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. 2017 Sep;21(7):2273-2281.
doi: 10.1007/s00784-016-2020-z. Epub 2016 Dec 9.

Permanent tooth agenesis in non-syndromic Robin sequence and cleft palate: prevalence and patterns

Anneline de Smalen  1 , Daan P F van Nunen  2 , Ruurd R Hermus  1 , Edwin M Ongkosuwito  3 , Arjen J van Wijk  1 , J Peter W Don Griot  4 , Corstiaan C Breugem  5 , Gem J C Kramer  1
Affiliations

Permanent tooth agenesis in non-syndromic Robin sequence and cleft palate: prevalence and patterns

Anneline de Smalen et al. Clin Oral Investig. 2017 Sep.

Abstract

Objectives: Partial tooth agenesis is frequently observed in Robin sequence. Tooth anomalies are increasingly considered as an extended phenotype of the cleft palate population. The study objective was to compare the prevalence and patterns of tooth agenesis in a group of patients with non-syndromic Robin sequence (ns-RS) and a group with non-syndromic cleft palate (ns-CP).

Materials and methods: The panoramic radiographs of 115 ns-RS and 191 ns-CP patients were assessed for agenesis of the permanent dentition (excluding third molars) and the patterns recorded using the Tooth Agenesis Code.

Results: Partial tooth agenesis was observed in 47.8% of ns-RS and 29.8% of ns-CP patients with a greater prevalence in the mandibula than in the maxilla, particularly in ns-RS. The teeth most frequently absent in both groups were the mandibular second premolars and maxillary lateral incisors. Tooth agenesis was bilateral in two-thirds of affected ns-RS patients and one-half of ns-CP patients. In ns-RS, bilateral agenesis of the mandibular second premolars was more frequently observed in female than that in male patients. Completely symmetrical patterns of hypodontia were found in around 45% of ns-RS patients with tooth agenesis compared to 35% in ns-CP. No association was found between the extent of the palatal cleft and the severity of hypodontia.

Conclusion: Tooth agenesis is more prevalent in ns-RS than that in ns-CP, demonstrates a much greater predilection for the mandible in ns-RS, and bears no relation to the extent of the palatal cleft.

Clinical relevance: When compared to ns-CP, additional developmental disturbances are likely involved in the etiology of tooth agenesis in ns-RS. Future research could help identify the underlying genetic traits and aid in classifying patients in those with and without expected tooth agenesis in order to facilitate orthodontic management strategies.

Keywords: Cleft palate; Etiology; Hypodontia; Robin sequence; Tooth agenesis.

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Conflict of interest statement

Conflict of interest

The authors declare that they have no conflict of interest.

Funding

The work was supported by internal funds of the Department of Orthodontics, Academic Centre for Dentistry Amsterdam (ACTA); the Division of Plastic and Reconstructive Surgery, Wilhelmina Children’s Hospital, University Medical Center Utrecht; the Department of Oral & Maxillofacial Surgery, Special Dental Care and Orthodontics of Erasmus Medical Centre in Rotterdam, the Netherlands; the Department of Plastic, Reconstructive and Hand Surgery, VU University Medical Center Amsterdam.

Ethical approval

Prior approval for this retrospective study was obtained from the Institutional Review Boards of both the Erasmus Medical Center Rotterdam (2014-183) and the University Medical Center Utrecht (13/407).

Informed consent

Dutch law did not require parental informed consent for this type of study, since patients were not subject to investigational actions.

Figures

Fig. 1
Fig. 1
Prevalence of agenesis of the mandibular second premolars
See this image and copyright information in PMC

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