Objectives To map the existing evidence on the role of FAT family cadherins in craniofacial development, identify knowledge gaps, and inform future research directions in this field. Design Electronic searches were conducted in PubMed, Embase, Scopus, Web of Science Core Collection, and ProQuest Dissertations & Theses Global from their inception to January 2026, complemented by manual searches. Studies investigating FAT family cadherins in craniofacial development were included without restrictions on language or publication year. Search strategy and eligibility criteria were pre-determined based on the population, concept and context framework of the Joanna Briggs Institute. Eligible studies included case reports and original studies encompassing bioinformatics analyses, in vitro experiments, animal studies, and human genetic studies. Results Twenty-one studies were included, encompassing craniofacial bone formation, cranial suture development, upper lip and palate formation, and tooth development. Among the FAT family members, FAT4 was the most frequently studied (n=12), followed by FAT1 (n=7). None of the included studies investigated the role of FAT2 in craniofacial development. These cadherins exhibit prominent, stage-specific expression patterns during craniofacial morphogenesis, including the mesenchyme of the medial nasal processes, zygomatic-maxillary suture, and alveolar bone. Six case reports described four congenital syndromes that present with craniofacial abnormalities. Conclusions The available evidence indicates that FAT family cadherins are substantially involved in craniofacial morphogenesis. However, important research gaps remain, particularly regarding their cooperative functions and precise spatiotemporal roles during craniofacial development, critical for understanding craniofacial anomalies. Registration This review was registered at the Open Science Framework database (https://osf.io/wcxrj).

OBJECTIVES:To assess the reporting quality of dental patient-reported outcomes (dPROs) in randomized controlled trials (RCTs) published in leading orthodontic journals during the past decade, and to identify factors associated with dPRO reporting. METHODS:A manual search was conducted with the online archives of 5 selected journals, to identify orthodontic RCTs that used dPROs as primary outcomes, published between 2015 and 2024. The overall reporting quality (ORQ) and dPRO-specific reporting quality (PRQ) of the included RCTs were assessed using a modified 33-item CONSORT 2010 checklist and a modified 13-item CONSORT PRO checklist, respectively. The adequate reporting proportion (ARP) was calculated for each checklist item. Univariable and multivariable linear regression analyses were performed to identify factors associated with ORQ and PRQ. RESULTS:A total of 47 eligible RCTs were included. The mean (standard deviation) ORQ and PRQ scores were 20.1 (5.4) and 7.0 (2.3), respectively. Items including the "background," "eligibility criteria," "intervention," and "interpretation" (from the modified CONSORT 2010 checklist), as well as the "background and rationale of PROs" (from the modified CONSORT PRO checklist), were adequately described in all included RCTs. However, reporting was particularly inadequate for several CONSORT PRO items, including the "validity and reliability of PROMs" (ARP, 19.1%) and "sample size calculation" (31.9%). Regression analyses suggested that more recent publication year was significantly associated with higher scores in both ORQ (P = .004, 95% CI: 0.251, 1.264) and PRQ (P < .001, 95% CI: 0.219, 0.643), whereas mentioning of CONSORT showed a significant association with higher ORQ scores (P = .018, 95% CI: 0.766, 6.202). CONCLUSIONS:Among orthodontic RCTs that use dPROs as primary outcomes, the dPRO-specific reporting quality is suboptimal. Collaborative efforts from authors, editors, peer reviewers, and other stakeholders are essential to improve the completeness, transparency, and accuracy of outcome reporting, and thereby facilitate shared decision-making and evidence-based orthodontic practice, strengthen the validity and reliability of evidence synthesis, and ultimately maximize the scientific and clinical value of orthodontic trials.

To systematically compare the clinical efficacy of various biomaterial-based regenerative strategies for periodontal intrabony defects and to provide clinically meaningful evidence for optimizing treatment selection. This study followed the PRISMA-NMA guidelines. PubMed, Embase, Web of Science, Cochrane Library, CNKI, Wanfang, and VIP databases were systematically searched from January 2010 to February 2026. Randomized controlled trials (RCTs) involving regenerative treatment of periodontal intrabony defects were included. Interventions consisted of different biomaterial-based regenerative therapies. The primary outcomes were changes from baseline in probing depth (PD), clinical attachment level (CAL), bone gain (mm), and gingival recession (REC). Two reviewers independently performed study selection and data extraction, and the risk of bias was assessed using the Cochrane RoB 2.0 tool. Bayesian network meta-analysis was conducted using STATA 16, Review Manager 5.4, and R 4.4.2 with the BUGSnet and gemtc packages. Effect sizes were expressed as weighted mean differences (WMD) with 95

