TREATMENT APPROACH FOR THE RARE MULTIPLE DENTAL ANOMALIES IN A SINGLE TOOTH IN PATIENT WITH OROFACIAL CLEFT

Abstract

Background. Orofacial cleft (OC) is the craniofacial malformation that affects facial structures. It is often associated with a high prevalence of dental anomalies that can be morphological, numerical, and structural. However, a single tooth is rarely affected by two anomalies. This article describes the diagnostic and treatment of a rare case of a permanent maxillary lateral incisor with three dental anomalies in a patient with OC. 

Case Description. A male with cleft lip and palate, operated of the lip, at nine years of age, after a radiographic examination, was diagnosed with three dental phenotypes: microdontia, dens invaginatus, and root dilaceration in the right upper permanent lateral incisor. At the age of 11, a secondary alveolar bone grafting (sABG) was performed with the autogenous iliac bone in the cleft area. After the maxillary expansion with Hyrax expander, a traditional fixed appliance was installed for dental alignment, without involving the right upper permanent lateral incisor due to the anomalies in this tooth. At the age of 16 years old, a small extrusion of this tooth was performed with a self-ligated bracket, moving this tooth for better alignment to facilitate the aesthetic procedure of re-anatomization.

Practical Implications and Conclusion. The rehabilitative dental treatment with orthodontic intervention was proposed to restore aesthetics and function. This approach improved the patient’s oral health and quality of life. In patients with OC, considering the possibility of multiple dental anomalies, a broad and accurate diagnosis is important to develop the most appropriate rehabilitation treatment plan for each case.

DOI: https://doi.org/10.56238/sevened2025.007-003