Relation Between Soft and Hard Tissue Changes Following Maxillary Osteotomies In Cleft Lip and Palate Patients: A Meta- Analysis
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The aim of the study is to systematically investigate the available literature regarding the relation between soft and hard tissue changes following maxillary osteotomies in cleft lip and palate patients that could be used as an aid in lateral cephalometric radiographic prediction. Search without any restrictions for published and unpublished literature and hand searching was conducted. Data on the relation between soft and hard tissue sagittal changes in patients with cleft lip and palate of any age having undergone any maxillary osteotomies for the correction of maxillary hypoplasia were reviewed and divided in 2 categories: (1) ratios between soft and hard tissue changes and (2) correlations between soft and hard tissue changes. Methodological quality was evaluated according to Cochrane Collaboration guidelines and the random effects method for meta-analysis was used to combine data across studies. Out of the 1054 initially identified unique records only 3 articles fulfilled the selection criteria for inclusion in the systematic review. The correlations between soft and hard tissue changes varied considerably from -0.44 to 0.95 and the ratios in the horizontal and vertical plane varied between 0.33 to 0.57 and 0.12 to 0.48 respectively, depending on the specific points considered and the time of assessment. Methodological quality assessment identified various drawbacks in the included studies. Based on the present systematic review and meta-analysis, evidence-based conclusions on the relation between soft and hard tissue changes following maxillary osteotomies in cleft lip and palate patients are difficult to draw. High statistically significant correlations were noted at the longest follow-up available only in the stomion superius horizontal and labrale superious vertical response to upper incisor tip movement. More studies of high quality are needed in order to produce results robust enough to be used as a clinical aid during prediction in cleft lip/palate patients.