Maxillary basal arch forms in operated adult patients with cleft lip and palate using root apices: A pilot study.

OBJECTIVES: The purpose was to identify the maxillary basal arch forms utilizing the root apices and compare the maxillary basal arch form of groups with cleft lip and palate (CLP) and normal group. MATERIALS AND METHODS: This study included 30 patients (21.8 ± 3.5 years old) with unilateral CLP (ULCP group) and 30 patients (20.9 ± 2.2 years old) with bilateral CLP (BCLP group). The normal group consisted of 30 non-cleft patients (21.2 ± 2.3 years old) with normal occlusion. Three-dimensional (3D) Cartesian coordinates of the root apices of each tooth were determined using cone-beam computed tomography. The 3D coordinates were projected onto the palatal plane to create the 2D coordinates. Thereafter, the basal arch forms were constructed by the Procrustes superimposition. Finally, For the basal arch form comparisons among groups, the inter-root widths were measured. RESULTS: Both CLP groups had a narrower inter-root width than the normal group. The BCLP group had significantly narrower premolar and molar widths than the UCLP group (P < .05). Especially, the inter-first molar width of the UCLP and BCLP groups was 3.7 ± 0.7 (P < .001) and 6.6 ± 0.8 (P < .001) mm smaller than that of the normal group, respectively. CONCLUSIONS: We used the root apices to identify the basal arch forms. The basal arch form of patients with CLP was narrower than that of the normal group. The basal arch form of patients with BCLP was narrower than that of patients with UCLP. Our findings may help clinicians better comprehend basal arch forms in patients with CLP and transverse discrepancies.

Three-dimensional evaluation of mandibular width after mandibular asymmetric setback surgery using sagittal split ramus osteotomy.

Objective: The study aimed to evaluate the changes in mandibular width after sagittal split ramus osteotomy (SSRO) in patients with mandibular asymmetric prognathism using cone-beam computed tomography (CBCT). Methods: Seventy patients who underwent SSRO for mandibular setback surgery were included in two groups, symmetric (n = 35) and asymmetric (n = 35), which were divided according to the differences in their right and left setback amounts. The mandibular width was evaluated three-dimensionally using CBCT images taken immediately before surgery (T1), 3 days after surgery (T2), and 6 months after surgery (T3). Repeated measures analysis of variance was applied to verify the differences in mandibular width statistically. Results: Both groups showed a significant increase in the mandibular width at T2, followed by a significant decrease at T3. No significant difference was observed between T1 and T3 in any of the measurements. No significant differences were found between the two groups (p > 0.05). Conclusions: After mandibular asymmetric setback surgery using SSRO, the mandibular width increased immediately but returned to its original width 6 months after surgery.

Three-dimensional evaluation of the pharyngeal airway space in patients with anterior open bite.

Objective: : This study aimed to three-dimensionally evaluate the pharyngeal airway space (PAS) of patients with anterior open bite (AOB) by using cone-beam computed tomography (CBCT) and compare the findings with those obtained in individuals with normal occlusion. Methods: : The open bite group (OBG, n = 25) consisted of patients with an anterior overbite of -3 mm or less, while the control group (n = 25) consisted of age- and sex-matched individuals with an anterior overbite of 1-3 mm, Angle Class I malocclusion (1° ≤ point A-nasion-point B angle ≤ 4°), and a normodivergent profile (22° ≤ Frankfort mandibular plane angle ≤ 28°). After the CBCT data were reconstructed into a three-dimensional image, the PAS was segmented into four parts, and the volume of each part was measured. Pharyngeal airway length (PAL) and the area and transverse width of the part showing minimal constriction were also measured. Pearson's correlation analysis was used to evaluate the correlation between changes in the PAS and the amount of anterior overbite. Results: : The OBG showed a significantly narrower airway space in the nasopharyngeal, hypopharyngeal, and total airway volumes. The OBG also showed a significantly smaller area and transverse width of the part with minimal constriction. The OBG showed a significantly longer PAL, but there was no correlation between the amount of anterior overbite and the changes in PAS. Conclusions: : The PAS was associated with AOB. Patients with AOB had a narrower PAS and a smaller part showing minimal constriction.

Effects of different distalization directions and methods on maxillary total distalization with clear aligners: a finite element study.

