Non-Cochrane · aetiology · PM39881261
Oral health in patients with cleft lip and palate: a systematic literature review and meta-analysis of periodontal and dental disease and oral microbiota (part 1).
Pardo A, Vanti V, Lonardi F, et al. · BMC oral health · 2025 · PubMed · doi:10.1186/s12903-025-05494-5
Full textEvery question was extracted from the full text, figures and supplements by two independent LLM extractors, disagreements adjudicated. Rows cite where in the review the value comes from.
Questions
8
current version
GRADE rated
3
No studies
0
Included studies
30
linked below
No studies 0 · 0%Ungraded 5 · 62.5%Very low 0 · 0%Low 3 · 37.5%Moderate 0 · 0%High 0 · 0%
Ungraded means an effect was reported without a GRADE rating; it is not a gap. No studies means the review found nothing to answer the question. The six categories are a display order, not a score.
Review question
| Element | Planned (methods) | Found (results) |
|---|---|---|
| Population | Human subjects of any age with cleft lip and/or palate (all cleft types: cleft lip, cleft palate, cleft lip and palate with/without alveolus, unilateral/bilateral), and healthy controls; no age/syndrome/surgical restriction | Persons with cleft lip and/or palate vs healthy controls; part 1 = 18 studies: 10 with periodontal measurements in 1619 subjects (643 cleft, 976 controls, aged >2 yrs) and 8 with oral microflora |
| Intervention | Orofacial cleft (cleft lip and/or palate) as exposure | Orofacial cleft (cleft lip and/or palate; unilateral/bilateral) (n=10 periodontal studies) |
| Comparison | Healthy controls without cleft | Healthy controls without cleft (20 of 24 studies had a control group; 4 were cleft-only) |
| Outcomes | Periodontal indices (plaque index PI/PIS/VPI/QHI, gingival index GI, bleeding index BI/BoP, probing pocket depth PPD, clinical attachment level CAL) and oral microbiota composition (caries indices analyzed in part 2) | Meta-analyzed as mean differences (fixed-effects): PI (6 studies), GI (4 studies), PPD (3 studies); BI and CAL also reported as meta-analyzed and significant but without tabulated effect sizes; oral microbiota synthesized qualitatively (not meta-analyzed) |
| Study designs | Observational studies in humans (case-control, cross-sectional, cohort); animal/in vitro, presurgical orthopedics, prosthesis wearers, case reports, letters, editorials, reviews and meta-analyses excluded | 10 periodontal studies (5 case-control, 4 cross-sectional, 1 cohort); 8 microbiota studies (observational) |
| Timing | Not specified (English full-text articles; pre-2013 records excluded during screening) | Not specified (cross-sectional/observational; mixed age groups) |
Search date: March 2023 to January 2024. Databases: PubMed; Scopus; Web of Science; Cochrane Library
Questions and results
Orofacial cleft (cleft lip and/or palate) as exposure vs Healthy controls without cleft
Population: Individuals assessed for periodontal health (mainly children and adolescents, age >2 years)
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Clinical Attachment Level (CAL) 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). Source: Abstract; Discussion, para 1 (CAL greater in cleft; p < 0.00001) · same question in other reviews | The loss of clinical attachment level (CAL) is greater in patients with cleft lip and palate than in healthy controls (p < 0.00001) | NR | Ungraded |
Gingival Index (GI) Persons with orofacial cleft have a higher gingival index than healthy controls (MD 0.15, 95% CI 0.11 to 0.19; low certainty). Source: Results, 'GI (Gingival Index) in patients with orofacial cleft and healthy controls'; Fig. 8 (forest plot; I2=57%; 201 cleft, 247… · same question in other reviews | MD 0.15 [0.11, 0.19] 0.15 [0.11, 0.19] SD higher | 4 studies · 488 participants | Low |
Oral microbiota composition Population: 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). Source: Methods 'Data parameters' (secondary outcome); Results 'Study characteristics' (eight observational studies analyzed oral microflora);… · same question in other reviews | no estimate extracted | 8 studies | Ungraded |
Bleeding Index (BI) 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). Source: Abstract; Discussion, para 1 (meta-analysis of GI and BI; BI p < 0.0001) · same question in other reviews | the bleeding index (BI) showed significantly higher values for subjects with cleft lip and/or palate (BI p < 0.0001) | NR | Ungraded |
Probing Pocket Depth (PPD) 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). Source: Results, 'PPD (Probing pocket depth) in patients with orofacial cleft and healthy controls'; Fig. 9 (forest plot; I2=99%; 173 cleft, 167… · same question in other reviews | MD 0.88 [0.82, 0.95] 0.88 [0.82, 0.95] SD higher | 3 studies · 340 participants | Low |
Plaque Index (PI) Persons with orofacial cleft have a higher plaque index than healthy controls (MD 0.29, 95% CI 0.24 to 0.34; low certainty). Source: Results, 'PI (Plaque Index) in patients with orofacial cleft and healthy controls'; Fig. 6 (forest plot; I2=79%; 352 cleft, 457 controls);… · same question in other reviews | MD 0.29 [0.24, 0.34] 0.29 [0.24, 0.34] SD higher | 6 studies · 1618 participants | Low |
Unilateral cleft lip and palate (UCLP) vs Bilateral cleft lip and palate (BCLP)
Population: Patients with cleft lip and palate (CLP)