Pediatric obstructive sleep apnea (OSA) is a respiratory disorder that may lead to significant neurocognitive, behavioral, and cardiovascular dysfunction. Studies show rapid maxillary expansion (RME) widens the maxilla and nasal cavity, potentially reducing OSA symptoms. This systematic review and meta-analysis summarized recent the international literature on the efficacy of RME in alleviating pediatric OSA. Adhering to PRISMA guidelines and PROSPERO registration, we searched five databases (including PubMed and Embase) through March 2025. We included randomized and non-randomized studies assessing RME in children with PSG-diagnosed OSA. Risk of bias was evaluated using ROBINS-I, and evidence certainty via GRADE. Random-effects meta-analyses were performed for respiratory and radiological outcomes. Meta-analyses performed with RevMan software (version 5.4) revealed that the apnea-hypopnea index (AHI) decreased within six months following the completion of active RME (MD: -4.04, 95

Alveolar bone defects, including dehiscence and fenestration, are commonly encountered in adult patients seeking orthodontic treatment. These anatomical deficiencies increase the risk of periodontal complications and may significantly compromise orthodontic tooth movement. Alveolar bone defects can also develop during orthodontic treatment, particularly in adult patients with narrow alveolar ridges requiring excessive tooth movement. Orthodontic-associated alveolar ridge augmentation (OARA) is an effective treatment approach that provides additional bone support and facilitates tooth movement, thereby reducing the incidence of periodontal complications and accelerating and broadening the scope of movement. At present, standardized diagnostic and treatment protocols for OARA in adult patients are lacking. This expert consensus aims to provide evidence-based recommendations for OARA in adult patients. A multidisciplinary panel of 27 experts conducted a Delphi-style process incorporating a targeted literature review and three voting rounds, achieving ≥70% agreement. Twenty-nine consensus statements across seven clinical domains, including pre-OARA examination, indications, bone graft material selection, timing, surgical protocols, standard operating procedures and considerations, were established with recommendations graded according to adapted GRADE criteria. This report presents a structured clinical framework for OARA and identifies future research priorities.

OBJECTIVE:Apical periodontitis (AP) is characterised by inflammatory infiltration and periapical bone loss, accompanied by high expression of tumour necrosis factor-alpha (TNF-α). SID1 transmembrane family member 2 (Sidt2) is a lysosomal membrane protein associated with inflammation. However, the effect of Sidt2 on AP remains unknown. METHODS:We established an AP mouse model, and then the adenovirus-associated virus was used to inhibit Sidt2 expression in the AP model. Periapical lesions were detected using micro-computed tomography. Haematoxylin and eosin staining, tartrate-resistant acid phosphatase staining, and immunohistochemistry staining were conducted to explore the roles of Sidt2 in inflammation and osteoclast differentiation in AP; F-actin staining, quantitative real-time polymerase chain reaction, western blot, enzyme-linked immunosorbent assay and RNA sequencing analysis were used to detect osteoclast differentiation and TNF-α signalling pathway in RAW 264.7 cells. RESULTS:Sidt2 was suppressed, and TNF-α was increased in AP. Sidt2 knockdown aggravated inflammation and bone loss in AP. Besides, Sidt2 inhibition upregulated osteoclast differentiation both in AP and in RAW 264.7 cells. Mechanistically, RNA sequencing analysis revealed Sidt2 may regulate osteoclast differentiation via the TNF-α signalling pathway. Profoundly, knockdown Sidt2 enhanced TNF-α production and secretion, while neutralising TNF-α partially relieved Sidt2-knockdown-increased osteoclast differentiation in RAW 264.7 cells. CONCLUSION:Our data demonstrated that Sidt2 negatively regulates autocrine TNF-α signalling to participate in osteoclast differentiation in AP, supporting the notion that Sidt2 may serve as a therapeutic target for bone resorption.

