Oral health-related quality of life in patients aged 8 to 19 years with cleft lip and palate: a systematic review and meta-analysis
Abstract Background Cleft lip and palate (CLP) is the most common facial birth defect worldwide and causes morphological, aesthetic, and functional problems with psychosocial implications for an individual’s life and well-being. The present systematic review and meta-analysis assessed whether the tr...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2023-09-01
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| Series: | BMC Oral Health |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12903-023-03382-4 |
| _version_ | 1797451260504309760 |
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| author | Augusto Garcia de Oliveira Júnior Erik Montagna Victor Zaia Caio Parente Barbosa Bianca Bianco |
| author_facet | Augusto Garcia de Oliveira Júnior Erik Montagna Victor Zaia Caio Parente Barbosa Bianca Bianco |
| author_sort | Augusto Garcia de Oliveira Júnior |
| collection | DOAJ |
| description | Abstract Background Cleft lip and palate (CLP) is the most common facial birth defect worldwide and causes morphological, aesthetic, and functional problems with psychosocial implications for an individual’s life and well-being. The present systematic review and meta-analysis assessed whether the treatment of CLP impacts the oral health-related quality of life (OHRQoL) in children and adolescents in comparison to healthy controls. Methods We searched MEDLINE/PubMed, EMBASE, and PsycINFO databases using terms related to CLP, and included articles until August 2023. Observational comparison studies that assessed OHRQoL in non-syndromic CLP patients aged 8–19 years with validated scales designed to such aim or scales capable to identify aspects related to oral health compared to healthy controls were included. We used the ROBINS-I tool for risk of bias assessment. A meta-analysis of continuous variables was performed using inverse variance for pooling estimates, Standardized Mean Difference (SMD) as a summary measure, with random effects model. Heterogeneity was estimated by the I2 statistics. Sensitivity analyses included subgrouping based on the scale, risk of bias and scale domains. Meta-regression was performed under a mixed-effects model considering the variables type of scale, scale domains and risk of bias. Results Fourteen studies were included comprising 1,185 patients with CLP and 1,558 healthy controls. The direction of the effect of OHRQoL favoured the healthy group (-0.92; 95% CI:-1,55;-0,10) and I2 = 95%. After removing three studies, I2 dropped to 80%. Meta-regression showed no influence on risk of bias (p = 0.2240) but influence of scale type (p = 0.0375) and scale domains (p < 0.001). The subgroup analysis indicated that the CPQ and COHIP scales presented very discrepant SMD values, despite pointing to the same effect direction. In contrast, the OHIP scale showed a non-significant difference between cases and controls, with estimates much lower than the other two scales. Results also suggest that OHRQoL associated with oral functionality and social well-being is more influential on outcomes than emotional well-being. Conclusion The global OHRQoL is slightly worst in the CLP patients than control group. The difference between OHRQoL was mainly detected through OHIP. The most affected domains are functional, emotional and social. Systematic review registration PROSPERO CRD42022336956. |
| first_indexed | 2024-03-09T14:52:09Z |
| format | Article |
| id | doaj.art-3bb5cfdc7753450c9a5d69ac4f4fb6dc |
| institution | Directory Open Access Journal |
| issn | 1472-6831 |
| language | English |
| last_indexed | 2024-03-09T14:52:09Z |
| publishDate | 2023-09-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Oral Health |
