Tooth agenesis patterns in bilateral cleft lip and palate

Bartzela TN, Carels CEL, Bronkhorst EM, Rønning E, Rizell S, Kuijpers-Jagtman AM. Tooth agenesis patterns in bilateral cleft lip and palate. Eur J Oral Sci 2010; 118: 47–52. © 2010 The Authors. Journal compilation © 2010 Eur J Oral Sci
Individuals with cleft lip and palate present significantly more dental anomalies, even outside the cleft area, than do individuals without clefts. Our aim was to evaluate the prevalence of tooth agenesis and patterns of hypodontia in a large sample of patients with complete bilateral cleft lip and palate (BCLP). Serial panoramic radiographs (the first radiograph was taken at 10.5–13.5 yr of age) of 240 patients with BCLP (172 male patients, 68 female patients) were examined. Third molars were not included in the evaluation. Agenesis of at least one tooth was present in 59.8% of patients. Upper laterals and upper and lower second premolars were missing most frequently. Using the tooth agenesis code (TAC), 52 different agenesis patterns were identified, of which simultaneous agenesis of 12, 22, 15, 25, 35, and 45 was the most frequent pattern. Nine of the 240 patients showed combined BCLP and oligodontia.     

Caries prevalence and enamel defects in 5- and 10-year-old children with cleft lip and/or palate: A case-control study

Objective. To determine the prevalence of dental caries and enamel defects in 5- and 10-year-old Swedish children with cleft lip and/or palate (CL(P)) in comparison to non-cleft controls. Materials and methods. The study group consisted of 139 children with CL(P) (80 subjects aged 5 years and 59 aged 10 years) and 313 age-matched non-cleft controls. All children were examined by one of two calibrated examiners. Caries was scored according to the International Caries Detection and Assessment System (ICDAS-II) and enamel defects as presence and frequency of hypoplasia and hypomineralization. Results. The caries prevalence among the 5-year-old CL(P) children and the non-cleft controls was 36% and 18%, respectively (p < 0.05). The CL(P) children had higher caries frequency (initial and cavitated lesions) in the primary dentition than their controls (1.2 vs 0.9; p < 0.05). A significantly higher prevalence of enamel defects was found in CL(P) children of both age groups and anterior permanent teeth were most commonly affected. Conclusions. Preschool children with cleft lip and/or palate seem to have more caries in the primary dentition than age-matched non-cleft controls. Enamel defects were more common in CL(P) children in both age groups.     

The incidence of congenital anomalies associated with cleft palate/cleft lip and palate in neonates in the Konya region, Turkey

Additional congenital anomalies have often been found in patients with orofacial clefts. We wanted to find out the incidence and type of congenital malformations that may accompany cleft palate (CP) and cleft lip and palate (CLP) in babies born in the Konya region. A total of 121 newborn babies with CP or CLP were prospectively included in the study, and all were assessed in detail for congenital anomalies. Of 121 babies, 86 (71%) had CLP and 35 (29%) had CP. There was at least one congenital malformation in 80 (66%) of the cases. Additional congenital malformations were seen in 26 (74%) of the 35 with isolated CP, and 54 (63%) in the 86 patients with CLP (p<0.05). The most common congenital malformation was congenital heart disease, followed by head and neck anomalies. The most common congenital heart disease was atrial septal defect. A serious chromosomal anomaly was found in 18/121 patients with CP or CLP (15%). Of the 80 babies in whom congenital malformations were found, 31 (39%) had dysmorphic features. While 21 (68%) of dysmorphic cases had isolated CP, 10 (32%) had CLP (p<0.05). The rates of premature delivery, intrauterine growth retardation, and consanguinity between parents were higher in patients with CP or CLP. The neonatal mortality was 20% (n=24). Our results indicate that at least one congenital anomaly is also present in about two-thirds of newborn babies with CP and CLP, and these anomalies significantly increase their morbidity and mortality. All newborn babies with CP and CLP should be screened for additional congenital anomalies, particularly of the cardiovascular system.     

