Thesis
Prevalence of dental anomalies in individuals with clefts and their unaffected family members
University of Iowa
Master of Science (MS), University of Iowa
Spring 2022
DOI: 10.25820/etd.006495
Abstract
ABSTRACT Introduction
Individuals born with cleft lip/palate exhibit a wide range of dental anomalies. Both genetic and environmental factors contribute to the etiology of the multidimensional phenotypic spectrum of orofacial anomalies that are observed. The timing of lip and palate repair attempts to allow for normal development of the individual, while minimizing scarring of the soft tissue which can diminish growth of facial structures. Surgical techniques have improved over the years but are still invasive and can damage developing teeth. Unaffected relatives of individuals with clefts would presumably have a higher genetic risk of presenting with similar anomalies found in the dentitions of individuals with orofacial clefts. Previous studies have used intraoral photographs to evaluate the presence of dental anomalies in individuals with clefts, unaffected family members, and controls. This study is a continuation of previous research with a more robust dataset to quantify the prevalence of dental anomalies in the dentitions of individuals with non-syndromic cleft lip/palates, unaffected parents and siblings, and controls.
Materials and Methods
A total of 4,000 individuals were rated, and after inclusion and exclusion criteria were applied, 3,804 were analyzed. These included 393 case probands, 2,192 control probands, 926 parents of case probands, 78 parents of control probands, 199 siblings of case probands, and 15 siblings of control probands. Intraoral photographs taken from six sites were evaluated to determine the presence of dental anomalies using an online screening form. Several raters contributed to the assessment of this dataset, and all raters were calibrated and followed the same rating rules. Differences between sample groups were evaluated using a logistic regression model to determine odds ratios and raw P-values.
Results
Compared with matched controls, case probands had significantly higher odds of at least one permanent tooth presenting with hypoplasia, agenesis, microdontia, mamelons, and displacement (p< 0.01). Case probands also had significantly higher odds of presenting with at least one supernumerary tooth- dentition type was not specified in our study for this anomaly (p<0.01). Control probands had higher odds of having at least one permanent tooth with hypocalcification (p<0.01). In the primary dentition, case probands had higher odds of having at least one tooth with hypoplasia, agenesis, hypocalcification, displacement, and rotation (p<0.01). There were no significant odds ratios of having dental anomalies in unaffected parents and unaffected siblings compared to controls, although some trends were detected.
Conclusions
There are significantly higher odds for an individual with cleft lip/palate to present with various dental anomalies compared to controls. However, unaffected parents and siblings do not have a significantly higher odds ratio of presenting with any of the dental anomalies evaluated in this study. While we hypothesized that the unaffected family members would be at a higher risk due to genetic predisposition, our data doesn’t support this. Instead, it appears the dental anomalies found in individuals with orofacial clefting are due to the physical nature of the cleft or from subsequent corrective surgeries that start at an early age to allow for normal development.
Details
- Title: Subtitle
- Prevalence of dental anomalies in individuals with clefts and their unaffected family members
- Creators
- Aden M Peterson
- Contributors
- Lina M. Moreno Uribe (Advisor)Brian Howe (Committee Member)Mary L Marazita (Committee Member)Kyungsup Shin (Committee Member)
- Resource Type
- Thesis
- Degree Awarded
- Master of Science (MS), University of Iowa
- Degree in
- Orthodontics
- Date degree season
- Spring 2022
- DOI
- 10.25820/etd.006495
- Publisher
- University of Iowa
- Number of pages
- ix, 58 pages
- Copyright
- Copyright 2022 Aden M Peterson
- Language
- English
- Description illustrations
- color illustrations
- Description bibliographic
- Includes bibliographical references (pages 55-58).
- Public Abstract (ETD)
Individuals born with cleft lip and palate have a defect in their upper lip or the bone in their upper jaw. They exhibit various dental anomalies including extra teeth, missing teeth, and flaws in the tooth structure – previously shown to be more common in their teeth compared to the general public. The cause of the clefting is complex, including inherited genetics and acquired factors during fetal development. For these individuals to thrive, surgical intervention is necessary for normal growth milestones, such as feeding and speaking. These surgeries must occur at an early age and can be invasive.
Based on the genetic factors that contribute to orofacial clefting, there have been many studies that investigate dental anomalies in unaffected relatives of individuals with clefts. These unaffected relatives may have a greater genetic risk compared to the general population for dental anomalies, and by studying them we can attempt to further understand the causal factors of cleft lip and palate.
This study includes photographs of over 3,000 people’s teeth evaluated for the presence of dental defects. The dataset included individuals with clefts and their unaffected family members compared to control individuals without family history of cleft anomalies. We found differences between individuals with clefts and control individuals. However, there were no significant differences between unaffected family members and control family members. This indicates family members of individuals with clefts do not have a higher risk for dental anomalies, and anomalies seen in individuals with clefts are related to the physical cleft and the surgeries required for repair.
- Academic Unit
- Orthodontics; Craniofacial Anomalies Research Center
- Record Identifier
- 9984271454102771
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