Mandibular asymmetry in cleft lip and palate patients

Abstract

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.

Three-dimensional craniofacial morphology in unilateral cleft lip and palate

“…Our evaluation of mandibular asymmetry indicated that the mandible was not affected in UCCLP, as more significant asymmetries were detected in the Class I control group. These results accord with previous findings (7,28).…”

A cone-beam computed tomography evaluation of facial asymmetry in unilateral cleft lip and palate individuals

“…Factors that may have affected the results include the tools used, reference planes, measuring methods, setting of control index etc (5,(20)(21)(22). Three reasons were considered to cause lower facial asymmetry in individuals with UCLP (9): 1) true skeletal mandibular asymmetry, 2) positional adaptation of the lower jaw to asymmetric mandibular fossae (cranial base), and 3) functional adaptation to dentoalveolar and occlusal disharmonies.…”

Cone-beam computed tomography assessment of mandibular asymmetry in unilateral cleft lip and palate patients

“…In the literature, some authors report significant mandibular asymmetries in cleft lip and palate patients, 5,6 whereas others have found no such asymmetry. 7,8 A number of tools have been used to assess mandibular asymmetry, including clinical examination; frontal-and side-view photographs; and 2-dimensional (2D) radiographs, such as lateral and posteroanterior cephalograms, oblique radiographs of the mandible tak- en at 45 o , and panoramic radiographs. 9,10 These 2D radiographs can be misleading, since complex 3-dimensional (3D) structures are projected onto flat 2D surfaces, creating distortion and magnification errors.…”

“…14 CBCTs therefore provide an opportunity for multiplanar imaging and assessment of 3D information. However, whereas many researchers have used 2D radiographs to assess mandibular asymmetry in cleft lip and palate patients, [5][6][7] few have used 3D imaging to investigate this phenomenon. Indeed, we could find no published studies that have evaluated mandibular asymmetry in cleft lip and palate patients using CBCT.…”

“…In contrast, Horswell and Levant investigated 16 complete UCLP patients and found that the mandible was normal in every dimension. 31 Kurt et al 7 compared the condylar, ramal, and condylar plus ramal height values on panoramic radiographs and found no statistically significant differences except gonial angle, and they considered that this difference might result from a compensation mechanism of the mandible on the cleft side. In the current study, only body volume was significantly different between cleft and non-cleft patients.…”