Mandibular Asymmetry in Cleft Lip and Palate Versus Class I Malocclusion: A Panoramic Radiographic Study in Mosul

Objective: This study aimed to evaluate the mandibular asymmetry between patients with Unilateral and Bilateral Cleft Lip and Palate in Mosul city by using panoramic radiographs and mandibular asymmetry index to compare with Class I malocclusion controls for selecting the type of treatment in future. Methods: A retrospective cross-sectional study was performed on 150 orthodontic patients (75 with CLP and 75 controls with Class I anterior relationship) visiting a dental hospital in Mosul city. Patients between 12 and 18 years of age who had not been previously treated orthodontically were included in the study. Digital orthopantomograms were analyzed for vertical ramus and condylar heights using Habets’ method. The mandibular asymmetry index for each patient was calculated as the percentage difference between right and left ramus or condylar heights. A p ≤ 0.05 was considered significant. Results: The CLP and Class I groups showed no statistically significant differences in mandibular asymmetry indices. The mean ramus asymmetry index was 2.61% in Class I vs 3.88% in CLP, and the mean condylar asymmetry index was 7.68% vs 8.99%, respectively (both comparisons, p>0.05). Within each group, the right and left ramus and condylar heights were symmetric (no significant side-to-side differences, p>0.1). Age was associated with increased asymmetry: older adolescents exhibited higher ramus asymmetry, significantly in the Class I group (p<0.01). Sex had no significant influence on asymmetry in either group (p>0.05). Conclusions: Both groups had vertical mandibular asymmetry, with no difference in asymmetry between CLP subjects and Class I malocclusion controls. The average asymmetry indices for both groups were greater than 3%, implying that mild vertical mandibular asymmetry was present in both boys and girls.