Morphological Assessment of Le Fort I Osteotomy in Unilateral Cleft Lip and Palate Patients—Part 1: Pterygomaxillary Region

Objective To evaluate the morphology of the pterygomaxillary junction (PMJ) in patients with unilateral cleft lip and palate (UCLP) and compare it with that of non-cleft individuals using cone-beam computed tomography (CBCT). Design Retrospective comparative CBCT study. Setting Department of Oral and Maxillofacial Radiology, İnonu University. Patients/Participants CBCT records obtained between January 1, 2015, and December 1, 2025, were reviewed. Fifty-three patients with UCLP and 53 age- and sex-matched non-cleft individuals meeting the inclusion criteria were included. Interventions Not applicable. Main Outcome Measure(s) PMJ thickness, width, angle, sagittal plane angle, inter-pterygoid plate angle, and pterygomaxillary suture (PMS) height were measured and compared between groups. Results PMJ width was significantly lower in the UCLP group than in the control group ( P < 0.05). No significant differences were observed in PMJ thickness or PMS height ( P > 0.05). Inter-pterygoid plate angles were significantly greater, whereas sagittal plane angles were significantly smaller in UCLP patients compared with controls ( P < 0.05). No significant differences were detected in the remaining measurements. Conclusions UCLP patients exhibit distinct PMJ morphological characteristics compared with non-cleft individuals. Variations in PMJ width and angular measurements may be relevant to posterior maxillary surgical procedures. CBCT-based assessment provides valuable anatomical information that may contribute to individualized surgical planning in patients with UCLP.