ObjectiveTo evaluate the impact of maxillary position on orbitomalar and suborbital projection by comparing patients with and without cleft with normal and retrusive maxilla, and to determine whether projection loss is primarily related to cleft pathology or maxillary retrusion.DesignRetrospective comparative cephalometric study.SettingSingle tertiary orthodontic center; records from 2010 to 2015.PatientsA total of 142 patients (74 with cleft, 68 without cleft) aged 7 to 13 years, meeting defined inclusion criteria. Patients were divided into 4 groups according to cleft status and maxillary AP position determined by SNA: retrusive maxilla with cleft (RCMx, n = 44), normal maxilla with cleft (NCMx, n = 30), retrusive maxilla without cleft (RMx, n = 28), and normal maxilla without cleft (NMx, n = 40).InterventionsNo intervention was performed.Main Outcome MeasuresLinear orbitomalar projection measurements (LOr-VP, IOr-VP, AOr-VP, SbOr1-VP, SbOr2-VP) and maxillary position parameters (SNA, ANS-VP, A-VP). Group comparisons and correlation analyses were performed using non-parametric statistics.ResultsSignificant intergroup differences were observed for all orbitomalar and suborbital projection measurements (P < .05). Patients with retrusive maxilla, regardless of cleft status, demonstrated lower orbital and suborbital projection values compared with those with normal maxillary position. Suborbital parameters showed the largest variation between groups. Moderate-to-strong positive correlations were found between maxillary anterior development (SNA, ANS-VP, A-VP) and orbitomalar projection.ConclusionMaxillary retrusion, rather than cleft status, appears to be a key determinant of reduced orbitomalar projection and midfacial convexity. In patients with retrusive maxilla, correction of midfacial deficiency may require consideration of infraorbital and zygomatic support in addition to maxillary advancement.
Tosun et al. (Wed,) studied this question.