This case report describes a two-phase orthodontic treatment of an 11-year-old adolescent patient with a Class II malocclusion. Before orthodontic treatment, the patient exhibited adenoid hypertrophy, mouth breathing, and snoring. He was referred to an otolaryngologist and diagnosed with paediatric obstructive sleep apnoea (PedOSA), which was treated with tonsillectomy and adenoidectomy. Thereafter, given that the patient was at the pubertal growth peak and preferred aesthetic appliances, clear aligner functional therapy was selected for orthodontic treatment. During the first phase (mandibular advancement), deep overjet and Class II molar relationship were improved using clear aligners with solid occlusal blocks, resulting in significant improvement in the patient's facial profile. In the second phase (comprehensive orthodontics), alignment and levelling of the dentition were performed. After approximately three years of treatment, all treatment objectives were achieved. This case suggests that CA with solid occlusal blocks, as a novel option, can be used for growing Class II malocclusion patients. The improvement in the facial profile appeared to result from a combination of minor skeletal changes and significant dentoalveolar compensation.

Objectives This systematic review aimed to summarize the current evidence on the skeletal and dental effects of the alternate rapid maxillary expansion and constriction (Alt-RAMEC) protocol combined with the miniscrew-anchored maxillary protraction (MAMP) in Class III patients. Methods Electronic searches were conducted in PubMed, Embase, Web of Science, Cochrane Central Register of Controlled Trials, Chinese National Knowledge Infrastructure and Google Scholar without language restrictions from inception to September 2025. Studies comparing the effectiveness of MAMP/Alt-RAMEC with other maxillary protraction interventions in Class III children and adolescents were included. The risk of bias (RoB) in randomized clinical trials (RCTs) was assessed using the RoB 2 tool, while the RoB in controlled clinical trials (CCTs) was evaluated by ROBINS-I tools. The certainty of evidence was evaluated using the GRADE tool. Results Seven studies met the inclusion criteria, including six RCTs and one CCT. Among the RCTs, two were judged to have a low RoB, three had some concerns, and one had a high RoB. The CCT was assessed as having a moderate RoB. Due to substantial heterogeneity among the included studies, a quantitative meta-analysis was not feasible. Children treated with MAMP/Alt-RAMEC demonstrated greater maxillary advancement (SNA, ANB, Wits and Co-A), while exhibiting comparable facial height increase and maxillary incisor proclination compared with untreated controls. In contrast, compared with children treated with tooth-anchored maxillary protraction (TAMP)/Alt-RAMEC, MAMP/Alt-RAMEC produced comparable sagittal skeletal changes but fewer vertical and dental side effects. The certainty of evidence across outcomes ranged from moderate to very low. Conclusion Current evidence suggests that MAMP/Alt-RAMEC appears to promote maxillary advancement in Class III children and may result in fewer dental and vertical side effects than conventional protraction interventions. However, the overall certainty of evidence is limited, and further high-quality RCTs are required to confirm these findings.

To develop and evaluate the reliability and validity of the Orthodontic Health Literacy (OrthoHL) Scale, designed to measure orthodontic health literacy. The scale was developed following a four-phase process that included item development, factor analysis, reliability assessment, and validity assessment. Data were collected in Wuhan, China, from three participant groups (total n = 974; n = 412, 512, and 50) in 2024. Item development phase utilised the Delphi method, achieving expert consensus from 13 specialists across orthodontics, general dentistry, nursing and public health and human factor engineering/ergonomics. Reliability assessment was conducted through internal consistency and test-retest methods, and validity assessment used exploratory factor analysis and confirmatory factor analysis. The 19-item OrthoHL Scale demonstrated strong psychometric properties, including acceptable test-retest reliability, internal consistency, and content, convergent, discriminant, and criterion-related validity. Additionally, the OrthoHL Scale had four dimensions of orthodontic health literacy, namely orthodontic knowledge, information access, information evaluation and specialist selection. The four dimensions were positively correlated with proactive orthodontic behaviours. The OrthoHL Scale is a reliable and valid tool for evaluating the orthodontic health literacy and facilitates dental health studies that take orthodontic health literacy into account.

