Presurgical three-dimensional palatal morphology in children with different cleft types compared to healthy controls

Palatal morphology in patients with clefts can be accurately assessed during the presurgical period, providing insights into how cleft type affect palatal development. These early observations are unbiased by treatment, making them broadly applicable. This study aimed to identify differences in palatal morphology among untreated patients with various cleft types before surgery. Primary outcomes included palatal size at the occlusal plane and palatal surface area, while secondary outcomes involved palatal width, length, and premaxilla rotation. Digital impressions from 150 patients (97 males, 53 females) were grouped by cleft type: cleft lip, soft palate cleft, complete cleft palate, unilateral cleft lip and palate (UCLP), bilateral cleft lip and palate (BCLP), and non-cleft controls. Measurements were performed using 3D software, and statistical analysis using a generalized least squares model. Patients with BCLP had a larger palatal size due to the prominent premaxilla, but palatal surface area was similar across groups. The posterior palatal width was wider in UCLP and BCLP, while the width at the canine position was narrower in patients with isolated cleft palate. Palatal surface areas remain consistent across cleft types, indicating that surgical challenges arise from the need to cover wider clefts during repair, rather than from the management of tissue deficits.