Cleide Felício de Carvalho Carrara

Tooth Abnormalities of Number and Position in the Permanent Dentition of Patients With Complete Bilateral Cleft Lip and Palate

Objective To radiographically evaluate the prevalence of tooth abnormalities of number and position in the permanent dentition of individuals with complete bilateral cleft lip and palate. Design Cross-sectional retrospective. Setting Hospital for Rehabilitation of Craniofacial Anomalies, University of São Paulo, Bauru, Brazil. Patients Two hundred five individuals with complete bilateral cleft lip and palate. Interventions Analysis of patient records and panoramic radiographs. Main outcome measures Evaluation of hypodontia and supernumerary teeth and analysis of the position of the permanent maxillary lateral incisor in relation to the alveolar cleft. Results Hypodontia was observed in 144 patients (70.2%), and the highest prevalence was observed for the maxillary lateral incisor. When both lateral incisors were present (43%), they were primarily located on the distal side of the cleft (25%). Supernumerary teeth were observed in 11.7% of individuals. Conclusion Patients with cleft lip and palate presented high prevalence of hypodontia and supernumerary teeth. The prevailing characteristics of their location may suggest the presence of a similar genetic component for the occurrence of hypodontia and cleft.

Dental Anomalies of Number in The Permanent Dentition of Patients With Bilateral Cleft Lip: Radiographic Study

Objective: To radiographically evaluate the prevalence of dental anomalies in patients with complete and incomplete bilateral cleft lip, comparing the prevalence of anomalies between genders and cleft types. Setting: Hospital for Rehabilitation of Craniofacial Anomalies, University of São Paulo (HRAC/USP), Bauru, São Paulo, Brazil. Participants: 150 randomly selected panoramic radiographs of individuals with complete or incomplete bilateral cleft lip; patient age 12 to 25 years (mean age 13.8 years). Results: Data were statistically analyzed to compare the possible association between presence of hypodontia and supernumerary teeth, according to gender and cleft type. Among the 150 patients evaluated, 80 (53.3%) were male and 70 (46.6%) were female. Since no statistically significant difference was found in hypodontia between genders, data were grouped for analysis, revealing prevalence of 31.6% for complete clefts and 26.8% for incomplete clefts. Concerning supernumerary teeth, the prevalence for the male patients was 28.2% for complete cleft lip and 29.2% for incomplete cleft lip. For female patients, the prevalence was significantly (p  =  .006) lower for complete cleft lip (17.5%) than for incomplete cleft lip (46.6%). Conclusions: The present results suggest that the prevalence of hypodontia was higher in patients with complete cleft lip, and the prevalence of supernumerary teeth was higher in patients with incomplete cleft lip, in agreement with previous studies.

Prevalence, Cause, and Location of Palatal Fistula in Operated Complete Unilateral Cleft Lip and Palate: Retrospective Study

Objective To evaluate the prevalence of fistulas after palate repair and analyze their location and association with possible causal factors. Design Retrospective analysis of patient records and evaluation of preoperative initial photographs. Setting Tertiary craniofacial center. Participants Five hundred eighty-nine individuals with complete unilateral cleft lip and palate that underwent palate repair at the age of 12 to 36 months by the von Langenbeck technique, in a single stage, by the plastic surgery team of the hospital, from January 2003 to July 2007. Interventions The cleft width was visually classified by a single examiner as narrow, regular, or wide. The following regions of the palate were considered for the location: anterior, medium, transition (between hard and soft palate), and soft palate. Main outcome measures Descriptive statistics and analysis of association between the occurrence of fistula and the different parameters were evaluated. Results Palatal fistulas were observed in 27% of the sample, with a greater proportion at the anterior region (37.11%). The chi-square statistical test revealed statistically significant association (P ≤ .05) between the fistulas and initial cleft width (P = .0003), intraoperative problems (P = .0037), and postoperative problems (P = .00002). Conclusions The prevalence of palatal fistula was similar to mean values reported in the literature. Analysis of causal factors showed a positive association between palatal fistulas with wide and regular initial cleft width and intraoperative and postoperative problems. The anterior region presented the greatest occurrence of fistulas.

Chronology and Sequence of Eruption of the Permanent Teeth in Patients With Complete Unilateral Cleft Lip and Palate

Objective To establish the chronology and sequence of eruption of the permanent teeth in subjects with complete unilateral cleft lip and palate. Design Cross-sectional. Data on children presenting complete cleft lip and palate were evaluated. Setting The study was carried out at the Hospital for Rehabilitation of Craniofacial Anomalies, Bauru, Sao Paulo, Brazil. Sample The sample comprised 477 patients with complete unilateral cleft lip and palate, aged 5 to 14 years. Of these patients, 166 were girls and 311 were boys. Results The girls presented, for all maxillary and mandibular teeth, a smaller mean age of eruption than the boys. The maxillary lateral incisor and cuspid adjacent to the cleft presented significantly higher mean ages of eruption than their homologous teeth on the noncleft side.

Chronology of Deciduous Teeth Eruption in Children With Cleft Lip and Palate

Objective To determine the chronology and sequence of eruption of the deciduous teeth in children with complete unilateral cleft lip and palate. Design Cross-sectional study. Setting Hospital for Rehabilitation of Craniofacial Anomalies, University of Sao Paulo, Bauru, Sao Paulo, Brazil. Sample A total of 435 children aged 0 to 48 months who presented with complete unilateral cleft lip and palate. Results All teeth on the cleft side in both jaws for both sexes presented a higher mean age of eruption than their homologues at the noncleft side. This difference was statistically significant for the maxillary lateral incisor, maxillary cuspid, and mandibular lateral incisor. There was a statistically significant sex difference regarding the mean age of eruption only for the maxillary second molar for the girls and mandibular cuspid for the boys. The maxillary lateral incisor on the cleft side was the last tooth to erupt, thus modifying the sequence of eruption of the deciduous teeth. Conclusions The results suggest the interference of the cleft on the chronology of eruption of the deciduous teeth that are directly related to it.

