Effectiveness of pre-surgical infant orthopedic treatment for cleft lip and palate patients: a systematic review and meta-analysis

2012 ◽  
Vol 15 (4) ◽  
pp. 207-236 ◽  
Author(s):  
M. A. Papadopoulos ◽  
E. N. Koumpridou ◽  
M. L. Vakalis ◽  
S. N. Papageorgiou
Keyword(s):  
Systematic Review ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Meta Analysis ◽  
Orthopedic Treatment

scholarly journals Efficaciousness of dexmedetomidine in children undergoing cleft lip and palate repair: a systematic review and meta-analysis

BMJ Open ◽  
2021 ◽  
Vol 11 (8) ◽  
pp. e046798
Author(s):  
Dengfeng Liu ◽  
Li Pan ◽  
Yin Gao ◽  
Jiefan Liu ◽  
Feng Li ◽  
...  
Keyword(s):  
Systematic Review ◽  
Adverse Events ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Meta Analysis ◽  
Cochrane Review ◽  
Random Effect Model ◽  
Control Group ◽  
Paediatric Patients ◽  
The Impact

ObjectiveTo systematically assess the efficacy and safety of dexmedetomidine as an anaesthesia adjuvant for cleft lip and palate (CLP) repair in children.DesignSystematic review and meta-analysis.Data sourcesPubMed, Embase, Cochrane, China National Knowledge Infrastructure (CNKI), China Science and Technology Journal Database (VIP) and Wanfang (up to October 2020). Studies in languages other than English and Chinese were excluded.Eligibility criteria for selecting studiesRandomised controlled trials (RCTs) evaluating the impact of dexmedetomidine on emergence agitation (EA), the need for postoperative rescue analgesics, postoperative nausea and vomiting (PONV), and other adverse events in paediatric patients during CLP repair.Data extraction and synthesisThe quality of evidence was assessed by using the Cochrane Review Methods and the Grading of Recommendations Assessment, Development and Evaluation approach. Data were screened, extracted and assessed by two independent authors. Outcomes were reported as a risk ratio (RR) with a 95% CI. A random-effect model was used when heterogeneity was detected.ResultsThirteen studies including 1040 children met the inclusion criteria. The incidence of EA was significantly decreased in the dexmedetomidine group (RR, 0.19; 95% CI 0.10 to 0.36; p<0.00001; I2=56%) as compared with the control group. Paediatric patients receiving dexmedetomidine had lower postoperative analgesic requirements (RR, 0.27; 95% CI 0.10 to 0.73; p=0.01; I2=84%) and a lower incidence of respiratory adverse events (RR, 0.49; 95% CI 0.31 to 0.78; p=0.003; I2=0%). There were no significant differences in the risk of PONV and cardiovascular adverse events.ConclusionsThere was a lack of high-quality studies in this field. Perioperative administration of dexmedetomidine reduced the need for postoperative rescue analgesics and the incidence of EA in children without side effects undergoing CLP repair. However, further verification with larger samples and higher-quality RCTs is needed.

Cranial Base Angle in Patients With Cleft Lip and Palate—A Systematic Review and Meta-Analysis

2021 ◽  
pp. 105566562110535
Author(s):  
Chandnee Murugan ◽  
Vignesh Kailasam
Keyword(s):  
Systematic Review ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Meta Analysis ◽  
Cranial Base ◽  
Class I ◽  
Base Angle ◽  
Registration Number ◽  
Newcastle Ottawa Scale ◽  
Ottawa Scale

Background: Diverse findings have been reported for the cranial base angle (CBA) in patients with CLP (cleft lip and palate) and non-CLP controls. Objective: The aim of this study is to assess and evaluate the CBA in patients with CLP and non-CLP controls. Methods: Data from PubMed, OVID Technologies, Inc., Cochrane, Literatura Latino-Americana e do Caribe em Ciências da Saúde (LILACS), Scopus, Web of Science, and EMBASE for Excerpta Medica dataBASE (EMBASE) with relevant terms was extracted until December 31, 2020. Inclusion criteria were data of patients with non-syndromic unilateral cleft lip and palate (UCLP) and bilateral cleft lip and palate (BCLP). In the case of UCLP and BCLP, patients with craniofacial syndromes were excluded. The study proposal was registered with PROSPERO (Registration number: CRD42021228632). Results: Fifteen studies with a total of 2032 participants were included for the systematic review and 14 studies with a total of 1972 participants were included for the meta-analysis. The risk of bias was assessed using the Modified Newcastle Ottawa scale under seven domains by two authors. Thirteen studies were graded as “good” and two as “satisfactory.” The CBA in patients with CLP were greater than the non CLP Class I controls in six of the 15 studies. CBA was greater in patients with CLP than non-CLP controls by 1.21° (95% CI of 0.19-2.22). Meta-analysis reported considerable heterogeneity (I2 = 86%). Anterior (ACB) and posterior cranial base (PCB) lengths were shorter in patients with CLP than in the non-cleft Class I controls by 2.14 mm (95% CI of 0.99-3.30) and 2.06 mm (95% CI of 1.52-2.60), respectively. Conclusion: Most studies were graded as good. Patients with CLP had greater CBA and shorter ACB and PCB lengths when compared to non-CLP controls.

