Epidemiology of Hoffmeister's "genetically determined predisposition to disturbed development of the dentition" in patients with cleft lip and palate.

OBJECTIVE: Type and prevalence rates of the symptoms of Hoffmeister's "genetically determined predisposition to disturbed development of the dentition" were studied in patients with clefts. PATIENTS: Data of 263 patients with nonsyndromic clefts of lip (alveolus and palate) or isolated cleft palates were examined in a retrospective study. SETTING: The clefts were classified as cleft lip or cleft lip and alveolus, cleft palate, unilateral cleft lip and palate, and bilateral cleft lip and palate. All patients were scrutinized for 28 individual symptoms. Prevalences of the individual symptoms were statistically evaluated regarding cleft type and gender by using the chi-square test and were also compared with findings in patients without clefts. RESULTS: In 97.7% of the patients with clefts, at least one symptom was found. Microdontia of individual teeth, hypodontia, and hyperodontia were the symptoms most frequently recorded. Comparison of the different cleft types revealed differences regarding the prevalences of supernumerary lateral incisors (p = .051), infraposition of deciduous molars (p < .001), and atypical tooth bud position (p = .030). Comparison of the prevalences of 10 symptoms recorded in the patients with clefts with the prevalences recorded in patients without clefts showed nine symptoms were found much more frequently in the population with clefts. CONCLUSION: These findings support the hypothesis that clefting is part of a complex malformation associated with other dental anomalies resulting from disturbed development of the dentition. Patients with clefts are also likely to present other deficiencies of dental development and tooth eruption in both dentitions, even in regions not affected by the cleft.

Epidemiological significance of Hoffmeister's "Genetically determined predisposition to disturbed development of the dentition".

BACKGROUND AND AIM: Hoffmeister was the first to recognize the common genetic origin of structurally very varied disturbances in the development of the dentition. He coined the term "microsymptoms of a genetically determined predisposition to disturbed development". The purpose of the present study was to examine the incidence of those microsymptoms in a group of patients undergoing orthodontic treatment. PATIENTS AND METHODS: The orthodontic findings in 4208 patients were evaluated, and nine characteristic symptoms were registered with reference to the panoramic and other radiographs and to the patients' records. RESULTS: 1297 patients (30.8%) were found to have one or more symptoms of genetically determined predisposition to disturbed development. The most frequent symptoms were atypical position of tooth buds (12.2%), absence of tooth buds of permanent teeth (9.2%), and displaced teeth (7.0%). 73.5% of the patients had only one symptom, and 26.5% two or more. Microdontia and displaced teeth were associated particularly frequently with other symptoms of predisposition to disturbed development. Genetically determined predisposition to disturbed development of the dentition is accordingly not rare but is of great epidemiological significance and may provide early indications of potential developmental disorders such as missing tooth buds or displacement of teeth.