title: Treatment of dental anomalies in children with complete unilateral cleft lip and palate at SickKids hospital, Toronto.
abstract: OBJECTIVE
  To quantify dental anomalies in permanent dentition associated with complete unilateral cleft lip and palate and to survey treatment modalities used to address these problems.
  
  
  METHODS
  Retrospective study of 116 children with complete unilateral cleft lip and palate treated at SickKids since birth. Presence and morphology of lateral incisors and second premolars were determined. Orthodontic, surgical, and/or prosthetic procedures were analyzed.
  
  
  RESULTS
  The cleft-side lateral incisor was absent in 93.1% of finished cases. The lateral incisor mesial to the cleft was present in 4.3%, absent due to agenesis in 75.9%, and extracted in 19.8% of cases. The lateral distal to the cleft was present in 2.6%, absent due to agenesis in 33.6%, and extracted in 63.8% of cases. Of 105 lateral incisors, only one had normal morphology. Noncleft-side lateral incisors were absent in 16% of finished cases. Absence was due to agenesis in 12.1% of cases and extraction in 4.3%. When the lateral incisor was missing, closure of the dental space occurred by orthodontic tooth movement after alveolar bone grafting (45%); surgical closure with simultaneous alveolar bone grafting (35%); prosthetic closure (17%); and 3% were failures. Agenesis of premolars occurred in 12.1% of cleft-side and 10.3% of noncleft-side maxillary second premolars.
  
  
  CONCLUSIONS
  The cleft-side lateral incisor is rarely present at the conclusion of orthodontic and surgical treatment of complete unilateral cleft lip and palate. Often absent due to agenesis, when present it is typically abnormal in size and bone support and is commonly extracted in favor of canine substitution.
authors.affiliation: SickKids Hospital, Toronto, Ontario, Canada. s.cassolato@utoronto.ca
authors.forename: Sandra F
authors.initials: SF
authors.lastname: Cassolato
authors.forename: Bruce
authors.initials: B
authors.lastname: Ross
authors.forename: John
authors.initials: J
authors.lastname: Daskalogiannakis
authors.forename: James
authors.initials: J
authors.lastname: Noble
authors.forename: Bryan
authors.initials: B
authors.lastname: Tompson
authors.forename: D
authors.initials: D
authors.lastname: Paedo
mesh_terms: D000543:Alveoloplasty; D001641:Bicuspid / Q000002:abnormalities / Q000473:pathology; D016025:Bone Transplantation; D002648:Child; D002971:Cleft Lip / Q000150:complications*; D002972:Cleft Palate / Q000150:complications*; D003481:Cuspid / Q000473:pathology; D017266:Dental Prosthesis; D005260:Female; D006776:Hospitals, Pediatric; D006801:Humans; D007180:Incisor / Q000002:abnormalities / Q000473:pathology; D008297:Male; D009864:Ontario; D019516:Orthodontic Space Closure; D010027:Osteotomy; D019340:Osteotomy, Le Fort; D012189:Retrospective Studies; D014071:Tooth Abnormalities / Q000628:therapy*; D019228:Tooth Crown / Q000002:abnormalities / Q000473:pathology; D014081:Tooth Extraction; D014087:Tooth Movement Techniques; D014092:Tooth Root / Q000002:abnormalities / Q000473:pathology; D014096:Tooth, Supernumerary / Q000628:therapy