Mohan Mahitha, Pillai S Babukuttan
Department of Orthodontics and Dentofacial Orthopedics, Government Dental College, Thiruvananthapuram, Thiruvananthapuram, IND.
Cureus. 2024 Dec 25;16(12):e76373. doi: 10.7759/cureus.76373. eCollection 2024 Dec.
Introduction Unilateral cleft lip and palate (UCLP) often leads to maxillary hypoplasia and skeletal Class III malocclusion, with conflicting evidence on mandibular asymmetry. This study evaluated vertical mandibular asymmetry in UCLP patients, comparing them with non-cleft individuals having skeletal Class III and Class I malocclusions. Methods Mandibular asymmetry was evaluated using orthopantomograms (OPGs) from 90 subjects divided into three groups of 30 each: UCLP group, non-cleft skeletal Class III, and non-cleft skeletal Class I. Measurements included condylar height, ramal height, condylar + ramal height, gonial angle, antigonial notch depth, mandibular body length, and total mandibular length. These parameters were analyzed to assess vertical mandibular asymmetry. Asymmetry indices were calculated for condylar, ramal, and combined condylar and ramal heights to compare mandibular symmetry across the groups. Results The UCLP group showed significant vertical asymmetry, with reduced condylar (-1.267 mm), ramal (-1.700 mm), and combined heights (-2.967 mm) on the cleft side, along with shorter mandibular body (-3.633 mm) and total lengths (-4.067 mm). Asymmetry indices in UCLP were comparable to non-cleft skeletal Class III but significantly differed from non-cleft skeletal Class I for condylar asymmetry (p = 0.042). No significant differences were found between non-cleft skeletal Class III and skeletal Class I groups. Conclusion This study revealed significant vertical mandibular asymmetry in UCLP patients, with reduced condylar and ramal heights on the cleft side. UCLP patients exhibited greater condylar asymmetry compared to skeletal Class I individuals, but no significant differences were found with non-cleft skeletal Class III patients. Early intervention is crucial to address these growth disturbances and improve patient outcomes.
引言 单侧唇腭裂（UCLP）常导致上颌骨发育不全和骨性III类错牙合畸形，关于下颌骨不对称的证据存在矛盾。本研究评估了UCLP患者的下颌骨垂直不对称情况，并将其与患有骨性III类和I类错牙合畸形的非腭裂个体进行比较。方法 使用全景X线片（OPG）对90名受试者的下颌骨不对称情况进行评估，将其分为三组，每组30人：UCLP组、非腭裂骨性III类组和非腭裂骨性I类组。测量指标包括髁突高度、升支高度、髁突+升支高度、下颌角、下颌角切迹深度、下颌体长和下颌骨全长。对这些参数进行分析以评估下颌骨垂直不对称情况。计算髁突、升支以及髁突与升支联合高度的不对称指数，以比较各组之间的下颌骨对称性。结果 UCLP组表现出明显的垂直不对称，腭裂侧的髁突高度（-1.267mm）、升支高度（-1.700mm）以及联合高度（-2.967mm）降低，同时下颌体长（-3.633mm）和全长（-4.067mm）缩短。UCLP组的不对称指数与非腭裂骨性III类组相当，但在髁突不对称方面与非腭裂骨性I类组有显著差异（p = 0.042）。非腭裂骨性III类组和骨性I类组之间未发现显著差异。结论 本研究揭示了UCLP患者存在明显的下颌骨垂直不对称，腭裂侧的髁突和升支高度降低。与骨性I类个体相比，UCLP患者表现出更大的髁突不对称，但与非腭裂骨性III类患者相比未发现显著差异。早期干预对于解决这些生长紊乱并改善患者预后至关重要。
