Investigation of skeletal relationships, tooth abnormalities, and biochemical composition of saliva in cleft lip and palate patients

Qadeer, Mustafa (2023) Investigation of skeletal relationships, tooth abnormalities, and biochemical composition of saliva in cleft lip and palate patients. PhD thesis, Universiti Sains Malaysia.

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Cleft lip and palate (CLP) that affects many neonates annually, is one of the most common birth deformities and has been found to be linked with various other orofacial abnormalities including dental enamel hypoplasia and skeletal defects. Several studies have investigated some dental anomalies associated with CLP patients. However, details of the internal tooth structure (enamel thickness, enamel density and dentine thickness) as well as biochemical composition of saliva in patients with CLP are not available. The overall goal of this study is to assess skeletal relationships, tooth structures, tooth size and biochemical composition of the saliva in patients with CLP. A retrospective record review was conducted in the Department of Orthodontics and Oral Radiology, CMH-Lahore Medical College and Institute of Dentistry. 4152 cone beam computed tomography (CBCT) data sorting was performed and 73 patients with cleft were included to identify skeletal relationships in different cleft-types. Meanwhile, 84 ‘non-syndromic’ CLP patients (41 unilateral cleft lip and palate (UCLP) and 43 bilateral cleft lip and palate (BCLP)) and 39 non cleft subjects were selected to identify tooth abnormalities. Enamel thickness, enamel density, dentin thickness, and tooth size of the permanent maxillary incisors and canines were measured from their CBCT scans. Two-way ANOVA with interaction effect was applied to examine if gender has an effect in addition to cleft on various measurements of teeth. A cross-sectional study was conducted where saliva samples were collected from 27 individuals with UCLP, 27 individuals with BCLP, and 27 non-cleft individuals. Precipitate and supernatant of this saliva samples were analised by using fourier transform infrared (FTIR) spectroscopy and scanning electron microscopy/energy-dispersive X-ray (SEM/EDX). Results of the skeletal relationships showed that the skeletal class III were found to be predominant in both sexes, followed by class II and class I (p ˃ 0.05). For tooth abnormalities, the enamel thickness, enamel density, mesiodistal width, crown height, root length and tooth length were significantly smaller in patients with CLP compared to non-cleft individuals (p < 0.05) while dentine showed no significant difference in most of teeth measured (p ˃ 0.05). Missing lateral incisor (81.4%) was found to be more common in BCLP. Atypical root shape was more prevalent in right lateral incisor in BCLP (p < 0.05). FTIR analysis of saliva showed the presence of inorganic phosphates, proteins, lipids, and hormone in the samples tested. Visible difference between FTIR spectra of cleft and non-cleft individuals, specifically in bands of inorganic phosphates, amide I, and amide II were observed. SEM results revealed interconnected filamentous network in the saliva of normal individuals whereas this filamentous network was not present in patients with CLP. In addition to variation in tooth sizes and decreased enamel density, abnormal biochemical composition as well as surface morphology of saliva may contribute to increase caries susceptibility in patients with CLP. Implementation of early oral health care prevention strategy to improve oral health status are essential in patients with CLP.

Item Type: Thesis (PhD)
Uncontrolled Keywords: Cleft lip and palate
Subjects: R Medicine
R Medicine > RK Dentistry > RK520-528 Orthodontics
R Medicine > RK Dentistry > RK641-667 Prosthetic dentistry. Prosthodontics
Divisions: Kampus Kesihatan (Health Campus) > Pusat Pengajian Sains Pergigian (School of Dental Sciences) > Thesis
Depositing User: Mr Abdul Hadi Mohammad
Date Deposited: 15 Feb 2024 03:24
Last Modified: 15 Feb 2024 03:43

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