Effectiveness of pre‐alveolar bone graft orthodontics for patients with non‐syndromic complete unilateral cleft lip, alveolus and palate: A systematic review and meta‐analysis

Abstract

The aim of this systematic review was to compare the effectiveness of pre‐alveolar bonegraft (ABG) orthodontics with no orthodontic treatment for patients with non‐syndromic unilateral cleft lip, alveolus and palate. All relevant studies from 1946 to October 30, 2022, were identified using several sources including The Cochrane Database of Systematic Reviews, Cochrane Central Register of Controlled Trials (CENTRAL), LILACS, Scopus, EMBASE, MEDLINE (Ovid) and EPUB ahead of publications and non‐indexed citations. Randomized Controlled Trials (RCT) and Controlled Clinical Trials (CCT) were included. Population: Non‐syndromic complete unilateral cleft lip, alveolus and palate patients who have had ABG surgery. Intervention: Orthodontics prior to ABG. Comparison: No orthodontic treatment prior to ABG. Primary outcome: Successful eruption of permanent canines. All articles were screened for the title, abstract and full text independently and in duplicate by 2 reviewers. The quality assessment of RCT was performed using Cochrane's risk of bias tool and the CCT was assessed using ROBINS‐I tool. Of the 904 studies retrieved in the search, one RCT and one CCT were included. Both studies were judged as high risk of bias. The results from one study showed a statistically significant increase in bone volume and decreased bone defect post‐ABG in the orthodontic treatment group. However, there was no difference with respect to other variables. Both included studies were of low quality. There is not enough evidence to recommend orthodontic treatment pre‐ABG for patients with complete unilateral cleft lip, alveolus and palate. Future high‐quality studies are required to inform patients and clinicians about the effectiveness of pre‐graft orthodontic treatment.