唇腭裂患者前牙区恒牙的发育异常

唇腭裂是口腔颌面部最常见的先天畸形,常伴发各种恒牙发育异常,尤其是靠近裂隙的前牙区.相较国外,目前国内对此的研究缺乏,本文对调查唇腭裂患者中切牙、侧切牙和尖牙区的形态、数目、萌出异常和牙根发育等各类发育异常的文献作回顾性概述,为临床医师早期酌情涉入治疗和适当降低序列治疗的难度和复杂性提供依据.     

Dental and oral hygiene status in Jordanian children with cleft lip and palate: a comparison between unilateral and bilateral clefts

To cite this article:
Int J Dent Hygiene 9 , 2011; 30–36
DOI: 10.1111/j.1601‐5037.2009.00426.x
Hazza’a AM, Rawashdeh MA, Al‐Nimri K, Al Habashneh R. Dental and oral hygiene status in Jordanian children with cleft lip and palate: a comparison between unilateral and bilateral clefts. Abstract: Objectives: The purpose of this study was to assess and compare the dental health and oral hygiene status of subjects with unilateral and bilateral cleft lip and palate (BCLP). Methods: Oral and dental examinations were carried out in 98 children with cleft lip and palate and 98 unaffected subjects matching in gender and age, using the standard dental indices dmft and DMFT. Plaque and gingival indices were scored using the plaque and gingival indices of Silness and Löe. Results: The prevalence of dental caries was significantly higher in children with cleft lip and palate than their control in both permanent and deciduous teeth. Patients with BCLP experienced more dental caries than unilateral cleft lip and palate (UCLP) patients in both dentitions. Similarly, plaque accumulation and gingivitis were significantly higher in the cleft lip and palate patients compared with their controls. Only plaque accumulation was significantly higher in the BCLP patients than in the UCLP patients. Conclusion: Bilateral cleft lip and palate patients appear to be at a higher risk of caries experience and poorer in oral hygiene than those with UCLP patients. These findings not only provide a baseline for oral health parameters in patients with cleft lip and palate but also emphasize the need for intensive preventive measures of oral disease to optimize clinical outcome.     

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双侧唇裂或(和)唇腭裂一期整复后,尽管修复了唇裂或唇腭裂,但仍有诸多畸形存在,如鼻尖低平、鼻小柱短小、双侧鼻孔不等大对称、鼻翼塌陷、鼻堤缺失;上唇过紧、人中     

Increased caries prevalence in 2.5-year-old children with cleft lip and/or palate

The prevalence of dental caries was determined clinically in 2.5-year-old Dutch cleft lip and/or palate children ( n =76) and in children without congenital malformation ( n =75). The parents were given a structured questionnaire regarding the child's dietary habits, oral hygiene, fluoride exposure and social economic background. The prevalence of dental caries was higher in children with oral cleft than in children without oral cleft. Initial caries (white spots) was diagnosed in 17.1% of the subjects with oral cleft compared with 4.0% of the control subjects. Manifest caries (cavities) was found in 26.3% of the children with oral cleft compared with 5.3% of the controls. The dft score (manifest caries) was significantly higher for the oral cleft group (0.59±1.35) than for the control group (0.11±0.54). 52% of the total number of initial and manifest lesions were localized to the maxillary incisors. A multivariate analysis yielded initial caries, oral hygiene and treatment with preoperative infant orthopaedics as the variables significantly associated with manifest caries.     

