Relationship between maxillary atresia and mandibular deviation in young adults: A retrospective CBCT study.

OBJECTIVE

To evaluate the relationship between maxillary atresia and mandibular deviation in young adults using cone-beam computed tomography (CBCT).

MATERIAL AND

METHODS

A descriptive, observational, cross-sectional study was conducted using 208 CBCT scans from 2022 to 2025, of which 85 met the inclusion criteria: 65 with maxillary atresia and 20 controls without maxillary atresia, matched for age and sex distribution. Maxillary atresia was assessed using the University of Pennsylvania transverse analysis, while mandibular deviation was measured as the displacement of the menton relative to the craniofacial midline. Additional assessments included occlusal relationships and craniometric evaluation of mandibular body, ramus, and condylar height. Data reliability was confirmed with intra-class correlation coefficient (ICC=0.90). Non-parametric tests (chi-square, Mann-Whitney U, Kruskal-Wallis, and Spearman correlation) were applied.

RESULTS

Mandibular deviation≥2mm was observed in 84.62% of patients with maxillary atresia (mean 3.52±1.73mm) compared to 30% of controls (mean 1.92±0.79mm), with a significant difference. Patients with atresia also showed greater variability in deviation severity and a predominance of left-side deviation (58.91%). Unilateral crossbite was significantly associated with greater mandibular deviation and maxillary constriction. Comparisons of skeletal dimensions revealed that condylar and ramus asymmetries were more pronounced in the atresia group than in controls. However, the correlation between the degree of maxillary constriction and mandibular deviation was weak and not statistically significant.

CONCLUSIONS

Maxillary atresia was strongly associated with the presence of mandibular deviation, occlusal asymmetry, and vertical skeletal imbalance, although the magnitude of constriction did not directly predict the degree of deviation. These findings underscore the importance of early diagnosis and treatment of maxillary atresia to reduce the risk of mandibular asymmetry and associated skeletal discrepancies.