Comparative Analysis of Maxillary Sinus Volume in Patients With Cleft Lip and Palate Versus Class III Malocclusion Patients Using CBCT

Sep 30, 2026

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Objectives: Compare maxillary sinus volume (MSV) in unilateral non-syndromic cleft lip and palate (CLP) patients versus a skeletally matched skeletal Class III malocclusion control group using cone-beam computed tomography (CBCT). Materials/Methods: Ninety CBCT images were evaluated (45 unilateral CLP; 45 Class III control), matched by SNA, SNB, ANB, GoGn-SN, and Wits. MSV was measured with ITK-SNAP and analyzed with Kolmogorov–Smirnov, t-tests, and paired t-tests. Results: No significant between-group MSV difference, but cleft-side MSV was smaller within CLP. Conclusions: CLP reduces MSV on the cleft side yet does not significantly lower average MSV versus matched Class III controls.

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Abstract

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Introduction

Orthodontics & Craniofacial Research RESEARCH ARTICLE OPEN ACCESS Comparative Analysis of Maxillary Sinus Volume in Patients With Cleft Lip and Palate Versus Class III Malocclusion Patients Using CBCT Sara Eslami1 | Anand Marya2,3 | Babak Sayahpour1 | Sarah Bühling1 | Stefan Kopp1 | Hanieh Mahmoudi4 | Ahmadreza Talaeipour5 | Ari Harsoputranto2,3 | Abdolreza Jamilian3,6 1Department of Orthodontics, Center for Dentistry and Oral Medicine (Carolinum), Goethe University Frankfurt, Frankfurt, Germany | 2Orthodontic department, Faculty of Dentistry, University of Puthisastra, Phnom Penh, Cambodia | 3The City of London Dental School, University of Greater Manchester, Bolton, UK | 4Faculty of Dentistry, Tehran Medical Science, Islamic Azad University, Tehran, Iran | 5Maxillofacial Radiology Department, Faculty of Dentistry, Tehran Medical Science, Islamic Azad University, Tehran, Iran | 6Orthodontic Department, Faculty of Dentistry, Tehran Medical Sciences, Islamic Azad University, Tehran, Iran Correspondence: Sara Eslami ([sara.eslami.sh@gmail.com](sara.eslami.sh@gmail.com)) Received: 11 April 2025 | Revised: 5 September 2025 | Accepted: 24 September 2025 Funding: The authors received no specific funding for this work. ABSTRACT Objectives: This study compared maxillary sinus volume (MSV) in patients with unilateral non-syndromic cleft lip and palate (CLP) to a skeletally matched control group with a skeletal class III pattern (group CTR) using cone-beam computed tomography (CBCT) images. Materials/Methods: Ninety CBCT images were evaluated, including 45 patients with unilateral CLP (group CLP, mean age 24.3 ± 6.1) and 45 patients with Class III malocclusion (group CTR, mean age 25.3 ± 5.9) . Both groups were skeletally matched based on SNA, SNB, ANB, GoGn-SN angles and Wits appraisal values. MSV was measured using ITK-SNAP software. The Kolmogorov–Smirnov test confirmed normal data distribution. Intergroup comparisons of average MSV, MSV stratified per side, cephalometric parameters and gender differences were performed using Student's t-test. Intragroup comparisons (cleft vs. noncleft side, right vs. left side) were conducted using a paired t-test. Statistical significance was set at p < 0.05. Results: No statistically significant differences in average MSV were found between the CLP group (7589.74 ± 4060.23 mm3) and the CTR group (7901.90 ± 3667.69 mm3) (p = 0.59). However, within the CLP group, the MSV on the cleft side (6870.53 ± 3695.29 mm3) was significantly smaller than on the non-cleft side (8308.96 ± 4316.53 mm3) (p < 0.05). No significant gender differences regarding MSV values were found (p >0.05) . Conclusions: Unilateral cleft lip and palate resulted in a significantly smaller MSV on the cleft side in CLP patients. However, the average MSV of CLP patients was not significantly reduced compared to non-cleft patients with a skeletal Class III pattern. 1 | Introduction Cleft lip and palate (CLP) are among the most common congenital developmental anomalies, affecting approximately 1 in 700–1000 live births worldwide [1] . These anomalies arise from the incomplete fusion of the maxillary and medial nasal processes during embryonic development, resulting in a spectrum of defects ranging from cleft lip to more complex forms involving both the lip and palate [2] . Affected individuals face numerous anatomical and functional challenges, including midface hypoplasia, otologic, rhinology and audiological disorders, as well as a heightened susceptibility to maxillary sinusitis [3] . This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited. © 2025 The Author(s). Orthodontics & Craniofacial Research published by John Wiley & Sons Ltd. 74 Orthodontics & Craniofacial Research, 2026; 29:74–82 [https://doi.org/10.1111/ocr.70041](https://doi.org/10.1111/oc

FAQs

How was maxillary sinus volume (MSV) measured in the study?

MSV was measured on CBCT images using ITK-SNAP software, with subsequent statistical testing for distribution and group differences.

Were there differences in average MSV between the CLP group and the Class III control group?

No statistically significant differences were found in average MSV between the CLP group and the Class III control group (p = 0.59).

What was the key intra-group finding for CLP patients?

Within the CLP group, MSV on the cleft side was significantly smaller than on the non-cleft side (p < 0.05).

Sep 30, 2026

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