单侧完全性唇腭裂儿童患侧前牙发育研究

目的 分析单侧完全性唇腭裂儿童（ＵＣＬＰ）患侧尖牙发育特点。方法 ５３例８～１２岁ＵＣＬＰ患儿,采用Ｂｒｏｕｗｅｒｓ方法,测量并比较术前曲面断层中健侧及患侧恒上尖牙长度,并观察恒上切牙缺失和畸形情况。结果 ＵＣＬＰ患儿健、患侧恒上尖牙长度有显著性差异（Ｐ〈０．０１）;患侧侧切牙缺失３５．８％,患侧上中、侧切牙畸形４７．２％。结论 患者患侧恒上尖牙发育明显迟缓,并伴有不同程度患侧侧切牙缺失、中、侧切     

腭裂术后患者口腔健康状况分析

目的 调查腭裂术后患者口腔健康状况，分析其与口鼻腔瘘存在的关系。方法 对67例年龄在8－17岁的腭裂术后患者的口腔健康状况进行检查，内容包括有无裂穿孔、牙槽嵴裂、龄病、咬合关系异常等情况。将全部病例分为穿孔组和无穿孔组，进行组间口腔卫生状况、患龋情况及咬合关系比较。结果 组间口腔卫生状况有显著差异。无穿孔组口腔卫生状况好，便患龋率比正常人群高，龋病和咬合关系情况在两组间无显著差异。结论 腭裂术后患者口腔卫生状况普遍较差，这与腭裂畸形有关，也与患者及其家长重视不够有关，采取针对性措施是唇腭裂序列治疗的重要组成部分。     

唇腭裂患者亲属颅面形态学特征的研究进展

非综合征性唇腭裂以及单发性腭裂是常见的先天发育性疾病.近年来,很多学者对患儿亲属所表现出来的一系列与患儿自身具有一定可重复性的颅面形态特征进行了研究,并且已经获得了一定的成果.本文就该领域的研究进展作一综述.     

101例新生儿唇腭裂临床统计与病因分析

1961年1月1日～1995年12月30日,在武汉市第二医院住院分娩97685例活产新生儿中共检出唇腭裂101例,唇腭裂发生率为1.03‰,其中,唇裂占37.62％,腭裂18.81％,唇裂伴腭裂43.57％。统计学分析发现在不同胎次和不同新生儿体重组别中,唇腭裂的发生率有显著性差异(P<0.01)。推测唇腭裂畸形的发生与母体分娩过多,生殖机能减退,生殖器官衰老及胎儿的营养状况有一定关系。     

A study of prevalence of caries and oral health behavior in Japanese children with cleft lip and palate

The aims of this study were to investigate the condition of dental caries in 1–4 years old Japanese children with cleft lip and/or palate, and also to examine the relationships between age, location of the cleft, oral health behavior of cleft children and the incidence of dental caries. The study was carried out through a dental examination of a sample of children and a questionnaire to their parents which included questions about infant feeding practices, frequency of consumption of specific drinks and children's frequency of tooth brushing. A sample of 116, 1–4 years old Japanese children (58 boys and 58 girls) with oral clefts referred to the Department of Pediatric Dentistry Clinic, Showa University, after receiving surgical treatment, participated in this study. Results indicated that the prevalence of caries in cleft children was related to patient age, location of clefts and oral health behavior. A higher level of dental caries was recognized in children with cleft lip and alveolus/palate than in those with cleft lip alone. Incidence of caries increased with patient age. Children who had been fed in a determined time were less affected than those who had been fed at will. Incidence of caries was also high in the children who ingested drinks with sugar than in those who did not. The results of this study suggest that it is important to improve the oral health behavior of cleft children to minimize the risk of caries. Moreover, children with clefts and their parents should as early as possible undergo a preventive program to ensure preservation of primary dentition.     

先天性唇腭裂患儿的艾森克个性问卷（儿童）调查

目的探求患有先天性唇腭裂少年儿童的个性状态。方法调查对象包括7～17岁50例先天性唇腭裂患儿组和年龄相仿的正常少年儿童对照组。两组均采用艾森克个性问卷（儿童）EPQ（Junior）进行个性调查。结果EPQ（Junior）量表（T分）两组总体情况相比较患儿异常例数高于对照组（P＜0．005），各项量表（T分）及多项量表（T分）也是患儿组高于对照组（P＜0．005）。结论唇腭裂少年儿童造成个性不良与唇腭裂畸形有关，所以在矫治唇腭裂的同时也必须注意个性不良的防治。     