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Plaque Index (PI) Plaque index does not differ significantly between unilateral and bilateral cleft lip and palate (MD -0.13, 95% CI -0.38 to 0.12; ungraded). Source: Results, 'PI (Plaque index) in patients with unilateral and with bilateral cleft lip and palate'; Fig. 7 (forest plot; I2=0%; 79 UCLP, 38… · same question in other reviews | MD -0.13 [-0.38, 0.12] | 2 studies · 117 participants | Ungraded |
Comparison
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Bleeding on Probing (BoP) Cleft lip/palate vs healthy controls | no estimate extracted | 1 study | Ungraded |
Included primary studies 30
Open as a trial list| Study | Also included by | Outcomes it informs here | Trial PICO | Results |
|---|---|---|---|---|
| Chopra 2014 Oral health in 4-6 years children with cleft lip/palate: a case control study. PMID:25006561 | 1 other review | Gingival Index (GI) | not extracted yet | not extracted yet |
| Khan 2023 matched by author and year (probable) | 1 other review | not stated | not extracted yet | not extracted yet |
| Sunderji 2017 Dental Caries Experience in Texan Children with Cleft Lip and Palate. PMID:29070163 | 1 other review | Plaque Index (PI) | not extracted yet | not extracted yet |
| Veiga 2017 Caries Experience and Periodontal Status in Children and Adolescents with Cleft Lip and Palate. PMID:28390464 | 1 other review | Plaque Index (PI); Probing Pocket Depth (PPD) | not extracted yet | not extracted yet |
| Allam 2020 matched by author and year (probable) | this review only | not stated | not extracted yet | not extracted yet |
| Boriollo 2022 matched by author and year (probable) | this review only | not stated | not extracted yet | not extracted yet |
| Chopra 2014 matched by author and year (probable) | this review only | not stated | not extracted yet | not extracted yet |
| Durhan 2018 matched by author and year (probable) | this review only | not stated | not extracted yet | not extracted yet |
| Fowler 2020 matched by author and year (probable) | this review only | not stated | not extracted yet | not extracted yet |
| Freitas 2013 matched by author and year (probable) | this review only | not stated | not extracted yet | not extracted yet |
| Gheller 2021 matched by author and year (probable) | this review only | not stated | not extracted yet | not extracted yet |
| Gheller 2021 Periodontal Findings in Children and Adolescents with Cleft Lip and/or Palate: A Case-Control Study. PMID:33892839 | this review only | Plaque Index (PI); Probing Pocket Depth (PPD) | not extracted yet | not extracted yet |
| Kamble 2016 matched by author and year (probable) | this review only | not stated | not extracted yet | not extracted yet |
| Khan 2023 Incidence and prevalence of oral candidal colonization in patients with cleft lip and palate. PMID:37273448 | this review only | Plaque Index (PI); Gingival Index (GI) | not extracted yet | not extracted yet |
| King 2013 matched by author and year (probable) | this review only | not stated | not extracted yet | not extracted yet |
| Kirchberg 2014 matched by author and year (probable) | this review only | not stated | not extracted yet | not extracted yet |
| Kulas 2016 matched by author and year (probable) | this review only | not stated | not extracted yet | not extracted yet |
| Liu 2017 Distribution of corticotrophin releasing factor activity within the hypothalamic-pituitary complex of rats and cattle. PMID:201710 | this review only | Plaque Index (PI); Gingival Index (GI); Probing Pocket Depth (PPD) | not extracted yet | not extracted yet |
| Nagappan 2019 matched by author and year (probable) | this review only | not stated | not extracted yet | not extracted yet |
| Pisek 2014 matched by author and year (probable) | this review only | not stated | not extracted yet | not extracted yet |
| Pisek 2014 Oral health status and oral impacts on quality of life in early adolescent cleft patients. PMID:25816532 | this review only | Plaque Index (PI); Gingival Index (GI) | not extracted yet | not extracted yet |
| Shashni 2015 matched by author and year (probable) | this review only | not stated | not extracted yet | not extracted yet |
| Sundell 2015 matched by author and year (probable) | this review only | not stated | not extracted yet | not extracted yet |
| Sundell 2018 matched by author and year (probable) | this review only | not stated | not extracted yet | not extracted yet |
| Sundell, Nilsson 2015 matched by author and year (probable) | this review only | not stated | not extracted yet | not extracted yet |
| Sunderji 2017 matched by author and year (probable) | this review only | not stated | not extracted yet | not extracted yet |
| Tuano 2015 matched by author and year (probable) | this review only | not stated | not extracted yet | not extracted yet |
| Veiga 2016 matched by author and year (probable) | this review only | not stated | not extracted yet | not extracted yet |
| Xiao 2015 matched by author and year (probable) | this review only | not stated | not extracted yet | not extracted yet |
| Zaira 2021 matched by author and year (probable) | this review only | not stated | not extracted yet | not extracted yet |
Overlap with other reviews
Reviews that include the same primary studies are not independent evidence. Shared counts match studies by PMID, DOI or NCT, and otherwise by author and year (a probable match).