Postgraduate Program in Dentistry and Hospital Universitário Lauro Wanderley-Universidade Federal da Paraíba, João Pessoa, Paraíba, Brazil.
Departments of Oral and Craniofacial Sciences and Pediatric Dentistry, School of Dental Medicine, University of Pittsburgh, Pittsburgh, PA, USA.
J Dent Res. 2023 Aug;102(9):979-987. doi: 10.1177/00220345231169915. Epub 2023 Jun 12.
Cleft lip and palate have a complex inheritance, and 90% of its variation in the population is due to genetic contributors. The impact of surgical procedures on maxillofacial growth is well known, but the interference of intrinsic factors in these growth outcomes is not elucidated. The present study aimed to analyze genetic polymorphisms and frequency of dental anomalies as predictors of maxillofacial growth in patients born with cleft lip with or without cleft palate. From a cohort of 537 individuals, operated on by the same surgeon, 121 were analyzed 2 times, to define changes in maxillary growth prognosis by occlusal scores in a minimum 4-y follow-up. In a second step, a subset of 360 individuals had maxillofacial growth outcomes evaluated using Wits, nasion perpendicular to point A, and occlusal scores. The markers rs9923304, rs3738880 and rs2279741, rs2166975, and rs11200014 and rs10736303 were genotyped, and frequency of dental anomalies and cleft severity were determined to define evidence of overrepresentation of alleles associated with maxillofacial growth outcomes. Age and age at primary surgical treatment, sex, and cleft laterality were variables adjusted in the analysis. We found an association between the frequency of dental anomalies and the maxillofacial growth in unilateral ( = 0.001) and bilateral ( = 0.03) individuals with clefts. rs9923304 and maxillofacial growth were associated ( < 0.0001). There was also an association between rs3738880 and rs2166975 and maxillary outcomes in individuals born with unilateral cleft lip and palate ( = 0.003 and = 0.004, respectively), as well as between rs11200014 and maxillary outcomes regardless of cleft type ( = 0.005). Statistical evidence of an interaction between rs9923304 and rs3738880 was observed ( < 0.0001). Presence of dental anomalies and genetic variation in , and were associated with worse maxillofacial growth outcomes in individuals born with clefts.
唇腭裂具有复杂的遗传基础,人群中 90%的变异是由遗传因素引起的。手术对颌面生长的影响是众所周知的,但内在因素对这些生长结果的干扰尚不清楚。本研究旨在分析唇裂伴或不伴腭裂患者的遗传多态性和牙齿畸形频率,以预测其颌面生长。从由同一位外科医生手术的 537 名患者中,分析了 121 名患者的 2 次随访结果,以确定在至少 4 年的随访中,通过咬合评分来定义上颌生长预后的变化。在第二步中,360 名患者的颌面生长结果使用 Wits、鼻根垂直于 A 点和咬合评分进行评估。对标记物 rs9923304、rs3738880 和 rs2279741、rs2166975 和 rs11200014 以及 rs10736303 进行基因分型,并确定牙齿畸形的频率和裂隙严重程度,以确定与颌面生长结果相关的等位基因过度表达的证据。在分析中调整了年龄、初次手术治疗年龄、性别和裂隙侧别等变量。我们发现单侧( = 0.001)和双侧( = 0.03)唇裂患者的牙齿畸形频率与颌面生长有关。rs9923304 与颌面生长有关(<0.0001)。rs3738880 和 rs2166975 与单侧唇裂腭裂患者的上颌结果也有关(分别为 = 0.003 和 = 0.004),而 rs11200014 与无论何种类型的裂隙,其与上颌结果有关( = 0.005)。还观察到 rs9923304 和 rs3738880 之间存在交互作用的统计证据(<0.0001)。存在牙齿畸形和 、 中的遗传变异与唇腭裂患者的颌面生长不良结果有关。