Mandibular and maxillary asymmetry in individuals with unilateral cleft lip and palate

Objective: This study was conducted to evaluate the degree of maxillary and mandibular asymmetry in the verticle and transverse planes seen in posteroanterior cephalometric radiographs relative to chronologic age in postoperative complete UCLP patients compared to controls. Method: Mandibular and nasomaxillary asymmetry was retrospectively studied in complete unilateral cleft lip and palate (UCLP) and noncleft individuals (controls) by means of posteroanterior cephalometric analysis. All the UCLP patients available (total 40) and randomly selected noncleft controls (total 142) were included in the study. The UCLP patients had undergone lip and palate reconstruction in Strong Memorial Hospital, University of Rochester, Rochester, New York, and orthodontic treatment in the Department of Orthodontics, Eastman Dental Center, Rochester, New York. The controls were selected based on the age that treatment was initiated and were treated in the department for various malocclusions; none had undergone maxillary expansion or surgical treatment. The asymmetry assessed on mixed longitudinal records of the patients with UCLP was analyzed relative to three chronologic age groups and compared to the controls. In addition, mandibular asymmetry was correlated to maxillary asymmetry in UCLP individuals to investigate possible growth patterns between the two jaws. Results: Mandibular asymmetry in UCLP individuals was found to increase with growth and time and peaked at post-pubertal growth-spurt stages. The cleft subjects were more asymmetric than controls in all stages of growth. Mandibular asymmetry followed the affected maxilla closely, indicating a parallel growth pattern of the jaws. Conclusion: The unilateral cleft lip and palate patients manifested asymmetry of the mandible. This asymmetry develops in a parallel pattern with the affected maxilla, suggesting that early evaluation and treatment of the anomalies in the nasomaxillary skeleton as well as in the mandible is necessary when treating unilateral cleft lip and palate individuals.