Covariation Between Palatal Shape and Craniofacial Morphology in Complete Unilateral Cleft Lip, Alveolus, and Palate: A Geometric Morphometric Study.

Background/Objectives: Unilateral cleft lip, alveolus, and palate (UCLAP) is associated with disturbed maxillary and craniofacial growth, and palatal morphology may reflect congenital, growth-related, surgical, and orthodontic influences. This retrospective study used geometric morphometrics to investigate covariation between palatal and craniofacial morphology in children treated for complete UCLAP. Methods: Maxillary dental casts and lateral cephalometric radiographs of 48 non-syndromic patients (33 boys, 15 girls; mean age 9.9 years) were digitized using 239 palatal and 152 craniofacial landmarks and semilandmarks. Covariation was assessed by two-block partial least squares (PLS) analysis with permutation testing. Results: Overall covariation was not statistically significant (RV = 0.254, p = 0.097). PLS1 accounted for 28.9% of total squared covariance and had a block-score correlation of r = 0.658 (p = 0.084). Bootstrap resampling showed only partial reproducibility of the PLS1 directions. Conclusions: Palatal morphology does not appear to reliably reflect the overall craniofacial configuration in children with operated complete UCLAP. Further longitudinal studies using fully three-dimensional assessment are needed to clarify clinically meaningful palate-craniofacial relationships.