Dental Treatment Needs Among 16-Year-Old Patients with Cleft Lip and Palate: An Observational Study in Western Norway.

Objectives: This study aimed to a) assess intermaxillary sagittal relations, dental alignment, and occlusion among patients with Cleft Lip and/or Palate (CL/P) and b) evaluate the need for future dental treatment.

Material/methods: Clinical assessment, lateral cephalogram, orthopantomogram, and study models from 1019 patients with CL/P collected at age 16 from the Bergen national CLP team in Norway. Records included the number of dental agenesis or hypoplasia, ANB angulation, dental alignment, occlusion, oronasal fistula, and indications for future dental treatment needs.

Results: One-third required further treatment by an orthodontist, prosthodontist, or oral surgeon in adulthood, and complete bilateral or unilateral CLP had a significantly higher need than patients with isolated cleft of the lip or the palate. Missing teeth increased the risk for retrognathic maxilla (OR = 3,62), need for orthodontic and prosthodontic treatment (OR = 5.20), and a negative overjet and need for orthognathic surgery (OR = 4.86) (p < 0.001). Oronasal fistula was present in 4.7% of the participants, significantly worsening all clinical indicators (p < 0.001). Boys exhibited more adverse findings than girls, except regarding the need for dental porcelain bridges. A noticeable trend indicated increased dental treatment needs among 16-year-old patients with clefts born between 1990-2001, compared to patients born between 1980-1990.

Conclusions/implications: The findings underscore the need for comprehensive, individualized treatment plans and interdisciplinary dental services for adult patients with CL/P. The original cleft pattern, male gender, presence of oronasal fistula, and a high number of missing teeth negatively influenced the dental status and treatment outcomes measured at the 16-year-old assessment.