Key Laboratory of Shaanxi Province for Craniofacial Precision Medicine Research, College of Stomatology, Xi'an Jiaotong University, Xi'an, Shaanxi, PR China.
Department of Orthodontics, College of Stomatology, Xi'an Jiaotong University, Xi'an, Shaanxi, PR China.
BMC Oral Health. 2024 Nov 19;24(1):1409. doi: 10.1186/s12903-024-05208-3.
Cleft lip and palate (CLP) is one of the most common birth defects worldwide. It typically results in significant maxillary dysplasia, causing severe oral function problems and substantially affecting the patient's facial aesthetics. Maxillary anterior segmental distraction osteogenesis (MASDO) has gained popularity in recent years as an effective treatment for correcting maxillary dysplasia. However, the evaluation of its effectiveness in patients with CLP varies across different studies. Our research was aimed at providing evidence of the effects of MASDO among CLP patients.
A meta-analysis covered Medline, Web of Science, Embase, Scopus, and Cochrane Library. Controlled clinical trial studies published before February 2024 and analyzed changes in maxillary cephalometric landmarks before and after MASDO among patients with maxillary hypoplasia and CLP were included.
Our meta-analysis included 10 papers in total. One study was at low risk of bias, seven were at medium risk, and two were at serious risk. MASDO significantly increased the maxillary length. The mean SNA angle increased by 6.43° (95% CI, 4.11° to 8.74°) and A-McNamara rose by 7.29 mm (95% CI, 6.21 mm to 8.37 mm). The maxilla also showed a slight counterclockwise rotation; however, this reached no statistical significance. The mandibular position did not vary remarkably. Moreover, a significant increase in upper anterior tooth tipping and overjet, a decrease in overbite, and an improvement in nasolabial soft tissue were observed.
MASDO might be a valid therapy option for CLP patients. It causes a significant increase in the maxillary length, anterior tooth crossbite, and nasolabial soft tissue were also greatly improved.
唇腭裂（CLP）是全球最常见的出生缺陷之一。它通常导致上颌骨明显发育不良，导致严重的口腔功能问题，并极大地影响患者的面部美观。近年来，上颌前段骨节段性牵引成骨术（MASDO）作为一种治疗上颌骨发育不良的有效方法越来越受到关注。然而，不同研究对其在 CLP 患者中的有效性评价存在差异。我们的研究旨在为 MASDO 在 CLP 患者中的效果提供证据。
系统检索 Medline、Web of Science、Embase、Scopus 和 Cochrane Library，纳入 2024 年 2 月前发表的评估 MASDO 治疗上颌骨发育不良的 CLP 患者的对照临床试验研究，分析 MASDO 治疗前后上颌骨侧位颅面测量标志点的变化。
共纳入 10 篇文献，1 篇研究为低偏倚风险，7 篇为中偏倚风险，2 篇为高偏倚风险。MASDO 可显著增加上颌长度，SNA 角平均增加 6.43°（95%CI：4.11°8.74°），A-McNamara 增加 7.29mm（95%CI：6.21mm8.37mm），上颌轻度逆时针旋转但无统计学意义，下颌位置无明显变化，上前牙倾斜度、覆合增加，覆盖减小，鼻唇软组织得到改善。
MASDO 可能是 CLP 患者的一种有效治疗选择，可显著增加上颌长度，显著改善前牙反合和鼻唇软组织。
