Abstract
Background: Among the alternatives for early treatment of cleft lip and palate (LPC), preoperative orthopedics has been proposed for the alignment of alveolar ridges. Currently, there are two treatment philosophies regarding whether or not using preoperative orthopedics because there is still much controversy on its actual effects. Purpose: To determine the reported usefulness of preoperative orthopedics in molding alveolar ridges in 0-to-12-monthold children with unilateral complete LPC. Methods: A systematic review of the literature was carried out using the Medline, Elsevier, Cochrane, and EBSCO databases. Search descriptors were pre-surgical orthopedics, alveolar ridge, alveolar molding, and unilateral complete cleft lip and palate. After reading of titles, abstracts, and full articles, the quality and validity of studies were determined through the Consort, Strobe, and Quorum checklists. Data were classified by the level of evidence and grades of recommendation based on the Scottish Intercollegiate Guidelines Network guidelines. Results: From a total of 4738 titles we identified 88 articles that met the inclusion criteria. After analyzing the files, we only found three articles that provided adequate evidence on the topic of study. Conclusion: There is not enough scientific evidence to support the usefulness of preoperative orthopedics in shaping alveolar ridges. There are other influencing factors that should also be studied.KEYWORDSpreoperative orthopedics; alveolar ridge; alveolar molding; unilateral complete cleft lip andpalate
Highlights
Among the alternatives for early treatment of cleft lip and palate (LPC), preoperative orthopedics has been proposed for the alignment of alveolar ridges
Por ello resultó de interés llevar a cabo una revisión sistemática, con el fin de recolectar y analizar la información disponible y relevante que determine la utilidad de la ortopedia prequirúrgica, en el moldeamiento de las crestas alveolares en pacientes con fisura labiopalatina unilateral completa, en niños entre los 0 y 12 meses de edad
En relación con la ortopedia prequirúrgica con placas activas, Adali y colaboradores, en su estudio “Presurgical orthopedics has no effect on archform in unilateral cleft lip and palate” [19], hallaron que la diferencia en el promedio de reducción en el ancho de la fisura alveolar entre grupos fue de 0,69 mm (p = 0,52; IC = 95 %)
Summary
Entre las variaciones de las relacionados con esta alternativa terapia, como son: FLP existen fisuras que afectan el labio o el paladar acercar los segmentos maxilares y disminuir con ello primario o secundario y que pueden ser completas, la tensión de las partes blandas para la reparación incompletas, unilaterales o bilaterales [1,7,8]. Los protocolos de atención para los pacientes con en los procesos frontonasal y maxilares, los cuales, FLP son variados y en la actualidad existen dos filoen condiciones normales, se fusionan para generar sofías de tratamiento en cuanto al uso o no de oruna lámina epitelial media que se divide en tejido metopedia prequirúrgica: uno quirúrgico, precedido por senquimático [1,7,8]. Otra parte, se sugiere que existen diferencias de sexo, con una relación de 2:1 entre hombres y mujeres
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