OBJECTIVES: To analyze the effects of maxillary tooth distalization by clear aligner (CA) treatment with variations in the angular direction of the distalization force, presence of attachments, and force-application method used. MATERIALS AND METHODS: A finite element model containing alveolar bone, dentition, and periodontal ligament was constructed. Analytical model groups were as follows: (1) distalization with buttons (without attachments), (2) buttons on canines (with attachments), (3) precision cuts on the canines (without attachments), and (4) precision cuts on the canines (with attachments). A distalization force of 1.5 N was applied to the button or precision cut at -30°, -20°, -10°, 0°, 10°, 20°, and 30° to the occlusal plane. RESULTS: As the direction of force approached +30°, the dentition inclined posteriorly. The posterior movement pattern was significantly influenced by the presence of an attachment and the direction of force, rather than the area where the force was applied. Distal inclination was dramatically reduced with attachments. A disengagement or deformation of the CA may reduce the distalization efficiency of the dentition or move the dentition in an inappropriate direction. CONCLUSIONS: Attachments for efficient distalization by the CA are necessary. The use of miniscrews in the direction of force parallel to the occlusal plane is more advantageous than the use of Class II elastics. Due to CA deformation, distalization with the button on the canines can be more effective for distal movement of the maxillary dentition.

Comparison of root apex's position between unilateral and bilateral palatally impacted canines: A pilot study.

INTRODUCTION: The purpose was to determine whether the location of the root apices of unilateral palatally impacted canines differs from that of bilateral palatally impacted canines using cone-beam computed tomography. METHODS: The subjects were divided into 3 groups: a bilateral palatally impacted canine group (BPG; n = 28), a unilateral palatally impacted canine group (UPG; n = 28), and a control group (CG; n = 28) that included contralateral normally erupted canines in the UPG. After selecting the root apex in the onDemand3D program, 3-dimensional coordinates were extracted. These 3-dimensional coordinates were converted using the MATLAB program to 2-dimensional coordinates via projection on the palatal plane. Procrustes analysis was used to superimpose these 2-dimensional coordinates. The x- and y-coordinates of the root apices were used to measure the distance between the origin and root apex. RESULTS: The distance between the root apex of the canine and the origin was 17.43 ± 1.78 mm in BPG, 17.96 ± 1.87 mm in UPG, and 13.96 ± 0.95 mm in CG. There was no statistically significant difference between UPG and BPG. However, there was a statistically significant difference between the CG and impacted groups (UPG and BPG). The same results were found for the x- and y-coordinates. CONCLUSIONS: The location of the root apices of unilateral palatally impacted canines is similar to that of bilateral palatally impacted. The location of root apices of palatally impacted canines differs from that of normally erupted canines.

Unilateral condylar hyperplasia treated with simultaneous 2-jaw orthognathic surgery and posterior segmental osteotomy.

A 25-year-old woman presented with left condylar hyperplasia, canting-type facial asymmetry, mandibular prognathism, and arch width discrepancy. Bone scintigraphy confirmed the inactive status of the condyle, and the temporomandibular joint functioned within the normal range; thus, orthognathic surgery without condylectomy was performed. To correct facial asymmetry successfully through orthognathic surgery, sufficient dentoalveolar decompensation must be achieved in the presurgical orthodontic phase. In cases of canting-type facial asymmetry, teeth on the nondeviated side are extruded as dentoalveolar compensation. Therefore, vertical decompensation is required for intrusion of the extruded teeth. A miniscrew and resin build-ups were used for the intrusion of teeth, and posterior segmental osteotomy was simultaneously performed with orthognathic surgery for further intrusion. The canting-type facial asymmetry was notably corrected through successful vertical decompensation and close cooperation between orthodontists and maxillofacial surgeons. After 2 years of retention, the treatment results remained stable.

Long-term condylar remodelling after bimaxillary orthognathic surgery in skeletal Class III patients.

In this study, we aimed to evaluate long-term condylar remodelling in skeletal Class III patients who underwent bimaxillary orthognathic surgery using cone-beam computed tomography (CBCT). Twenty-three patients were studied retrospectively, and a total of 4 CBCT scans were obtained for each subject: 1 month before surgery (T0), immediately after the surgery (T1), 6 months after the surgery (T2), and 6.1 (±2.1 years after the surgery) (T3). Condylar remodelling was measured using the condylar volume, height, width, and depth. To examine a significant change, a one-way repeated measures analysis of variance was performed. The correlation between postoperative skeletal movement and condylar volume was assessed using Spearman's correlation analysis. Condylar volume and height showed a significant decrease from T1 to T2 but a significant increase from T2 to T3. Furthermore, a significant decrease was observed between T1 and T3. The condylar width and depth showed no significant changes. Postoperative skeletal movement showed no correlation with the change in condylar volume. The change in condylar volume mostly occurred as the condylar height changed. However, it did not contribute much to the postoperative skeletal movement.

