Dental Anomalies in Patients with Cleft Lip and/or Palate in the Brazilian Population: A Systematic Review

Purpose The 2 most commonly used operations to treat velopharyngeal inadequacy (VPI) are superiorly based pharyngeal flap and sphincter pharyngoplasty, both of which may result in hyponasal speech and airway obstruction. The purpose of this article is to (a) describe the bilateral buccal flap revision palatoplasty (BBFRP) as an alternative technique to manage VPI while minimizing these risks and (b) conduct a systematic review of the evidence of BBFRP on speech and other clinical outcomes. A report comparing the speech of a child with hypernasality before and after BBFRP is presented. Method A review of databases was conducted for studies of buccal flaps to treat VPI. Using the principles of a systematic review, the articles were read, and data were abstracted for study characteristics that were developed a priori. With respect to the case report, speech and instrumental data from a child with repaired cleft lip and palate and hypernasal speech were collected and analyzed before and after surgery. Results Eight articles were included in the analysis. The results were positive, and the evidence is in favor of BBFRP in improving velopharyngeal function, while minimizing the risk of hyponasal speech and obstructive sleep apnea. Before surgery, the child's speech was characterized by moderate hypernasality, and after surgery, it was judged to be within normal limits. Conclusion Based on clinical experience and results from the systematic review, there is sufficient evidence that the buccal flap is effective in improving resonance and minimizing obstructive sleep apnea. We recommend BBFRP as another approach in selected patients to manage VPI. Supplemental Material https://doi.org/10.23641/asha.9919352

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Three-Dimensional Printing in Cleft Care: A Systematic Review

The Cleft Palate-Craniofacial Journal ◽

10.1177/10556656211013175 ◽

2021 ◽

pp. 105566562110131

Author(s):

Farrukh R. Virani ◽

Evan C. Chua ◽

Mary Roz Timbang ◽

Tsung-yen Hsieh ◽

Craig W. Senders

Keyword(s):

Systematic Review ◽

3D Printing ◽

Clinical Outcomes ◽

Outcome Measures ◽

Cleft Lip ◽

Cleft Lip And Palate ◽

Secondary Outcome ◽

Exclusion Criteria ◽

3 Dimensional ◽

Dimensional Printing

Objective: To determine the current applications of 3-dimensional (3D) printing in the care of patients with cleft lip and palate. We also reviewed 3D printing limitations, financial analysis, and future implications. Design: Retrospective systematic review. Methods: Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines were used by 3 independent reviewers. Articles were identified from Cochrane library, Ovid Medline, and Embase. Search terms included 3D printing, 3 dimensional printing, additive manufacturing, rapid prototyping, cleft lip, and cleft palate. Exclusion criteria included articles not in English, animal studies, reviews without original data, oral presentations, abstracts, opinion pieces, and articles without relevance to 3D printing or cleft lip and palate. Main Outcome Measures: Primary outcome measure was the purpose of 3D printing in the care of patients with cleft lip and palate. Secondary outcome measures were cost analysis and clinical outcomes. Results: Eight-four articles were identified, and 39 met inclusion/exclusion criteria. Eleven studies used 3D printing models for nasoalveolar molding. Patient-specific implants were developed via 3D printing in 6 articles. Surgical planning was conducted via 3D printing in 8 studies. Eight articles utilized 3D printing for anatomic models/educational purposes. 3-Dimensional printed models were used for surgical simulation/training in 6 articles. Bioprinting was utilized in 4 studies. Secondary outcome of cost was addressed in 8 articles. Conclusion: 3-Dimensional printing for the care of patients with cleft lip and palate has several applications. Potential advantages of utilizing this technology are demonstrated; however, literature is largely descriptive in nature with few clinical outcome measures. Future direction should be aimed at standardized reporting to include clinical outcomes, cost, material, printing method, and results.

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Parental response to the feeding behavior problems in children with cleft lip and palate: A systematic review

Special Care in Dentistry ◽

10.1111/scd.12604 ◽

2021 ◽

Author(s):

Sukeshana Srivastav ◽

Isha Duggal ◽

Ritu Duggal ◽

Nitesh Tewari ◽

Prabhat Kumar Chaudhari ◽

...

