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Comparative Study
. 2025 Apr 19;25(1):602.
doi: 10.1186/s12903-025-05798-6.

Prevalence of upper cervical vertebral anomalies in children with non-syndromic cleft lip and/or palate in comparison with children without cleft in Iranian population

Shabnam Ajami  1 , Samaneh Dehghanpoor  2 , Seyedeh Sara Tabibi  1 , Najmeh Movahhedian  3
Affiliations
Comparative Study

Prevalence of upper cervical vertebral anomalies in children with non-syndromic cleft lip and/or palate in comparison with children without cleft in Iranian population

Shabnam Ajami et al. BMC Oral Health. .

Abstract

Background: To evaluate the prevalence of upper cervical vertebral anomalies (CVA) in Iranian children with cleft lip and/or palate (CL/P) and compare it with children without a cleft.

Methods: A case-control study on lateral cephalograms from Orthodontics Research Center, Shiraz University of Medical Sciences, Shiraz, Iran of 92 subjects (41 females and 51 males) with non-syndromic CL/P with a mean age of 13.54 ± 4.63 years, and 184 age- and sex-matched individuals (82 females and 102 males) with no craniofacial anomalies or skeletal malocclusion as the control group. Upper cervical vertebrae (C1-C3) were examined regarding the following CVA: (1) posterior arch deficiencies: spina bifida and dehiscence; (2) Fusion Anomalies (FAs): fusion and occipitalization; (3) accessory ossicles. Vertebral artery canal morphology was also evaluated.

Results: The prevalence of CVA was significantly higher in the cleft group (62%) than in the control group (25%) (P < 0.001). FAs, fusion, accessory ossicle, and deviation of artery canal type 2 were the anomalies with significantly higher prevalence in the cleft group compared to the noncleft group (all P < 0.05). 11 individuals (11.9%) of the cleft group and five (2.7%) of the control group had more than one CVA. When considering the subgroups of the CL/P, the prevalence of CVA was significantly higher in almost all the CL/P subgroups compared to the control group (all P < 0.05).

Conclusions: Upper CVA, especially fusion anomalies, were significantly more prevalent in children with non-syndromic CL/P compared to the children without cleft in an Iranian population. A female predilection for CVA was also noted in both the general population and the cleft group.

Keywords: Cervical vertebrae anomaly; Cleft lip and palate; Posterior arch deficiency; Vertebral artery Canal; Vertebral fusion.

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Conflict of interest statement

Declarations. Ethics approval and consent to participate: This cross-sectional study has been performed following the Declaration of Helsinki and was approved by the Human Ethics Review Committee of the Faculty of Dentistry, Shiraz University of Medical Sciences, approved the present study’s research protocol (IR.Sums.Dental.REC.1399.118). All the patients or their legal guardians signed written informed consent at the imaging time for anonymous use of their radiographic data in future research/publications. Consent for publication: Not applicable. Competing interests: The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Radiographic images showing cervical vertebral anomalies: (a) spina bifida, (b) dehiscence, (c) fusion, (d) occipitalization, and (e) accessory ossicle
Fig. 2
Fig. 2
The classification of cervical vertebral canal morphologies: (a) Type 1: nearly perpendicular posterior margin without lipping, (b) Type 2: slight posterior lipping, (c) Type 3: extension toward the posterior arch without fusion, and (d) Type 4: complete ring formation (foramen arcuate)
See this image and copyright information in PMC

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