The aims of this study were to evaluate condylar, ramal, and condylar plus ramal mandibular vertical asymmetry in a group of cleft lip and palate (CLP) patients and compared with subjects with a 'normal' occlusion. Mandibular asymmetry index (condylar, ramal, and condylar plus ramal) and gonial angle measurements were examined on panoramic radiographs. The study groups comprised 20 unilateral cleft lip and palate (UCLP) patients (10 males and 10 females; mean age 13.03 +/- 3.33 years), 20 bilateral cleft lip and palate (BCLP) patients (10 males and 10 females; mean age 13.73 +/- 3.53 years), and a control group of 20 subjects (9 males and 11 females; mean age 14.35 +/- 2.46 years) with a normal occlusion. Kruskal-Wallis one-way analysis of variance was used to determine statistically significant differences between the groups for condylar, ramal, and condylar plus ramal asymmetry index measurements at the 95 per cent confidence interval. None of the investigated groups showed statistically significant gender differences for posterior vertical height measurements (P > 0.05). Asymmetry indices were similar, with no statistically significant differences found in any of the groups. However, gonial angle showed statistically significant differences (P < 0.05) in the UCLP group and condylar height (CH) in the BCLP patients (P < 0.001). Except for CH measurement in the BCLP group, CLP patients have symmetrical mandibles when compared with a normal occlusion sample.
Surgically assisted rapid maxillary expansion (SARME), which combines orthodontics and surgery, is a well-established therapy for transverse maxillary hypoplasia in adults after sutural closure or completion of skeletal maturation. X-rays are usually the preferred monitoring technique for this treatment. Recently, ultrasound scanning has been used successfully in the follow-up of patients undergoing distraction osteogenesis. In this study, ultrasonography (US) was used in the evaluation of bone callus formation in the midpalatal suture in 3 patients undergoing SARME. For each patient, US was performed immediately after active expansion, at 2 and 4 months of the expansion period, at the removal of the expander 6 months later, and at 2 months after expander removal. The results indicated that US might be a useful and accurate method to assess bone fill in the midpalatal suture in patients undergoing SARME. However, further studies are necessary to clarify the US scores in a larger patient group undergoing SARME.
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