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CONTENTS
Introduction Embryology & Anatomy Etiology & Classification Occurance Risk Syndromes associated What can we expect Objective Material & Methods Statistical analysis RESULTS Discussion What this paper adds? Literature Review Conclusion
Etiology
Classification
By Fogh Andersen (1942)
Occurrence
0.5 to 3.63 per 1000 live births
Geographic section / race Incidence /1000
Types of Clefts with Percentage CLP CP CL 44.3 12.8 42.9 84.7 1.9 13.3 68 18 14
Risk
parental age - risk of affected child. consanguineous marriage - incidence of clefts . Genetics
Objective
To evaluate the prevalence of dental abnormalities of the 1 & 2 maxillary dentitions in children affected by unilateral (UCLP) and bilateral (BCLP) cleft of the lip and palate.
Control
1000 subjects - NCLP control sample
482 and 518 , and it was selected randomly None of the control subjects had received any orthodontic treatment.
Department of Orthodontics and Pediatric Dentistry of the University of Florence Subjects with inadequate dental records, craniofacial syndromes, or other medical disorders, were not included in the NCLP sample.
Clinical examination
Diagnostic cast
radiographs
The following dental anomalies in the maxillary arch were recorded: aplasia of primary and permanent lateral incisors; aplasia of premolars; anomaly in shape: peg or conoid shape associated with reduced size; supernumerary teeth; and enamel hypoplasia of permanent incisors In UCLP subjects, - cleft side and non-cleft side, separately.
Statistical analysis
The prevalence rates for the various dental anomalies were calculated in UCLP, BCLP, and total CLP groups, and they were contrasted to those in the NCLP group.
RESULTS
The statistical analysis revealed significant differences for the prevalence rates of all dental anomalies compared with the control group with the exception of the aplasia of the second premolars.
Discussion
CONGENITALLY MISSING TEETH:
LATERAL INCISORS permanent maxillary lateral incisor - most frequently missing in the cleft area. UCLP subjects- 8.1% for the primary lateral incisors and 27.9% for the permanent lateral incisors. (Primary Laterals overestimated ??)
In BCLP, the prevalence rates for congenitally missing maxillary lateral incisors were much higher than in UCLP: 17% for the primary incisors, and 60% for the permanent incisors.
Other authors : 45 48.1% (permanent laterals)
SA: significantly greater prevalence in both UCLP and BCLP groups when compared with NCLP group.
In BCLP sample - congenital absence of the maxillary second premolar was found in 8.8% of the cases.
SA: No statistical significance UCLP/BLCP vs NCLP
SUPERNUMERARY TEETH
second most common dental anomaly in the cleft area
Literature Review
Incidence of Cleft Lip and Palate in British Columbia Indians (r. b. Lowry and d. h. g. Renwick) J. med. Genet. (1969).
CANADA
RATES PER 1000 LIVE BIRTHS IN BRITISH COLUMBIA IN 1952-1964 (RACE SPECIFIC) Type of Cleft Lip and or Palate Cleft lip only Cleft palate only Cleft lip and palate All forms of cleft lip and/ or palate Indian 0.25 0.44 2.48 3.17 Non-Indian 0.38 0.54 0.71 1.63
78% of the Indians with Cleft had the cleft lip and palate combination compared with 43 % in the non-Indian population. These studies show that the British Columbia Indian has a high frequency of oral clefts than that of the other American Indian groups.
Primary dentition status and treatment needs of children with cleft lip and/ or palate (Ankola A. v.. Nagesh L.. Hegde P.,
Karibasappa G. N) - J. Ind. Soc. Pedod prev dent june 2005
The result of this study shows that: (1) all age groups of cleft affected children had dental caries experience (2) children with primary type of cleft had less dental caries prevalence than children with cleft of secondary or combination type
Dental Abnormalities in the Deciduous and Permanent Dentitions of Individuals with Cleft Lip and Palate (bertram s. kraus, ronald e. jordan, and samuel pruzansky) - j dent res
Casts of 39 subjects with CL(P) were studied
7. Abnormally shaped maxillary first primary molars. 8. Complete absence of the distolingual cusp on maxillary second primary or first permanent molars. 9. Unusual reduction in size of the distolingual cusps of the maxillary second primary or first permanent molars. 10. Replacement of the distobuccal and mesiolingual cusps of the maxillary second primary or first permanent molars with a single cusp situated in the center of the oblique ridge.
Management of children with cleft lip and Palate: a review (peter d hodgkinson, susan brown, dorothy duncan, christine grant, amy mcnaughton, polly thomas and c rye mattick) Fetal and Maternal Medicine Review 2005 Non-syndromic CLP - 1 in 700 live births.
Caries, Gingivitis, and Dental Abnormalities in Preschool Children with Cleft Lip and/or Palate (goran dahllof, d.d.s., ph.d. reet ussisoo-joandi, d.d.s. margareta ideberg, d.d.s. thomas modeer, d.d.s., ph.d.) - cleft palate journal july 1989
CLP vs Normal Caries
Timing and sequence of primary tooth eruption in children with cleft lip and palate (mrcia ribeiro gomide, cleide felcio de carvalho carrara)- J App Oral Science 2010
CLP vs Normal
Higher mean age of eruption of all primary teeth - max. & mand
The greatest delay was found for the maxillary lateral incisor
Conclusion
References
Timing and sequence of primary tooth eruption in children with cleft lip and palate (mrcia ribeiro gomide, cleide felcio de carvalho carrara)- J App Oral Science 2010 Caries, Gingivitis, and Dental Abnormalities in Preschool Children with Cleft Lip and/or Palate (goran dahllof, d.d.s., ph.d. reet ussisoo-joandi, d.d.s. margareta ideberg, d.d.s. thomas modeer, d.d.s., ph.d.) - cleft palate journal july 1989 Management of children with cleft lip and Palate: a review (peter d hodgkinson, susan brown, dorothy duncan, christine grant, amy mcnaughton, polly thomas and c rye mattick) Fetal and Maternal Medicine Review 2005
Dental Abnormalities in the Deciduous and Permanent Dentitions of Individuals with Cleft Lip and Palate (bertram s. kraus, ronald e. jordan, and samuel pruzansky) - j dent res
Incidence of Cleft Lip and Palate in British Columbia Indians (r. b. Lowry and d. h. g. Renwick) J. med. Genet. (1969).
Primary dentition status and treatment needs of children with cleft lip and/ or palate (Ankola A. v.. Nagesh L.. Hegde P.,
Karibasappa G. N) - J. Ind. Soc. Pedod prev dent june 2005 Dentistry for the child and adolescent McDonald, Avery Human embryology nderbir Singh 7th ed Text book of pediatric dentistry Nikhil Marwah Text book of pedodontics Shoba Tandon 2nd ed