Qadeer Mustafa, Jaafar Saidi, Khamis Mohd F, Saeed Muhammad Q, Khan Haris, Arshad Anas I
Department of Oral Biology, Institute of Dentistry, CMH Lahore Medical College, National University of Medical Sciences, Rawalpindi, Pakistan.
Basic and Medical Sciences Unit, School of Dental Sciences, Universiti Sains Malaysia, Kubang Kerian, Kelantan, Malaysia.
J Taibah Univ Med Sci. 2025 May 28;20(3):307-317. doi: 10.1016/j.jtumed.2025.05.002. eCollection 2025 Jun.
This study aimed to investigate tooth structural abnormalities, including the enamel thickness, enamel density, dentine thickness, and mesiodistal width in maxillary central incisors in patients with cleft lip and palate (CLP).
A retrospective record review was conducted at CMH-Lahore Medical College and Institute of Dentistry. Eighty-four nonsyndromic CLP patients (41 unilateral CLP (UCLP) and 43 bilateral CLP (BCLP)) and 39 controls were included. Cone beam computed tomography images were used to measure mesial enamel thickness, distal enamel thickness, dentine thickness, and mesiodistal width perpendicular to the long axis of the tooth. Two-way analysis of variance with interaction effects was conducted to determine whether gender influenced the teeth measurements in addition to the cleft.
In central incisors, enamel thickness, enamel density, and mesiodistal width were significantly smaller in the CLP group compared with the non-cleft group ( < 0.05), but no significant difference was found in dentine thickness ( > 0.05). Total enamel thickness was 1.94 ± 0.32 mm in the non-cleft group, 1.52 ± 0.25 mm in UCLP, and 1.32 ± 0.34 mm in BCLP. Mesiodistal width measured 8.44 ± 0.54 mm in the non-cleft group, 7.65 ± 0.63 mm in UCLP, and 7.48 ± 0.87 mm in BCLP, with a significant difference between the non-cleft group and BCLP ( < 0.05). A similar trend was observed for enamel density. Gender and cleft type exhibited substantial interaction effects for all measures ( < 0.05), except for mesiodistal width in the left central incisor, which was not significant ( > 0.05).
Maxillary central incisors were smaller in CLP patients, with significantly reduced enamel thickness and density, but dentine was largely unaffected. This study provides evidence that cleft conditions affect enamel more significantly than dentine. Hence, it is suggested that clinicians should adopt a conservative approach and use appropriate resin bonding materials to minimise enamel damage during restoration and orthodontic treatment.
本研究旨在调查唇腭裂（CLP）患者上颌中切牙的牙齿结构异常情况，包括釉质厚度、釉质密度、牙本质厚度和近远中宽度。
在拉合尔CMH医学院和牙科学院进行了一项回顾性记录审查。纳入了84例非综合征性CLP患者（41例单侧唇腭裂（UCLP）和43例双侧唇腭裂（BCLP））以及39例对照。使用锥形束计算机断层扫描图像测量近中釉质厚度、远中釉质厚度、牙本质厚度以及垂直于牙齿长轴的近远中宽度。进行了具有交互作用的双向方差分析，以确定除了腭裂外，性别是否会影响牙齿测量结果。
在中切牙中，CLP组的釉质厚度、釉质密度和近远中宽度显著小于非腭裂组（P<0.05），但牙本质厚度无显著差异（P>0.05）。非腭裂组的总釉质厚度为1.94±0.32mm，UCLP组为1.52±0.25mm，BCLP组为1.32±0.34mm。非腭裂组的近远中宽度为8.44±0.54mm，UCLP组为7.65±0.63mm，BCLP组为7.48±0.87mm，非腭裂组与BCLP组之间存在显著差异（P<0.05）。釉质密度也观察到类似趋势。除了左中切牙的近远中宽度不显著（P>0.05）外，性别和腭裂类型对所有测量指标均表现出显著的交互作用（P<0.05）。
CLP患者的上颌中切牙较小，釉质厚度和密度显著降低，但牙本质基本未受影响。本研究提供的证据表明，腭裂情况对釉质的影响比对牙本质的影响更为显著。因此，建议临床医生应采取保守方法，并使用合适的树脂粘结材料，以在修复和正畸治疗期间尽量减少釉质损伤。
