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Cleft Palate and Presurgical Orthopedics: A Systematic Review and Meta-Analysis of Intra-Arch Dimensions During the
Ana Rabal-Soláns1, Carmen Mediero-Pérez1, Rosa M Yáñez-Vico2
1School of Dentistry, Complutense University of Madrid, 28040 Madrid, Spain.
Insights
Presurgical orthopedics (PSO) did not significantly alter maxillary arch dimensions in infants with cleft lip and palate. This systematic review found no statistically significant differences in cleft widths with or without PSO treatment.
Area of Science:
- Craniofacial Surgery
- Pediatric Dentistry
- Orthodontics
Background:
- Infants with cleft lip and palate (CLP) often undergo presurgical orthopedics (PSO).
- The impact of PSO on maxillary arch dimensions in the first year of life requires thorough investigation.
- Understanding these effects is crucial for optimizing CLP treatment protocols.
Purpose of the Study:
- To systematically review and meta-analyze the effects of PSO on maxillary arch dimensions in infants with CLP.
- To evaluate changes in alveolar and posterior cleft widths during the first year of life.
- To determine the statistical significance of PSO interventions on craniofacial development in CLP infants.
Main Methods:
- Systematic review and meta-analysis adhering to PRISMA guidelines.
- Comprehensive literature search across major biomedical databases (MEDLINE, Embase, Cochrane, Scopus, Google Scholar).
- Independent data extraction, quality assessment, and risk of bias evaluation by two reviewers.
Main Results:
- Five studies were included in the meta-analysis.
- No statistically significant differences were observed in alveolar cleft widths (MD, -3.06; 95% CI, -8.03 to 2.70; p=0.30).
- Comparable posterior cleft widths were found with and without PSO (MD, -0.88; 95% CI, -2.06 to 0.30; p=0.14).
Conclusions:
- Presurgical orthopedics (PSO) showed no statistically significant impact on maxillary arch dimensions in infants with cleft lip and palate within the first year of life.
- While some clinical differences favored PSO, they did not reach statistical significance.
- Further high-quality randomized controlled trials are necessary to definitively ascertain the efficacy of PSO in this population.
Abstract:
Background: This systematic review and meta-analysis aimed to investigate the effects of presurgical orthopedics (PSO) on maxillary arch dimensions in infants with cleft lip and palate during the first year of life. Methods: The review was conducted following PRISMA guidelines. A comprehensive electronic search was performed in MEDLINE, Embase, Cochrane, Scopus, and Google Scholar databases, supplemented by manual searching. Two reviewers independently conducted study selection, data extraction, quality assessment, and risk of bias evaluation. Results: Five studies were included in the meta-analysis. Quantitative analysis was performed based on the primary outcomes. The estimate was calculated using a random-effects model and z distribution (95% confidence interval (CI)). The results showed similar alveolar cleft widths (mean difference, -3.06; 95% CI, -8.03 to 2.70, p = 0.30, I2 = 99%) with clinical differences in favor of PSO, and comparable posterior cleft widths (mean difference, -0.88; 95% CI, -2.06 to 0.30, p = 0.14, I2 = 89%) with and without PSO in CLP babies. Conclusions: This meta-analysis found no statistically significant effects of presurgical orthopedic treatment on maxillary arch dimensions in infants with cleft lip and palate during the first year of life. Further high-quality randomized controlled trials are needed to definitively establish the efficacy of PSO.