Melatonin Attenuates RANKL-Induced Osteoclastogenesis via Inhibition of Atp6v0d2 and DC-STAMP through MAPK and NFATc1 Signaling Pathways.

Melatonin is a hormone secreted by the pineal gland that is involved in the biorhythm of reproductive activities. The present study investigated the inhibitory effects of melatonin on osteoclastogenesis in RAW 264.7 cells according to changes in V-ATPase and the corresponding inhibition of the MAPK and NFATc1 signaling processes. METHODS: the cytotoxic effect of melatonin was investigated by MTT assay. Osteoclast differentiation and gene expression of osteoclast-related factors were confirmed via TRAP staining, pit formation assay, immunofluorescence imaging, western blot, and real-time PCR. RESULTS: melatonin was found to inactivate the p38 and JNK of MAP kinase in RAW264.7 cells treated with RANKL and treated with a combination RANKL and melatonin for 1, 3, and 5 days. The melatonin treatment group showed a reduction in osteoclastogenesis transcription factors and ATP6v0d2 gene expression. CONCLUSIONS: melatonin inhibits osteoclast differentiation and cell fusion by inhibiting the expression of Atp6v0d2 through the inactivation of MAPK and NFATc1 signaling in RANKL-stimulated RAW264.7 macrophages. The findings of the present study suggest that melatonin could be a suitable therapy for bone loss and imply a potential role of melatonin in bone health.

Action observation training and brain-computer interface controlled functional electrical stimulation enhance upper extremity performance and cortical activation in patients with stroke: a randomized controlled trial.

PURPOSE: Brain-computer interface (BCI)-functional electronic stimulation (FES) systems are increasingly being explored as potential neuro-rehabilitation tools. Here, we investigate the effect of action observation training (AOT) plus electroencephalogram (EEG)-based BCI-controlled FES system on motor recovery of upper extremity and cortical activation in patients with stroke. METHOD: There were a total of 26 patients: an AOT plus BCI-FES group (n = 13) and a control group (n = 13). The control group performed FES treatment and the conventional physical therapy, while the AOT plus BCI-FES group performed AOT plus BCI-FES and the conventional physical therapy. Upper extremity performance was measured using the Fugl-Meyer Assessment of the Upper Extremity (FMA-UE), Wolf Motor Function Test (WMFT), Motor Activity Log (MAL) and Modified Barthel Index (MBI). Cortical activation was measured using electro-encephalographic recordings from alpha and beta power, concentration, and activation. RESULTS: After intervention, there were significant differences between two groups in FMA-UE, WMFT, MAL and MBI and the results of EEG including alpha power, beta power, concentration and activation. CONCLUSIONS: This study demonstrated that AOT plus BCI-FES can enhance motor function of upper extremity and cortical activation in patients with stroke. This training method may be feasible and suitable for individuals with stroke.

Comparison of maxillary basal arch forms using the root apex in adult women with different skeletal patterns: A pilot study.

INTRODUCTION: This study aimed to establish maxillary basal arch forms using the root apices and to determine the differences in the basal arch forms in adult women with different sagittal skeletal patterns. METHODS: This retrospective study included 91 adult women, with either a Class I (n = 24), Class II Division 1 (n = 22), Class II Division 2 (n = 23), or Class III (n = 22) malocclusion, who underwent cone-beam computed tomography. Three-dimensional coordinates of the root apices were determined using the multiplanar reformation mode of OnDemand3D software (Cybermed Inc, Seoul, South Korea). Two-dimensional coordinates were converted from acquired 3-dimensional coordinates via projection on the palatal plane, and the Procrustes superimposition method was used to build the basal arch form. Finally, interroot width measurements were performed for basal arch form comparisons. RESULTS: There were significant differences among the 4 groups (P <0.05) with respect to the intercanine width. The intercanine width of Class II Division 1 group was significantly narrower than that of the other groups. The Class II Division 1 and Class II Division 2 groups tended to have tapered arch forms and squared arch forms, respectively. CONCLUSIONS: We established maxillary basal arch forms using the root apices. The Class II Division 1 group had a significantly narrower intercanine distance. The use of the root apex to depict the basal arch form seems reasonable.

