Long-Term Stability of Alveolar Bone Graft in Cleft Lip and Palate Patients: Systematic Review and Meta-Analysis

Abstract

However, only the lower midfacial area can be advanced, and it is impossible to resolve the overall midface deficiency due to the position of the Le Fort I osteotomy line. 5,9 Thus, facial implant placement can be considered because the upper-midface deficiency cannot be resolved through Le Fort I osteotomy.Various types of prosthesis, including silicone (polydimethylsiloxane), GoreTex (expanded polytetrafluorethylene, WL Gore & Associates Inc, Flagstaff, AZ), and MedPor (high-density porous polyethylene, Porex Industries, Fairburn, GA), have been used to alleviate facial depression. Since these prostheses are supplied by sizes, premanufactured prostheses of an appropriate size should be selected during the surgery and need to be carved before placing them. Consequentially, the prostheses are not passively fitted on the bone surface, and the gap is formed, leading to a risk of prothesis migration to an unwanted area. Also, since prostheses are often placed based on the surgeon's tactile sense and experiences, there are possibilities of malpositioning or under-/overcorrection. 10

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 , ...…”

“…There was an increasing trend in their numbers with time. The maximum number of published articles were from the year 2021 (n = 29) [ 28 , 46 , 47 , 48 , 55 , 61 , 62 , 63 , 64 , 65 , 69 , 76 , 81 , 82 , 99 , 100 , 101 , 102 , 111 , 128 , 129 , 130 , 142 , 143 , 145 , 148 , 153 , 154 , 161 ]. It was observed that only three studies performed before 2010 could qualify during the two-stage scrutiny [ 72 , 112 , 113 ].…”

“…A search for gray literature was performed in 83 SRs [ 22 , 25 , 26 , 27 , 28 , 29 , 31 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 43 , 44 , 45 , 50 , 54 , 56 , 57 , 60 , 62 , 64 , 66 , 67 , 68 , 76 , 77 , 79 , 80 , 81 , 82 , 83 , 84 , 87 , 88 , 89 , 91 , 93 , 99 , 102 , 103 , 104 , 105 , 108 , 109 , 111 , 112 , 113 , 114 , 115 , 116 , 117 , 118 , 119 , 120 , 121 , ...…”

“…The number of databases searched ranged from 2 (n = 18) [ 22 , 23 , 27 , 34 , 35 , 37 , 38 , 40 , 45 , 48 , 61 , 92 , 102 , 109 , 130 , 138 , 142 , 143 ] to 10 (n = 3) [ 113 , 114 ] and the number of primary studies included in the SRs and MAs ranged from 1 [ 112 , 113 , 126 , 147 ] to 144 [ 58 ]. There was variability in the methods used for quality analysis/ROB with the Cochrane Collaboration tool being the most popular method used (n = 33) [ 21 , 36 , 41 , 43 , 73 , 75 , 81 , 86 , 88 , 89 , 90 , 94 , 95 , 97 , 108 , 110 , 111 , 112 , 113 , 114 , 115 , 120 , 122 , 123 , 124 , 126 , 130 , 132 , 147 , ...…”

“…The maximum number of SRs and MAs could be categorized in the therapeutic domain (n = 58) [ 73 , 74 , 75 , 76 , 77 , 78 , 79 , 80 , 81 , 82 , 83 , 84 , 85 , 86 , 87 , 88 , 89 , 90 , 91 , 92 , 93 , 94 , 95 , 96 , 97 , 98 , 99 , 100 , 101 , 102 , 103 , 104 , 105 , 106 , 107 , 108 , 109 , 110 , 111 , 112 , 113 , 114 , 115 , 116 , 117 , 118 , 119 , 120 , 121 , 122 , 123 , 124 , 125 , 126 , 127 , 128 , 129 , ...…”