Maxillary canine angulation and position before alveolar bone grafting in patients with unilateral complete cleft lip and palate a cross-sectional study

Abstract Background The rate of maxillary canine displacement is reported to be higher in patients with cleft compared to normal population. The aim of this study is to compare the displacement tendency of developing maxillary canines in patients with unilateral complete cleft lip and palate (UCLP) versus non-cleft controls before secondary alveolar bone grafting or orthodontic treatment. Design: A cross-sectional observational study. Setting : University orthodontic clinic. Materials and Methods : Eighty-six children aged (8–12 years) were included: 43 with non-syndromic UCLP and 43 non-cleft controls with skeletal Class I relationships. The percentage of patients with high-risk alpha angle (> 30 degrees ) of maxillary canines was assessed between study groups as well as between cleft side and non-cleft side in group. The canine horizontal and vertical sector positions were also evaluated. Results Maxillary canines in patients with UCLP demonstrated significantly greater alpha angles than those in controls. The odds of an alpha angle > 30 degrees were approximately 15-fold higher in patients with UCLP than in controls and approximately 11-fold higher on cleft than non-cleft sides. Vertical canine position also differed significantly, with a greater proportion of canines occupying more apical sectors on cleft sides. Horizontal sector distribution did not differ significantly between groups. No significant association was found between lateral-incisor agenesis and alpha angle. Conclusions Before secondary alveolar bone grafting or orthodontic intervention, UCLP was associated with greater maxillary canine angulation and a more apical vertical position, particularly on the cleft side. These findings suggest that panoramic assessment of canine angulation and vertical position may help identify developing canines at increased risk of ectopic eruption. Longitudinal studies are required to determine their predictive value for subsequent canine impaction.