Tooth agenesis and craniofacial morphology in pre-orthodontic children with and without morphological deviations in the upper cervical spine

Prevalence of upper cervical vertebral anomalies in children with non-syndromic cleft lip and/or palate in comparison with children without cleft in Iranian population

BACKGROUND

To evaluate the prevalence of upper cervical vertebral anomalies (CVA) in Iranian children with cleft lip and/or palate (CL/P) and compare it with children without a cleft.

METHODS

A case-control study on lateral cephalograms from Orthodontics Research Center, Shiraz University of Medical Sciences, Shiraz, Iran of 92 subjects (41 females and 51 males) with non-syndromic CL/P with a mean age of 13.54 ± 4.63 years, and 184 age- and sex-matched individuals (82 females and 102 males) with no craniofacial anomalies or skeletal malocclusion as the control group. Upper cervical vertebrae (C1-C3) were examined regarding the following CVA: (1) posterior arch deficiencies: spina bifida and dehiscence; (2) Fusion Anomalies (FAs): fusion and occipitalization; (3) accessory ossicles. Vertebral artery canal morphology was also evaluated.

RESULTS

The prevalence of CVA was significantly higher in the cleft group (62%) than in the control group (25%) (P < 0.001). FAs, fusion, accessory ossicle, and deviation of artery canal type 2 were the anomalies with significantly higher prevalence in the cleft group compared to the noncleft group (all P < 0.05). 11 individuals (11.9%) of the cleft group and five (2.7%) of the control group had more than one CVA. When considering the subgroups of the CL/P, the prevalence of CVA was significantly higher in almost all the CL/P subgroups compared to the control group (all P < 0.05).

CONCLUSIONS

Upper CVA, especially fusion anomalies, were significantly more prevalent in children with non-syndromic CL/P compared to the children without cleft in an Iranian population. A female predilection for CVA was also noted in both the general population and the cleft group.