Facial appearance significantly influences several life outcomes, and a convex profile often prompts patients to seek treatment to enhance their facial esthetics. This study aimed to assess the facial appearance outcomes of combined orthodontic and orthognathic intervention compared to orthodontic camouflage treatment in convex facial profile individuals. The study sample comprised 36 consecutively selected Class II Division 1, convex facial profile patients. Two groups of 18 non-growing patients with similar characteristics were compared. Group A was treated with orthodontics and orthognathic surgery, whereas Group B with orthodontics exclusively. Pre- and post-treatment profile and frontal facial photographs were presented simultaneously to orthodontists, oral and maxillofacial surgeons, convex profile patients, and laypeople, asking them to assess changes in facial appearance. Considerable positive changes in facial appearance were perceived for Group A, compared to no changes for Group B, with a 17/100 VAS units difference. The rater groups demonstrated a high degree of consistency (ICC > 0.88). Multivariate analysis revealed significant differences in perceived changes between the two treatment groups (F = 14.63, P < 0.001, Pillai's Trace = 0.36, partial η2 = 0.36), with no significant effects from the rater group (P > 0.05). Similar results were evident when only profile photos were rated (P > 0.05). The combined orthodontic and surgical intervention is an efficient approach for the enhancement of facial appearance in convex profile cases. On the contrary, orthodontic treatment alone has no such impact. These findings should be properly communicated during patient consultation and considered for treatment planning.

Incidental findings (IFs) depicted in imaging tests during diagnostic evaluation of patients with cleft lip and/or palate (CL/P) can guide clinicians during treatment-planning procedures for effective, comprehensive cleft care. Evidence regarding IFs in different anatomical regions distant from the dentition are scarce. The aim of this study was to compare the prevalence of IFs in various anatomical areas between patients with non-syndromic CL/P and unaffected subjects. Orthopantomographs (OPT), lateral cephalometric (LC) radiographs and cone-beam computed tomography (CBCT) scans of 120 subjects (case group: n = 40, 18 females, age 14.5 ± 5.0 years; control group: n = 80, 36 females, age 14.6 ± 4.9 years) were examined and IFs were assessed by four observers. Significantly higher prevalence of IFs (p &lt; 0.001) was reported in the case group (97.5%) compared with the control group (62.5%). The most prevalent location of IFs in the case group was the maxilla (92.5%), followed by the nasal cavity (75.8%) and the mandible (63.2%), while in the control group, the highest rates of IFs occurred in the maxilla (43.8%), mandible (41.3%) and temporomandibular joint (TMJ) (14.7%). No gender-dependent pattern for IF occurrence was detected overall. Orofacial clefts may affect the mandible. However, the reported IFs were limited compared to those in the maxilla. In conclusion, individuals with CL/P are more likely to present with a range of IFs than their unaffected peers. Understanding the association between CL/P and IFs is critical for successful interdisciplinary treatment, raising awareness of the potential need for future dental care for cleft patients, and managing extra-dental aberrations. A systematic assessment of diagnostic records is required to eliminate the risk of overlooking clinically significant IFs.