{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T13:57:33Z","timestamp":1790776653268,"version":"4.1.0"},"reference-count":44,"publisher":"SAGE Publications","issue":"9","license":[{"start":{"date-parts":[[2025,11,17]],"date-time":"2025-11-17T00:00:00Z","timestamp":1763337600000},"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":[[2026,9]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>This systematic review and meta-analysis aimed to evaluate electromyographic (EMG) activity of the orbicularis oris muscle in children, adolescents, and young adults with repaired cleft lip and\/or palate (CLP), compared to noncleft controls.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>Systematic review and Meta-analysis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Patients and Exposures<\/jats:title>\n                    <jats:p>Patients with CLP.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Comparison<\/jats:title>\n                    <jats:p>Patients without CLP.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Main Outcome Measures<\/jats:title>\n                    <jats:p>Electrical activity of orbicularis oris muscle at rest and during swallowing salaiva, lip compression, and articulation of bilabial phonemes (\/pa\/, \/ba\/, and \/ma\/).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods &amp; Materials<\/jats:title>\n                    <jats:p>\n                      Observational studies reporting quantitative surface EMG outcomes of the orbicularis oris in participants with repaired CLP and noncleft controls were included. Data extraction and risk of bias assessment were performed independently by two reviewers; certainty of evidence was evaluated with Grading of Recommendations, Assessment, Development and Evaluation, and heterogeneity was assessed with\n                      <jats:italic toggle=\"yes\">I<\/jats:italic>\n                      <jats:sup>2<\/jats:sup>\n                      .\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>A comprehensive literature search was conducted across five databases (MEDLINE, Web of Science, EMBASE, Scopus, CENTRAL) from their inception until February 2025. Eligible observational studies based on the PECO question were selected and assessed for bias using the ROBINS-E tool. Random-effects meta-analyses were used to pool mean differences. Finally, six studies met the inclusion criteria. Pooled findings showed significantly higher orbicularis oris EMG amplitudes in tasks requiring strong lip seal\u2014saliva swallowing, lip compression, and the bilabial phenome \/pa\/\u2014among participants with repaired CLP relative to controls. In contrast, EMG activity at rest and certain other bilabial phonemes (\/ba\/ and \/ma\/) showed borderline or nonsignificant differences. Heterogeneity was generally moderate to high, reflecting methodological diversity among studies.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Children with repaired CLP exhibit elevated orbicularis oris muscle activity during tasks demanding strong lip closure. This may represent a compensatory mechanism to overcome structural alterations or scarring. Although such hyperactivation can enhance oral function (eg, swallowing and speech), it might also have long-term implications for maxillary growth or soft-tissue scarring.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/10556656251391504","type":"journal-article","created":{"date-parts":[[2025,11,17]],"date-time":"2025-11-17T18:03:02Z","timestamp":1763402582000},"page":"2808-2821","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":1,"title":["Evaluation of Electromyographic Activity of Orbicularis oris Muscle in Cleft Lip and Palate Patients: A Systematic Review and Meta-analysis"],"prefix":"10.1177","volume":"63","author":[{"ORCID":"https:\/\/orcid.org\/0009-0001-4453-2952","authenticated-orcid":false,"given":"Mahsa","family":"Ghorbani","sequence":"first","affiliation":[{"name":"Dental Research Center, Mashhad University of Medical Sciences"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shirin","family":"Shahnaseri","sequence":"additional","affiliation":[{"name":"School of Dentistry, Meharry Medical College"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4606-9551","authenticated-orcid":false,"given":"Chung H.","family":"Kau","sequence":"additional","affiliation":[{"name":"School of Dentistry, University of Alabama at Birmingham"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3780-5032","authenticated-orcid":false,"given":"Erfan","family":"Bardideh","sequence":"additional","affiliation":[{"name":"Dental Research Center, Mashhad University of Medical Sciences"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Seyed A.","family":"Mousavi","sequence":"additional","affiliation":[{"name":"School of Dentistry, Meharry Medical College"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hooman","family":"Shafaee","sequence":"additional","affiliation":[{"name":"Dental Research Center, Mashhad University of Medical Sciences"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Reyhaneh","family":"Gholamifard","sequence":"additional","affiliation":[{"name":"Mashhad University of Medical Sciences"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2025,11,17]]},"reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.adnc.2004.12.006"},{"key":"e_1_3_2_3_2","volume-title":"Taber's cyclopedic medical dictionary","author":"Venes D","year":"2017","unstructured":"Venes D. Taber's cyclopedic medical dictionary. FA Davis; 2017."