Comparison of dentofacial changes after orthognathic surgery in adults with unilateral cleft lip and palate and isolated cleft palate.

The aim of this retrospective cohort study was to assess dentofacial changes in patients with unilateral cleft lip and palate (UCLP) and isolated cleft palate (ICP) who underwent bimaxillary orthognathic surgery (Le Fort I and bilateral sagittal split osteotomy) for Class III correction. Cephalometric measurements were obtained from lateral reconstructions derived from computed tomography scans taken one week preoperatively (T1) and six months postoperatively (T2). The experimental group (UCLP) showed greater maxillary vertical height, less sagittal projection of the subnasal point, and increased protrusion, thickness, and eversion of the lower lip compared to the control group (ICP) at both time points. The repeatability test demonstrated high reliability (intraclass correlation coefficient >0.90), and the study achieved 80% power with a minimum detectable difference of 4.0°. Statistically significant differences (p < 0.05) were observed between groups. While skeletal stability was not directly assessed, the measurements at T2 suggest that, at six months, there was soft tissue adaptation consistent with the surgical movements performed. Patients with UCLP exhibited greater skeletal and soft tissue changes than those with ICP following orthognathic surgery, highlighting the potential need for cleft-type-specific considerations during surgical planning.