Skeletal Maturation in Patients With Cleft Lip and/or Palate: A Systematic Review

Abstract

Objective: The objective of this systematic review was to evaluate the evidence regarding skeletal maturation in patients with cleft lip and/or palate (CL/P) and to investigate whether the skeletal maturation is delayed in these patients. Design: Systematic review. Methods: Electronic and manual searches of scientific literature were conducted in 4 databases (MEDLINE, Embase, Cochrane Library, and Web of Science). Cohort studies that compared the skeletal maturation of patients with CL/P with that of children without CL/P were eligible for inclusion. The quality of included cohort studies was assessed using the Newcastle-Ottawa Scale. Patients and Participants: Patients of any sex and ethnicity with CL/P and children without CL/P were included in this systematic review. Main Outcome Measures: Difference in skeletal maturation between patients with CL/P and patients without CL/P. Results: Thirteen retrospective cohort studies were included in this systematic review. Ten studies were considered of high quality and 3 were considered of general quality. The results of the included studies comparing skeletal maturation of patients with CL/P and children without CL/P were heterogeneous. Conclusion: Heterogeneity of skeletal maturation assessment methods, chronological age, sex, cleft type, and race may influence the final results of clinical studies on skeletal maturation in patients with CL/P. Overall, there is limited evidence to determine whether the skeletal maturation level of patients with CL/P is delayed compared to that of normal children. Further studies are needed to determine the skeletal maturation patterns in patients with CL/P.

Evidence Mapping and Quality Analysis of Systematic Reviews on Various Aspects Related to Cleft Lip and Palate

“…These steps resulted in the inclusion of 18 more SRs. Altogether, 144 SRs and MAs [ 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 , 54 , 55 , 56 , 57 , 58 , 59 , 60 , 61 , 62 , 63 , 64 , 65 , 66 , 67 , 68 , 69 , 70 , 71 , 72 , 73 , 74 , 75 , 76 , 77 , 78 , 79 , 80 , ...…”

Assessment of Skeletal Maturation in Nonsyndromic Cleft and Non-cleft Children—A Comparative Study

“…The possible reason for such differentiation in skeletal maturation status would be variation in sample size, population type, cleft type, cleft severity, genetic behavior, and nutrition status. 37 It is essential to improve the feeding and rehabilitation of infants and young children. Future studies with cross-racial comparisons should be assessed with caution.…”

“…Thus, literature varies concerning cleft children’s growth and development status compared with non-cleft children. The possible reason for such differentiation in skeletal maturation status would be variation in sample size, population type, cleft type, cleft severity, genetic behavior, and nutrition status 37 . It is essential to improve the feeding and rehabilitation of infants and young children.…”

Customized Tray for Impression Taking in Children With Cleft Lip and Palate

“…The assessment of oral clefts rehabilitation outcomes requires a patient documentation protocol, including records obtained at standardized ages, to compare different types of surgeries, the effects of pre-surgical orthopedics (when available), as well as comparison of different rehabilitation centers. This documentation is an extremely important step for rehabilitation, allowing clinical evaluation of treatments, 1,2 for educational purposes, 3 research, comparison of treatment centers, 4 and legal records. 5,6…”

“…The assessment of oral clefts rehabilitation outcomes requires a patient documentation protocol, including records obtained at standardized ages, to compare different types of surgeries, the effects of pre-surgical orthopedics (when available), as well as comparison of different rehabilitation centers. This documentation is an extremely important step for rehabilitation, allowing clinical evaluation of treatments, 1,2 for educational purposes, 3 research, comparison of treatment centers, 4 and legal records. 5,6 In the rehabilitation protocol of the Hospital of Rehabilitation of Craniofacial Anomalies/USP (HRAC/USP), impression of dental arches is obtained at about before lip repair-3 months, before palate repair-12 months and 1 year after primary surgeries.…”