Orthodontic Graduate Program, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Canada.
Angle Orthod. 2012 Nov;82(6):1115-22. doi: 10.2319/011212-27.1. Epub 2012 Apr 12.
To systematically review the long-term skeletal stability after maxillary advancement with distraction osteogenesis (DO) in cleft lip and palate (CLP) patients.
Electronic databases, grey literature, and reference list searches were conducted. The inclusion criteria were stability of maxillary advancement with distraction osteogenesis assessed at the posttreatment follow-up ≥ 1 year in CLP patients. Full articles were retrieved from abstracts or titles that appear to meet the inclusion criteria or lacked sufficient detail for immediate exclusion. Once full articles were collected, they were again reviewed considering more detailed inclusion criteria for a final selection decision. A methodologic quality assessment tool was utilized.
Thirty abstracts/titles met the initial search criteria, and 13 articles were finally selected. Overall, methodologic quality scores were high in only one randomized clinical trial. After maxillary advancement with DO in CLP patients, the long-term horizontal relapse in A-point was less than 15% in eight studies and between 20% and 25% in four studies. The study that was judged as a high-quality study reported 8.2% horizontal relapse in A-point. The relapse rate was higher in DO with external distracter device than DO with internal distracter device.
Current evidence suggests maxillary advancement with DO has good stability in CLP patients with moderate and severe maxillary hypoplasia.
系统评价唇腭裂患者上颌骨牵引成骨术后的长期骨骼稳定性。
电子数据库、灰色文献和参考文献搜索。纳入标准为唇腭裂患者上颌骨牵引成骨术后，在治疗后随访≥1 年时评估上颌骨前徙的稳定性。从似乎符合纳入标准的摘要或标题中检索全文，或因缺乏即时排除的详细信息而检索全文。一旦收集到全文，将再次进行审查，以考虑更详细的纳入标准做出最终选择决定。使用了一种方法学质量评估工具。
最初的搜索有 30 个摘要/标题符合标准，最终选择了 13 篇文章。总的来说，只有一项随机临床试验的方法学质量评分较高。在唇腭裂患者中进行上颌骨牵引成骨术后，8 项研究中 A 点的长期水平复发小于 15%，4 项研究中为 20%至 25%。被判断为高质量研究的研究报告 A 点的水平复发率为 8.2%。使用外部牵引器的牵引成骨术比使用内部牵引器的牵引成骨术的复发率更高。
现有证据表明，对于中重度上颌骨发育不全的唇腭裂患者，上颌骨牵引成骨术具有良好的稳定性。