The maturity of the mid-palatal suture (MPS) could largely determine the necessity of more invasive interventions for correcting transverse maxillary deficiency. CBCT, the most commonly used method for assessing MPS maturity, is not routinely available and exposes patients to higher levels of ionizing radiation than a cephalogram. Given the substantial number of morphological features contained in a cephalogram, this study aimed to estimate CBCT-defined MPS maturity using an entire cephalogram alone via deep learning (DL) algorithms. A total of 543 paired CBCT and cephalogram files available from two distinct hospital settings formed the internal and external datasets. Data augmentation and five-fold cross-validation strategies were applied. Six ResNet-based DL algorithms were initiated via transfer learning. The AdamW optimizer and an early-stopping strategy were employed during training. The models were subsequently tested on the held-out external dataset. The Grad-CAM technique was applied to offer insights into the models’ decision-making process. All algorithms exhibited promising classification performance, with area under the curve (AUC) values ranging from 0.91 to 0.97. The models with the TKSGA module demonstrated better discriminative ability, calibration, and clinical usefulness than their baseline counterparts. Models integrated with the TKSGA module exhibited an interpretable decision pattern. The heatmaps revealed that morphological characteristics of patients’ dentition, cervical vertebrae, and nasopharyngeal airway were primary areas of interest for the DL models. When CBCT imaging is unavailable or not justified, a lateral cephalogram coupled with advanced DL algorithms, could be considered as a supplementary tool to inform palatal expander selection.

The oral cavity serves as the primary source of oral mesenchymal stem/progenitor cell populations residing in the dental pulp, periodontal ligament, deciduous tooth pulp, and gingival connective tissue. Oral and periodontal tissues exist in a constantly loaded biomechanical environment, where forces from mastication, vascular pulsation, and orthodontic manipulation continuously act on resident mesenchymal stem cells, including dental pulp stem cells (DPSCs), periodontal ligament stem cells (PDLSCs), stem cells from human exfoliated deciduous teeth (SHEDs), and gingival mesenchymal stem cells (GMSCs). In this review, we use the term “oral stem cells” to specifically denote oral mesenchymal stem/progenitor populations residing in dental pulp, periodontal ligament (PDL), deciduous tooth pulp, and gingival connective tissue (DPSCs, PDLSCs, SHEDs, and GMSCs), which are most relevant to orthodontic remodeling and dento-periodontal regeneration. For clarity, this review highlights the defining characteristics, representative markers, differentiation potential, and immunomodulatory properties of these oral stem cells within the manuscript, establishing a foundation for understanding how mechanical forces shape their fate. These forces are not merely physical stimuli; they actively reshape stem cell fate by engaging a multilayered mechano - epigenetic regulatory network that integrates cytoskeletal mechanotransduction, nuclear mechanics, and chromatin remodeling. Mechanical inputs such as compression, tension, shear stress, and extracellular matrix stiffness modulate DNA methylation, histone acetylation and methylation, 3D genome architecture, and non-coding RNA programs. These epigenetic and epitranscriptomic adaptations stabilize lineage commitment, influence inflammatory and regenerative outputs, and may establish “mechanical memory” that persists after load removal. Metabolic rewiring, including YAP/TAZ- and MAPK-driven control of mitochondrial activity and metabolite pools, provides an additional axis linking mechanics to chromatin state. Building on these mechanisms, emerging therapeutic strategies aim to couple defined mechanical cues with epigenetic modulators and mechano-tunable biomaterials to enhance pulp regeneration, periodontal repair, and orthodontic bone remodeling with higher precision. The review further highlights single-cell multi-omics and live-cell imaging approaches as essential tools to resolve force-dependent chromatin dynamics in vivo, and proposes that integrating biomechanics, epigenetics, and metabolic control will enable next-generation regenerative dentistry and personalized orthodontic intervention.

Adenotonsillar hypertrophy (ATH) is a major cause of upper airway obstruction and is associated with specific craniofacial characteristics. However, the craniofacial morphology of children with ATH is controversial. This study aimed to clarify these discrepancies by investigating the association between the adenoid-to-tonsil (A/T) size ratio and craniofacial characteristics in children with ATH, and examining whether age modifies these associations. Children aged 6–10 years were recruited and classified into ATH or no hypertrophy (NH) groups based on lateral cephalograms. For children with ATH, the relative size of the adenoids and tonsils was quantified using the A/T length ratio measured on lateral cephalograms. Based on the median A/T ratio, the ATH group was further divided into two equal-sized groups: a tonsil-dominant (TD) and an adenoid-dominant (AD) group. Craniofacial differences between groups were evaluated. In addition, associations between the A/T ratio and craniofacial morphology were assessed in the ATH cohort. We further examined whether age (6–8 vs. 8–10 years) acted as a moderator of these associations using interaction analyses. A total of 563 children (207 AD, 207 TD, and 149 NH) were included. TD group exhibited greater SNB (B = 0.65, p = 0.028) and Go-Me (B = 0.69, p = 0.038), along with smaller Ar-Go-Me (B = − 0.98, p = 0.029) and Wits (B = − 0.68, p = 0.026) than AD group. In addition, the A/T ratio was positively associated with SGn/FH (B = 0.74, p = 0.048). Moreover, interactions between age and the A/T ratio were observed for MP-SN (B = 2.45, p = 0.044) and Ar-Go-Me (B = 2.86, p = 0.045), and Go-Me (B = − 2.12, p = 0.013). The relative size of the adenoids and tonsils may be associated with craniofacial morphology in children with ATH, with lower A/T ratios tending to be associated with mandibular protrusion and overgrowth, whereas higher ratios appearing to be associated with clockwise mandibular rotation. Notably, age may modify these associations, suggesting the potential importance of timely airway evaluation and management in orthodontic practice.

