Effectiveness of presurgical orthodontics in cleft lip and palate patients with alveolar bone grafting: A systematic review

Abstract

ObjectiveAlveolar repair has become a routine part of treatment protocols for patients with non-syndromic cleft lip and/or palate, but there is no clear conclusion of whether the presurgical orthodontic treatment is necessary to alveolar bone grafting or not. The purpose was to determine the necessity of the presurgical orthodontics in cleft lip and palate patients. Materials and methodsElectronic databases including PubMed, Ovid, Embase, Cochrane Library, Web of Knowledge, and China Biology Medicine disc (SinoMed) were searched. Only studies published in English or Chinese were included. The last search was updated on 1 May 2020. 1225 articles remaining after the exclusion of duplicates. Finally, there were 11 publications (five in English and six in Chinese) eligible for systematic review according to the previously established inclusion and exclusion criteria. A descriptive statistical method was used to present data. The methodological index for non-randomized studies (MINORS) was used to determine the risk of bias. ResultEleven articles were included in this review, of which seven publications were retrospective study and four articles were comparative study. The average success rate of reconstruction with the presurgical orthodontic treatment was approximately 70–97%, while the success rate of the non-presurgical orthodontics was 25–80%. The fixed and removable presurgical orthodontic methods were frequently performed, rather than a single treatment model. The incidence of the postoperative complications resulting from whether adopting the presurgical orthodontics was different from none to 75%. ConclusionThere are a higher postoperative bone formation rate and a lower complication rate after ABG with presurgical orthodontics. However, more studies with high methodological quality and with a longer follow-up are needed to offer more safety for practitioners and patients regarding the surgical method selected to repair the cleft alveolar.