Keyword(s):

Systematic Review ◽

Behavior Problems ◽

Feeding Behavior ◽

Cleft Lip ◽

Cleft Lip And Palate ◽

Parental Response

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Perioperative Management of Cleft Lip Repair: A Meta-Analysis and Clinical Practice Guideline

The Cleft Palate-Craniofacial Journal ◽

10.1177/1055665620984909 ◽

2021 ◽

pp. 105566562098490

Author(s):

Matthew Ranzer ◽

Edward Daniele ◽

Chad A. Purnell

Keyword(s):

Systematic Review ◽

Cleft Lip ◽

Wound Closure ◽

Perioperative Management ◽

Outpatient Surgery ◽

Meta Analysis ◽

Bottle Feeding ◽

Perioperative Antibiotics ◽

Cleft Lip Repair ◽

Postoperative Feeding

Objective: Few studies have focused on perioperative management of cleft lip repair. We sought to evaluate the available data on this topic to create evidence-based clinical guidelines. Design: Systematic review, meta-analysis. Methods: A PubMed search was performed focusing on perioperative management of cleft lip repair. Studies were included if they included comparative data. A systematic review and meta-analysis was performed according to preferred reporting items for systematic reviews and meta-analyses (PRISMA) guidelines. Main Outcome Measures: Systematic review of literature regarding wound closure, postoperative arm restraints, perioperative antibiotics, outpatient or ambulatory surgery, or feeding restrictions postoperatively. Results: Twenty-three articles met inclusion criteria after initial screening of 3103 articles. This included 8 articles on wound closure, 2 on postoperative restraints, one on perioperative antibiotics, 6 on outpatient surgery, and 6 on postoperative feeding. Meta-analysis could be performed on dehiscence rates with postoperative feeding regimen and readmission rates after outpatient versus inpatient lip repair. There were few studies with low risk of bias. Outpatient cleft lip repair does not increase readmission (odds ratio [OR]: 0.92, 95% CI: 0.28-3.07). Allowing postoperative breastfeeding or bottle-feeding does not increase dehiscence (OR: 0.61, 95% CI: 0.19-1.95). There was no evidence of publication bias. Conclusion: Within the limitations of available data, there is no evidence of a clearly superior closure material. The evidence does not support use of postoperative arm restraints. The evidence does not support the use of preoperative nasal swabs for antibiotic guidance. With careful patient selection, outpatient cleft lip repair appears safe. The evidence supports immediate breastfeeding or bottle-feeding after cleft lip repair.

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Association between IRF6 and 8q24 polymorphisms and nonsyndromic cleft lip with or without cleft palate: Systematic review and meta‐analysis

Birth Defects Research Part A Clinical and Molecular Teratology ◽

10.1002/bdra.23540 ◽

2016 ◽

Vol 106 (9) ◽

pp. 773-788 ◽

Cited By ~ 18

Author(s):

Kachin Wattanawong ◽

Sasivimol Rattanasiri ◽

Mark McEvoy ◽

John Attia ◽

Ammarin Thakkinstian

Keyword(s):

Systematic Review ◽

Cleft Palate ◽

Cleft Lip ◽

Meta Analysis

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Secondary Dentition Characteristics in Children With Nonsyndromic Unilateral Cleft Lip and Palate

The Cleft Palate-Craniofacial Journal ◽

10.1177/1055665617750489 ◽

2018 ◽

Vol 55 (4) ◽

pp. 582-589 ◽

Cited By ~ 3

Author(s):

Elaine Li Yen Tan ◽

Meaw Charm Kuek ◽

Hung Chew Wong ◽

Serene Ai Kiang Ong ◽

Mimi Yow

Keyword(s):

Cleft Lip ◽

Cleft Lip And Palate ◽

Permanent Teeth ◽

Tooth Size ◽

Dental Anomalies ◽

Supernumerary Teeth ◽

High Prevalence ◽

Dental Records ◽

Congenitally Missing ◽

Maxillary Region

Objective: Children with cleft lip and palate are reported to be commonly associated with higher prevalence of dental anomalies such as hypodontia, supernumeraries, and abnormalities in tooth size, shape, and position. This study investigated the prevalence of dental anomalies in a longitudinal cohort of children with unilateral cleft lip and palate (UCLP). Design: The study was a retrospective analysis of radiographs, study models, and treatment notes. Patients: Sixty patients with repaired UCLP aged 13 years old with complete dental records dating from 5 years of age were included. Methods: Study casts, dental panoramic, anterior maxillary occlusal, and periapical radiographs of the patients were examined for cleft-sidedness, congenitally missing permanent teeth, supernumerary teeth, microdontic, and macrodontic teeth in the anterior maxillary region, presence of malformed permanent cleft-sided lateral incisor and its morphology (peg-shaped, conical shaped, canine-formed), positions of the permanent lateral incisors relative to the cleft side and presence of rotated cleft-sided central incisors. Results: Of the 60 patients studied, 63.3% had hypodontia, 21.7% had supernumerary teeth, 69.6% had microdontia, and 12.5% had macrodontia. All of the cleft-sided permanent lateral incisors had associated anomalies, with a large proportion (43.1%) missing; and when present in 31 subjects, the majority (90.3%) was positioned distal to the cleft. Most of the cleft-sided permanent central incisors were rotated if present, and prevalent at 86.7%. Conclusion: A high prevalence of dental anomalies was observed in this sample of children with UCLP.

