title: Mandibular asymmetry and antigonial notching in individuals with unilateral cleft lip and palate.
abstract: OBJECTIVE
  To determine whether asymmetric antigonial notching is associated with the development of mandibular and lower facial asymmetry in individuals with unilateral cleft lip and palate (UCLP).
  
  
  METHODS
  Retrospective mixed-longitudinal investigation including UCLP and nonaffected orthodontic patients.
  
  
  METHODS
  All (24) available patients with UCLP treated in our clinic with complete longitudinal records, and 72 skeletal maturation matched noncleft orthodontic patients that served as controls. Subject records included hand-wrist, panoramic, frontal, and 45 degrees oblique cephalometric radiographs.
  
  
  METHODS
  The development of mandibular asymmetry, measured on oblique cephalometric radiographs, as well as lower facial asymmetry, measured on frontal cephalometric radiographs, was monitored in individuals with UCLP in relation to antigonial notching asymmetry, assessed on panoramic and oblique cephalometric radiographs.
  
  
  RESULTS
  First, no statistical differences were found in antigonial notching asymmetry between patients with UCLP and noncleft controls. Second, antigonial notching asymmetry, observed on panoramic and oblique cephalometric radiographs, significantly correlated with the attendant development of mandibular and lower facial asymmetry in individuals with UCLP. Third, the development of mandibular and lower facial asymmetry at pubertal and postpubertal growth spurt stages significantly correlated with antigonial notching asymmetry, measured on panoramic radiographs, at prepubertal and pubertal growth spurt stages, respectively.
  
  
  CONCLUSIONS
  The degree of antigonial notching noted on panoramic radiographs can be used as an early indicator of developing mandibular and lower facial asymmetry in individuals with UCLP.
authors.affiliation: Eastman Department of Dentistry, University of Rochester School of Medicine and Dentistry, Eastman Dental Center, Rochester, New York 14620, USA. Stephanos_Kyrkanides@urmc.rochester.edu
authors.forename: Stephanos
authors.initials: S
authors.lastname: Kyrkanides
authors.forename: Liubov
authors.initials: L
authors.lastname: Richter
mesh_terms: D000293:Adolescent; D000365:Age Determination by Skeleton; D000704:Analysis of Variance; D002508:Cephalometry; D002648:Child; D002971:Cleft Lip / Q000000981:diagnostic imaging / Q000473:pathology* / Q000503:physiopathology; D002972:Cleft Palate / Q000000981:diagnostic imaging / Q000473:pathology* / Q000503:physiopathology; D005146:Facial Asymmetry / Q000000981:diagnostic imaging / Q000473:pathology* / Q000503:physiopathology; D005260:Female; D006801:Humans; D016014:Linear Models; D008137:Longitudinal Studies; D008297:Male; D008334:Mandible / Q000000981:diagnostic imaging / Q000254:growth & development / Q000473:pathology*; D008445:Maxillofacial Development; D015588:Observer Variation; D009971:Orthodontics, Corrective; D011627:Puberty / Q000502:physiology; D011862:Radiography, Panoramic; D015203:Reproducibility of Results; D012189:Retrospective Studies; D013223:Statistics as Topic