Canine eruption in patients with complete cleft lip and palate.
OBJECTIVE
To describe erupting maxillary canine positions in patients with bone-grafted alveolar clefts.


METHODS
The sample consisted of 101 cleft sites from patients with complete unilateral or bilateral cleft lip and palate who had early (< or =9 years) or late (>9 years) secondary alveolar bone grafts.


METHODS
Canine position was assessed using panoramic radiographs taken before and after alveolar bone grafts. Vertical canine positions were assessed using the long axis of the maxillary permanent canine relative to a 90 degrees vertical reference line. Lateral canine positions were defined using the relationship between the canine tip and the midplane of the lateral incisor root. Anomalous lateral incisors were recorded. Statistical analysis included Student's t tests and chi-square tests.


RESULTS
Patients with alveolar clefts had a 20-fold increased risk for canine impaction, based on erupting canine positions. Abnormal vertical canine positions decreased following early and late alveolar bone grafts (p < .05), whereas abnormal lateral canine positions increased following late alveolar bone grafts (p < .01). Of the cleft sites with altered canine positions, 61% also had a lateral incisor anomaly. Based on canine position, the non-cleft-side canine had the same risk for impaction as the cleft-side canine.


CONCLUSIONS
Patients with alveolar clefts have a significantly higher risk for canine impaction compared with patients without clefts. Timing of alveolar bone grafts and lateral incisor anomalies influenced the risk for canine impaction. An alveolar bone graft should be planned in accordance with maxillofacial development, including the eruption of teeth adjacent to the cleft.
Russell
Kathleen A D D S
KA
Division of Orthodontics, Faculty of Dentistry, Dalhousie University, Halifax, NS, Canada. kathy.russell@dal.ca
McLeod
Catherine E
CE
D000367:Age Factors; D000539:Alveolar Process / Q000002:abnormalities / Q000601:surgery*; D000540:Alveolar Ridge Augmentation / Q000379:methods; D016025:Bone Transplantation / Q000009:adverse effects; D016009:Chi-Square Distribution; D002648:Child; D002971:Cleft Lip / Q000150:complications* / Q000503:physiopathology / Q000601:surgery; D002972:Cleft Palate / Q000150:complications* / Q000503:physiopathology / Q000601:surgery; D003481:Cuspid; D006801:Humans; D008437:Maxilla; D008445:Maxillofacial Development; D011859:Radiography; D018709:Statistics, Nonparametric; D014078:Tooth Eruption; D014095:Tooth, Impacted / Q000000981:diagnostic imaging / Q000209:etiology*; D014097:Tooth, Unerupted / Q000000981:diagnostic imaging / Q000209:etiology*