Evaluation of dental and skeletal age among unilateral cleft lip and palate patients in an eastern Indian population

Abstract

Background: Unilateral cleft lip and palate affects dental and skeletal maturation, leading to delays that impact treatment planning and forensic age estimation. Understanding the correlation between dental age, skeletal age, and chronological age is essential for clinical and medico-legal applications.

Aim: To evaluate and compare dental and skeletal age in non-syndromic unilateral cleft lip and palate patients with an age- and gender-matched non-cleft control group.

Materials and Methods:

This cross-sectional study included 216 individuals (108 unilateral cleft lip and palate cases and 108 controls), aged 7 to 18 years. Dental age was assessed using Acharya’s modified Demirjian method on panoramic radiographs, while skeletal age was estimated using the Greulich and Pyle Atlas from left hand-wrist radiographs. Statistical analyses were conducted to compare dental age, skeletal age, and chronological age.

Results: Skeletal age was more delayed than dental age, with males experiencing greater delays than females. Males had a mean skeletal delay of 0.92 years (p < 0.001), and females had a delay of 0.90 years (p < 0.001). Dental age delay was 0.28 years in males (p = 0.016) and 0.21 years in females (p = 0.150, not significant). The most significant delays were observed between ages 10 to 14 years, with a peak skeletal delay of 1.04 years at age 10 in females (p < 0.001).

Conclusion: Skeletal age is more delayed than dental age, with males experiencing greater delays. These findings highlight the need for individualized treatment planning and reinforce the importance of cleft-specific age estimation methods in forensic and legal contexts.

Clinical Significance: Accurate assessment of skeletal and dental age is essential for timely orthodontic and surgical interventions and for preventing age misclassification in forensic applications.