 individuals presented the permanent lateral incisors on both cleft and non-cleft sides, which were included in this study.ResultsThe results were evaluated in percentages and by descriptive statistics. The association between maintenance of the lateral incisor and timing of alveolar bone graft were analyzed by the t test. Among the 487 individuals, 265 had not completed treatment, 62 presented insufficient information, and 44 concluded the treatment elsewhere. Among the remaining 116 individuals, the lateral incisor was extracted from 88 (75.86%) of them on the cleft side (CS) and from 23 (19.83%) people on the non-cleft side (NCS). The age at accomplishment of alveolar bone graft was significantly associated with maintenance of the lateral incisor on the cleft side (p<0.01). Most extractions were indicated because of the inadequate positioning on the CS and for midline correction on the NCS. Rehabilitation was primarily completed by orthodontic movement (53 individuals on the CS and 13 individuals on the NCS).ConclusionIn conclusion, the lateral incisor on the cleft side was not maintained in most individuals. Positive relationship was observed between extraction of the lateral incisor and age at accomplishment of the alveolar bone graft, suggesting the need to anticipate the initial radiographic evaluation to enhance its maintenance and reduce the procedures required for rehabilitation.

Survey on Condition and Orthodontic Treatment of Maxillary Lateral Incisors in Patients with Cleft Lip and Palate

“…Taking into account the position of the canines in the cleft 5) , prosthetic replacement was selected for cases where a Class III relationship could be improved by camouflage treatment 15) ; when the symmetry of dentition could be maintained, even with a unilateral defect of the maxillary lateral incisors; or when there was a desire to maintain tongue space 9,15) . On the other hand, some studies have reported the advantages of using alveolar bone grafting prior to eruption of the maxillary canines 8) , or as early as possible, to achieve permanent dentition without prosthodontics 20) and to preserve the maxillary lateral incisors 22) .…”

Developmental characteristics of the permanent upper lateral incisor in unilateral cleft lip and palate

“…The timing of secondary alveolar bone grafting (SABG) can be significantly influenced by the presence, localization, and developmental stage of the lateral incisor on the cleft side [ 7 – 9 ]. The primary goal of SABG is to provide continuity and stability to the upper arch, thereby facilitating the potential eruption of the canine or lateral incisor relative to the cleft area [ 10 ].…”

Developmental Characteristics of the Upper Lateral Incisor in Unilateral Clefts

“…The timing of secondary alveolar bone grafting (SABG) can be signi cantly in uenced by the upper lateral incisor's presence, localization, and development stage on the cleft side [7][8][9]. The primary goal of SABG is to provide continuity and stability to the upper arch by facilitating the potential eruption of the canine or lateral incisor relative to the cleft area [10].…”