Evaluation of mandibular bone dimensions and structurein patients with cleft lip and palate

Cleft lip and palate (CLP) are congenital anomalies that affect craniofacial growth. Most studies have focused on maxillary changes, and data on mandibular morphology, microstructure and asymmetry are limited. This study evaluated mandibular trabecular bone structure and condyle–ramus morphometry in patients with unilateral and bilateral CLP, compared the findings with skeletal Class I and Class III subjects without CLP, and examined right–left asymmetry. The sample consisted of four groups of 25 individuals each: bilateral CLP, left unilateral CLP, skeletal Class III without CLP and skeletal Class I controls without CLP. On panoramic radiographs, 50×50-pixel regions of interest were placed on posterior mandibular regions, and fractal analysis, histogram analysis and AutoCAD-based condylar height measurements were performed. Data were analysed using one-way ANOVA and post-hoc Tukey tests. The results showed significant intergroup differences, particularly at the left mandibular angle, and higher condylar Height-1 values in the Class I control group than in the other groups (p<0.05). Right–left comparisons revealed more pronounced asymmetry in unilateral CLP and skeletal Class III cases in terms of mandibular angle and condylar height, whereas Class I controls exhibited a more symmetrical pattern. Histogram analysis demonstrated a tendency towards reduced gray-level intensity in CLP groups; CLP and skeletal Class III malocclusion were found to alter mandibular trabecular structure and condyle–ramus symmetry, and the applied methods were considered useful non-invasive quantitative tools for evaluating these differences on panoramic radiographs.