Comparative Assessment of Sagittal Skeletal Discrepancy in Patients with Bilateral Cleft Lip and Palate - A Cephalometric Study

Context: In orthodontic diagnosis, it is important to recognize the sagittal difference between the maxillary and mandibular apical bases as treatment planning aims at normalization of the maxillo-mandibular relationship. In contrast to normal individual, the development of the craniofacial complex in cleft lip/palate cases is altered and this difference may affect the growth and positioning of other facial structures. Aims: The present study is aimed at comparison of Beta angle, ANB angle, Wit?s appraisal, YEN angle and W angle for assessment of sagittal skeletal discrepancy in the patients with cleft lip / palate and to find out which is the most reliable amongst them. Methods and Material: 50 lateral cephalograms of patients with bilateral cleft lip and palate and Normal individuals were traced using Auto-cad software. After marking the points, reference lines were marked and evaluated for ANB angle, Wits Appraisal, Beta angle, YEN angle and W angle. These angles were compared for reliability using statistical analysis. Results: t-test analysis was performed and highly significant differences were found in ANB angle, Beta angle, W-angle and Wits appraisal in all the 50 patients. Coefficient of variability was calculated for intra-group comparisons. Conclusions: It is concluded from the study that ANB angle, Beta angle, W-angle and Wits appraisal are highly significant measurements to assess the sagittal jaw relationship between maxilla and mandible. Wits appraisal was found to be least variable parameter and Yen angle was found to be the most variable parameter.