Microesthetic Dental Analysis in Parents of Children with Oral Clefts

Objective: Nonsyndromic cleft lip and palate (NSCL/P) is a complex trait caused by genetic and environmental factors that interact producing a wide spectrum of orofacial malformations including dental anomalies. The underlying genetic etiology that accounts for the phenotypic variation in affected families is still poorly understood. This study utilized a microesthetic analysis to characterize the maxillary anterior dental morphology in unaffected parents of children with NSCL/P (cases) compared to control adults with no CL/P history to identify dental morphology features that are part of the NSCL/P phenotypic spectrum and can therefore be used in refining NSCL/P phenotypes and identifying genetic risk factors.

Method: Digital photographs for 139 females (68 cases, 71 controls) and 59 males (31 cases, 28 controls) were analyzed using both linear metrics and 2D-coordinate landmark-based geometric morphometrics (GM) to compare dental esthetics and deviations from “golden proportions” between cases and controls. Differences in central incisor and anterior connector height proportions were evaluated using paired T-tests.  Anterior tooth shapes, angulations, and gingival margin heights were examined using GM techniques.

Result: Female cases had significantly (p<0.05) wider central incisors, more square anterior tooth shapes, increased inward (towards the upper midline) dental angulations, and more unaesthetic gingival margin height configurations compared to female controls. Male cases also displayed increased inward dental angulations and a tendency for unaesthetic gingival margin height configurations.

Conclusion: Significant differences in anterior dental morphology were found between cases and controls, with controls displaying a more ideal dental morphology than the cases for most evaluated measures. The identification of these distinct dental features in carriers of NSCL/P genetic risk factors further characterizes the phenotypic spectrum of NSCL/P which can enhance the power of genetic studies.