Cleft Lip and Plate and other syndromes part 1
Long-Term Skeletal Stability after Maxillary Advancement with Distraction Osteogenesis in Cleft Lip and Palate Patients: A Systematic Review.
Humam Saltajia; Michael P. Majorb; Mostafa Altalibib; Mohamed Youssefc; Carlos Flores-Mird
ABSTRACT
Objective: To systematically review the long-term skeletal stability after maxillary advancement with distraction osteogenesis (DO) in cleft lip and palate (CLP) patients.
Materials and Methods: Electronic databases, grey literature, and reference list searches were conducted. The inclusion criteria were stability of maxillary advancement with distraction osteogenesis assessed at the post treatment follow-up $ 1 year in CLP patients. Full articles were retrieved from abstracts or titles that appear to meet the inclusion criteria or lacked sufficient detail for immediate exclusion. Once full articles were collected, they were again reviewed considering more detailed inclusion criteria for a final selection decision. A methodologic quality assessment tool was utilized.
Results: Thirty abstracts/titles met the initial search criteria, and 13 articles were finally selected. Overall, methodologic quality scores were high in only one randomized clinical trial. After maxillary advancement with DO in CLP patients, the long-term horizontal relapse in A-point was less than 15% in eight studies and between 20% and 25% in four studies. The study that was judged as a high-quality study reported 8.2% horizontal relapse in A-point. The relapse rate was higher in DO with external distracter device than DO with internal distracter device.
Conclusions: Current evidence suggests maxillary advancement with DO has good stability in CLPpatients with moderate and severe maxillary hypoplasia. (Angle Orthod. 2012;82:1115-1122.) KEY WORDS: Stability; Distraction osteogenesis; Cleft lip and palate; Systematic review