The unoperated adult cleft patient: teeth in the cleft area

Abstract

In cleft lip and/or palate patients, anomalies of the teeth in the cleft area are often found. The anomalies consist of missing, supernumerary, or malformed teeth. The studies, up to now, have been performed on patients treated surgically in early childhood and therefore the influence of surgery on the number, size, and form of the teeth in the cleft area cannot be excluded. Furthermore, in the majority of publications the different types of clefts are not analysed separately and the results are therefore not reliable. In the present study, a sample of 267 adult cleft patients who had not undergone surgery were investigated for variations in the size and form of the teeth in the cleft area. Four different cleft groups were examined: UCLA (n=174), UCLP (n=62), BCLA (n=17) and BCLP (n=14). Absence of teeth was observed in all four groups, less so in the UCLA than in the BCLA group. The absence of the most teeth was observed in the UCLP and BCLP groups. There was no difference in missing teeth between the unilateral and bilateral cleft lip and palate groups. When one single tooth was found it was merely a peg-shaped one. Most of the teeth were localised to the dorsal part of the cleft. Finally, combinations of more than one tooth were only incidentally found and only in the UCLA group. As the percentage of missing teeth in all four groups is clearly less than that quoted in the literature for corresponding groups of cleft individuals operated on early, it is suggested that surgical damage might be an additional factor for absence of teeth in individuals operated on early.