Efficacy of the maxillary anterior segmental distraction osteogenesis in patients with cleft lip and palate.

IF 2.6 2区医学 Q1 DENTISTRY, ORAL SURGERY & MEDICINE BMC Oral Health Pub Date : 2024-11-19 DOI:10.1186/s12903-024-05208-3

Panjun Pu, Shanying Bao, Jianbo Gao, Yuhua Jiao, Feiyu Wang, Huaxiang Zhao, Yuxia Hou, Yalin Zhan

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Abstract

Background: Cleft lip and palate (CLP) is one of the most common birth defects worldwide. It typically results in significant maxillary dysplasia, causing severe oral function problems and substantially affecting the patient's facial aesthetics. Maxillary anterior segmental distraction osteogenesis (MASDO) has gained popularity in recent years as an effective treatment for correcting maxillary dysplasia. However, the evaluation of its effectiveness in patients with CLP varies across different studies. Our research was aimed at providing evidence of the effects of MASDO among CLP patients.

Methods: A meta-analysis covered Medline, Web of Science, Embase, Scopus, and Cochrane Library. Controlled clinical trial studies published before February 2024 and analyzed changes in maxillary cephalometric landmarks before and after MASDO among patients with maxillary hypoplasia and CLP were included.

Results: Our meta-analysis included 10 papers in total. One study was at low risk of bias, seven were at medium risk, and two were at serious risk. MASDO significantly increased the maxillary length. The mean SNA angle increased by 6.43° (95% CI, 4.11° to 8.74°) and A-McNamara rose by 7.29 mm (95% CI, 6.21 mm to 8.37 mm). The maxilla also showed a slight counterclockwise rotation; however, this reached no statistical significance. The mandibular position did not vary remarkably. Moreover, a significant increase in upper anterior tooth tipping and overjet, a decrease in overbite, and an improvement in nasolabial soft tissue were observed.

Conclusions: MASDO might be a valid therapy option for CLP patients. It causes a significant increase in the maxillary length, anterior tooth crossbite, and nasolabial soft tissue were also greatly improved.

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唇腭裂患者上颌前段牵引成骨术的疗效。

背景：唇腭裂（CLP）是全球最常见的出生缺陷之一。唇腭裂通常会导致严重的上颌骨发育不良，造成严重的口腔功能问题，并严重影响患者的面部美观。上颌骨前段牵张成骨术（MASDO）作为一种矫正上颌骨发育不良的有效治疗方法，近年来受到越来越多人的青睐。然而，不同的研究对其在CLP患者中的有效性评估各不相同。我们的研究旨在为MASDO在CLP患者中的效果提供证据：荟萃分析涵盖 Medline、Web of Science、Embase、Scopus 和 Cochrane 图书馆。纳入的对照临床试验研究发表于 2024 年 2 月之前，分析了上颌骨发育不良和 CLP 患者在 MASDO 前后上颌骨头测量标志物的变化：我们的荟萃分析共纳入了10篇论文。一项研究存在低偏倚风险，七项研究存在中度偏倚风险，两项研究存在严重偏倚风险。MASDO明显增加了上颌长度。平均SNA角增加了6.43°（95% CI，4.11°至8.74°），A-McNamara增加了7.29毫米（95% CI，6.21毫米至8.37毫米）。上颌骨也有轻微的逆时针旋转，但没有统计学意义。下颌位置没有明显变化。此外，还观察到上前牙倾斜和过咬合明显增加，过咬合减少，鼻唇软组织有所改善：结论：MASDO 可能是治疗 CLP 患者的有效方法。结论：MASDO 可能是治疗 CLP 患者的有效方法，它能使上颌长度明显增加，前牙交叉咬合和鼻唇软组织也得到极大改善。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

BMC Oral Health DENTISTRY, ORAL SURGERY & MEDICINE-

CiteScore

3.90

自引率

6.90%

发文量

481

审稿时长

6-12 weeks

期刊介绍： BMC Oral Health is an open access, peer-reviewed journal that considers articles on all aspects of the prevention, diagnosis and management of disorders of the mouth, teeth and gums, as well as related molecular genetics, pathophysiology, and epidemiology.