Maxillary expansion in grafted alveolar arches in patients with cleft lip and palate: A literature review

Abstract

Objective: the aim of the present review was to assess maxillary expansion (ME) in grafted alveolar arches in patients with cleft lip and palate (CLP). Material and methods: the addressed focused question was: “What are the clinical and radiographic outcomes of ME after alveolar bone grafting (ABG) in patients with CLP?” An electronic search of indexed databases was performed without language and time restrictions, up to and including March 2021, to identify studies that addressed the focused question. Study selection and data extraction were performed independently by 2 authors; and the risk of bias for the clinical studies was assessed using the Downs and Black tool. Any disagreements were resolved through consensus discussion. Results: five studies [2 clinical studies (1 prospective and 1 retrospective) and 3 case reports] were included and processed for data extraction. The outcomes of ME were assessed using cone-beam computed tomography and two-dimensional radiographic imaging 12-months after ABG in 1 clinical study, and 6-months after ME in the other clinical study. In the case reports, the outcomes of ABG after ME were assessed 3–6 months after ME. No significant bone loss of the ABG after ME was reported, and adequate bone volume and bone density were observed at the follow up periods in all studies. Maxillary expansion was achieved after the ABG in all of the studies. Conclusion: the relationship between ABG and ME remains debatable. Further power-adjusted, well-designed, randomized controlled clinical trials are needed to study the outcomes of ME after ABG in patient with CLP.

Keywords

• Alveolar bone graft
• Cleft lip and palate
• Maxillary expansion
• Orthodontics