Oblique lateral oro-ocular facial cleft. Case report.

2 patients are presented, and the oblique lateral oro-ocular clefts discussed with emphasis on classification, dentition and microforms. A review of the literature revealed 10 patients with oblique lateral oro-ocular facial cleft (no. 5 in Tessier's classification), 3 bilateral and 7 unilateral. 5 unilateral cases had a median oblique facial cleft (no. 4) on the other side. 3 cases had a cleft lip and palate. The site of the alveolar cleft was in the region of the first and second premolar in 2 and slightly posterior to the canine tooth in 3 of 5 reliably documented cases. The dentition was documented only in 1 child with a lateral and median oblique facial cleft, resulting in full permanent dentition. The author's 2 cases had a bilateral oblique lateral oro-ocular facial cleft with the alveolar defect in the region of the first and second premolar. An isolated cleft (no. 6 in Tessier's classification) has to our knowledge not been reported at all. Furthermore, there are transitional forms between Tessier's clefts 5-8. Based upon our observations, it is also evident that variations inside one type occur as well. More attention should be paid to the exact location of the cleft and especially to the skeletal deformity, alveolar site and dentition. This would facilitate both classification and diagnosis of microforms.