Non-Cochrane · aetiology · PM42894730
Oral Candida colonisation and cariogenic bacteria in children and adolescents with cleft lip and/or palate: A systematic review and meta-analysis.
Hendrawan Muhammad Irpan, Amanda Elsa Ayu, Alwi Ita Purnama, et al. · Journal of oral biology and craniofacial research · 2026 · PubMed · doi:10.1016/j.jobcr.2026.101555
Findings
12 findings
| Population | ||||
|---|---|---|---|---|
| Children and adolescents | Non-syndromic cleft lip and/or palate | Non-cleft controls | Oral Candida colonisation Unresolved: the two extractors disagree on this row. | RR 2.94 [2.04, 4.22] 43 [23, 71] per 100 Low Downgraded: risk of bias 4 studies · 334 participants |
| Children and adolescents | Non-syndromic cleft lip and/or palate | Non-cleft controls | Caries prevalence First primary-incisor eruption (approximately 8–15 months) | 19.0% vs 0% at first incisor eruption (P = 0.144); 47.6% vs 38.5% at primary molar (P = 0.728) 19 per 100 Very low Downgraded: imprecision 1 study · 34 participants |
| Children and adolescents | Non-syndromic cleft lip and/or palate | Non-cleft controls | Caries prevalence Post-primary-molar eruption (approximately 24–30 months) | 19.0% vs 0% at first incisor eruption (P = 0.144); 47.6% vs 38.5% at primary molar (P = 0.728) 9 per 100 Very low Downgraded: imprecision 1 study · 34 participants |
| Children and adolescents | Non-syndromic cleft lip and/or palate | Non-cleft controls | High salivary Streptococcus mutans count Leave-one-out: excluding Shashni et al. | RR 2.18 [1.05, 4.52] GRADE not reported 2 studies |
| Children and adolescents aged 0-18 years with non-syndromic cleft lip and/or palate | Non-syndromic cleft lip and/or palate (CL/P) (exposure) | Healthy non-cleft children and adolescents (controls) | Caries experience indices (DMFT/dmft/def) At examination (cross-sectional) · Cleft and non-cleft children from India, Jordan and Japan · Sensitivity: leave-one-out excluding Sravani et al. 2026 | SMD 0.42 [0.17, 0.67] GRADE not reported 2 studies |
| Children and adolescents | Non-syndromic cleft lip and/or palate | Non-cleft controls | High salivary Lactobacillus count | RR 1.33 [0.71, 2.47] 1 [-1, 7] per 100 Very low Downgraded: risk of bias, imprecision 3 studies · 512 participants |
| Children and adolescents | Non-syndromic cleft lip and/or palate | Non-cleft controls | High salivary Streptococcus mutans count Unresolved: the two extractors disagree on this row. | RR 2.74 [1.42, 5.27] 6 [2, 15] per 100 Very low Downgraded: risk of bias, indirectness 3 studies · 512 participants |
| Children and adolescents | Non-syndromic cleft lip and/or palate | Non-cleft controls | Oral Candida colonisation Lowest reported leave-one-out estimate; omitted study unspecified | RR 2.41 [1.62, 3.59] GRADE not reported 3 studies |
| Children and adolescents | Non-syndromic cleft lip and/or palate | Non-cleft controls | Oral Candida colonisation Highest reported leave-one-out estimate; omitted study unspecified | RR 3.43 [2.31, 5.10] GRADE not reported 3 studies |
| Children and adolescents | Non-syndromic cleft lip and/or palate | Non-cleft controls | DMFT/dmft/def caries burden | SMD 0.74 [-0.55, 2.03] Very low Downgraded: inconsistency 3 studies · 210 participants |
| Children and adolescents with CL/P | Not reported | None | Oral Candida colonisation crude pooled prevalence Unresolved: the two extractors disagree on this row. | Prevalence (%) 66.1 GRADE not reported 4 studies · 171 participants |
| Non-cleft controls | Not reported | None | Oral Candida colonisation crude pooled prevalence Unresolved: the two extractors disagree on this row. | Prevalence (%) 22.1 GRADE not reported 4 studies · 163 participants |
Included primary studies 10
Open in Studies| Study | Year | Also included by | Outcomes it informs here | Trial data |
|---|---|---|---|---|
