Impacto da reabilitação com implantes e próteses dentárias em sujeitos com fissuras labiopalatais: uma revisão sistemática da literatura

Abstract

Cleft lip and palate represent the second most frequent congenital deformity, usually associated with aesthetic deformations, dental abnormalities, speech problems swallowing and growth. The majority of the studies that assessed the success of dental implants and prostheses in cleft patients was not held with a thorough and systematic methodology, or presents a small number of patients. The aim of this systematic review was to assess the success/survival rates of implants and prostheses in cleft patients and their satisfaction with aesthetics, phonetics and chewing. An electronic search was performed in nine databases by two independent and calibrated reviewers, followed by hand search within ten journals in the field using eligibility criteria, key-words and quality assessment. Electronic search yielded 323 and 180 studies for title and abstract screening, respectively. Following hand search and full-text screening, 27 studies were included with case series, cohort, cross-sectional and retrospective (majority) designs. Twenty-one studies provided implant-supported prostheses whereas seven provided tooth-supported prostheses for the patients. Follow-up period ranged from 1 month to 25 years. Success rate of the implants ranged from 80 to 100%. Regarding the prostheses, success rates were as follows: telescopic crowns (60%); bar-retained prostheses (78%); and fixed prostheses (78-100%). Patient's satisfaction with regards to chewing, phonetics and aesthetics ranged from 70 to 85%. It can be concluded that there are evidences that cleft patients can be successfully rehabilitated with dental prostheses with or without implant, combined or not with bone graft, as long as a meticulous treatment plan of the case is done. The included studies were all very heterogeneous with regards to the methodology and results; thus, a meta-analysis could not be performed.