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Abstract

Objective: Tooth agenesis is quite common in cleft lip and palate patients. This study was aimed for retrospectively investigating the prevalence and patterns of tooth agenesis among bilateral cleft lip and cleft palate (CLCP) patients. Patients: The hospital data and x-ray films of bilateral CLCP patients no younger than 7 years old in the Craniofacial Center, Kaohsiung Chang Gung Memorial Hospital from June 1974 to September 2015 were selected. The enrolled list contained 188 patients (male: 124; female: 64). The mean age of our patient was 10.13 years (range: 7.0 ~ 23.6 years). Materials and methods: Patients’ dental records and x-ray imaging including panoramic radiographs, periapical films of anterior teeth and upper occlusal films were inspected. Third molars were excluded in the evaluation. Tooth agenesis code (TAC) was applied for categorizing the missing tooth patterns. Results: The prevalence of tooth agenesis among these 188 cleft subjects was 77.7% (146/188). The total teeth number present with congenital missing in these188 subjects was 328 (6.2%). The most frequent missing teeth were maxillary lateral incisors (right side: 63.3%, left side: 62.8%), followed by maxillary second premolars, mandibular second premolars and mandibular lateral incisors. Regarding the gender, the frequency of missing teeth was similar with the overall sample sizes. However, in females, the prevalence of missing upper lateral incisors was higher in the right side (64.1%) than the left side (45.3%). There were 38 different agenesis patterns, including one non-missing type. The most frequent pattern was maxillary bilateral lateral incisors missing (37%), and the second was non-missing-tooth pattern (22.3%). Agenesis pattern involved upper lateral incisors missing was highly related to the cleft site (29/37 = 78.4%). Conclusion: There were 38 different patterns of tooth agenesis presenting in bilateral CLCP patients of our study. This study showed the prevalence of individual tooth missing and percentage of agenesis patterns. The distribution of tooth agenesis patterns in our study was different from the studies in other countries. The result may support the tooth agenesis patterns in CLCP patients are region-specific.

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