الفهرس | Only 14 pages are availabe for public view |
Abstract This systematic review aimed to give a comprehensive overview of the two orthognathic surgical approaches CO and DO that were used to treat the maxillary hypoplasia in CLP individuals, with the aim to assist the surgeons to make a better decision. The review was done by searching Pubmed, Science Direct, Scopus and other gray literatures This was done by reviewing articles discussing both interventions in CLP patients and their effect on stability and relapse, soft tissue changes, VP state, speech, morbidities and blood supply. Inclusion criteria: 1. All articles that are randomized clinical trials, prospective, retrospective and case series of participants number 4 or more. 2. Cleft type unilateral, bilateral and isolated cleft lip and/or palate. 3. The average age of participants is 16 years or more. 4. Both genders. 5. CLP patients who need maxillary advancement of 4 mm or more. 6. CLP patients with/without pharyngeal flaps. 7. Le fort I surgery with conventionnel and/or distraction with all types. Exclusion criteria: 1. Articles with Non-English language. 2. Previous orthognathic surgeries. 3. Cleft syndromic patients. 4. Double jaw surgery. 5. Systematic reviews and meta-analysis. 6. Animal research. 7. Case reports, letters or commentaries were excluded, as well as studies that did not meet the inclusion criteria. Results: Relapse rate: CO ranges from 8.5% to 43%, while DO ranges from 0% to 39%. Soft tissue changes: both CO and DO showed increase in NL angle. VP gap: VP gap increase in CO, however in DO showed increase, decrease and no change of VP gap. Speech: deterioration in CO ranges from 18% to 43% and in DO 0.6% to 47% of the total participants. Morbidities: both CO and DO showed morbidities. Conclusion: Based on the limitation of the study, the results showed that there was no difference between CO and DO in terms of relapse rate, soft tissue changes, speech and morbidities. However, DO showed better results in VP gap than CO. |