• Anatomy
• apexification
• cleft lip-palate
• cone-beam computed tomography
• dental esthetics
• tooth abnormalities

• OHIP-14
• OHRQoL
• cleft lip and palate
• dental
• orthodontics

• Humans
• Cleft Lip/psychology
• Cleft Palate/psychology
• Adolescent
• Quality of Life
• Male
• Female
• Norway
• Oral Health/statistics & numerical data
• Cross-Sectional Studies
• Surveys and Questionnaires
• Malocclusion/psychology
• Malocclusion/epidemiology

• abg
• bilateral cleft lip and palate
• marryland bridge
• multidisciplinary management
• permanent dentition

An extra tooth in the normal tooth sequence in any region of the dental arch is regarded as a supernumerary tooth (SNT). Due to the large variation in location and morphology, the extraction of impacted SNTs is an extensive and complex procedure with high risks of several complications. This report presents a rare case of seven impacted SNTs in the bilateral upper and lower arch that were successfully extracted with the use of digital positioning guide plates.

In January 2022, a 21-year-old male was referred to our department with a chief complaint of pain in relation to tooth #36. Clinical examination showed a deep carious lesion with pulpal involvement in tooth #36 and lingual swelling of the bilateral mandibular posterior area. Radiographic examination revealed seven deeply impacted SNTs in the bilateral posterior area and bilateral impacted mandibular third molars. Based on these findings, the patient was diagnosed with bilateral, multiple impacted SNTs and tooth #36 chronic pulpitis. A root canal treatment and an all-ceramic crown restoration for tooth #36 were performed. An individualized digital positioning guide plate was designed by computer-aided design/computer-aided manufacturing technology and cone-beam computed tomography for extraction of the impacted SNTs. During the operation, the digital positioning guide plate allowed rapid positioning and exposure of the SNTs while avoiding adjacent important anatomical structures. At 3-month follow-up, regeneration of bone and soft tissues was visible.

The application of digital positioning guide plates is useful for the individualized and minimalized extraction of impacted supernumerary teeth.

• Supernumerary teeth
• Computer aided design/computer aided manufacturing
• Digital
• Surgical guide
• Minimal invasion
• Case report

• Cleft lip
• Cleft palate
• Congenital abnormalities
• Craniofacial abnormalities
• Tooth abnormalities

Bone height assessment alone is frequently used to guide rehabilitation choice, without consideration for soft tissues or adjacent teeth. This study aimed to evaluate the impact of different preoperative cleft assessments on implant success and patient satisfaction.

The study involved a retrospective assessment of records from 40 patients with cleft lip and palate (CLP). The alveolar cleft score (ACS; clinical criteria), interdental alveolar bone height (IABH) score (radiological criteria), patient compliance score (dental hygiene, medical visit observance, and smoking), and a novel combined score (IABH-ACS-Compliance) were assessed from patient records. Patients who required prosthetic tooth rehabilitation in the cleft dental arch space were included. Twenty-six patients (Group 1) were treated with dental implants, and 14 patients (Group 2) selected another prosthetic option (fixed prosthodontics, removal prosthesis), orthodontic space closure, or no rehabilitation. The main outcomes measured were relative implant success (no implant loss involving marginal bone loss ≤ 1.9 mm) for patients treated with dental implant therapy (Group 1) and patient satisfaction for all patients (Groups 1 and 2).

Forty dental implants were placed in the patients in Group 1. Four implants in four patients (Group 1 relative failure, RF) were lost (implant survival rate of 90%) after 36 (± 12.4) months of follow-up. Twenty-two patients who received implants belonged to the relative implant success group (Group 1 RS). The average “IABH-ACS-Compliance” scores were significantly different (p < 0.05): 16.90 ± 2.35 and 12.75 ± 0.43 for the Group 1 RS and RF groups, respectively.

Preoperative cleft parameters have an impact on relative implant success and patient satisfaction. The new cleft assessment combined-score (“IABH-ACS-Compliance”) allows an accurate selection of cleft cases eligible for dental implants, thereby improving postoperative outcomes.

• Alveolar cleft score
• Cleft lip
• Cleft palate
• Dental implant
• Interdental alveolar bone height
• Patient compliance
• Patient satisfaction

Patients born with cleft lip and/or palate (CL/P) have orthodontic treatment challenges due to maxilla deficiency, malocclusions, and dental abnormalities. In Norway, orthodontic treatment is done by centralized CL/P teams. Due to traveling restrictions, this treatment might be done locally in the future. The experience of Norwegian community orthodontists in managing such patients has not been investigated previously.

To assess Norwegian orthodontists’ management of patients with CL/P and need for further education.

All orthodontists in Norway were sent a questionnaire about their experience, challenges, and knowledge and asked about their need of further theoretical education and clinical training in the management of patients with CL/P.

Norwegian orthodontists’ standard of knowledge of CL/P treatment is adequate. However, few respondents have treated a high number of cleft patients. Eighty-six percent of the participants believed that treating CL/P patients involves challenges, such as time-consuming treatment and technical difficulties. Increased perceived need for more education was revealed among participants stated unpreparedness during education (4 folds), encountered challenges, and lack of knowledge (almost 3 folds).