Immediate effects of mandibular posterior displacement on the pharyngeal airway space: A preliminary study.

OBJECTIVE: This study aimed to evaluate the immediate effects of mandibular posterior displacement on the pharyngeal airway space (PAS) by using cephalometric evaluations and to investigate how the surrounding structures are schematically involved. METHODS: In this retrospective study, 38 subjects with functional Class III malocclusion and two lateral cephalograms were selected. The first lateral cephalogram was taken with the mandible in the habitual occlusal position, and the second in anterior edge-to-edge bite. Paired t-test was used to analyze changes in the PAS, hyoid bone, tongue, and soft palate, followed by mandibular posterior displacement. Pearson's correlation analysis was used to determine the relationship between the amount of mandibular posterior displacement and other variables. RESULTS: A statistically significant decrease was observed in the PAS following mandibular posterior displacement. Along with mandibular posterior displacement, the tongue decreased in length (p < 0.001) and increased in height (p < 0.05), while the soft palate increased in length, decreased in thickness, and was posteriorly displaced (p < 0.001). The hyoid bone was also posteriorly displaced (p < 0.05). There was no correlation between the amount of mandibular posterior displacement and the measured variables. CONCLUSIONS: The PAS showed a statistically significant decrease following mandibular posterior displacement, which was a consequence of retraction of the surrounding structures. However, there were individual variances between the amount of mandibular posterior displacement and the measured variables.

Anatomical relationship between the maxillary posterior teeth and the sinus floor according to an anterior overbite.

OBJECTIVE: To evaluate the vertical relationship between the maxillary sinus floor (MSF) and the maxillary posterior teeth (MPT) according to an anterior overbite. SETTINGS AND SAMPLE POPULATION: The patients were divided into three groups according to an anterior overbite. The open bite group (OBG) included patients with an anterior overbite of ≤0 mm, the normal overbite group (NBG) included patients with an overbite of 0-3 mm, and the deep bite group (DBG) included patients with an overbite ≥3 mm. Thirty patients were randomly matched into each group based on age and sex. MATERIALS AND METHODS: The distances and vertical relationship between the MSF and the MPT was analysed using cone-beam computer tomography. The vertical relationship between the two was classified as either favourable or unfavourable for the intrusion of the posterior teeth. RESULTS: A higher ratio of patients in the OBG had MPT positioned close to the MSF than the DBG. Intrusion of the posterior teeth was unfavourable for an average of 87.2%, 77.2% and 70.2% molars in the OBG, NBG and DBG, respectively. CONCLUSIONS: The vertical distance between the MSF and the MPT is associated with an anterior overbite. The posterior teeth were in an unfavourable position for the orthodontic intrusion in the OBG as compared to the other groups. Additional caution is needed when planning orthodontic intrusion treatment for patients with an anterior open bite. But, there were some individual variations within each group.

Root proximity of miniscrews at a variety of maxillary and mandibular buccal sites: Reliability of panoramic radiography.

OBJECTIVES: To assess the root proximity and the insertion angles of miniscrews after miniscrew placement at a variety of maxillary and mandibular buccal sites using cone-beam computed tomography (CBCT) and to determine the differences in root proximity between CBCT and panoramic radiography (PR). MATERIALS AND METHODS: This retrospective study included 50 patients (mean age, 22.0 ± 4.5 years) who underwent postoperative CBCT and PR after miniscrew placements for intermaxillary fixation in orthognathic surgery. Twelve miniscrews were placed in the buccal bone of each patient: at sites between the central incisor and lateral incisor (SII), sites between the canine and first premolar (SCP), and sites between the second premolar and first molar (SPM) on the right and left sides of the mandible and maxilla. The insertion angles were measured on CBCT, and the root proximity was assessed on CBCT and PR. RESULTS: The mean vertical placement angles ranged from 84.27° to 95.12°, and the mean horizontal placement angles ranged from 90.93° to 101.1°. The rates of no contact between the root and the miniscrew were 68.0% in the SII, 50.5% in the SCP, and 57.8% in the SPM, which were significantly different (P = .000). The total concordance rate between PR and CBCT was 41.3%. CONCLUSIONS: Clinicians should use extreme caution during placement of miniscrews in the SCP. There are limitations on the use of PR for evaluating the root proximity of miniscrews.

