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Palikaraki G, Makrygiannakis MA, Zafeiriadis AA, Benetou V, Sanoudos M, Bitsanis I, Tsolakis AI. The effect of facemask in patients with unilateral cleft lip and palate: a systematic review and meta-analysis. Eur J Orthod 2021; 43:69-79. [PMID: 32274494 DOI: 10.1093/ejo/cjaa027] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
BACKGROUND Patients with cleft lip and palate usually present a Class III skeletal pattern. Facemask (FM) is one of the conventional orthodontic treatment modalities used to address the skeletal discrepancy in cleft patients. OBJECTIVE To investigate the potential effectiveness of FM in unilateral cleft lip and palate (UCLP) patients. SEARCH METHODS Search without restrictions except language in seven databases since inception and hand searching until January 2019 was conducted. Detailed search strategies were developed for each database which were based on the PubMed strategy and adapted accordingly. SELECTION CRITERIA Controlled studies assessing the effect of FM in UCLP patients were to be included. DATA COLLECTION AND ANALYSIS After retrieval and selection of the studies, data extraction was performed. Both angular and linear cephalometric measurements were collected. Weighted mean differences (WMDs) and 95% confidence intervals (CΙs) between treated and untreated UCLP patients concerning the pre- and post-treatment angular measurements of each group were calculated using a random-effects meta-analysis model. The risk of bias in individual studies was assessed using the ROBINS-I tool. RESULTS From nine eligible studies, five were included in the meta-analysis investigating the use of FM in patients and controls with UCLP (with and without maxillary expansion). Statistically significant differences were evident for SNA/S-N-ss, SNB/S-N-sm, ANB/ss-N-sm, and SN-MP. FM was found to induce an increase of SNA (WMD = 2.12 degrees, 95% CI: 1.58 to 2.66), ANB (WMD = 4.17 degrees, 95% CI: 3.60 to 4.74), and SN-MP angles (WMD = 2.60 degrees, 95% CI: 1.10 to 4.10) and a decrease of SNB angle (WMD = -1.94 degrees, 95% CI: -2.48 to -1.40) in UCLP patients. Low to moderate heterogeneity was observed. LIMITATIONS They emerge due to risk of bias, exclusion of non-English papers and methodological characteristics of the included papers. CONCLUSIONS According to the available data, FM seems to improve the sagittal skeletal relationships in UCLP patients, increasing the SNA and ANB angles and decreasing the SNB angle. Moreover, in the vertical dimension, FM increases the SN-MP angle. Regarding dental measurements, there are controversial results. More high-quality studies need to be conducted in order to further clarify the impact of FM on UCLP patients. REGISTRATION NUMBER PROSPERO: CRD42019131619.
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Affiliation(s)
| | - Miltiadis A Makrygiannakis
- Department of Orthodontics, School of Dentistry, National and Kapodistrian University of Athens, Athens, Greece
| | - Anastasios A Zafeiriadis
- Department of Orthodontics, Faculty of Dentistry, School of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Vassiliki Benetou
- Department of Hygiene, Epidemiology and Medical Statistics, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - Mattheos Sanoudos
- Department of Orthodontics, School of Dentistry, National and Kapodistrian University of Athens, Athens, Greece
| | - Ilias Bitsanis
- Department of Orthodontics, School of Dentistry, National and Kapodistrian University of Athens, Athens, Greece
| | - Apostolos I Tsolakis
- Department of Orthodontics, School of Dentistry, National and Kapodistrian University of Athens, Athens, Greece.,Department of Orthodontics, School of Dental Medicine Case Western Reserve University, Cleveland, OH, USA
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MIRANDA CM, SOUZA RMD, VENEZIAN GC, FRANZINI C, CUSTODIO W. Immediate and late follow-up effects of class III early correction in cleft lip and palate patients treated with maxillary protraction. REVISTA DE ODONTOLOGIA DA UNESP 2020. [DOI: 10.1590/1807-2577.04920] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Abstract Introduction There is no consensus about the immediate and latte follow-up effects of maxillary protraction in cleft lip and palate patients. Objective To evaluate the stability of Class III early treatment in cleft lip and palate patients through maxillary expansion and protraction. Material and method The sample consists in three lateral cephalometric radiographs of 28 patients (mean pre-treatment age of 6.7±1.8 years) who presented cleft lip and palate and were treated with maxillary expansion and Petit facial mask. The angular (SNA, SNB, ANB, SN.GoGn, FMA, Z Angle) and linear (overjet, Co-A, Co-Gn, Nperp-A, Nperp-Pg, AO-BO) cephalometric measures were evaluated through the Dolphin® software, in three moments: T0 (initial), T1 (after treatment), and T2 (follow-up). Data were submitted to the analysis of variance (ANOVA) and Tukey-Kramer test. The correlation between cephalometric measures and patient’s age was determined by Pearson’s chi-squared test. Result The SNA, ANB, and AO-BO measures increased considerably (p<0.05), and they did not present any differences compared to the initial ones after the follow-up time. The overjet measure increased (p<0.05) after treatment and, even with its decrease at the follow-up time, it was still higher than at the beginning (p<0.05). The Z angle showed improvement with treatment and remained stable at the follow-up time. Conclusion After treatment (maxillary expansion associated with protraction), there was a skeletal pattern improvement. During the follow-up period, those alterations decreased to a measure close to the beginning. There was an improvement in the dental pattern and facial profile that continued in the follow-up period.
