Dental Subphenotypes in Infants With Orofacial Clefts—A Longitudinal Population-Based Retrospective Radiographic Study of the Primary and Secondary Dentitions

Abstract

Objectives: To determine the developmental patterns of primary and secondary dentitions in infants with orofacial clefts. Design: Retrospective, longitudinal, population-based cohort study. Materials: Longitudinal records and radiographs of 192 nonsyndromic Northern European infants with isolated unilateral cleft lip (UCL, n = 111) and isolated cleft palate (CP, n = 81). Methods: Radiographic assessments of primary and secondary dentition anomalies and dental maturation, by gender and cleft severity for comparisons between the groups and with historical controls. Results: In infants with UCL, the frequencies of dental anomalies were high in both primary (38.7%) and secondary (18.0%) dentitions. Primary and secondary dentition anomalies were not observed in infants with CP and different in the UCL group ( P = .003). Risk differences involved primary supernumerary teeth ( P = .0001) and talon cusp formation ( P = .0001), and secondary tooth agenesis ( P = .001) of the maxillary lateral incisor on the side of the cleft lip. Delayed primary and secondary dental maturation occurred in the UCL and CP groups, greater in infants with UCL ( P < .0001). Primary and secondary dental maturation featured sexual dimorphism with greater delay in males (UCL, P < .0001; CP, .0001 > P = .001). The effect of cleft severity on dental maturation was significant in infants with UCL ( P = .0361) and CP ( P = .0175) in the primary but not in the secondary dentition. Conclusions: There were different dental anomalies in the primary and secondary dentitions in operated infants with UCL and no dental anomalies in unoperated infants with CP. Dental maturation was delayed in infants with UCL and CP with greater delay in males compared to females.

Volumetric Analysis of Unilateral Alveolar Bone Defect Using Modified Subtraction in Older Chinese Patients

“…This finding is different from the results of Berkowitz et al, 29 who reported that the alveolar cleft occurs between the canine and lateral incisor, but consistent with the findings of Tsai et al 30 We suspect this is likely due to the maxillary lateral incisor being a composite tooth formed from the fusion of 2 dental epithelia. 31 Degeneration of the dental epithelium in the medial nasal process causes lateral incisors to appear at the distal side of the cleft, and degeneration in both processes causes tooth agenesis.…”