| Durhan 2019 Microbial Profile and Dental Caries in Cleft Lip and Palate Babies Between 0 and 3 Years Old. PMID:29800530 | 2019 | 1 other review | Oral Candida colonisation; High salivary Streptococcus mutans count; High salivary Lactobacillus count | not extracted yet |
| Funahashi 2019 Functional dysbiosis within dental plaque microbiota in cleft lip and palate patients. PMID:30906959 | 2019 | 1 other review | DMFT/dmft/def caries burden | not extracted yet |
| Hassani 2020 Comparison of Microbial Activity Among Infants With or Without Using Presurgical Nasoalveolar Molding Appliance. PMID:32253929 | 2020 | 1 other review | not stated | not extracted yet |
| Khan 2023 Incidence and prevalence of oral candidal colonization in patients with cleft lip and palate. PMID:37273448 | 2023 | 1 other review | Oral Candida colonisation | not extracted yet |
| Rawashdeh 2011 Oral candidal colonization in cleft patients as a function of age, gender, surgery, type of cleft, and oral health. PMID:20691530 | 2011 | 1 other review | Oral Candida colonisation; DMFT/dmft/def caries burden | not extracted yet |
| Sundell 2015 Comparing caries risk profiles between 5- and 10- year-old children with cleft lip and/or palate and non-cleft controls. PMID:26208495 | 2015 | 1 other review | High salivary Streptococcus mutans count; High salivary Lactobacillus count | not extracted yet |
| Shashni 2015 Comparison of risk indicators of dental caries in children with and without cleft lip and palate deformities. PMID:25684913 | 2015 | this review only | High salivary Streptococcus mutans count; High salivary Lactobacillus count | not extracted yet |
| Shi 2026 Investigating oral microbiome profiles of children with cleft lip and palate in different states of caries. PMID:42023035 | 2026 | this review only | not stated | not extracted yet |
| Sravani 2026 Early Oral Colonization of Candidal Species in Young Children With Cleft Lip and Palate. PMID:41909384 | 2026 | this review only | Oral Candida colonisation; DMFT/dmft/def caries burden | not extracted yet |
| Zhang 2024 Characterization and functional prediction of the dental plaque microbiome in patients with alveolar clefts. PMID:38800834 | 2024 | this review only | not stated | 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). Only the non-Cochrane dental reviews have study lists, so overlap with Cochrane reviews is not counted yet.
Review question
| Element | Planned (methods) | Found (results) |
|---|---|---|
| Population | Children and adolescents aged 0-18 years with non-syndromic cleft lip and/or palate (CLO, CPO, CLP; unilateral or bilateral) | 421 children/adolescents with CL/P vs 567 non-cleft controls across 9 two-group studies (n=10 studies; ages 0-30 y incl. Zhang young adults) |
| Intervention | Exposure: non-syndromic CL/P | Non-syndromic CL/P (UCLP, BCLP, CPO, mixed) (n=10) |
| Comparison | Healthy non-cleft children and adolescents (primary); within-CL/P caries-free vs high-caries comparisons (secondary) | Non-cleft controls (n=10; Shashni caries-free Group III only) |
| Outcomes | Quantitative oral burden of S. mutans, Lactobacillus and Candida spp. (culture, qPCR, sequencing); clinical caries outcomes (dmft/DMFT, dmfs/DMFS, deft, ICDAS, CSI, caries prevalence) | Candida colonisation (n=4, pooled); high S. mutans count (n=3, pooled); high Lactobacillus count (n=3, pooled); caries indices DMFT/dmft/def (3 studies, 4 datasets, pooled SMD reported narratively); caries prevalence (n=1, single study, Very Low GRADE, not pooled); microbiome outcomes (narrative) |
| Study designs | Observational primary studies: cross-sectional, case-control, prospective or retrospective cohort | Cross-sectional/case-control (n=9); longitudinal cohort (n=1) |
| Timing | Not specified | Cross-sectional sampling; Durhan 24-month cohort with 3 timepoints |