Distracción osteogénica versus cirugía ortognática en pacientes con maxilares hipoplásicos y secuela de labio y paladar hendido: revisión sistemática de la literatura.

Galviz Tabares, Brandon; Gomez Rueda, Maria Alejandra

Distracción osteogénica versus cirugía ortognática en pacientes con maxilares hipoplásicos y secuela de labio y paladar hendido: revisión sistemática de la literatura.

dc.contributor.advisor	Ruiz Valero, Carlos Alberto
dc.contributor.advisor	Gamboa Hernandez, Carolina
dc.contributor.advisor	Tocora Rodriguez, Juan Camilo
dc.contributor.author	Galviz Tabares, Brandon
dc.contributor.author	Gomez Rueda, Maria Alejandra
dc.contributor.orcid	Galviz Tabares, Brandon [0009-0007-4242-9322]
dc.date.accessioned	2024-08-26T23:55:09Z
dc.date.available	2024-08-26T23:55:09Z
dc.date.issued	2024-07-25
dc.description.abstract	Antecedentes: La fisura labio-palatina, incluida Colombia, es una malformación muy frecuente, se asocia con hipoplasia maxilar y existen dos opciones quirúrgicas: osteogénesis por distracción y cirugía ortognática, cada una con sus implicaciones, por lo que es indispensable un adecuado plan de tratamiento diagnóstico. Existen estudios en Colombia sobre dichas alternativas y sus resultados. Objetivo: establecer los resultados clínicos a largo plazo de la distracción osteogénica del maxilar superior en comparación con la cirugía ortognática en el tratamiento de hipoplasia del maxilar en avances mayores a 10mm del maxilar superior en pacientes con antecedente de fisura de labio y paladar hendido de acuerdo con la literatura científica en población colombiana en un rango de edad entre 16-50 años de edad. Metodología: Se realizó una revisión sistemática en Medline y Embase y el protocolo fue archivado en PROSPERO como CRD42023482788. Se incluyeron MeSH, DeCs y palabras clave libres, así como ensayos aleatorios del grupo etario mencionado y comparación de técnicas. La búsqueda se adaptó a la base de datos, los títulos y resúmenes fueron revisados de forma independiente por dos investigadores del proyecto. Posteriormente, los mismos realizaron una revisión del texto completo y las diferencias se resolvieron por consenso. La extracción de datos se archivó en Excel y el control de calidad fue realizado por un segundo investigador. Dos revisores independientes adicionales evaluaron la calidad de la evidencia con la herramienta Cochrane para el riesgo de sesgo en ensayos aleatorios (RoB 2). Se desarrolló una síntesis narrativa con los datos sobre recaída de tejidos blandos y duros, hipernasalidad, función velofaríngea, emisión nasal y comorbilidades posquirúrgicas. Resultados: La mayoría de los ensayos y los datos de la revisión no tuvieron una calidad óptima, por lo que se requiere más investigación. La tasa de satisfacción con la osteogénesis por distracción es mayor que con la cirugía ortognática; sin embargo, se requieren estudios prospectivos adicionales con una población más grande y estudios nacionales publicados para determinar la efectividad comparativa.
dc.description.abstractenglish	Background: Reported studies regarding oral microbiology among patients with cleft lip and palate (CLP) are scarce, especially those which evaluate the differences in oral microflora with and without an oro-nasal fissure. Oro-nasal communication is a factor associated with a higher risk of developing caries, periodontal disease, otitis media and complications during or after surgical procedures. The present study pretends to establish the differences in micro-flora in patients with CLP with and without oro-nasal communication which supports possible changes in the handling protocols of this type of patients. Objective: to describe the oral micro-flora in children with cleft lip and palate, with or without oro-nasal communication, compared with a non-cleft control group. Materials and methods: An informed consentient was previously signed and 25 patients with CLP with an oro-nasal fistula, 25 patients with CLP but without oro-nasal fistula and a control group comprised of 25 children without CLP with ages ranging between 7 and 15 years of age were assessed. Saliva and palatal swab samples were taken, particularly among the fistula group. The samples were processed for the identification and quantification of aerobic, anaerobic and over-infecting micro-organisms by means of a culture technique. Descriptive and comparison analyses were carried out between groups with the Kruskal Wallis and U Mann Whitney tests. Results: Among the micro-organisms studied in the saliva, the Streptococcus of the viridians group presented significant differences among the p = 0.001 groups. The swab samples from the patients with an oro-nasal fistula presented an over-growth of Capnocythophaga spp p = 0.019 and no significant differences in Candida albicans p = 0.09. Conclusions: The clinical and socio-demographic valuation contributes to a higher risk of caries and periodontal disease. New protocols must be evaluated for oro-nasal hygiene among these patients.
dc.description.degreelevel	Especialización	spa
dc.description.degreename	Especialista en cirugía oral y maxilofacial	spa
dc.description.sponsorship	Grupo de Investigación UNIECLO – Unidad de Epidemiologia Clínica Oral
dc.format.mimetype	application/pdf
dc.identifier.instname	instname:Universidad El Bosque	spa
dc.identifier.reponame	reponame:Repositorio Institucional Universidad El Bosque	spa
dc.identifier.repourl	repourl:https://repositorio.unbosque.edu.co
dc.identifier.uri	https://hdl.handle.net/20.500.12495/12903
dc.language.iso	es
dc.publisher.faculty	Facultad de Odontología	spa
dc.publisher.grantor	Universidad El Bosque	spa
dc.publisher.program	Especialización en cirugía oral y maxilofacial	spa
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dc.rights	Atribución-NoComercial-CompartirIgual 4.0 Internacional
dc.rights.accessrights	info:eu-repo/semantics/openAccess
dc.rights.accessrights	http://purl.org/coar/access_right/c_abf2
dc.rights.local	Acceso abierto	spa
dc.rights.uri	http://creativecommons.org/licenses/by-nc-sa/4.0/
dc.subject	Labio y paladar hendido
dc.subject	Malformaciones craneofaciales
dc.subject	Maxilares hipoplasicos
dc.subject	Distraccion osteogenica
dc.subject	Cirugia ortognatica
dc.subject.keywords	Cleft lip and palate
dc.subject.keywords	Craniofacial malformations
dc.subject.keywords	Maxillary hypoplasia
dc.subject.keywords	Distraction osteogenesis
dc.subject.keywords	Orthognatic Surgery
dc.subject.nlm	WU 600
dc.title	Distracción osteogénica versus cirugía ortognática en pacientes con maxilares hipoplásicos y secuela de labio y paladar hendido: revisión sistemática de la literatura.
dc.title.translated	Osteogenic distraction versus orthognathic surgery in patients with hypoplastic maxillaries and cleft lip and palate sequelae: systematic review of the literature.
dc.type.coar	https://purl.org/coar/resource_type/c_7a1f
dc.type.coarversion	https://purl.org/coar/version/c_970fb48d4fbd8a85
dc.type.driver	info:eu-repo/semantics/bachelorThesis
dc.type.hasversion	info:eu-repo/semantics/acceptedVersion
dc.type.local	Tesis/Trabajo de grado - Monografía - Especialización	spa