Comparative assessment of periodontal conditions between bilateral cleft lip and palate (BCLP) and unilateral cleft lip and palate (UCLP): A systematic review and meta-analysis

The existing literature on the periodontal condition in different cleft types is inconclusive and has yielded conflicting results. Therefore, the aim of this systematic review and meta-analysis is to assess and compare the oral health needs of children with bilateral cleft lip and palate (BCLP) with those of children with unilateral cleft lip and palate (UCLP).Six electronic databases were thoroughly searched for articles published up to June 2022 that directly compared the periodontal condition of BCLP patients with that of UCLP patients. A meta-analysis was conducted using the random-effects model with inverse variance weighting. The literature search yielded 858 articles, out of which 58 studies were selected for a full-text review. Finally, 5 articles, which compared 86 BCLP individuals with 132 UCLP patients across 3 continents, were evaluated. The selected papers compared gingival and periodontal parameters, including the plaque index (PI), the gingival index (GI), periodontal probing depth (PPD), and clinical attachment loss (CAL).The meta-analysis revealed a significant difference in CAL on the facial side in BCLP individuals (mean difference: -0.44, 95% confidence interval (CI): 0.27-0.61, Z = 5.07, p < 0.0001). The remaining parameters did not reveal any significant differences between the 2 groups.In light of the established correlation between cleft lip and palate morbidity and surgical interventions on gingival and periodontal health, these factors must be incorporated into treatment planning.