Correction to: Hard- and soft-tissue profiles of the midface region in patients with skeletal Class III malocclusion using cone-beam computed tomography multiplanar-reconstructed image analysis.

[This corrects the article on p. 143 in vol. 48, PMID: 29732300.].

Healing pattern of intentional pterygoid plate fracture after posterior movement of maxilla through Le Fort I osteotomy.

BACKGROUND: To evaluate maxillary stability following Le Fort I osteotomy using postero-superior movement after pterygoid plate fracture. Additionally the authors sought to analyze the postoperative changes at the intentional pterygoid plate fracture site. MATERIALS AND METHODS: Thirty-six patients with class III deformities treated with total maxillary setback at the Lefort I level were enrolled in a retrospective cohort study. Relative changes in measurement points were identified on cone-beam computed tomographic scans (CBCT) as well as lateral cephalograms. The outcome variables were determined as changes at measurement points obtained preoperatively, immediately postoperatively, and 6 months after surgery. RESULTS: The average posterior repositioning of ANS in the 36 patients was 1.78 mm and the mean superior repositioning at PNS was 2.78 mm. The maximal recurrence rate was less than 10% at the 6 months postoperative time point. The intentional fracture site of the pterygoid plates healed with a linear pattern. There were no major complications such as airway edema, hemorrhage and nerve damage reported over the 6-month follow-up period. CONCLUSIONS: Intentional fracture of the pterygoid plates has a role in the retropositioning of the maxilla with good healing at the fracture site, little relapse and satisfactory postoperative stability.

Hard- and soft-tissue profiles of the midface region in patients with skeletal Class III malocclusion using cone-beam computed tomography multiplanar-reconstructed image analysis.

OBJECTIVE: This study examined cone-beam computed tomography (CBCT)-derived multiplanar-reconstructed (MPR) cross-sections to clarify the salient characteristics of patients with skeletal class III malocclusion with midface deficiency (MD). METHODS: The horizontal and sagittal plane intersection points were identified for middle-third facial analysis in 40 patients in the MD or normal (N) groups. MPR images acquired parallel to each horizontal plane were used for length and angular measurements. RESULTS: A comparison of the MD and N groups revealed significant differences in the zygoma prominence among female patients. The convex zygomatic area in the N group was larger than that in the MD group, and the inferior part of the midface in the N group was smaller than that in the MD group for both male and female patients. A significant difference was observed in the concave middle maxillary area among male patients. CONCLUSIONS: This study was conducted to demonstrate the difference between MD and normal face through MPR images derived from CBCT. Male patients in the MD group had a more flattened face than did those in the N group. Female patients in the MD group showed a concave-shaped lower section of the zygoma, which tended to have more severe MD. These findings indicate that orthognathic surgery to improve skeletal discrepancy requires different approaches in male and female patients.

Assessment of the root apex position of impacted maxillary canines on panoramic films.

INTRODUCTION: In this study, we aimed to analyze the root apex positions of impacted maxillary canines on panoramic radiographs according to their labiopalatal positions and to propose a new panoramic radiographic predictor of impacted maxillary canines. METHODS: Paired panoramic films and cone-beam computed tomography images of 104 patients with unilateral impacted maxillary canines were selected. The sector locations of the impacted canine root apices on the panoramic radiographs were compared with the labiopalatal positions of impacted maxillary canines on cone-beam computed tomography. Statistical correlations between panoramic and cone-beam computed tomography findings were examined with the chi-square test. RESULTS: A statistically significant association was observed between the sector locations of impacted canine root apices and the labiopalatal positions of the canines (P <0.001). The root apices of labially impacted canines were more frequently located in sector 2 (corresponding to the lateral incisor position), those of palatally impacted canines were more frequently located in sector 4 (corresponding to the first premolar), and those of midalveolus impacted canines were more frequently located in sector 3 (corresponding to the canine). CONCLUSIONS: On panoramic films, the root apices of palatally impacted canines tended toward the root apices of the maxillary first premolars, whereas those of labially impacted canines tended toward the root apices of the maxillary lateral incisors. Therefore, the sector locations of impacted canine root apices on panoramic radiographs could be used for the early prediction of maxillary canine impactions and determination of the labiopalatal positions of impacted canines.

Comparison of masticatory efficiency according to Angle's classification of malocclusion.