Evaluation of oral health knowledge and oral health status in mothers and their children with cleft lip and palate.

Objective: To assess the oral health knowledge of mothers of children with cleft lip and/or palate, analyzing the practical application of this information on the basis of the oral hygiene of the children and caries prevalence of mothers and children. Design: Cross-sectional. Setting: Pediatric Dentistry sector of the Hospital for Rehabilitation of Craniofacial Anomalies. Patients: Mothers (n = 300) and their children with cleft lip and/or palate, ages 3 years to 5 years 6 months. Materials and Methods: An interview with questions related to dietary habits and oral health knowledge and habits was conducted. Children and their mothers also were evaluated by intraoral clinical examination. Results: Of the mothers, 47.3% displayed poor oral health status (Group A) and 52.7% had a satisfactory oral health status (Group B). Children in Group A presented a mean dmft of 6.0, whereas children in Group B had a mean dmft of 5.6. No significant differences were observed between groups. Mothers demonstrated a reasonable knowledge on prevention of dental caries and oral hygiene. Conclusion: Even though the mothers interviewed had some knowledge on the causes and prevention of dental caries, other factors should be regarded as relevant in the caries process.

Timing and sequence of primary tooth eruption in children with cleft lip and palate

Objective To determine the timing and sequence of eruption of primary teeth in children with complete bilateral cleft lip and palate. Material and Methods This cross-sectional study was conducted at the Hospital for Rehabilitation of Craniofacial Anomalies of the University of São Paulo, Bauru, SP, Brazil, with a sample of 395 children (128 girls and 267 boys) aged 0 to 48 months, with complete bilateral cleft lip and palate Results Children with complete bilateral clefts presented a higher mean age of eruption of all primary teeth for both arches and both genders, compared to children without clefts. This difference was statistically significant for all teeth, except for the maxillary first molar. Mean age of eruption of most teeth was lower for girls compared to boys. The greatest delay was found for the maxillary lateral incisor, which was the eighth tooth of children with clefts of both genders. Analyzing by gender, the maxillary lateral incisor was the eighth tooth to erupt in girls and the last in boys. Conclusion The results suggest an interference of the cleft on the timing and sequence of eruption of primary teeth.

Oral-Facial-Digital Syndrome Type 1: Oral Features in 12 Patients Submitted to Clinical and Radiographic Examination

OBJECTIVE To evaluate the oral features in individuals with oral-facial-digital syndrome type 1 (OFD 1), previously diagnosed by the Genetic Sector of the Hospital of Rehabilitation of Craniofacial Anomalies of the University of São Paulo (HRAC-USP). DESIGN Twelve patients with OFD 1 were examined clinically and radiographically; their medical files were also evaluated. RESULTS Associated oral malformations were observed in all patients (100%). The most frequent findings were tongue hamartomas, multiple buccal frena, asymmetric lips, asymmetric tongue, and bilateral maxillary gingival swelling. Interestingly, atrophy of the maxillary midline frenum was also observed in all the individuals examined. CONCLUSIONS Several extra and intraoral alterations were observed in patients with OFD 1. The authors suggest the inclusion of atrophy of the maxillary midline frenum as a commonly found characteristic of OFD 1.

Evaluation of the intercanine distance in newborns with cleft lip and palate using 3D digital casts.

Objective The purpose of this present study was to compare, by means of 3D digital casts, the anterior transverse dimension of the dental arch of newborns with and without cleft lip and palate. Material and Methods The sample was composed of ninety-four children aged from 3 to 9 months divided into three study groups: Group I - children without craniofacial deformities (control group); Group II - children with unilateral cleft lip and palate; Group III - children with bilateral cleft lip and palate. Impressions were executed before lip and palate repair in patients with clefts. Dental casts were digitized using a 3D scanner linked to a computer. Measurements of the intercanine distance were measured on the digital casts. Intergroup comparisons were performed using ANOVA (p<0.05). Results The results showed a mean of 36.5 mm for unilateral cleft lip and palate group, 34.8 mm for bilateral cleft lip and palate group and 27.52 mm for the control group. There was a statistically significant difference between the control group and both groups of patients with cleft lip and palate. There was no statistically significant difference between complete unilateral and bilateral cleft lip and palate groups. Conclusions Patients with complete cleft lip and palate were born with an increased anterior dimension of the maxillary dental arch compared to non cleft patients.

Prevalence of palatal and alveolar cysts in babies with cleft lip and palate

Objective To evaluate the prevalence of palatal and alveolar cysts in babies with cleft lip and/or palate. Design Cross-sectional. Setting Hospital for Rehabilitation of Craniofacial Anomalies, University of São Paulo (HRAC-USP), Bauru, São Paulo, Brazil. Participants Two hundred ninety-one Caucasian babies divided into four groups according to the type of cleft: cleft lip with or without cleft alveolus (70), complete unilateral cleft lip and palate (112), complete bilateral cleft lip and palate (56), and cleft palate (53). Results A low prevalence of palatal and alveolar cysts was observed among patients with the four different types of clefts, with no statistically significant difference between genders. The maxilla and the anterior area of the mouth were more affected than the mandible and the posterior area. Conclusions The low prevalence of palatal and alveolar cysts in the four groups of babies with clefts included in this study may have been due to the high mean age of the sample.