Vertical Mandibular Asymmetry in Unilateral Cleft Lip and Palate: A Comparative Analysis With Skeletal Class III and Class I Malocclusions

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.