A Retrospective Mixed Longitudinal Study of Tooth Formation in Children With Clefts

Abstract

Objective: To test for systematic age changes in cleft children based on dental age. Design: Retrospective case–control longitudinal study. Setting: One orthodontic solo practice. Patients: Nonsyndromic, complete cleft lip and palateCLP cases, either unilateral or bilateral (102 children; 370 radiographs), between 4 and 16 years of age. Interventions: Children were treated with a team approach, but only orthodontic radiographs were studied. Main Outcome Measure: The principal outcome measure was dental age of the cleft cases compared to a sex-specific sample of phenotypically normal children (1107 children), from the same geographical region. Multiple panoramic radiographs taken during the course of orthodontic treatment were examined to track patterns of dental age as children matured. Analysis used linear mixed models primarily testing for sex, cleft type (unilateral, bilateral), and hypodontia differences. Initial expectation was that cleft children would exhibit delayed dental ages from postnatal stressors and would become more deviant with maturity. Results: In childhood (4-6 years), both sexes were significantly delayed ( P < .001), but dental age normalized around 8 to 10 years. Boys experienced faster maturation thereafter than girls ( P < .001). Only trivial differences occurred between unilateral CLP and bilateral CLP samples.Hypodontia further depressed maturation rates ( P < .001). Dental age improved in a decidedly curvilinear fashion ( P < .001), with greater change at earlier ages. Conclusions: This report agrees with other contemporary studies, showing childhood catch-up. Older studies observed that clefting caused significant delays that worsened with growth. This potential “seachange” suggests better recovery and quicker normalization of children with clefts, perhaps due to improved management.

Dental and skeletal maturation of Chinese male children with unilateral cleft lip and palate

“…Patients with UCLP had a significantly higher CA-DA difference than the controls; this was a key finding. The mean age of the UCLP subjects was underestimated by 0.319 years, thus indicating a possible delay in dental maturation; these results are consistent with previous research [21,22]. Van Dyck et al [23] systematically reviewed children with CL/P aged 5 to 13 years and noted that delayed dental development ranged from 0.2 to 0.9 years, with a mean delay of 0.56 years.…”

Dental Age Estimation According to European Formula and Willems Method: Comparison Between Children With and Without Cleft Lip and Palate

“…Neither standard protocol for treatment nor the same local influences were present in the study group. Results of previous studies showed disparity in dental development of patients with and without clefts, and no pattern in dental development in children with CL/P was universally noticed (Pöyry et al, 1989; Tan et al, 2012; Almotairy & Pegelow, 2018; Kimbrough et al, 2020). Diversity of influences in study group, along with the fact that no pattern in dental development was established so far, was taken into account when study sample in the present study was created.…”