The study revealed that community orthodontists in Norway lack experience and acknowledged the challenges in treating patients with CL/P. Most of the respondents perceived a need for additional education and clinical training to treat CL/P patients competently. The findings suggested more focus on patients with CL/P management in the curricula and more collaboration between centralized CL/P teams and community orthodontists.

• CL/P
• Norway
• education
• experience
• orthodontist

• cleft lip and palate
• dental anomalies
• supernumerary teeth

The distribution of dental abnormalities among cleft patients concerning cleft type frequently poses ambiguity wherefore the aim of this study was to evaluate the prevalence of hypodontia and supernumerary teeth in an exemplary German cleft population dependent on the cleft type.

Radiographs and dental records of cleft patients, which had been treated and followed up in the Department of Oral and Maxillofacial Surgery, University Hospital Carl Gustav Carus Campus, Dresden, Germany (investigation period of 22 years) were evaluated concerning hypodontia and supernumerary teeth dependent on the cleft type. Out of 386 records, 108 patients met the inclusion criteria: non-syndromic cleft of the alveolus with or without palate (CL/P), at least one clear panoramic x-ray, sufficient dental records. Statistical analysis was performed using x-square and binominal test (p ≤ 0.05).

Hypodontia was more frequent (54/50%) than supernumerary teeth (36/33.3%) and was more common in bilateral clefts of the lip and palate (BCLP) (70.1%) than in unilateral clefts of the lip and palate (UCLP) (51.6%) or clefts of the lip and alveolus (CLA) (34.5%) (p << 0.001). There was an average of 0.9 missing teeth per patient, thereof the upper lateral incisor was most often affected (23.2%). In contrast, supernumerary teeth were more frequent in CLA (51.7%; p = 0.014) than UCLP (29.0%) and BCLP patients (17.6%).

The prevalence for numerical dental anomalies was significantly different among the cleft types. Hypodontia significantly increased with the extend of the cleft, whereas the prevalence of supernumerary teeth decreased.

• Cleft lip
• Cleft palate
• Hypodontia
• Supernumerary teeth

• cleft lip and palate; dental anomalies; panoramic radiograph.

• Cleft lip
• Cleft lip and palate
• Cleft palate

• Cleft
• Norway
• children
• dental anomalies
• occlusion

Cleft defects are one of the most frequent birth-deformities of the orofacial region and they are commonly associated with anomalies of the tooth structure, size, shape, formation, eruption, and tooth number. The aim of our study was to evaluate the prevalence, distribution, and potential association of combined hypodontia in cleft-affected patients with regard to all types of teeth in both jaws in the permanent dentition.

This retrospective radiographic analysis included patients with various types of clefts treated orthodontically in the Department of Orofacial Orthopedics and Orthodontics at Heim Pàl Children’s Hospital, Budapest. There were 150 patients (84 males, 66 females) with non-syndromic unilateral (UCLP; n=120 patients) or bilateral (BCLP; n=30 patients) cleft formation (lip, alveolus and palate) who met the inclusion criteria. Statistical analysis was performed using the chi-square test and Fisher’s exact test (significance level p<0.05).

Hypodontia was significantly more frequent in patients with cleft-sided lateral incisor (104 patients, 69%), with a total of 235 missing teeth, followed by the second premolars of the upper and lower jaw. A significant correlation of congenital missing teeth was observed in left-sided clefts between the upper and lower second premolar in the cleft area.

Hypodontia inside and outside the cleft area was frequently observed. This should affect the therapy plans, especially if the cleft-sided premolar is also absent. Further comprehensive research including numerous random samples is necessary for better estimating other possible associations.

• cleft lip and/or palate
• dental anomaly
• fused teeth
• hypodontia
• microform

The aims of this study were to investigate the prevalence and distribution of dental anomalies in a group of Saudi subjects with cleft lip and palate (CLP), to examine potential sex-based associations of these anomalies, and to compare dental anomalies in Saudi subjects with CLP with published data from other population groups.

This retrospective study involved the examination of pre-treatment records obtained from three CLP centers in Riyadh, Saudi Arabia, in February and March 2010. The pre-treatment records of 184 subjects with cleft lip and palate were identified and included in this study. Pre-treatment maxillary occlusal radiographs of the cleft region, panoramic radiographs, and orthodontic study models of subjects with CLP were analyzed for dental anomalies.

Orthopantomographs and occlusal radiographs may not be reliable for the accurate evaluation of root malformation anomalies. A total of 265 dental anomalies were observed in the 184 study subjects. Hypodontia was observed most commonly (66.8%), followed by microdontia (45.6%), intra-oral ectopic eruption (12.5%), supernumerary teeth (12.5%), intra-nasal ectopic eruption (3.2), and macrodontia (3.2%). No gender difference in the prevalence of these anomalies was observed.