This study aimed to determine if tonsillar hypertrophy (TH) influenced the postsurgical skeletal stability of Class III patients receiving two-jaw orthognathic surgery. Sixty patients with skeletal Class III malocclusion corrected by conventional two-jaw surgery were included in the study. Patients were divided into the TH group (n = 30) and normal tonsil (NT) group (n = 30) depending on tonsil size on the presurgical cone beam computed tomography. Serial lateral cephalograms were traced and analyzed at 3 stages: before surgery (T0), within 2 weeks of surgery (T1), and 1 year after surgery (T2). Linear and angular cephalometric parameters were used to evaluate the surgical change (T0-T1) and postsurgical relapse (T1-T2). The data were analyzed with the paired t-test, independent t-test, chi-square test, correlation analysis and regression analysis. From T0 to T1, the TH and NT groups showed a similar surgical pattern of the maxilla and mandible for repositioning. From T1 to T2, significant differences in skeletal relapse were observed in the mandible horizontally but not in the maxilla between the 2 groups. Compared to the NT group, the TH group exhibited significantly more forward movement at point B as well as a greater increase in SNB angle one year after surgery. Skeletal Class III patients with TH presented less skeletal stability of the mandible following two-jaw orthognathic surgery compared to those with NT. The factor of TH needs to be considered when orthognathic surgery is indicated in Class III patients.

Critical-sized bone defects possess inherently limited self-healing potential, posing a persistent challenge in clinical bone repair. In recent years, numerous hydrogel systems have been developed for bone defect repair and have made remarkable progress, but most lack programmable responsiveness to microenvironmental cues, hindering precise drug delivery and dynamic regulation during bone reconstruction. Here, we developed a near-infrared (NIR)-responsive smart hydrogel (GP/MPL) based on GelMA and PEGDA, incorporating polydopamine-coated Ti3C2 MXene nanosheets decorated with lactoferrin (LF), with an average interlayer spacing of 1.88 nm to enhance bioactivity. Upon 808 nm NIR irradiation, the hydrogel temperature rises to approximately 42 °C, enabling targeted LF release. In vitro, the multifunctional hydrogel exhibited inhibition rates of 88.6 ± 2.3