OBJECTIVE: The objective of this study was to investigate the differences in masticatory efficiency among patients with different Angle's classes of malocclusion and to assess the correlation between masticatory efficiency and the occlusal contact area. METHODS: The mixing ability index (MAI) was calculated for measuring masticatory efficiency of 61 adult patients according to Angle's classifications of malocclusion. The study included 25, 15, and 21 patients with Angle's Class I, II, and III malocclusions, respectively. Silicone interocclusal recording material was used to measure the occlusal contact area. RESULTS: Both the MAI and occlusal contact area showed the highest average values in the Class I malocclusion group, followed by the Class II and Class III malocclusion groups. No significant difference was observed in the MAI values between the Class I and Class II malocclusion groups (p > 0.05), whereas a significant difference was observed between the Class I and Class III malocclusion groups (p < 0.01) and between the Class II and Class III malocclusion groups (p < 0.05). A weak positive correlation was also observed between the MAI and occlusal contact area (p < 0.01, r2 = 0.13). CONCLUSIONS: The results of this study indicated that masticatory efficiency was the highest in patients with Angle's Class I malocclusion, followed by those with Angle's Class II and Angle's Class III malocclusions. Moreover, a weak positive correlation was observed between masticatory efficiency and the occlusal contact area.

How far is the root apex of a unilateral impacted canine from the root apices' arch form?

INTRODUCTION: The purpose of this study was to determine the arch form of the root apices of normally erupting teeth and then determine the differences in the location of the apex of impacted canines relative to normally erupting canines. In addition, we sought to determine whether the labiopalatal position of the impacted canines influences the position of the apices. METHODS: The study included 21 patients with unerupted canines that subsequently had a normal eruption, 21 patients with palatally impacted canines, 27 patients with labially impacted canines, and 17 patients with midalveolus impacted canines. Images were obtained using cone beam computed tomography, and the x, y, and z coordinates of the root apices were determined using Ondemand3D software (Cybermed Co., Seoul, Korea). Two-dimensional coordinates were converted from acquired 3-dimensional coordinates via projection on a palatal plane, and the Procrustes method was used to process the converted 2-dimensional coordinates and to draw the arch forms of the root apices. Finally, we measured the extent of root apex deviation from the arch forms of the root apices. RESULTS: Normally erupting canines showed that even though calcifications may be immature, their positions were aligned with a normal arch form. The root apices of the impacted canines were an average of 6.572 mm away from the root apices' arch form, whereas those of the contralateral nonimpacted canines were an average distance of 2.221 mm away, a statistically significant difference. The palatally impacted canines' root apices distribution tended toward the first premolar root apices. CONCLUSIONS: Incompletely calcified, unerupted teeth with a subsequent normal eruption showed a normal arch form of the root apices. The root apices of impacted canines were farther from the arch forms than were the nonimpacted canines. Also, the root apices of impacted canines in the palatal area showed distributions different from those of the other impacted canine groups.

Preliminary Study to Determine the Reference Plane of Patients With a Unilateral Cleft Lip and Palate.

OBJECTIVE: The objective of this study was to determine the three-dimensional midsagittal reference planes for unilateral cleft lip and palate (UCLP) patients that can be easily applied in a clinical setting. DESIGN: This was a retrospective analysis. PATIENTS: There were 35 UCLP patients (25 men, 10 women; 28.1 ± 6.9 years old) in this study. METHODS: With landmark's three-dimensional coordinates obtained from cone-beam computed tomography, the symmetric midsagittal reference planes were calculated by applying the ordinary Procrustes superimposition method using the original and mirror images. Procrustes analysis was also used to find the closest landmarks to the calculated symmetric midsagittal reference plane and test its compatibility with the symmetrical midsagittal reference plane. MAIN OUTCOME MEASURE: The three nearest landmarks to the symmetric midsagittal reference plane were Opisthion, Basion, and Nasion. RESULTS: The averages of the sums of the squared Euclidean distance and squared Procrustes distance differences between the two configurations and shapes fabricated by the symmetrical and landmark-based midsagittal reference planes, respectively, were calculated as 1.836 ± 3.295 and 1.519 × 10-5 ± 2.351 × 10-5. CONCLUSION: It was confirmed that the midsagittal reference planes from these selected landmarks for UCLP patients were compatible with symmetric midsagittal reference planes from the Procrustes analysis and the asymmetric measurements.