*3.5.1 Crown abnormalities*

CLP patients commonly present with anomalies in shape and size of permanent teeth, especially at the maxillary anterior region. The malformations frequently exhibit as microdontia or macrodontia [47, 50, 52, 62].

Other dental anomalies associated with CLP patients include thick curved maxillary central incisors [53, 54], addition of paralabial tubercles on the central incisor and canine, missing cusp or altered cusp patterns of the maxillary molars and mandibular bicuspids [53] and smaller mesial-distal width of central incisors on the cleft side [44, 84]. Interactive compensations with dental variations in size have been reported to occur within tooth classes [85]. In non-cleft oligodontia with multiple missing teeth, the dentition was found to be reduced in size. However, in dentition with isolated tooth agenesis, tooth-size was larger compared to those of fully dentate individuals without hypodontia [86]. The premise of an odontogenic interactive compensatory mechanism was suggested in that a size reduction of a lateral incisor was a localised response to a large adjacent central incisor [87].

### *3.5.2 Root abnormalities*

Taurodontism [65, 88], root dilacerations [62], fusion, germination and concrescence [81] have also been associated with CLP patients.

## **3.6 Abnormalities in position of permanent teeth**

### *3.6.1 Rotated cleft-sided central incisors*

Cleft sided central incisors are often found to be rotated, with a prevalence of 68.6% to 86.17 [48, 50, 89] reported. This has been attributed to the lack of space at the end of the alveolar segment [90].
