Treatment outcomes of digital nasoalveolar moulding in infants with cleft lip and palate: A systematic review with meta-analysis

IF 2.4 3区医学 Q2 DENTISTRY, ORAL SURGERY & MEDICINE

Orthodontics & Craniofacial Research Pub Date : 2024-05-21 DOI:10.1111/ocr.12809

Prabhat Kumar Chaudhari, Abirami Rajasekaran, Partha Haldar, Edlira Zere, Kunaal Dhingra, Raj Kumar Manas, Xianrui Yang

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引用次数: 0

Abstract

The aim of this systematic review was to compare the treatment outcomes of digital nasoalveolar moulding (dNAM) technique with conventional nasoalveolar moulding (cNAM) or non-presurgical intervention protocol in infants with unilateral (UCLP) or bilateral (BCLP) cleft lip and palate. A bibliometric search by MEDLINE (via Ovid), Embase, Cochrane Library, grey literature and manual method was conducted without language restriction until November 2023. Literature screening and data extraction were undertaken in Covidence. The risk of bias was evaluated using the Newcastle-Ottawa Scale and RoB-2. Pooled effect sizes were determined through random-effects statistical model using R-Software, and the certainty of evidence was assessed using the GRADE approach. Among 775 retrieved articles, nine studies were included for qualitative synthesis (6-UCLP, 3-BCLP), with only three eligible UCLP studies for meta-analysis. In the UCLP group, very low certainty of evidence indicated no difference in alveolar cleft width (SMD, 0.13 mm; 95% CI, −0.31 to 0.57; I², 0%), soft tissue (lip) cleft gap, nasal width, nasal height, and columellar deviation angle changes between dNAM and cNAM. In the BCLP group, qualitative synthesis suggested similar changes in alveolar, lip, and nasal dimensions with dNAM and cNAM. In both cleft groups (UCLP, BCLP), reduced alveolar cleft width was observed in the dNAM group compared to the non-presurgical intervention protocol, along with fewer clinical visits and reduced chairside time for dNAM compared to cNAM. It can be concluded that the treatment outcomes with dNAM were comparable to cNAM in reducing malformation severity and were advantageous in terms of chairside time and clinical visit frequency. However, the overall quality of evidence is very low and standardization is needed for the virtual workflow regarding the alveolar movements and growth factor algorithms. Registration: PROSPERO-database (CRD42020186452).

查看原文本刊更多论文

数字鼻齿槽成型术对唇腭裂婴儿的治疗效果：系统回顾与荟萃分析。

本系统性综述旨在比较数字鼻齿槽成型（dNAM）技术与传统鼻齿槽成型（cNAM）或非手术干预方案对单侧（UCLP）或双侧（BCLP）唇腭裂婴儿的治疗效果。在 2023 年 11 月之前，我们通过 MEDLINE（通过 Ovid）、Embase、Cochrane 图书馆、灰色文献和人工方法进行了文献计量学检索，没有语言限制。文献筛选和数据提取在 Covidence 中进行。采用纽卡斯尔-渥太华量表和 RoB-2 评估偏倚风险。使用 R 软件通过随机效应统计模型确定汇总效应大小，并使用 GRADE 方法评估证据的确定性。在检索到的 775 篇文章中，有 9 项研究被纳入定性综合（6 项 UCLP，3 项 BCLP），只有 3 项符合条件的 UCLP 研究被纳入荟萃分析。在 UCLP 组中，极低的证据确定性表明 dNAM 和 cNAM 在齿槽裂宽度（SMD，0.13 毫米；95% CI，-0.31 至 0.57；I2，0%）、软组织（唇）裂间隙、鼻腔宽度、鼻腔高度和结肠偏角变化方面没有差异。在 BCLP 组中，定性综合结果表明 dNAM 和 cNAM 对牙槽骨、嘴唇和鼻腔尺寸的影响相似。在两个裂隙组（UCLP、BCLP）中，与非手术干预方案相比，dNAM 组的齿槽裂隙宽度减小，同时与 cNAM 相比，dNAM 的临床就诊次数减少，椅旁时间缩短。可以得出的结论是，在降低畸形严重程度方面，dNAM 的治疗效果与 cNAM 相当，而且在椅旁时间和临床就诊次数方面更具优势。然而，证据的总体质量很低，需要对有关牙槽移动和生长因子算法的虚拟工作流程进行标准化。注册：PROSPERO-database (CRD42020186452).

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Orthodontics & Craniofacial Research 医学-牙科与口腔外科

CiteScore

5.30

自引率

3.20%

发文量

审稿时长

>12 weeks

期刊介绍： Orthodontics & Craniofacial Research - Genes, Growth and Development is published to serve its readers as an international forum for the presentation and critical discussion of issues pertinent to the advancement of the specialty of orthodontics and the evidence-based knowledge of craniofacial growth and development. This forum is based on scientifically supported information, but also includes minority and conflicting opinions. The objective of the journal is to facilitate effective communication between the research community and practicing clinicians. Original papers of high scientific quality that report the findings of clinical trials, clinical epidemiology, and novel therapeutic or diagnostic approaches are appropriate submissions. Similarly, we welcome papers in genetics, developmental biology, syndromology, surgery, speech and hearing, and other biomedical disciplines related to clinical orthodontics and normal and abnormal craniofacial growth and development. In addition to original and basic research, the journal publishes concise reviews, case reports of substantial value, invited essays, letters, and announcements. The journal is published quarterly. The review of submitted papers will be coordinated by the editor and members of the editorial board. It is policy to review manuscripts within 3 to 4 weeks of receipt and to publish within 3 to 6 months of acceptance.