Tannure Patricia Nivoloni, Oliveira Cristiana Aroeira G R, Maia Lucianne Cople, Vieira Alexandre R, Granjeiro José Mauro, Costa Marcelo de Castro
Department of Pediatric Dentistry and Orthodontics, School of Dentistry, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil.
Cleft Palate Craniofac J. 2012 Mar;49(2):194-200. doi: 10.1597/10-043. Epub 2011 Jul 8.
To assess whether individuals born with nonsyndromic oral clefts display a higher frequency of dental anomalies.
A search of MEDLINE, BIREME, OVID ALL EMB Reviews, and The Cochrane Library was conducted. The methodologic quality of the papers selected was assessed and scored. Papers reporting observational controlled studies of nonsyndromic forms of oral cleft matched for dental anomalies in primary and/or permanent teeth were included without language restrictions. Eligible studies were scored as "A"-low risk of bias, "B"-moderate risk of bias, or "C"-high risk of bias and poor quality. Fixed and random effects models were used to aggregate individual odds ratios (OR) and to derive pooled estimates and 95% confidence intervals.
Six studies fulfilled our selection criteria and were included in the meta-analysis. Three distinct subgroup analyses were carried out in terms of dental anomalies. In the tooth agenesis meta-analysis, a random effects model was used because of heterogeneity and showed a significant association between tooth agenesis and oral clefts (OR = 12.31; 95% confidence interval [CI] = 3.75 to 40.36). In the remaining analyses, the fixed effects model revealed a positive association between supernumerary (OR = 4.99; 95% CI, 2.58 to 9.64) and crown morphologic abnormalities (OR = 5.69; 95% CI, 3.96 to 8.19) with oral clefts. Most included studies were of low to moderate quality.
Although general limitations in study design were observed, the evidence suggests that a higher number of dental anomalies in the permanent dentition are noted in individuals born with oral clefts.
评估非综合征性口腔颌面部裂隙患者是否有更高的牙齿异常发生率。
检索了MEDLINE、BIREME、OVID所有循证医学综述及考克兰图书馆。对所选论文的方法学质量进行评估并打分。纳入报告了对非综合征性口腔颌面部裂隙患者与乳牙和/或恒牙牙齿异常进行匹配的观察性对照研究的论文，无语言限制。符合条件的研究被评为“A”（低偏倚风险）、“B”（中度偏倚风险）或“C”（高偏倚风险且质量差）。采用固定效应模型和随机效应模型汇总个体比值比（OR），并得出合并估计值和95%置信区间。
六项研究符合我们的纳入标准，被纳入荟萃分析。根据牙齿异常情况进行了三项不同的亚组分析。在牙齿缺失的荟萃分析中，由于存在异质性，采用随机效应模型，结果显示牙齿缺失与口腔颌面部裂隙之间存在显著关联（OR = 12.31；95%置信区间[CI] = 3.75至40.36）。在其余分析中，固定效应模型显示多生牙（OR = 4.99；95% CI，2.58至9.64）和牙冠形态异常（OR = 5.69；95% CI，3.96至8.19）与口腔颌面部裂隙呈正相关。大多数纳入研究的质量为低到中等。
尽管观察到研究设计存在一般局限性，但证据表明，患有口腔颌面部裂隙的个体恒牙列中牙齿异常的数量更多。
