Findings

What do systematic reviews say?

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Evidence found and GRADE certainty

15 questions · 15 findings · 3 reviews · Oral and maxillofacial surgery · All outcomes

No studies found 4 · 26.7%GRADE not reported 8 · 53.3%Very low 0 · 0%Low 3 · 20%Moderate 0 · 0%High 0 · 0%

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

Perceptual speech assessment: residual post-operative velopharyngeal insufficiency · 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
    Five (14%) of the participants in group 1 (MIPP) and four (11%) in group 2 had residual post-operative velopharyngeal insufficiency, P > 0.05. The report provided no details on post-operative speech assessment other…
    1 study · 72 participants
    GRADE not reported

2 mm titanium plates vs 2.5 mm bioresorbable plates

Post-operative pain (residual pain, any severity) · Adults (16 to 68 years) with mandibular fractures excluding condylar involvement

2 mm titanium plates showed no clear difference in post-operative pain (residual pain, any severity) compared with 2.5 mm bioresorbable plates; GRADE not reported.

1 finding from 1 review

Cleft lip and/or palate (CL/P) vs Healthy controls without cleft

Gingival index (GI) · Individuals assessed for periodontal health (mainly children and adolescents, age >2 years)

Persons with orofacial cleft have a higher gingival index than healthy controls (MD 0.15, 95% CI 0.11 to 0.19; low certainty).

1 finding from 1 review

Cleft lip and/or palate (CL/P) vs Healthy controls without cleft

Clinical attachment level (CAL) · Individuals assessed for periodontal health (mainly children and adolescents, age >2 years)

Clinical attachment level loss is greater in persons with orofacial cleft than in healthy controls (p<0.00001), but no pooled effect size was reported (ungraded).

1 finding from 1 review

Cleft lip and/or palate (CL/P) vs Healthy controls without cleft

Bleeding Index (BI) · Individuals assessed for periodontal health (mainly children and adolescents, age >2 years)

Bleeding index is significantly higher in persons with orofacial cleft than in healthy controls (p<0.0001), but no pooled effect size was reported (ungraded).

1 finding from 1 review

Cleft lip and/or palate (CL/P) vs Healthy controls without cleft

Oral microbiota composition · Individuals assessed for oral microbiota (mainly children and adolescents)

Oral microbiota composition differs between persons with orofacial cleft and healthy controls, synthesized qualitatively across 8 studies but not meta-analyzed (ungraded).

1 finding from 1 review

Cleft lip and/or palate (CL/P) vs Healthy controls without cleft

Probing pocket depth · Individuals assessed for periodontal health (mainly children and adolescents, age >2 years)

Persons with orofacial cleft have a greater probing pocket depth than healthy controls (MD 0.88, 95% CI 0.82 to 0.95; low certainty).

1 finding from 1 review

Cleft lip and/or palate (CL/P) vs Healthy controls without cleft

Plaque · Individuals assessed for periodontal health (mainly children and adolescents, age >2 years)

Persons with orofacial cleft have a higher plaque index than healthy controls (MD 0.29, 95% CI 0.24 to 0.34; low certainty).

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