Pulp enlargement in individuals born with cleft lip and palate pulp, a radiographic study from the cleft lip and palate service of paraiba, Brazil'.

PURPOSE: Pulp chamber enlargement impacts endodontic treatment planning. The aim of this study was to evaluate alterations in pulp chamber size of posterior teeth in individuals born with cleft lip with or without cleft palate. METHODS: Ninety individuals were treated at the Cleft Lip and Palate Service of the University Hospital Lauro Wanderley, Federal University of Paraíba, between the ages of 4 and 15 years born with cleft lip with or without cleft palate were selected. Ninety-nine patients from the archives of the residency program in Orthodontics of the Brazilian Dental Association (ABO) were paired by sex and age as a comparison group. Radiographs were evaluated by a single examiner, observing the presence/absence of an enlarged pulp chamber in the first and second permanent molars of all quadrants. Chi square or Fisher's exact tests were used (α = 0.05) in all comparisons. RESULTS: Pulp enlargement was more frequently found among individuals born with cleft lip with or without cleft palate (p = 0.0005). However, pulp enlargement frequency was different among subjects born with clefts (p = 0.0006). Pulp enlargement was more common in the maxilla, in both groups. Individuals born with cleft lip with or without cleft palate more often had six or more teeth affected (p = 0.02). Furthermore, individuals with a bilateral cleft more often had six or more teeth affected in comparison to unilateral cases (p = 0.002). CONCLUSION: Pulp enlargement is a frequent finding, particularly among individuals born with cleft lip with or without cleft palate, with a higher prevalence in the maxilla.

COMT rs4818, pain sensitivity and duration, and alveolar bone grafting of oral clefts.

PURPOSE: Verifying whether the mutation in COMT rs4818 could be involved in pain modulation. METHODS: Thirty-two individuals born with cleft lip and palate that underwent bone graft from the iliac crest bone were assessed at 12, 24, 48, 72 h, and 7 days regarding their pain experience using a visual analogic scale. DNA from each participant was collected from saliva samples, and genotyping of rs4818 was performed using TaqMan chemistry. Overrepresentation of rs4818 alleles was tested using chi-square or Fisher's exact tests with an alpha of 0.05. RESULTS: Of the 32 individuals, eighteen reported long pain duration, nine reported high pain intensity, and fourteen low pain intensity up to 48 h. No differences were found in the distribution of individuals depending on the reported pain by sex (p = 0.12), age (p = 0.42), or cleft type (p = 0.5). The distribution of COMT r4818 alleles was different depending on the intensity and duration of pain. Carriers of the C wild-type allele were four times more likely to show high pain intensity and duration (odds ratio = 4.29, 95% confidence interval 1.13-16.18), meaning that the G variant allele is protective. CONCLUSION: COMT rs4818 is associated with postoperative pain after alveolar bone grafting.