Distoangulation of mandibular second premolars in individuals with complete unilateral cleft lip and palate: a cohort longitudinal assessment.

Abstract

Objective: This study aimed to assess the frequency of distoangulation of mandibular second premolars (MnP2) in individuals with complete unilateral cleft lip and palate, the angular changes of distoangulated MnP2 from the mixed to the permanent dentition, the clinical outcomes after the follow-up period and the frequency of other associated dental anomalies.

Methods: The distoangulation group (DA) was composed of 37 patients (mean age 9.29, SD = 1.24 years, 15 females, 22 males) with distoangulation of MnP2. The control group (CG) was composed of 37 patients (mean age 9.9 years, SD = 1.13, 13 females, 24 males) without distoangulation of MnP2. Digital panoramic radiographs taken in the mixed dentition (T1) and early permanent dentition (T2) were analyzed in both groups. Longitudinal angular changes, the degree of root formation, second premolar depth, and the frequency of associated dental anomalies were analyzed. Intergroup comparison was performed with paired and independent t tests and χ² test (p < 0.05).

Results: The prevalence of MnP2 distoangulation in the mixed dentition was 18.5%. The DA showed a smaller initial distal angle (θ = 56.45° ± 6.72) compared to the CG (78.24° ± 6.09). The most common clinical outcome was the uprighting and spontaneous eruption of the MnP2 observed in 80.0% of the sample. MnP2 distoangulation was significantly associated with deciduous molar infraocclusion, agenesis of maxillary second premolar and ectopic eruption of maxillary first permanent molar.

Conclusion: The frequency of MnP2 distoangulation among individuals with UCLP was 18.5%, with favorable spontaneous uprighting and eruption observed in most cases.