Subphenotypes in Non-Syndromic Orofacial Cleft Patients Based on the Tooth Agenesis Code (TAC).

Background: It was the aim of this study to investigate tooth agenesis patterns, which are expressed to different subphenotypes according to the TAC method in a spectrum of non-syndromic orofacial cleft patients. Methods: A total of 183 orofacial cleft patient records were assessed for tooth agenesis and TAC patterns. The association between TAC and sex, and cleft type was examined, and logistic regression models were additionally applied. Additionally, the distribution of missing teeth by cleft type and the tooth agenesis inter-quadrant association were examined. Results: The most frequent cleft type was CLPL (n = 72; 39.3%), while the maxillary left lateral incisor was the most frequently missing tooth that was strongly dependent on the cleft type (29.5%, p < 0.001). Of the 31 TAC patterns identified, four were the most prevalent and occurred in 80.8% of the sample, while 20 TAC patterns were unique. Cleft type contrary to sex (p = 0.405) was found to play a significant role in TAC distribution (p = 0.001). The logistic regression's results suggested that overall, neither sex nor cleft type were associated with tooth agenesis. Prevalence of tooth agenesis in each quadrant clearly depended on cleft type; and there was a strong association found between tooth agenesis in different quadrants. Conclusions: Thirty-one different subphenotypes were identified in TAC patterns. The first four TAC patterns accounted for the 80.8% of the sample's variability while twenty of the patterns were unique. A strong association was present between TAC pattern and cleft type. No association was found between the sex of the patient, tooth agenesis and TAC patterns. Tooth agenesis depended strongly on the cleft type, and the most frequently missing tooth was the maxillary left lateral incisor. The interquadrant association for tooth agenesis found suggests a genetic link in the etiology of clefts.

A cross-sectional analysis of the prevalence of tooth agenesis and structural dental anomalies in association with cleft type in non-syndromic oral cleft patients.

BACKGROUND: The aim of this study was to investigate the prevalence of tooth agenesis, microdontia, and tooth malformation among non-syndromic oral cleft patients and their potential association with cleft type and gender. METHODS: Intraoral records and radiographs of 154 patients (97 males and 57 females) were examined. The variables assessed were tooth agenesis, microdontia, dental malformations, and cleft types. The statistics included chi-square and Fisher's exact tests as well as logistic regression to assess any mutual effects of gender and cleft type on the dental variables. RESULTS: Tooth agenesis occurred in 50% of the sample and microdontia in 18%. Non-statistically significant odds ratios for the association of gender and cleft type with tooth agenesis were obtained. Tooth agenesis was substantially higher at the unilateral right CL + P and the bilateral CL + P in quadrant 1 and at the unilateral left CL + P and bilateral CL + P in quadrant 2. It was also higher, at the isolated cleft palate (CP) in quadrants 3 and 4. These results were attributed to teeth 22 (31.8%) and 12 (21.6%) in the maxilla and to teeth 35 (6.1%) and 45 (5.4%) in the mandible. In unilateral CL + P patients, the cleft quadrant that presented tooth agenesis was associated with the side of the cleft. CONCLUSIONS: Interdisciplinary treatment of the oral cleft patients should take into consideration the high prevalence of tooth agenesis and their association with the different cleft types. The most frequently affected teeth by cleft are by far the upper lateral incisors. Results indicate that tooth agenesis appears to be a genetically controlled anomaly related to the orofacial cleft development through various genetic links and not caused by the cleft disruptive process.

Adhesion of Streptococcus mutans to different types of brackets.

OBJECTIVE: To examine the difference in the adhesion of Streptococcus mutans to three different types of orthodontic brackets and the effect of the presence of an early salivary pellicle and Streptococcus sanguis on adhesion. MATERIALS AND METHODS: Three adhesion experiments were performed using stainless steel, ceramic, and plastic orthodontic brackets. In the first experiment a clinical strain of S mutans adhered to the three different types of brackets (n = 6 for each). For the second, the brackets were treated with saliva before adhesion of S mutans (n = 6 per type of bracket). Finally, the third experiment concerned saliva coated brackets (n = 6 per type of bracket), but before S mutans, S sanguis bacteria were allowed to adhere. The bacteria were always allowed to adhere for 90 minutes in all the experiments. Adhesion was quantitated by a microbial culture technique by treating the brackets with adhering bacteria with trypsin and enumerating the total viable counts of bacteria recovered after cultivation. RESULTS: There were consistently no differences in the adherence to stainless steel, ceramic, or plastic brackets. The presence of an early salivary pellicle and S sanguis reduced the number of adhering S mutans to all three types of brackets. CONCLUSIONS: Adhesion of bacteria to orthodontic brackets depends on several factors. The presence of a salivary pellicle and other bacterial species seem to have a significant effect on the adhesion of S mutans, reducing their numbers and further limiting any differences between types of brackets.