Plastic Surgery Research Council

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Dental Agenesis and Maxillary Growth Restriction in Cleft Lip and Palate Patients
Lindsay E. Janes, MD1, Mohamed Bazina, DDS,MSD2, Sherif Morcos, DDS2, Angelica Ukaigwe, BS3, Manish Valiathan, DDS, MDS2, Ronald Jacobson, DDS, MSD3, Arun K. Gosain, MD3.
1Northwestern University, Chicago, IL, USA, 2Case Western Reserve University, Cleveland, OH, USA, 3Lurie Children's Hospital, Chicago, IL, USA.

Purpose: Maxillary retrusion is well known facet of the cleft palate pathology, however whether that underdevelopment is an intrinsic process or secondary to surgical scarring after palatoplasty remains the subject of controversy. The aim of this study is to evaluate the relationship between hypodontia and maxillary volume.
Methods: After IRB approval, a retrospective review of patients age 6-9 with unilateral cleft palate at Lurie Children's Hospital and Case Western University who underwent CBCTs in preparation for alveolar bone grafting between 2010-2016 was conducted. Serial Panorex scans were reviewed by two researchers to determine the number and location of congenitally absent teeth. Dolphin Imaging was used to measure SNA angle, ANB angle, and maxillary volume. Group 1 (poor growers) consisted of the bottom 50% of ANB angles and Group 2 (good growers) consisted of the top 50% of ANB angles.
Results: 38 patients were identified that met inclusion criteria and had adequate imaging. The lateral incisor was the most commonly missing tooth (29%), first pre-molar on either side (18%). As seen in table 1, patients with higher ANB angles had fewer missing teeth and higher maxillary volume compared to patients with lower, Class III ANB angles.
Conclusions: Cleft patients with Class III occlusal relationships are more likely to have more congenitally missing teeth and decreased maxillary volume. The causative nature of this relationship requires further study.


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