Findings

What do systematic reviews say?

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Evidence found and GRADE certainty

275 questions · 299 findings · 21 reviews · Oral and maxillofacial surgery

No studies found 50 · 16.7%GRADE not reported 207 · 69.2%Very low 17 · 5.7%Low 20 · 6.7%Moderate 5 · 1.7%High 0 · 0%

Non-syndromic cleft lip and palate (CLP) status and its oral microbiota (exposure/grouping) vs Children and adolescents aged 0-18 years without CLP (controls)

Periodontal conditions (gingival inflammation, bleeding on probing, probing depth, clinical attachment loss) · Children and adolescents aged 0-18 years with non-syndromic cleft lip and palate (CLP)

Narrative synthesis of 6 studies suggests children/adolescents with CLP have poorer periodontal status (higher gingival and plaque indices, deeper probing, more bleeding and attachment loss) and harbor periodontopathogens; no pooled estimate and the evidence is ungraded.

1 finding from 1 review

Oral propranolol vs placebo

Reduction in pain intensity · Adult patients aged >=18 years, clinically or radiographically diagnosed with TMD (McNeill 1997 criteria); moderate to severe pain of…

Oral propranolol (beta-blocker) led to lower reduction in pain intensity (percentage of patients responding) compared with placebo; GRADE not reported.

2 findings from 1 review

Oral propranolol vs placebo

Reduction in pain duration (percentage of day) · Adult patients aged >=18 years, clinically or radiographically diagnosed with TMD (McNeill 1997 criteria); moderate to severe pain of…

Oral propranolol (beta-blocker) showed no clear difference in reduction in pain duration (percentage of day) compared with placebo; GRADE not reported.

1 finding from 1 review

Reassurance / behavioral management (control of contributory factors)

Outcome not reported · Adults (>18 years) with temporomandibular joint osteoarthritis (TMJ OA) diagnosed by RDC/TMD or compatible criteria

The review found no eligible studies for this question.

1 finding from 1 review

CBT vs alternative treatment

Reduction in pain intensity · People aged 12 years and over with painful TMD lasting 3 months or longer

Cognitive behavioural therapy (CBT) showed no clear difference in pain intensity at treatment completion compared with alternative (active) treatment (e.g. oral splint, medication,… (low certainty).

2 findings from 1 review

CBT vs alternative treatment

Mental distress · People aged 12 years and over with painful TMD lasting 3 months or longer

Cognitive behavioural therapy (CBT) may leads to lower psychological distress at follow-up compared with alternative (active) treatment (e.g. oral splint, medication,… (low certainty).

2 findings from 1 review

CBT vs alternative treatment

Additional physical symptoms · People aged 12 years and over with painful TMD lasting 3 months or longer

The review found no eligible studies for this question.

1 finding from 1 review

CBT vs alternative treatment

Disability caused by pain at follow-up · People aged 12 years and over with painful TMD lasting 3 months or longer

Cognitive behavioural therapy (CBT) showed no clear difference in disability caused by pain at treatment completion compared with alternative (active) treatment (e.g. oral splint, medication,… (low certainty).

2 findings from 1 review

CBT vs alternative treatment

Adverse events · People aged 12 years and over with painful TMD lasting 3 months or longer
1 finding from 1 review
  • SoF: 3 studies reported minor adverse events in the control group; 1 study reported minor adverse events in psychological therapy group; 1 study reported that there were no adverse events. Results: NCT00066937 minor…
    5 studies
    Very low

Open reduction and fixation vs Closed (conservative) management (no active intervention other than soft diet, analgesics or antibiotics; or intermaxillary/maxillary-mandibular fixation with rigid or elastic traction)

Outcome not reported · Adults, over 18 years of age, with unilateral or bilateral fractures of the mandibular condyles

The review found no eligible studies for this question.

1 finding from 1 review

Minimal incision palatopharyngoplasty (MIPP) vs MIPP with additional individualised velopharyngeal surgery (pharyngeal flap or sphincter pharyngoplasty)

Quality of life (validated questionnaire) · Children or adolescents aged 3 years or older with velopharyngeal insufficiency (VPI) associated with non-syndromic submucous cleft palate

The review found no eligible studies for this question.

1 finding from 1 review

Minimal incision palatopharyngoplasty (MIPP) vs MIPP with additional individualised velopharyngeal surgery (pharyngeal flap or sphincter pharyngoplasty)

Instrumental assessment: nasalance score (nasometry and pressure-flow measure) · Children or adolescents aged 3 years or older with velopharyngeal insufficiency (VPI) associated with non-syndromic submucous cleft palate

The review found no eligible studies for this question.

1 finding from 1 review

Minimal incision palatopharyngoplasty (MIPP) vs MIPP with additional individualised velopharyngeal surgery (pharyngeal flap or sphincter pharyngoplasty)

Self-esteem (Piers-Harris self-concept scale) · Children or adolescents aged 3 years or older with velopharyngeal insufficiency (VPI) associated with non-syndromic submucous cleft palate

The review found no eligible studies for this question.

1 finding from 1 review

Minimal incision palatopharyngoplasty (MIPP) vs MIPP with additional individualised velopharyngeal surgery (pharyngeal flap or sphincter pharyngoplasty)

Instrumental assessment: velopharyngeal complete closure and gap size (videonasopharyngoscopy and multiview videofluoroscopy) · Children or adolescents aged 3 years or older with velopharyngeal insufficiency (VPI) associated with non-syndromic submucous cleft palate
1 finding from 1 review
  • Interventions for the management of submucous cleft palate 2008 · Cochrane All outcomes
    3 months post-operatively
    Complete closure occurred in 32 (86%) of the participants in group 1 (MIPP) and in 31 (89%) in group 2, P > 0.05. After eliminating the nine patients with residual velopharyngeal insufficiency, the post-operative gap…
    1 study · 72 participants
    GRADE not reported

Minimal incision palatopharyngoplasty (MIPP) vs MIPP with additional individualised velopharyngeal surgery (pharyngeal flap or sphincter pharyngoplasty)

Adverse effect: failure of muscle fusion in the region of the cleft after surgery · Children or adolescents aged 3 years or older with velopharyngeal insufficiency (VPI) associated with non-syndromic submucous cleft palate
1 finding from 1 review

Minimal incision palatopharyngoplasty (MIPP) vs MIPP with additional individualised velopharyngeal surgery (pharyngeal flap or sphincter pharyngoplasty)

Adverse effect: unacceptable nasal resonance after repair · Children or adolescents aged 3 years or older with velopharyngeal insufficiency (VPI) associated with non-syndromic submucous cleft palate

The review found no eligible studies for this question.

1 finding from 1 review

Minimal incision palatopharyngoplasty (MIPP) vs MIPP with additional individualised velopharyngeal surgery (pharyngeal flap or sphincter pharyngoplasty)

Adverse effect: obstructive sleep apnoea or airway compromise · Children or adolescents aged 3 years or older with velopharyngeal insufficiency (VPI) associated with non-syndromic submucous cleft palate
1 finding from 1 review