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目的 了解唇腭裂患儿父母的心理状况,探讨影响唇腭裂患儿父母心理状况的相关因素.方法 采用标准化问卷对2008年9月至2010年5月福建医科大学附属协和医院口腔颌面外科收治的68例唇腭裂患儿的父母进行调查,以艾森克成人个性问卷(EPQ)评价其个性特征,以症状自评表(SCL-90)评价其自觉症状,并采用国内常模作为对照组进行对比分析.结果 唇腭裂惠儿的父母有其特殊的个性特征,存在着明显的心理问题.但父母之间心理状况无明显差异.结论 对唇腭裂患儿父母应采取积极的社会心理干预措施.     

唇腭裂患儿口腔健康状况调查

目的：调查唇腭裂患儿的口腔健康状况及发病规律。方法：对１１２ 例２．５～６ 岁唇腭裂患儿的口腔健康及卫生状况进行调查,内容包括龋病情况、乳牙釉质发育情况、乳牙牙体畸形和口腔卫生状况的调查。结果：唇腭裂患儿乳牙龋均为２．４１;牙釉质发育缺陷占６．８９％ ;牙体畸形占２．０２％ ;菌斑指数≥２者占４４．６％ 。     

1433例唇腭裂患者临床资料分析

目的：分析先天性唇腭裂的发病情况及特点,为唇腭裂的预防提供临床资料。方法：对1433例先天性唇腭裂患者进行回顾性临床分析。结果：本组病例中,唇裂390例,唇裂伴腭裂794例,单纯腭裂249例;男性明显多于女性（2.35：1）,但在不完全性腭裂中,女性多于男性（1：0.87）;在单侧唇裂伴或不伴腭裂及完全腭裂中,左侧明显多于右侧（3.58：1）;有家族遗传史的病例占总病例的6.35%;母亲妊娠初期经历危险因素316例,占22.05%;85.97%的患者来自农村;唇腭裂伴发其他畸型者42例,占2.93%。结论：多基因遗传与胚胎发育早期的环境因素是唇腭裂发病的重要因素。     

单侧完全性唇腭裂术后牙弓问横向关系的不调及正畸矫治后变化的探讨

目的 探讨单侧完全性唇腭裂术后患者上下颌牙弓间横向关系以及正畸治疗对上颌牙弓的影响。方法 对84名单侧完全性唇腭裂术后患者的错(牙合)畸形和上下颌颌间关系进行研究;并对36名唇腭裂术后患者进行正畸治疗前后的牙(牙合)模型进行测量分析上颌牙弓宽度的变化。结果 (1)单侧完全性唇腭裂术后60.7％的患者出现牙弓间横向关系的不协调,双尖牙区较易受累。(2)在出现牙弓间横向关系不调的患者中,双侧后牙反(牙合)者为60％。(3)正畸治疗后上颌牙弓的尖牙、第一、第二双尖牙间各自的宽度均有显著增加,第一磨牙间宽度变化不显著。上颌第一、第二双尖牙间各自宽度较尖牙间、第一磨牙间宽度增加显著。结论 单侧完全性唇腭裂术后患者上颌宽度的发育受到明显的限制,牙弓间横向关系不协调的比率较高,以双尖牙区为主;正畸矫治扩弓的重点应在双尖牙区。     

唇腭裂婴儿术前正畸的研究进展

随着唇腭裂序列治疗的不断完善和改进,其术前正畸治疗也变得越来越重要,尤其体现在减小手术的难度和提高术后的效果上,而矫治器的种类繁多,目的和效果也不尽相同。本文就唇腭裂婴儿术前正畸的研究进展作一综述。     

唇腭裂的分期护理

随着唇腭裂序列治疗的发展,其护理亦不断发展.目前对唇腭裂患者的护理内容已由单纯的临床护理转变为临床护理与心理护理和咨询相结合,其护理范围也不局限于医院和病房而扩大到院前期及患者出院后.本文根据唇腭裂患者治疗的不同阶段进行分期,并就其所处的不同时期、不同治疗模式情况下的针对性护理进行了总结.