Page 46 - MDA MIDEC 2024 Programme Book

ORAL PRESENTATION ABSTRACTS

P003 Name of Presenter: Dr Ashwini a/p M.Madawana @ Madawan, Hospital Universiti Sains
Malaysia
Title of Presentation: Clinical Effectiveness of Different Types of Maxillary Protraction Devices
in Cleft Patient: A Systematic Review and Meta-Analysis

Abstract
Ashwini MM 1, Mohamad Arif AN 2,*, Ahmad Hashridz R 3
1 Paediatric Dentistry Unit, School of Dental Sciences, Universiti Sains Malaysia, Health Campus,
Kelantan, Malaysia
2 Biostatistics Unit, School of Dental Sciences, Universiti Sains Malaysia, Kelantan, Health Campus,
Malaysia
3 Orthodontics Unit, School of Dental Sciences, Universiti Sains Malaysia, Health Campus, Kelantan,
Malaysia
Introduction: Maxillary hypoplasia is a common challenge in patients with cleft lip and palate (CLP),
significantly impacting facial aesthetics and function. Adolescents with this condition often require
maxillary protraction therapy to improve maxillary growth and correct malocclusion.
Objectives: This study aims to evaluate and compare the clinical effectiveness of facemask with mini plates
(FM-MP) and class III elastics with mandibular and maxillary mini plates (C3-IE) in adolescents with CLP.
Methodology: A systematic review and meta-analysis were conducted following PRISMA guidelines.
Five databases such as Scopus, Web of Science, PUBMED/Embase, Google Scholar and Cochrane Library
were searched for relevant studies from 2012 to 2024. Inclusion criteria encompassed prospective and
retrospective studies focused on maxillary protraction devices in CLP patients. The quality of included
studies was assessed using the Newcastle Ottawa Scale (NOS) and GRADE system. Data from five eligible
studies were analyzed, with cephalometric measurements compared between intervention and control
groups using a random-effects inverse-variance model.
Results: The meta-analysis revealed significant improvements in maxillary protrusion and correction of
class III malocclusion post-treatment. The FM-MP subgroup showed more pronounced changes in SNA,
2.14 degrees (95% CI: 0.97–3.31, p-value=0.003), ANB (improved 1.75 degrees), and overjet compared to the
C3-IE subgroup. However, no significant differences were observed in the vertical dimension alterations or
mandibular rotation (p-value>0.05). The facemask with mini plates (FM-MP) was more effective in enhancing
overjet compared to class III elastics with bone anchors.
Conclusion: Maxillary protraction therapy is effective for adolescents with CLP, with FM-MP showing
superior results in certain parameters compared to C3-IE. These findings support the use of maxillary
protraction devices as viable treatment options to address maxillary hypoplasia and class III malocclusion
in CLP patients. Further studies are recommended to confirm these results and refine treatment protocols.

Key words: Cleft lip, maxillary protraction device, CLP, facemask, class III elastics

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