Structural changes of dental enamel in both dentitions of cleft lip and palate patients.

The aim of this study was to register the incidence, the location and the character of structural changes in dental morphology in cleft lip and palate patients and to examine the connection between defects of dental enamel and the development of clefts. Twenty-two children and adolescents from a cross-section study carried out in 1987/89 with cleft lip and palate patients could be covered in a second study (longitudinal study). The frequency, the extent and the location of changes of dental hard tissues in both dentitions were assessed in the form of a static and a dynamic examination. Dental enamel anomalies were found in all patients, with opacities of cleft-adjacent incisors being the dominating form of classified defects in both dentitions. In 20 of the 22 examined patients, dental enamel dysplasia was found both in the primary and in the secondary dentition. The intraindividual comparison of the maxillary teeth in both dentitions showed that 19 patients had at least 1 permanent tooth retaining the structural changes in the dental enamel. The location of the defect and the fact that both dentitions were involved reflect the moment of effectiveness of pathogenetic stimuli. Consequently this can be interpreted as the outcome of corresponding pathomechanisms both for disorders of the dental structure and for the development of the primary palate.