Morphometric Evaluation of the Pterygomaxillary Suture in Patients with Unilateral and Bilateral Cleft Lip and Palate Using Cone-Beam Computed Tomography

Abstract

Objective

To evaluate and compare the morphology of the pterygomaxillary suture (PMS) in unilateral cleft lip and palate (UCLP), bilateral cleft lip and palate (BCLP), and non-cleft (NC) individuals using cone-beam computed tomography (CBCT), focusing on side-specific differences relevant to Le Fort I osteotomy planning.

Design

Retrospective cross-sectional study.

Setting

Oral and maxillofacial radiology clinic of a university-affiliated center, where CBCT data were originally obtained for diagnostic purposes.

Patients

One hundred and fifty-six subjects—57 UCLP, 21 BCLP, and 78 NC—matched for age and sex (P > .25). Inclusion required complete records and high-quality CBCT scans; patients with syndromic anomalies or prior orthognathic surgery were excluded.

Interventions

CBCT scans were retrospectively analyzed using standardized NNT software (v 6.2). Anatomical landmarks were referenced to the midsagittal plane for reproducibility.

Main Outcome Measures

Seven PMS parameters—thickness, width, length, angulation, lateral pterygoid plate (LPP) length, medial pterygoid plate (MPP) length, and distance to the greater palatine foramen (GPF)—were compared using ANOVA, paired-sample t-tests, and Tukey post-hoc analyses (α = 0.05).

Results

PMS angulation was higher in UCLP (79.82 ± 7.96°) and BCLP (79.84 ± 9.11°) compared with NC (75.90 ± 8.07; P < .001). In UCLP, the cleft side showed greater angulation and shorter LPP (P = .027; P = .001). Other parameters did not differ significantly.

Conclusions

CLP patients show increased PMS angulation and cleft-side LPP shortening compared with controls. These variations may be relevant to surgical planning; however, the present study did not assess surgical outcomes. Future research should determine whether such differences influence intraoperative complexity.