Primary Maxillary Hypoplasia in Complete Unilateral Cleft Lip and Palate: Analysis of Clinical Data and Associations
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Updated: Oct 31, 2026
Midface Hypoplasia and Cranial Base Morphology in Syndromic Craniosynostosis: A Comparative Analysis Study Using a Predictive Regression Model
Published on: November 4, 2025
Marcela B Scarpa1, Paulo R P Câmara1, Isadora M Fabiani2
1Division of Maxillofacial Surgery, Hospital das Clínicas of University of São Paulo Medical School, São Paulo.
Objective:
Investigate the volumetric differences between the cleft and noncleft hemi-maxillae in patients with complete unilateral CLP and compare them with the average population. It also aimed to correlate the hemi-maxilla volumetry with maxillary sinuses' volumes, with the occlusal index in digitized models and tooth agenesis.
Design:
This is a retrospective cohort study. Setting: Cleft lip and palate center in quaternary-level institutions.
Patients, Participants:
This study included 23 patients with complete unilateral CLP who underwent cheiloplasty between 2008 and 2012 and a control group of 24 patients without craniofacial abnormalities.
Interventions:
None.
Main Outcome Measures:
The computed tomography scans of cleft patients were analyzed before and after alveolar bone grafting. Following 3-dimensional tomographic reconstruction, a volumetric index was calculated as the ratio of cleft and normal side volumes (CV/NV). Cuts and measurements were also conducted in the control group. Additionally, the volumetric index of the maxillary sinuses (MSCV/MSNV) was calculated, and occlusal index analyses were performed using digitized models. In addition, dental agenesis was observed.
Results:
The CV/NV relationship was significantly lower in the prealveolar and postalveolar bone grafting periods than in the normal population (P<0.01), confirming primary maxillary hypoplasia in patients with complete unilateral CLP. The CV/NV decreased progressively with worsening occlusal index classifications (P=0.03). No associations were observed between MSV and any of the studied variables.
Conclusion:
The complex anatomy of patients with complete unilateral CLP impairs treatment outcomes, and maxillary hypoplasia must be considered an important predictive factor.
