## 4 Discussion  
The aim of this study was to present the issue of dental asymmetries in patients with cleft lip and palate. Due to the abundance of data available, we decided to focus on the maxillary front region. This is the challenging part of regaining the smile esthetics and sense of symmetry of an individual, making it a focal point for many dentists. The researchers' initial observation centers around the prevalence of left-sided clefts among individuals with cleft lip and palate. This occurrence can be attributed to embryoology, as the right side of the maxillary bone attaches to the premaxilla segment earlier, leading to a longer period required for closing the gap [27]. Consequently, if the closure process fails around the 8 th week in utero, it offers an opportunity for the right side of the maxilla to join later in development. Because of the complex etiology and the varied appearance of defects, patient care starts either during the pubertal period or shortly after birth. The treatment of cleft patients adopts a multidisciplinary approach aimed at regaining the function and symmetry of the individual [1]. Dental treatment initially starts with orthodontics, but it is crucial to plan the outcome in collaboration with a restorative or prosthetic dentist. Our research highlighted the considerable challenges associated with restoring perfect symmetry, especially since dental anomalies are most evident in the cleft region. Anatomical differences between the left and right sides of the dental arch might cause problems with the esthetic restoration and significantly influence the final result. Similar findings have been reported by other researchers as well [28; 29]. Furthermore, studies have shown that these asymmetries extend beyond the incisors and canines, affecting the entire dentoalveolar arch. Many patients require prosthetic rehabilitation following surgical and orthodontic treatments, with the most symmetric arches observed when dental implants are utilized [30]. Additionally, Canadian researchers [31] have revealed that the most significant arch contraction occurs in the canine region of the clefted side. The presence of nasal and lip asymmetry, as demonstrated by [PERSON] et al. [32], further contributes to the perspective of dental asymmetry. It should be noted that our data, along with previously mentioned studies, were not categorized based on patient age, as the dental anomalies discussed do not vary over time. Nasal asymmetry impacts facial perception and is observed in all patients with clefts in the lip area, thereby influencing the feasibility of prosthetic restoration for the upper arch. An intriguing alternative for restoring asymmetrically shaped teeth is the flow injection technique, also known as the injectable resin technique. This method helps minimize tooth preparation while addressing asymmetry [33]. The data obtained in our research will be helpful for general treatment planning and highlight the problems that may arise in achieving a perfect smile for patients with cleft deformities. Asymmetry of the incisors is a commonly observed phenomenon that holds significant self-esteem implications for many individuals, including those with cleft lip and palate [19]. In terms of further investigation, establishing an asymmetry index based on 3D images of individuals could be a valuable approach [34; 35]. However, for practical purposes, dental casts or 3D scans remain the most accessible methods for assessing teeth asymmetries [34]. Our research aligns with a previous study [36], which found that cleft individuals tend to have lower mesiodistal width of teeth. Furthermore, similar findings from other studies indicate that most of the asymmetries in teeth structure are concentrated in the region of the lateral incisors [28; 29]. Our paper also confirms this pattern, as the majority of dental anomalies were observed in that specific region, reflecting the highest degree of asymmetry.