关键词: 牵张成骨, 唇腭裂, Meta分析, 骨组织工程, 口面裂

Abstract:

BACKGROUND: The repairing effect of distraction osteogenesis surgery in patients with craniofacial deformity secondary to cleft lip and palate remains unclear.
OBJECTIVE: To evaluating the repairing effect of distraction osteogenesis surgery in patients with craniofacial deformity secondary to cleft lip and palate.
METHODS: Databases of CNKI, Wanfang, VIP, CBM, Medline(ovid), science direct, ISI, as well as hand working were retrieved for the literatures about the curative effect of distraction osteogenesis on clef lip and palate patents with secondary craniofacial deformity which have been published. Clinical research about distraction osteogenesis used in clef lip and palate patents with secondary craniofacial deformity must have the same assignment style of investigation method and measurement indicators that include objective, design and detailed statistical method of the research. All of the findings can provide elementary data for weighted mean difference and 95% confidence interval (95%CI) or odd ratio and 95% CI. There are at least three patients included in the research and controlled by changes after operation. Meta-analysis was used to make a comprehensive quantitative analysis of ANB, the labial teeth overjet, SNA and nasolabial angle which are the soft or hard tissue measured by X-ray cephalometry for the forward-backward and perpendicular direction of the maxillafacial region. According to homogeneity tests, researches about ANB and overjet of the labial teeth adopted random effect model while SNA and nasolabial angle adopted fixed effect model. So total pooling weighted mean difference and its corresponding 95%CI for the models were calculated.
RESULTS AND CONCLUSION: Totally 9 references and 123 patients were involved. Homogeneity test showed that, researches about ANB and overjet of the labial teeth are heterogeneous while SNA and nasolabial angle are homoeonomous. Conus arteriosus maps showed no publication bias was observed in all the literature that used in this article. Meta-analysis results showed that, the total pooled weighted mean difference of ANB, overjet of the labial teeth, SNA and nasolabial angle were below zero, all showed significant statistical difference. Meta-analysis can prove the curative effect of extraoral support-type distraction on the craniofacial deformity secondary to cleft lip and palate. To some extent, this research will provide guidance for choosing therapeutic regimen by the clinicians. After rigid external distraction by Le Fort Ⅰostetomy, most of the patients show great changes such as the increased SNA and ANB angle, the flatter of the upper lip curvature followed by the increased nosolabial angle, cured reverse overjet and returned normal occlusion relations.