INTRODUCTION:As a common cause of upper airway obstruction in children, adenotonsillar hypertrophy (ATH) has been hypothesized to adversely affect dentofacial development and morphology. This systematic review aimed to summarize the existing evidence regarding the association between ATH and dentofacial characteristics of children. METHODS:Four databases (PubMed, Embase, Web of Science, and VIP Chinese Journal Database) were searched from inception to November 1, 2024, for cross-sectional studies that compared the dental or craniofacial characteristics of children with and without adenoid hypertrophy (AH) and/or tonsillar hypertrophy (TH). The Newcastle-Ottawa Scale for Cross-Sectional Studies was used to assess the methodologic quality of included studies. Meta-analyses were performed with the random-effects model. RESULTS:Thirty-six studies were included in this review. According to meta-analyses, the mandibular plane angle (SN-MP: mean difference [MD] = 2.20° [95% confidence interval {CI} 1.47-2.92]; P <0.00001), articular angle (ArGoMe: MD, 1.23° [95% CI, 0.68-1.79]; P <0.0001) were significantly greater in children with AH and/or TH. No significant differences were found between the ANB angle between the 2 groups (MD, 0.31° [95% CI, -0.35 to 0.61]; P = 0.59). However, the SNA (MD, -0.30° [95% CI, -0.53 to -0.06]; P = 0.01) and SNB angle (MD, -0.78° [95% CI, -1.33 to -0.24]; P = 0.005) were found to be significantly smaller in children with AH and/or TH. Regarding dental characteristics, the rate of Angle Class II and III malocclusions (relative risk = 1.29 [95% CI, 1.14-1.45]; P <0.0001) and open bite (relative risk = 1.65 [95% CI, 1.21-2.25]; P = 0.001) were found to be higher in the AH and/or TH children. In addition, the width between the maxillary first molars (MD, -1.34 mm [95% CI, -2.12 to -0.56]; P = 0.0008) was found to be smaller both in AH and TH children. CONCLUSIONS:On the basis of evidence of low to very low certainty, children with ATH tend to exhibit craniofacial characteristics such as sagittal maxillary and mandibular retrognathia and an increased mandibular plane angle. In addition, children with ATH children appear to have a higher prevalence of Class II and III malocclusions, open bite, and a narrower maxillary arch width compared with their non-ATH counterparts. However, these findings must be interpreted with caution because of the limited quality and consistency of the available evidence. The statistically significant differences identified in this review are relatively small when compared with population deviations, raising questions about their clinical significance. Further high-quality studies with standardized methodologies are needed to confirm these associations and clarify their clinical relevance.

Clear aligner treatment is a novel technique in current orthodontic practice. Distinct from traditional fixed orthodontic appliances, clear aligners have different material features and biomechanical characteristics and treatment efficiencies, presenting new clinical challenges. Therefore, a comprehensive and systematic description of the key clinical aspects of clear aligner treatment is essential to enhance treatment efficacy and facilitate the advancement and wide adoption of this new technique. This expert consensus discusses case selection and grading of treatment difficulty, principle of clear aligner therapy, clinical procedures and potential complications, which are crucial to the clinical success of clear aligner treatment.

The prevalence of Class III malocclusion varies among different countries and regions. The populations from Southeast Asian countries (Chinese and Malaysian) showed the highest prevalence rate of 15.8%, which can seriously affect oral function, facial appearance, and mental health. As anterior crossbite tends to worsen with growth, early orthodontic treatment can harness growth potential to normalize maxillofacial development or reduce skeletal malformation severity, thereby reducing the difficulty and shortening the treatment cycle of later-stage treatment. This is beneficial for the physical and mental growth of children. Therefore, early orthodontic treatment for Class III malocclusion is particularly important. Determining the optimal timing for early orthodontic treatment requires a comprehensive assessment of clinical manifestations, dental age, and skeletal age, and can lead to better results with less effort. Currently, standardized treatment guidelines for early orthodontic treatment of Class III malocclusion are lacking. This review provides a comprehensive summary of the etiology, clinical manifestations, classification, and early orthodontic techniques for Class III malocclusion, along with systematic discussions on selecting early treatment plans. The purpose of this expert consensus is to standardize clinical practices and improve the treatment outcomes of Class III malocclusion through early orthodontic treatment.

The study aims to compare methods for 3D volumetric assessment of unilateral alveolar clefts using CBCT, evaluating their accuracy and analysing clinical applicability, and to provide recommendations for improved precision in treatment planning and scientific research. Two methods were used to assess the volumes of 20 patients with unilateral alveolar clefts. One was based on anterior nasal spine (ANS) and greater palatine foramen (GPF); while the other was based on ANS and posterior nasal spine (PNS), regarding the palatal plane (PP) as the reference plane. Reliability for the different outcome variables was analyzed with intra-class correlation (ICC) and by calculating a paired Student’s t tests and Pearson’s correlation coefficient. The mean volume measured by the ANS PNS based method (957.70 ± 174.25 mm3) was higher than the one measured by the combined method based on ANS GPF (786.74 ± 146.10 mm3) with statistically significant difference (P < 0.001). The Pearson correlation coefficient between the groups showed good stability in the differences (r = 0.957, P < 0.001). The volumetric assessment of alveolar clefts varies with the reference plane used. The method based on palatal plane offers relatively easier identification of landmarks, closely reflecting actual alveolar bone volume. The refined method for alveolar cleft assessment could improve treatment planning for orthodontics and alveolar bone grafting in patients with UCLP, while also supporting research on alveolar cleft morphology and its developmental mechanisms.