Is caries prevalence site‑specific in cleft lip and palate patients? A systematic review and meta‑analysis

Abstract

Background: Previous systematic reviews indicate that there is an increased prevalence of caries
in cleft patients in comparison to their healthy control group. To date, the prevalence of caries
between unilateral cleft lip and palate (UCLP) and bilateral cleft lip and palate (BCLP) has not
been quantitatively evaluated. This review aims to include published studies that examined caries
prevalence in patients with UCLP and BCLP to find out whether a quantitative difference exists
in caries experience among them.
Materials and Methods: Medline/PubMed, Scopus, and EBSCOhost databases were searched
from inception to November 2021. The protocol was registered with PROSPERO registration
no. CRD2021292425. Prevalence‑based studies that evaluated caries experience using the
decayed–missing–filled teeth (DMFT) index in the permanent dentition or dmft in case of primary
dentition in patients with UCLP or BCLP were included in the analysis with the outcome given in
mean and standard deviation. Meta‑analysis was performed using a random effect model through
a forest plot. An adapted version of the Newcastle–Ottawa Scale for cross‑sectional studies was
modified to assess the quality of included studies.
Results: Three studies were included in the review. The difference in caries prevalence was
statistically significant in the permanent and primary dentition which were evaluated using DMFT
and dmft scores with P = 0.01 and P = 0.03, respectively. Forest plot values were obtained for
permanent dentition (DMFT) and primary dentition (dmft), 0.57 (95% confidence interval [CI]:
1.03–0.11) and 0.36 (95% CI: 0.69–0.03), respectively. The result of the meta‑analysis indicates that
patients with BCLP have higher caries prevalence.
Conclusion: The outcome of the study indicates a higher occurrence of caries in patients with
BCLP than UCLP in both permanent and primary dentition.
Key Words: Caries prevalence, cleft lip/palate, meta‑analysis, site‑specific, systematic review

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