The second monozygotic twin pair concordant for Van der Woude syndrome Is reported. Clinical manifestations of this autosomal dominant clefting syndrome Included bilateral lower lip pits, cleft lip, and cleft palate. Both sibs were found to have a natal tooth. No other cases of Van der Woude syndrome with this feature have been described previously. It is uncertain whether the presence of a natal tooth in this instance represents a low-frequency association of this disorder. However, it appears more likely that its occurrence was incidental, since natal teeth have been reported before in twin pairs as an isolated finding.
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