Affiliation:
1. Department of Orthodontics & Dentofacial Orthopedics, Armed Forces Medical College, Pune, India
2. Department of Oral & Maxillofacial Surgery, Armed Forces Medical College, Pune, India
Abstract
Abstract
Objectives
To compare the long-term skeletal stability following maxillary advancement using Rigid External Distraction (RED) in growing and non-growing patients with Cleft Lip and Palate (CLP).
Methods
Data sources: A systematic literature search was performed according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines from database inception till August 2020 in MEDLINE-PubMed, Cochrane Central Register of Controlled Trials (CENTRAL), Science Direct, Google Scholar and a manual search in the institutional library. Study eligibility criteria, participants and intervention: All available literature published in English, with a minimum of six human subjects with well-defined age range either 7–14.9 years or 15–30 years, follow up period of a minimum of 12 months assessing the skeletal stability as horizontal change at Point A (Subspinale) following maxillary advancement using a RED device, without the use of rigid internal fixation or bone grafts were included in the study. Study appraisal and synthesis method: The quality assessment of selected articles was done using the Newcastle-Ottawa scale. The meta-analysis was carried out with Q statistic method, I-squared statistics, fixed-effect model to estimate pooled mean and Begg-Mazumdar bias indicator.
Results
Selected nine articles that were qualitatively assessed for relapse rate following maxillary advancement using a RED device, showed consistent and stable results. The meta-analysis found no significant difference in long-term skeletal stability of maxillary advancement by RED device in growing and non-growing patients with CLP [(growing group: Pooled proportion = 0.2927; 95% CI = 0.1534 to 0.4319) (non-growing group: Pooled proportion = 0.23077; 95% CI = 0.09854 to 0.36300)].
Limitations
No study, as revealed by the search, was available that compared the two groups as defined by the inclusion criteria. Data for the two groups were retrieved from different studies and meta-analysed.
Conclusion
RED is an effective modality for correction of maxillary hypoplasia secondary to CLP, requiring large maxillary advancement. The technique can be used in young and adult patients with similar long-term results.
PROSPERO registration number
CRD42020205513
Publisher
Oxford University Press (OUP)
Reference49 articles.
1. External distraction of the maxilla in patients with craniofacial dysplasia;Krimmel;The Journal of Craniofacial Surgery,,2001
2. Early craniofacial morphology and growth in children with bilateral complete cleft lip and palate;Hermann;The Cleft Palate-Craniofacial Journal,,2004
3. Risk factors for poor dental arch relationships in young children born with unilateral cleft lip and palate;Williams;Plastic and Reconstructive Surgery,,2003
4. Craniofacial morphological outcome following treatment with three different surgical protocols for complete unilateral cleft lip and palate: a premilinary study;Kulewicz;International Journal of Oral and Maxillofacial Surgery,,2010
5. Influence of pharyngeal flap surgery on maxillary outgrowth in cleft patients;Voshol;International Journal of Oral and Maxillofacial Surgery,,2013
Cited by
2 articles.
订阅此论文施引文献
订阅此论文施引文献,注册后可以免费订阅5篇论文的施引文献,订阅后可以查看论文全部施引文献