Influence of Cleft Laterality on Cleft Width, Canine and Lateral Incisor Status, and Adjacent Midfacial Midline Structures: A Retrospective CBCT Analysis

Background/Objectives: This retrospective study examined, in patients with cleft palate, whether canine eruption status is associated with lateral incisor status, whether cleft width differs by laterality, age, or sex, and whether nasopalatine canal and septal position correlate with cleft laterality. Methods: CBCT examinations of 33 patients were reviewed, including small subgroups of 7 unilateral right-sided, 14 unilateral left-sided and 12 bilateral cases. Lateral incisor and canine status were compared using Fisher’s exact test; cleft width was compared by laterality, age, and sex using the Kruskal– Wallis, Spearman, and Mann–Whitney U tests; and canal and septal position were tested against laterality using the Fisher–Freeman–Halton test, with comparisons repeated excluding the six youngest patients. Results: Canine eruption status was not associated with lateral incisor status (right p = 1.000; left p = 0.733). Root resorption occurred in 13.2% of present lateral incisors, and at least one was absent in 45.5% of patients (all p > 0.14 for age, sex, and side). Canine eruption status was associated with age (unerupted canines younger, 10.8 vs. 15.1 years; p = 0.005). Cleft width did not differ by laterality, age, or sex (all p > 0.14; ICC 0.974). Canal and septal position correlated significantly with laterality (p = 0.002, p = 0.001): the canal deviated away from the cleft side in 87.5% of unilateral cases, and the septum toward it in 90.5%; findings were unchanged after excluding the youngest patients. Intra-examiner reliability for these two variables was almost perfect (Cohen’s κ = 0.86–0.88). Conclusions: Dentoalveolar findings showed no significant association with cleft laterality, apart from the expected age-eruption link, and should be read as inconclusive given the modest sample size. Canal and septal position, by contrast, were significantly and reciprocally correlated with laterality, consistent with cleft palate reflecting a regional craniofacial disturbance rather than an isolated alveolar defect, relevant to pre-surgical planning pending larger-cohort confirmation.