Dental anomalies as part of the cleft spectrum

Objective: The aim of this study was to determine subphenotypes of clefts based on tooth development. Dental phenotypes (tooth agenesis, supernumerary and impacted teeth, transposition, and structural anomalies) outside the cleft area in the permanent dentition of oral cleft individuals were investigated. Design: Evaluation of dental records of cleft patients. Setting: National Museum of Health and Medicine, Washington, D.C. Patients, Participants: A collection of dental casts, radiographic and clinical records of 146 patients with oral clefts was evaluated. Main Outcome Measure: Association of dental anomalies with preferential subtypes of clefts. Results: Forty-seven individuals (32.19%) presented at least one dental anomaly outside the cleft area. Individuals with complete cleft lip and palate (CLP) presented more dental anomalies than individuals with incomplete CLP (p = .04). Cleft palate individuals presented more dental anomalies than CLP individuals (p = .048). Maxillary lateral incisors and premolars were the most affected teeth. High incidence of maxillary second premolar agenesis was observed in individuals with bilateral CLP (p = .04). In cases with unilateral CLP, 12.5% presented dental anomalies of the maxillary lateral incisors on the noncleft side. Cleft palate individuals presented a high incidence of mandibular premolar anomalies (p = .004). Conclusion: Future studies should consider the inclusion of a complete dental description to aid in the definition of cleft subphenotypes to be studied.