| spelling | doaj.art-3bb5cfdc7753450c9a5d69ac4f4fb6dc2023-11-26T14:24:54ZengBMCBMC Oral Health1472-68312023-09-0123111610.1186/s12903-023-03382-4Oral health-related quality of life in patients aged 8 to 19 years with cleft lip and palate: a systematic review and meta-analysisAugusto Garcia de Oliveira Júnior0Erik Montagna1Victor Zaia2Caio Parente Barbosa3Bianca Bianco4Postgraduation Program in Health Sciences, Faculdade de Medicina do ABC/Centro Universitário FMABCPostgraduation Program in Health Sciences, Faculdade de Medicina do ABC/Centro Universitário FMABCPostgraduation Program in Health Sciences, Faculdade de Medicina do ABC/Centro Universitário FMABCDiscipline of Sexual and Reproductive Health, and Populational Genetics, Department of Collective Health, Faculdade de Medicina do ABC/Centro Universitário FMABCDiscipline of Sexual and Reproductive Health, and Populational Genetics, Department of Collective Health, Faculdade de Medicina do ABC/Centro Universitário FMABCAbstract Background Cleft lip and palate (CLP) is the most common facial birth defect worldwide and causes morphological, aesthetic, and functional problems with psychosocial implications for an individual’s life and well-being. The present systematic review and meta-analysis assessed whether the treatment of CLP impacts the oral health-related quality of life (OHRQoL) in children and adolescents in comparison to healthy controls. Methods We searched MEDLINE/PubMed, EMBASE, and PsycINFO databases using terms related to CLP, and included articles until August 2023. Observational comparison studies that assessed OHRQoL in non-syndromic CLP patients aged 8–19 years with validated scales designed to such aim or scales capable to identify aspects related to oral health compared to healthy controls were included. We used the ROBINS-I tool for risk of bias assessment. A meta-analysis of continuous variables was performed using inverse variance for pooling estimates, Standardized Mean Difference (SMD) as a summary measure, with random effects model. Heterogeneity was estimated by the I2 statistics. Sensitivity analyses included subgrouping based on the scale, risk of bias and scale domains. Meta-regression was performed under a mixed-effects model considering the variables type of scale, scale domains and risk of bias. Results Fourteen studies were included comprising 1,185 patients with CLP and 1,558 healthy controls. The direction of the effect of OHRQoL favoured the healthy group (-0.92; 95% CI:-1,55;-0,10) and I2 = 95%. After removing three studies, I2 dropped to 80%. Meta-regression showed no influence on risk of bias (p = 0.2240) but influence of scale type (p = 0.0375) and scale domains (p < 0.001). The subgroup analysis indicated that the CPQ and COHIP scales presented very discrepant SMD values, despite pointing to the same effect direction. In contrast, the OHIP scale showed a non-significant difference between cases and controls, with estimates much lower than the other two scales. Results also suggest that OHRQoL associated with oral functionality and social well-being is more influential on outcomes than emotional well-being. Conclusion The global OHRQoL is slightly worst in the CLP patients than control group. The difference between OHRQoL was mainly detected through OHIP. The most affected domains are functional, emotional and social. Systematic review registration PROSPERO CRD42022336956.https://doi.org/10.1186/s12903-023-03382-4Cleft lip and palateOral health-related quality of lifePsychometryChild and adolescence |
| spellingShingle | Augusto Garcia de Oliveira Júnior Erik Montagna Victor Zaia Caio Parente Barbosa Bianca Bianco Oral health-related quality of life in patients aged 8 to 19 years with cleft lip and palate: a systematic review and meta-analysis BMC Oral Health Cleft lip and palate Oral health-related quality of life Psychometry Child and adolescence |
| title | Oral health-related quality of life in patients aged 8 to 19 years with cleft lip and palate: a systematic review and meta-analysis |
| title_full | Oral health-related quality of life in patients aged 8 to 19 years with cleft lip and palate: a systematic review and meta-analysis |
| title_fullStr | Oral health-related quality of life in patients aged 8 to 19 years with cleft lip and palate: a systematic review and meta-analysis |
| title_full_unstemmed | Oral health-related quality of life in patients aged 8 to 19 years with cleft lip and palate: a systematic review and meta-analysis |
| title_short | Oral health-related quality of life in patients aged 8 to 19 years with cleft lip and palate: a systematic review and meta-analysis |
| title_sort | oral health related quality of life in patients aged 8 to 19 years with cleft lip and palate a systematic review and meta analysis |
| topic | Cleft lip and palate Oral health-related quality of life Psychometry Child and adolescence |
| url | https://doi.org/10.1186/s12903-023-03382-4 |
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