Comparison of mid-palatal suture morphology via suture bone densities between unilateral cleft lip and palate with non-cleft individuals using python programming language

This study aimed to compare the mid-palatal suture (MPS) bone density between individuals with unilateral cleft lip and palate (UCLP) and non-cleft (NC) controls using cone-beam computed tomography (CBCT) imaging and Python-based computational analysis. We hypothesized that children with UCLP would exhibit significantly lower bone density in the MPS region compared to NC individuals, reflecting defective MPS maturation secondary to the congenital cleft defect and its associated surgical interventions. A retrospective case-control study was carried out. A total of 100 participants were included. Data were collected from the databases of Hospital Universiti Sains Malaysia and Hospital Raja Perempuan Zainab II, respectively. Cone beam computed CT scans of both UCLP and NC patients were used to evaluate MPS maturation phases. The images were analysed using the Romexis software version 3.8.2. Data distribution was assessed using the Shapiro–Wilk test for normality ( p < 0.05 indicating deviation from normality) and Levene’s test for homogeneity of variances. The group comparisons were conducted using the Mann–Whitney U test. Significant differences were observed in the means of MPSD1, MPSD2, MPSD3, MPSD4, and MPSD5. In comparison to NC individuals, UCLP children displayed considerably decreased bone densities in the MPS region of the palate. Based on the distribution of the participants across the MPS stages, the highest frequency was noticed in Stage E (37%), followed by Stage D (27%), Stage C (20%), and Stage B (8%). Children with the UCLP group had lower palatal bone density compared to the NC group, indicating defective MPS fusion. These results highlight the need for individualized treatment planning for orthodontic treatment and maxillary expansion in children with clefts.