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Reading Development in Children With Nonsyndromic Cleft Palate With or Without Cleft Lip: Meta-analysis and Systematic Review

The Cleft Palate-Craniofacial Journal ◽

10.1177/10556656211039871 ◽

2021 ◽

pp. 105566562110398

Author(s):

Hope Sparks Lancaster ◽

Kari M. Lien ◽

Jordan Haas ◽

Paige Ellis ◽

Nancy J. Scherer

Keyword(s):

Systematic Review ◽

Cleft Palate ◽

Phonological Awareness ◽

Cleft Lip ◽

Meta Analysis ◽

Reading Development ◽

Effect Sizes ◽

School Age Children ◽

School Age ◽

Word Decoding

Objective We conducted a meta-analysis and systematic review of literature comparing pre-reading and general reading in school-age children with nonsyndromic cleft palate with or without cleft lip (NSCP/L) to their peers without NSCP/L. Methods Our literature search identified 1238 possible records. After screening we identified 11 samples for inclusion for systematic review and eight for meta-analysis. We compared 292 children with NSCP/L to 311 peers for 23 pre-reading effect sizes and 17 general reading effect sizes (EFg). We conducted a random-effects metaregression using robust variance estimation. Results On average school-age children with NSCP/L scored lower on pre-reading (EFg = −0.36) and general reading measures (EFg = −0.38) compared to their peers. We conducted post-hoc analyses on phonological awareness and word decoding effect sizes; children with NSCP/L performed lower on phonological awareness (EFg = −0.22) and word decoding (EFg = −0.39) compared to their peers. There was weak evidence that hearing status and/or speech-language functioning might moderate reading development. There was limited evidence that age or socioeconomic status moderated reading development. However, samples did not consistently report several characteristics that were coded for this project. Conclusions Our findings suggest that school-age children with NSCP/L have persistent reading problems. Further research is needed to explore reading development in children with NSCP/L, as well as the relationships among hearing, speech, language, and reading development.

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CBCT in orthodontics: a systematic review on justification of CBCT in a paediatric population prior to orthodontic treatment

European Journal of Orthodontics ◽

10.1093/ejo/cjy066 ◽

2018 ◽

Vol 41 (4) ◽

pp. 381-389 ◽

Cited By ~ 11

Author(s):

Annelore De Grauwe ◽

Irem Ayaz ◽

Sohaib Shujaat ◽

Simon Dimitrov ◽

Logan Gbadegbegnon ◽

...

Keyword(s):

Computed Tomography ◽

Systematic Review ◽

Orthodontic Treatment ◽

Cleft Lip ◽

Treatment Options ◽

Correct Diagnosis ◽

Conventional Radiography ◽

Paediatric Population ◽

Treatment Optimization ◽

Diagnostic Efficacy

Summary Background Taking into account radiation doses, safety, and protection, we highlighted the features in which cone-beam computed tomography (CBCT) can offer an advantage compared to the conventional two-dimensional imaging in paediatric dentistry before orthodontic treatment. Objective The aim of this article was to conduct a systematic review to assess the diagnostic efficacy of CBCT in the paediatric population at a pre-orthodontic phase. Search methods MEDLINE via PubMed was searched to identify all peer-reviewed articles potentially relevant to the review until 1 July 2018. Relevant publications were selected by two reviewers independently. Selection criteria The literature selection for this systematic review was carried out according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement and was based on predetermined inclusion criteria. Data collection and analysis Data were collected on overall study characteristics and examination characteristics of the selected studies. Methodological quality of the selected studies was evaluated. Original studies were assessed using the Quality Assessment of Diagnostic Accuracy Studies (QUADAS) tool. Thereafter, levels of evidence were obtained according to Grading of Recommendations Assessment, Development and Evaluation criteria. Results As a result of the QUADAS assessment, a total of 37 articles were included in the protocol. Following a proper protocol, CBCT was regarded as a reliable tool for assessment and management of impacted canine and root fracture. It provided a better evaluation of normal and pathological condylar shape and volume. CBCT was a superior choice for pre-surgical diagnostic applications in cleft lip and/or palate over a medical computed tomography based on its lower radiation exposure, shorter investigation time, and low purchase costs. Conclusions CBCT is justified only in those cases where conventional radiography fails to provide a correct diagnosis of pathology. Therefore, it cannot be regarded as a standard method of diagnosis. CBCT imaging may also be justified when it positively affects treatment options or provides treatment optimization. Registration None. Conflict of interest None to declare.

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