Dental anomalies were common in Saudi subjects with CLP type. This will complicate the health care required for the CL/P subjects. This study was conducted to epidemiologically explore the prevalence of dental anomalies among Saudi Arabian subjects with CLP.

• CLP
• Cleft lip
• Cleft palate
• Dental anomalies

The aim of this article was to review the literature on supernumerary teeth, analyzing their prevalence, etiology, diagnosis, treatment and possible complications. An electronic search was made in the Pubmed-Medline database up to January 2014 using the key search terms “multiple supernumerary teeth” (n=279), “prevalence supernumerary teeth” (n=361), and “supernumerary teeth” (n=2412). In addition to the articles initially identified, others were included in the review proceeding from a manual search and from any references considered of relevance. Supernumerary teeth are those that exceed the normal dental formula. They are more common in men, more common in the upper maxilla, and more prevalent in permanent dentition. Complications associated with supernumerary teeth include dental impaction, delayed eruption, ectopic eruption, overcrowding, spacing anomalies and the formation of follicular cysts. The treatment of supernumerary teeth depends on their type, position, and possible complications, detected clinically and radiographically. No clear consensus exists as to the best time to extract unerupted supernumerary teeth.

Key words:Hyperdoncia, supernumerary teeth, impacted teeth, treatment, permanent teeth, deciduous teeth.

• Cleft lip and palate
• Symmetry
• Tooth size

• Adolescent
• Bicuspid/pathology
• Cleft Lip/pathology
• Cleft Palate/pathology
• Cuspid/pathology
• Dental Arch/pathology
• Female
• Humans
• Imaging, Three-Dimensional/methods
• Incisor/pathology
• Male
• Mandible/pathology
• Maxilla/pathology
• Molar/pathology
• Odontometry/instrumentation
• Odontometry/methods
• Retrospective Studies
• Tooth Crown/pathology

• Anodontia/therapy
• Cleft Lip/therapy
• Cleft Palate/therapy
• Cuspid/pathology
• Esthetics, Dental
• Female
• Follow-Up Studies
• Humans
• Imaging, Three-Dimensional/methods
• Incisor/abnormalities
• Malocclusion, Angle Class II/therapy
• Nose Diseases/surgery
• Oral Fistula/surgery
• Orthodontic Space Closure/methods
• Orthognathic Surgical Procedures/methods
• Osteotomy, Le Fort/methods
• Palatal Expansion Technique
• Patient Care Planning
• Patient Care Team
• Patient Satisfaction
• Respiratory Tract Fistula/surgery
• Tomography, X-Ray Computed/methods
• Tooth Eruption, Ectopic/therapy
• Tooth Movement Techniques/methods
• User-Computer Interface
• Young Adult

Cleft lip and/or palate is the most frequent congenital abnormality occurring in the craniofacial region and is often associated with numerous dental defects such as tooth agenesis, supernumerary teeth, microdontia, taurodontism, crown malformations, or delay in eruption. The prevalence of hypodontia in cleft-affected patients is much higher in comparison with a healthy population. The aim of this study was to evaluate the prevalence of second premolar hypodontia in patients with cleft lip and/or palate.

We performed a retrospective, evaluation of panoramic radiographs and dental casts in the Department of Dentofacial Orthopeadics and Orthodontics, Wroclaw Medical University. Two independent observers evaluated the records of 469 patients with various types of clefts and analyzed dental casts and panoramic radiographs.

202 individuals met inclusion criteria. The sample comprised 120 UCLP patients, 38 BCLP patients, 28 CP patients, and 17 CLA patients. Hypodontia in the premolar region was observed in 39 individuals (19.3%). A total number of 58 second premolars were missing, of which 35 were maxillary second premolars (U5) and 23 were mandibular second premolars (L5).

Estimated hypodontia in the Polish CL/P sample was considerably higher than the hypodontia in permanent dentition reported for a European healthy population. The number of congenitally missing second premolars was higher in the maxillary arch than in the mandibular.

Fusion, an uncommon anomaly of the hard dental tissues, is potentially the cause of clinical problems related to esthetics, tooth spacing, and other periodontal complications. This paper describes a multidisciplinary approach involving surgical, endodontic, restorative, and orthodontic attention for the successful, functional, and esthetic rehabilitation of a maxillary left lateral incisor fused with a supernumerary tooth in unilateral cleft lip adolescence in contralateral side. After clinical and radiographic examinations, a fusion between the left maxillary lateral incisor and a supernumerary tooth was diagnosed in the patient, and a small connection was detected between the pulp systems of the two root canals. The case reported in this paper presents the successful resolution of a fused maxillary lateral incisor with a supernumerary tooth, using endodontic, surgical, restorative, and orthodontic management. The decision made in extracting or retaining the fused tooth depends on the arch discrepancy and esthetic needs. Future studies, with long-term followup, will be helpful in evaluating the long-term efficacy of the different treatment options.

• Tessier cleft
• commissuroplasty
• hyperdontia
• oblique facial clefts

• Alveolar cleft
• Bone graft
• Flap