Dental development in children with cleft lip and palate: a comparison between unilateral and bilateral clefts.

AIM: The aims of this study were to assess and compare the dental development in patients with unilateral (UCLP) and bilateral (BCLP) cleft lip and palate. STUDY DESIGN: Dental developmental delay was compared between 40 UCLP patients (20 boys and 20 girls, average age 9.6 +/- 2.7 years) and 40 BCLP patients matched by sex and age (to the nearest 6 months). For the purpose of comparison, a total of 80 panoramic radiographs of unaffected group matching in age and sex were selected randomly. METHODS: Using panoramic radiographs, the seven left mandibular permanent teeth, second molar to central incisor, were rated on eight stage scales using the methods described by Demirjian et al. [1973]. The stage of each tooth was converted to the corresponding numeric value, and then all values were added to obtain a dental maturity score, which corresponded to a dental age. STATISTICS: The differences in developmental delay between the two cleft groups were determined using independent t-test. RESULTS: There was statistically significant difference (P<0.0001) between chronologic and dental age in cleft patients. The mean dental development delay in UCLP was 0.34 years and for BCLP was 0.61 years. BCLP patients were found to have a greater delay than UCLP patients (P<0.05). Girls showed an advanced dental development in both types of clefts. Comparison between the two cleft groups showed only significant difference in the amount of delay in female subjects. CONCLUSION: Dental development in UCLP and BCLP patients was significantly delayed compared to non cleft reference. Dental development in boys was significantly behind that of girls. A significant difference in the amount of delay between both cleft types was found only in female subjects.

Craniofacial morphology in patients with hypophosphataemic vitamin-D-resistant rickets: a cephalometric study.

Hypophosphataemic vitamin-D-resistant rickets (HVDRR) is a hereditary disease mainly transmitted as an X-linked dominant trait and characterized by certain general clinical signs (Filho HM, de Castro LC, Damiani D. Arq Bras Endocrinol Metab. 2006;50:802). In literature, only one study had been published in 1965 on the cephalometric findings in patients with HVDRR (Marks SC, Lindahl RL, Bawden JW. J Dent Child. 1965;32:259). This is the first detailed study on craniofacial characteristics of patients with HVDRR in the dental literature. The aim of this study was to determine the effect of HVDRR on the parameters of the craniofacial skeleton of young Jordanian patients using cephalometric analysis. Lateral cephalometric radiographs were made for 22 Jordanian children (aged 2-16 years) diagnosed with HVDRR. The cephalometeric parameters of HVDRR group were compared with those of normal control group matched for gender and chronological age using paired t-test. The HVDRR group had a significant increase in the SNBa angle (P < 0.01); as well as reduced anterior cranial base length (P = 0.01), reduced maxillary length, corpus mandibular length and mandibular height (P = 0.01, 0.04 and 0.008 respectively). The cranial base and gonial angles were significantly increased in diseased individual, but the SNA and ANB angles were significantly reduced (P = 0.018 and 0.000 respectively). The angulation of the lower incisor to mandibular plane was also significantly reduced in the diseased group compared with Jordanian norm (P = 0.004). Patients with HVDRR have deficiency in the anterior cranial base length, ramus height and cranial base angle. Patients with HVDRR also have class III skeletal relationship.

Radiographic features of the jaws and teeth in thalassaemia major.

OBJECTIVES: This investigation aimed to compare the radiographic changes and root and crown-body lengths of the mandibular first permanent molar in a group of thalassaemic patients with a control group, matched for age and sex. METHODS: Panoramic radiographs of 50 thalassaemic patients and 50 controls were examined for the presence of radiological changes. Crown body and root lengths were determined using the method of Seow and Lai. The average lengths were calculated and compared between the two groups. RESULTS: The mean crown-body and root lengths of the mandibular first molar of patients with thalassaemia major were 9.58+/-0.83 mm and 11.89+/-1.33 mm, while those for the control group were 10.45+/-0.78 mm and 12.78+/-1.67 mm, respectively. A significant difference (P<0.05) was found between the mean crown-body and root values of the two groups. A significant difference (P<0.05) was also found between thalassaemic patients and controls in the occurrence of spiky-shaped roots, root and crown lengths, taurodontism, attenuated lamina dura, enlarged bone marrow spaces, small maxillary sinuses, faint inferior alveolar canal and thin cortex of the mandible. CONCLUSIONS: While thalassaemia major may not be associated with the occurrence of either vascular canals or prominent antegonial notch, spiky-shaped and short roots, taurodonts, attenuated lamina dura, enlarged bone marrow spaces, small maxillary sinuses, absence of inferior alveolar canal and thin cortex of the mandible were found to be reliable diagnostic criteria for thalassaemia major.