Dento-skeletal Sequel of Hyrax in Nonsyndromic Cleft Lip and Palate: A Systematic Review and Meta-analysis
Udayakumar Deepika, Prayas Ray, Amit Nayak, Louis Soloman Simon, Manoranjan Mahakur, Moushmi Sahu
Keywords :
Cleft palate rapid expansion, Rapid maxillary expansion cleft palate, Rapid palatal expansion in cleft palate with hyrax
Citation Information :
Deepika U, Ray P, Nayak A, Simon LS, Mahakur M, Sahu M. Dento-skeletal Sequel of Hyrax in Nonsyndromic Cleft Lip and Palate: A Systematic Review and Meta-analysis. Int J Clin Pediatr Dent 2023; 16 (6):882-896.
Aim: To critically evaluate and review the dento-skeletal outcomes of hyrax with or without nonsurgical protraction therapy in nonsyndromic cleft lip and palate (CLP) patients.
Materials and methods: Electronic databases were searched from PubMed, Cochrane, Scopus, SciELO, Lilacs, and Google Scholar from January 2005 to April 2022 to identify studies reporting on the dento-skeletal effect of hyrax with or without nonsurgical protraction therapy among children aged 7–15 years with CLP before the secondary alveolar bone grafting (SABG) procedure. Abstracts and subsequently eligible full-text articles were screened. The risk of bias in the included randomized and nonrandomized studies was assessed using Cochrane collaboration's risk of bias tool. The random-effects meta-analyses of the mean difference were carried out.
Results: A total of 423 studies were identified. After a thorough screening, 19 studies met the inclusion criteria. Of these 19 studies, 13 studies were conducted with only hyrax appliances, six studies had hyrax with nonsurgical protraction therapy.
Conclusion: Hyrax had increased intermolar width, anterior nasal cavity width, and posterior maxillary width compared to inverted mini hyrax with p-values = 0.027, 0.004, and 0.03, respectively. Inverted mini hyrax had more canine inclination on noncleft than hyrax. Hyrax and fan-type expanders had an equivalent effect on the dento-skeletal structures indicating that hyrax can be used as an alternative to fan-type expanders. Hyrax with protraction therapy had a remarkable change in ANB angle compared to noncleft patients.
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