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Takahashi M, Yamaguchi T, Lee MK, Suzuki Y, Adel M, Tomita D, Nakawaki T, Yoshida H, Hikita Y, Furuhata M, Tsuneoka M, Nagahama R, Marazita ML, Weinberg SM, Maki K. Three-dimensional assessment of the pharyngeal airway in Japanese preschoolers with orofacial clefts. Laryngoscope 2019; 130:533-540. [PMID: 30977521 DOI: 10.1002/lary.27957] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2018] [Revised: 02/15/2019] [Accepted: 03/13/2019] [Indexed: 12/11/2022]
Abstract
OBJECTIVES/HYPOTHESIS Individuals with orofacial clefts often experience respiratory problems because of nasopharyngeal abnormalities. Pharyngeal airway morphology is thought to differ among the various cleft types. We measured three-dimensional (3D) airway volume using cone-beam computed tomography (CBCT) analysis to evaluate and compare pharyngeal airways in Japanese preschoolers with and without orofacial clefts. STUDY DESIGN Retrospective case-control study. METHODS We enrolled 83 subjects (37 boys, 46 girls; mean age = 4.66 ± 0.56 years) with nonsyndromic orofacial clefts and 16 noncleft healthy subjects (seven boys, nine girls; mean age = 5.30 ± 0.52 years) as controls. The subjects were divided into five groups. Four groups were based on the cleft type: isolated cleft palate, unilateral cleft lip and alveolus), unilateral cleft lip and palate, and bilateral cleft lip and palate. The fifth group included the noncleft controls. All subjects were examined with CBCT, and the 3D airway volume was measured. We analyzed group differences statistically using analysis of covariance with the Bonferroni post hoc pairwise comparison tests for the corrected means. RESULTS Compared with the noncleft group, each cleft group exhibited significantly decreased total and nasal airway volumes and increased superior and inferior pharyngeal airway volumes. The differences were all statistically significant. CONCLUSIONS Our findings suggest that anatomical differences exist in pharyngeal airway volumes among various cleft groups and in those without a cleft. LEVEL OF EVIDENCE 3b Laryngoscope, 130:533-540, 2020.
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Affiliation(s)
- Masahiro Takahashi
- Department of Orthodontics, School of Dentistry, Showa University, Tokyo, Japan
| | - Tetsutaro Yamaguchi
- Department of Orthodontics, School of Dentistry, Showa University, Tokyo, Japan
| | - Myoung K Lee
- Department of Oral Biology, Center for Craniofacial and Dental Genetics, Pittsburgh, Pennsylvania, U.S.A
| | - Yoko Suzuki
- Department of Orthodontics, School of Dentistry, Showa University, Tokyo, Japan
| | - Mohamed Adel
- Department of Orthodontics, Suez Canal University, Ismailia, Egypt
| | - Daisuke Tomita
- Department of Orthodontics, School of Dentistry, Showa University, Tokyo, Japan
| | - Takatoshi Nakawaki
- Department of Orthodontics, School of Dentistry, Showa University, Tokyo, Japan
| | - Hiroshi Yoshida
- Department of Orthodontics, School of Dentistry, Showa University, Tokyo, Japan
| | - Yu Hikita
- Department of Orthodontics, School of Dentistry, Showa University, Tokyo, Japan
| | - Mayu Furuhata
- Department of Orthodontics, School of Dentistry, Showa University, Tokyo, Japan
| | - Misato Tsuneoka
- Department of Orthodontics, School of Dentistry, Showa University, Tokyo, Japan
| | - Ryo Nagahama
- Department of Orthodontics, School of Dentistry, Showa University, Tokyo, Japan
| | - Mary L Marazita
- Department of Oral Biology, Center for Craniofacial and Dental Genetics, Pittsburgh, Pennsylvania, U.S.A.,Department of Human Genetics, Graduate School of Public Health, Clinical and Translational Science Institute, Pittsburgh, Pennsylvania, U.S.A.,Department of Human Genetics, Clinical and Translational Science Institute, Pittsburgh, Pennsylvania, U.S.A.,Department of Psychiatry, School of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, U.S.A
| | - Seth M Weinberg
- Department of Oral Biology, Center for Craniofacial and Dental Genetics, Pittsburgh, Pennsylvania, U.S.A.,Department of Human Genetics, Graduate School of Public Health, Clinical and Translational Science Institute, Pittsburgh, Pennsylvania, U.S.A.,Department of Anthropology, University of Pittsburgh, Pittsburgh, Pennsylvania, U.S.A
| | - Koutaro Maki
- Department of Orthodontics, School of Dentistry, Showa University, Tokyo, Japan
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