{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,7]],"date-time":"2026-07-07T12:14:37Z","timestamp":1783426477727,"version":"3.54.6"},"reference-count":42,"publisher":"SAGE Publications","issue":"8","license":[{"start":{"date-parts":[[2025,10,14]],"date-time":"2025-10-14T00:00:00Z","timestamp":1760400000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["The Cleft Palate Craniofacial Journal"],"published-print":{"date-parts":[[2026,8]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>This systematic review and meta-analysis aimed to quantify morphological changes in the anterior maxillary arch\u2014specifically anterior cleft width (CW) and anterior curvature angle (ACA)\u2014following primary lip repair in children with unilateral cleft lip and palate (UCLP).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A comprehensive search of PubMed, Google Scholar, DOAJ, and the Cochrane Library was conducted through January 2025. Eligible studies reported quantitative pre- and post-operative data on anterior arch morphology. Pooled effect sizes were calculated using a random-effects model with the Knapp\u2013Hartung adjustment. Meta-regression assessed the influence of baseline cleft width and follow-up duration.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Ten studies comprising 11 patient cohorts and 265 participants met the inclusion criteria. The pooled mean difference in anterior CW) was \u22126.217\u2005mm (95% confidence interval (CI): \u22127.230 to \u22125.204;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u2009&lt;\u2009.001), with substantial heterogeneity (\n                      <jats:italic toggle=\"yes\">I<\/jats:italic>\n                      \u00b2\u2009=\u200981.8%). Meta-regression identified initial cleft width as a significant predictor (\n                      <jats:italic toggle=\"yes\">\u03b2<\/jats:italic>\n                      \u2009=\u2009\u22120.842;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u2009=\u2009.002), and follow-up duration showed a borderline association (\n                      <jats:italic toggle=\"yes\">\u03b2<\/jats:italic>\n                      \u2009=\u2009\u22120.387;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u2009=\u2009.051). The predictive equation was:\n                      <jats:italic toggle=\"yes\">CW(change)<\/jats:italic>\n                      \u2009\n                      <jats:italic toggle=\"yes\">=<\/jats:italic>\n                      \u2009\n                      <jats:italic toggle=\"yes\">4.465<\/jats:italic>\n                      \u2009\u2212\u2009\n                      <jats:italic toggle=\"yes\">0.842<\/jats:italic>\n                      \u2009\n                      <jats:italic toggle=\"yes\">\u00d7<\/jats:italic>\n                      \u2009\n                      <jats:italic toggle=\"yes\">initial width<\/jats:italic>\n                      \u2009\u2212\u2009\n                      <jats:italic toggle=\"yes\">0.387<\/jats:italic>\n                      \u2009\n                      <jats:italic toggle=\"yes\">\u00d7<\/jats:italic>\n                      \u2009\n                      <jats:italic toggle=\"yes\">duration.<\/jats:italic>\n                      Lip repair also reduced the anterior curvature angle (MD\u2009=\u2009\u221214.66\u00b0; 95% CI: \u221219.62 to \u22129.7), though heterogeneity was very high (\n                      <jats:italic toggle=\"yes\">I<\/jats:italic>\n                      \u00b2\u2009=\u200988.1%).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Primary lip repair significantly improves anterior arch dimensions in children with UCLP. Initial cleft width predicts postoperative changes, and the proposed model may support early treatment planning. However, due to substantial heterogeneity across studies, small sample sizes in some included cohorts, and very low certainty of evidence for both outcomes (GRADE approach), the findings should be interpreted with caution and considered exploratory.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/10556656251381637","type":"journal-article","created":{"date-parts":[[2025,10,14]],"date-time":"2025-10-14T15:42:07Z","timestamp":1760456527000},"page":"2565-2577","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["How Does the Anterior Maxillary Arch Change After Unilateral Lip Repair? 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