Dental Development and Treatment in Clefts

**3**

**Chapter 1**

**Abstract**

Dental Development and

*Elaine Li Yen Tan and Mimi Yow*

esis may share critical pathways.

**1. Introduction**

presence of the cleft [3].

Anomalies in Cleft Lip and Palate

Cleft lip and/or palate is a birth defect with heterogeneous clinical presentations. Prevalence and cleft-types differ by gender, ethnic groups and geographic locations. Published literature indicates high frequencies of cleft-associated dental anomalies, commonly variations in tooth-number, shape and size. Delayed dental development is also reported with catch-up growth at a later age. In the unilateral cleft phenotype, delayed development can occur on the cleft-side of the maxilla. Dental anomalies present frequently in the spectrum of cleft defects. Heterogeneity of defects is wide-ranging and may represent different aetiological origins of cleft phenotypes and sub-types due to: genetic mutations with altered ectomesenchymal growth; iatrogenesis from disrupted blood supply during early postnatal surgery; and maldevelopment or mistimed development. Orofacial clefting and odontogen-

**Keywords:** dental anomalies, dental development, cleft lip, cleft palate

**2. Dental development and eruption in CLP patients**

population-specific groups to reduce confounders [15].

**2.1 Methods in assessing dental development**

Cleft lip and/or palate (CLP) is a birth defect with heterogeneous clinical presentations [1]. Prevalence and cleft-types differ by gender, ethnic groups and geographic locations [2]. It has been widely reported that dental anomalies (delayed dental development and eruption, hypodontia, supernumeraries, hypoplasia and abnormalities in tooth size and shape) in CLP are commonly associated with the

There are several methods that have been devised for assessing dental development or calculating dental age [4–12]. Essentially, tooth development is observed from radiographs and compared with the formation stages in each system. Some systems allow dental age to be calculated after ascertaining the teeth formation stages. Of the various systems available, the method proposed by Demirjian et al. [9] and Demirjian and Goldstein [12] has been well researched and was found to be highly accurate and precise for estimation of dental age, particularly during early childhood [13, 14]. For any method of age estimation, it is best established within