Efficacy of rhBMP-2 in Cleft Lip and Palate Defects: Systematic Review and Meta-analysis

2018 ◽  
Vol 104 (2) ◽  
pp. 115-129 ◽  
Author(s):  
Wellington Luiz de Oliveira da Rosa ◽  
Tiago Machado da Silva ◽  
Arthur Dias Galarça ◽  
Evandro Piva ◽  
Adriana Fernandes da Silva
Keyword(s):  
Systematic Review ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Meta Analysis

scholarly journals Use of autologous platelet derivatives for secondary alveoloplasty in patients with cleft lip and palate: a protocol for a systematic review and meta-analysis

2021 ◽  
Author(s):  
Andres Campolo ◽  
Claudia Heider ◽  
Ismael Canete ◽  
Francisca Verdugo ◽  
Rocio Bravo ◽  
...  
Keyword(s):  
Systematic Review ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Platelet Rich Plasma ◽  
Meta Analysis ◽  
Controlled Trials ◽  
Cochrane Central Register ◽  
Platelet Rich Fibrin ◽  
Alveolar Bone Grafting ◽  
Autologous Platelet

Objective: To assess the effectiveness and safety of autologous platelet derivatives, specifically platelet-rich plasma (PRP) or platelet-rich fibrin (PRF), for secondary alveoloplasty in patients with cleft lip and palate. Eligibility criteria: We will include randomized trials evaluating the effect of autologous platelet derivatives on newly bone formed after secondary alveoloplasty in cleft lip and palate patients. Two reviewers will independently screen each study for eligibility, data extraction, and bias assessment using the Cochrane "risk of bias" tool. We will pool the results using meta-analysis and apply the GRADE system to assess the certainty of the evidence for each outcome. Data sources: A comprehensive search will include all relevant randomized controlled trials (RCTs), the ongoing investigation reported in specialty congresses and trials regardless of language or publication status (published, unpublished, in press, and progress). We will conduct searches in the following databases: Cochrane Central Register of Controlled Trials (CENTRAL), PUBMED, Embase, and LILACS. We will screen trial registries and other sources in order to identify articles that might have been missed in the electronic searches. Ethics and dissemination: As researchers will not access information that could identify an individual participant, obtaining ethical approval was waived. Keywords: Platelet-rich fibrin; Platelet-rich plasma; Secondary alveoloplasty; Cleft lip; cleft palate; Alveolar Bone Grafting; Systematic review, protocol, meta-analysis

Long-Term Effects of Nasoalveolar Molding in Patients With Unilateral Cleft Lip and Palate: A Systematic Review and Meta-Analysis

2021 ◽  
pp. 105566562110097
Author(s):  
William M. Padovano ◽  
Gary B. Skolnick ◽  
Sybill D. Naidoo ◽  
Alison K. Snyder-Warwick ◽  
Kamlesh B. Patel
Keyword(s):  
Systematic Review ◽  
Risk Ratio ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Meta Analysis ◽  
Insufficient Evidence ◽  
Nasoalveolar Molding ◽  
Cephalometric Measurements ◽  
The Impact

Objective: The aim of this systematic review and meta-analysis was to investigate long-term treatment effects of nasoalveolar molding (NAM) in patients with unilateral cleft lip and palate (UCLP). Design: Included manuscripts met the following criteria: (1) involved patients with UCLP who received NAM; (2) included comparison group(s) who either received non-NAM passive presurgical infant orthopedic appliances (PSIO) or who did not receive any PSIO; (3) reported at least one objective or validated measure of nasolabial, craniofacial, or palatal form; and (4) had patient follow-up beyond 4 years of age. Results: A total of 12 studies were included in this review. Meta-analyses were possible for Asher-McDade parameters and cephalometric measurements. Compared to patients who did not receive any PSIO, those who underwent NAM therapy were more likely to have good to excellent frontal nasal form (Risk ratio: 2.4, 95% CI: 1.24-3.68) and vermillion border (Risk ratio: 1.8, 95% CI: 1.19-2.71). However, there were no statistically significant differences in cephalometric measurements between these groups. Additionally, there were no statistically significant differences between patients receiving NAM versus non-NAM PSIO. There was insufficient evidence to determine the impact of NAM on dental arch development. Conclusions: The preponderance of evidence in this review suggests that NAM produces benefits in nasolabial aesthetic form when compared with no appliance-based presurgical treatment. However, there is insufficient evidence to conclude whether NAM produces such benefits when compared with other passive PSIOs.

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