Department of Orthodontics & Dentofacial Orthopedics, Armed Forces Medical College, Pune, India.
Department of Oral & Maxillofacial Surgery, Armed Forces Medical College, Pune, India.
Eur J Orthod. 2022 Jan 25;44(1):22-29. doi: 10.1093/ejo/cjab017.
To compare the long-term skeletal stability following maxillary advancement using Rigid External Distraction (RED) in growing and non-growing patients with Cleft Lip and Palate (CLP).
Data sources: A systematic literature search was performed according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines from database inception till August 2020 in MEDLINE-PubMed, Cochrane Central Register of Controlled Trials (CENTRAL), Science Direct, Google Scholar and a manual search in the institutional library. Study eligibility criteria, participants and intervention: All available literature published in English, with a minimum of six human subjects with well-defined age range either 7-14.9 years or 15-30 years, follow up period of a minimum of 12 months assessing the skeletal stability as horizontal change at Point A (Subspinale) following maxillary advancement using a RED device, without the use of rigid internal fixation or bone grafts were included in the study. Study appraisal and synthesis method: The quality assessment of selected articles was done using the Newcastle-Ottawa scale. The meta-analysis was carried out with Q statistic method, I-squared statistics, fixed-effect model to estimate pooled mean and Begg-Mazumdar bias indicator.
Selected nine articles that were qualitatively assessed for relapse rate following maxillary advancement using a RED device, showed consistent and stable results. The meta-analysis found no significant difference in long-term skeletal stability of maxillary advancement by RED device in growing and non-growing patients with CLP [(growing group: Pooled proportion = 0.2927; 95% CI = 0.1534 to 0.4319) (non-growing group: Pooled proportion = 0.23077; 95% CI = 0.09854 to 0.36300)].
No study, as revealed by the search, was available that compared the two groups as defined by the inclusion criteria. Data for the two groups were retrieved from different studies and meta-analysed.
RED is an effective modality for correction of maxillary hypoplasia secondary to CLP, requiring large maxillary advancement. The technique can be used in young and adult patients with similar long-term results.
CRD42020205513.
比较使用刚性外牵引（RED）治疗唇腭裂（CLP）患者生长中和非生长中上颌骨前突的长期骨骼稳定性。
数据来源：根据系统评价和荟萃分析的首选报告项目，从数据库开始到 2020 年 8 月，在 MEDLINE-PubMed、Cochrane 中央对照试验注册中心（CENTRAL）、Science Direct、Google Scholar 进行了系统文献检索，并在机构图书馆进行了手动检索。研究合格标准、参与者和干预措施：所有可用的文献均以英语发表，参与者至少有 6 人，年龄范围明确为 7-14.9 岁或 15-30 岁，随访时间至少为 12 个月，评估上颌骨前突后骨骼稳定性，使用 RED 装置，不使用刚性内固定或骨移植。研究评估和综合方法：使用纽卡斯尔-渥太华量表对选定文章的质量进行评估。使用 Q 统计量法、I-平方统计量、固定效应模型对 Meta 分析进行了评估，以估计汇总平均值和 Begg-Mazumdar 偏倚指标。
选择了 9 篇定性评估使用 RED 装置治疗上颌骨前突后复发率的文章，结果一致且稳定。Meta 分析发现，在生长中和非生长的 CLP 患者中，使用 RED 装置进行上颌骨前突的长期骨骼稳定性无显著差异[（生长组：汇总比例=0.2927；95%置信区间=0.1534 至 0.4319）（非生长组：汇总比例=0.23077；95%置信区间=0.09854 至 0.36300）]。
没有研究如搜索结果所示，可将两组按纳入标准进行比较。两组的数据来自不同的研究并进行了荟萃分析。
RED 是治疗 CLP 继发上颌骨发育不全的有效方法，需要进行较大的上颌骨前突。该技术可用于年轻和成年患者，长期效果相似。
PROSPERO 注册号：CRD42020205513。
