Enamel defects on the maxillary premolars in patients with cleft lip and/or palate: a retrospective case-control study
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The purpose of this study was to investigate the presence of developmental defects of enamel on maxillary premolars in patients with cleft lip and/or palate. In addition, the relationship with the surgical technique of soft palate closure was studied. Such a relationship could be suspected since formation of enamel occurs around the same time period as soft palate closure.
Materials and methods
The study consisted of three groups. Patients from the first group (n = 123) were recruited from the Cleft Lip and Palate Team of the University Hospitals Leuven (CLPT-UHL). The second group (n = 81) consisted of patients consulting the Cleft Lip and Palate Team of the Radboud University Medical Centre Nijmegen (CLPT-UMCN). Healthy non-cleft lip and/or palate patients (n = 100) recruited from a private orthodontic practice were enrolled in group 3. All maxillary premolars were examined.
Out of the total sample, 43 patients showed developmental defects on one or more premolars. All defects occurred in patients of group 1 who received surgical closure by the CLPT-UHL. None of the patients from group 2 and 3 showed defects.
It can be suggested that the surgical technique, used by the CLPT-UHL for soft palate closure, causes these defects. It is postulated that the technique used by the CLPT-UHL leads to interference with the blood supply of the developing premolar at a critical stage of tooth enamel development. More research is needed to confirm these findings.
KeywordsEnamel defects Maxillary premolars Cleft patients
The authors would like to thank Prof. Dr. Em. F. Ostyn, ENT surgeon, Prof. Dr. G. Hens, ENT surgeon, Prof. Dr. V. Van der Poorten, ENT surgeon, and Mrs. C. Vergalle, paediatric dentist, of the Cleft Lip and Palate Team, University Hospitals Leuven, Belgium; W. Coucke, statisticus; and Prof. Dr. A.M. Kuijpers-Jagtman, orthodontist, and Prof. Dr. Em. P.H.M. Spauwen, plastic surgeon, both of the Cleft Palate Craniofacial Unit Radboud University Nijmegen Medical Centre, The Netherlands for their contribution to this article.
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