Findings

What do systematic reviews say?

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Evidence found and GRADE certainty

83 questions · 109 findings · 12 reviews · Oral and maxillofacial surgery

No studies found 2 · 1.8%GRADE not reported 95 · 87.2%Very low 2 · 1.8%Low 10 · 9.2%Moderate 0 · 0%High 0 · 0%

Second molar at Demirjian stage A-D at extraction vs Second molar at Demirjian stage F-H at extraction

Spontaneous space closure · Children and adolescents after extraction of a mandibular permanent first molar (before eruption of the second molar)

In the mandible, earlier Demirjian stage A-D (vs F-H) increases odds of space closure (OR 3.11; low certainty).

1 finding from 1 review

Second molar mesially inclined at extraction vs Second molar upright at extraction

Spontaneous space closure · Children and adolescents after extraction of a mandibular permanent first molar (before eruption of the second molar)

In the mandible, mesial inclination of the second molar vs upright was not significantly associated with space closure (OR 0.68; not GRADE-rated).

1 finding from 1 review

Extraction at patient age <8 years vs Extraction at patient age >10 years

Spontaneous space closure · Children and adolescents after extraction of a mandibular permanent first molar (before eruption of the second molar)

In the mandible, extraction before age 8 (vs after 10) increases odds of space closure (OR 5.01; low certainty).

1 finding from 1 review

Age 8-10 years vs Extraction at patient age >10 years

Spontaneous space closure · Children and adolescents after extraction of a mandibular permanent first molar (before eruption of the second molar)

In the mandible, extraction at age 8-10 (vs after 10) increases odds of space closure (OR 3.32; low certainty).

1 finding from 1 review

Extraction of the mandibular permanent first molar vs Not applicable (single-group prevalence)

Rotation of the mandibular second permanent molar · Children and adolescents after extraction of a mandibular permanent first molar (before eruption of the second molar)

After mandibular first molar extraction, the second molar was rotated in about 77% of cases (2 studies; very imprecise; not GRADE-rated).

1 finding from 1 review

Second molar at Demirjian stage E at extraction vs Second molar at Demirjian stage F-H at extraction

Spontaneous space closure · Children and adolescents after extraction of a mandibular permanent first molar (before eruption of the second molar)

In the mandible, extraction at Demirjian stage E (vs later F-H) increases odds of space closure (OR 3.81; low certainty).

1 finding from 1 review

Dental crowding present vs Dental spacing present

Spontaneous space closure · Children and adolescents after extraction of a mandibular permanent first molar (before eruption of the second molar)

One study found space closure more likely with crowding than spacing (OR 5.9; single study; not GRADE-rated).

1 finding from 1 review

Cleft lip and/or palate (CL/P) vs No cleft lip and/or palate (non-CL/P)

Streptococcus mutans count · Children and adolescents aged 0-18 years with non-syndromic cleft lip and palate (CLP)

No difference in mean Streptococcus mutans presence was reported; GRADE was not reported.

1 finding from 1 review

Extraction of the mandibular permanent first molar vs Not applicable (single-group prevalence)

Rotation of the mandibular first premolar · Children and adolescents after extraction of a mandibular permanent first molar (before eruption of the second molar)

After mandibular first molar extraction, the first premolar was rotated in about 38% of cases (2 studies; very imprecise; not GRADE-rated).

1 finding from 1 review

Second molar at Demirjian stage A-D at extraction vs Second molar at Demirjian stage F-H at extraction

Spontaneous space closure · Children and adolescents with maxillary permanent first molar extraction

In the maxilla, M2 Demirjian stages A-D were not associated with a statistically significant difference in space closure odds.

1 finding from 1 review

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

Cleft lip and/or palate (CL/P) vs No cleft lip and/or palate (non-CL/P)

Early childhood caries experience (mean dmft) · Children in the primary dentition with non-syndromic cleft lip and/or palate (CL/P) and comparable children without CL/P

In the combined primary and mixed dentition, there was no evidence of a difference in caries experience between children with and without CL/P (SMD 0.09, 95% CI -0.59-0.76; 5 studies; ungraded).

4 findings from 1 review
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Cleft lip and/or palate (CL/P) vs No cleft lip and/or palate (non-CL/P)

Care index (CI = f/[d+m+f]) in the primary dentition · Children in the primary dentition with non-syndromic cleft lip and/or palate (CL/P) and comparable children without CL/P

The care index tended to be higher in children without CL/P (2 of 3 studies), suggesting more extraction-based caries management in children with CL/P; not pooled (narrative; ungraded).

1 finding from 1 review
  • Caries in children with and without orofacial clefting: A systematic review and meta-analysis. 2022 All outcomes
    Children with CL/P and comparable non-CL/P children across 12 countries (India, Brazil, China, Sweden, UK, USA, Germany, Greece, Ireland, Netherlands, Jordan, Thailand); studies published 1989-2021
    Two out of three studies for which the CI could be calculated (Nagappan 2019; Veiga 2016) showed a higher CI for non-CL/P children demonstrating a higher proportion of extraction-based treatment in CL/P children…
    3 studies
    GRADE not reported

Isolated cleft palate (CP) or other specific cleft type vs Cleft lip and palate (CLP) or other cleft type

Caries experience by cleft type · Children in the primary dentition with cleft lip and/or palate (CL/P)

Whether cleft type is associated with caries experience could not be determined; the planned CP-versus-CL/P subgroup analysis was not possible owing to sparse isolated-CP data (5 studies described narratively; ungraded).

1 finding from 1 review
  • Caries in children with and without orofacial clefting: A systematic review and meta-analysis. 2022 All outcomes
    Children with CL/P and comparable non-CL/P children across 12 countries (India, Brazil, China, Sweden, UK, USA, Germany, Greece, Ireland, Netherlands, Jordan, Thailand); studies published 1989-2021
    Five studies investigated caries experience by cleft type (Howe 2017; Kirchberg 2014; Mutarai 2008; Sunderji 2017; Zhu 2010). A subgroup analysis comparing CP and CL/P as different entities was not possible due to the…
    5 studies
    GRADE not reported