},{"issue":"1","key":"e_1_3_2_4_2","article-title":"Genetics of cleft lip and palate: Syndromic genes contribute to the incidence of non-syndromic clefts","volume":"13","author":"Stanier P","year":"2004","unstructured":"Stanier P, Moore GE. Genetics of cleft lip and palate: Syndromic genes contribute to the incidence of non-syndromic clefts. Hum Mol Genet. 2004;13(suppl_1):R73\u2010R81.","journal-title":"Hum Mol Genet."},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcms.2015.08.013"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.1597\/1545-1569_2001_038_0068_dccfaa_2.0.co_2"},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.1597\/1545-1569_1997_034_0531_icaruc_2.3.co_2"},{"key":"e_1_3_2_8_2","doi-asserted-by":"publisher","DOI":"10.1155\/2014\/583416"},{"issue":"6","key":"e_1_3_2_9_2","first-page":"416","article-title":"Surface electromyography in orthodontics\u2013a literature review","volume":"19","author":"Wo\u0178niak K","year":"2013","unstructured":"Wo\u0178niak K, Pi\u0105tkowska D, Lipski M, Mehr K. Surface electromyography in orthodontics\u2013a literature review. Med Sci Monit Int Med J Exp Clin Res. 2013;19(6):416.","journal-title":"Med Sci Monit Int Med J Exp Clin Res"},{"issue":"2","key":"e_1_3_2_10_2","first-page":"271","article-title":"Chewing efficiency of prepubertal children with cleft lip and\/or palate","volume":"13","author":"Yamamoto I","year":"1988","unstructured":"Yamamoto I. Chewing efficiency of prepubertal children with cleft lip and\/or palate. J Jpn Cleft Palate Assoc. 1988;13(2):271\u2013280.","journal-title":"J Jpn Cleft Palate Assoc"},{"key":"e_1_3_2_11_2","doi-asserted-by":"publisher","DOI":"10.1016\/0007-1226(83)90081-4"},{"issue":"1","key":"e_1_3_2_12_2","first-page":"5","article-title":"Actividad electromiogr\u00e1fica del m\u00fasculo oris orbicularis en pacientes con labio hendido. Estudio piloto","volume":"18","author":"Rivera JAC","year":"2023","unstructured":"Rivera JAC, Bello JG, Ram\u00edrez JJM, Rodr\u00edguez DF, Gonz\u00e1lez FDJI, Guti\u00e9rrez J\u00c1G. Actividad electromiogr\u00e1fica del m\u00fasculo oris orbicularis en pacientes con labio hendido. Estudio piloto. Rev Mex Cir Bucal Maxilofac. 2023;18(1-3):5\u201011.","journal-title":"Rev Mex Cir Bucal Maxilofac"},{"key":"e_1_3_2_13_2","doi-asserted-by":"publisher","DOI":"10.34172\/jlms.2022.67"},{"key":"e_1_3_2_14_2","doi-asserted-by":"publisher","DOI":"10.3390\/jcm10081720"},{"key":"e_1_3_2_15_2","doi-asserted-by":"publisher","DOI":"10.1001\/jamasurg.2021.0522"},{"issue":"5","key":"e_1_3_2_16_2","first-page":"42","article-title":"Electromyographic characteristics of the muscles of the perioral region in residual deformities of the nose and upper lip following elimination of unilateral congenital cleft","volume":"54","author":"Kosachev AN","year":"1975","unstructured":"Kosachev AN, Korneev Iu A, Verbanov VS. [Electromyographic characteristics of the muscles of the perioral region in residual deformities of the nose and upper lip following elimination of unilateral congenital cleft]. Stomatologiia (Mosk). 1975;54(5):42--45.","journal-title":"Stomatologiia (Mosk)"},{"issue":"3","key":"e_1_3_2_17_2","first-page":"45","article-title":"Results of the electromyographic study of the mimetic muscles of healthy persons and of patients with clefts of the soft and hard palates","volume":"59","author":"Shchegoleva VD","year":"1980","unstructured":"Shchegoleva VD, Lagutina TS. [Results of the electromyographic study of the mimetic muscles of healthy persons and of patients with clefts of the soft and hard palates]. Stomatologiia (Mosk). 1980;59(3):45--48.","journal-title":"Stomatologiia (Mosk)"},{"issue":"6","key":"e_1_3_2_18_2","first-page":"427","article-title":"Electromyographic study of cleft palate","volume":"21","author":"Li CL","year":"1958","unstructured":"Li CL, Lundervold A. Electromyographic study of cleft palate. Plast Reconstr Surg Transplant Bull. 1958;21(6):427--432.","journal-title":"Plast Reconstr Surg Transplant Bull"},{"key":"e_1_3_2_19_2","doi-asserted-by":"publisher","DOI":"10.1597\/1545-1569_1992_029_0032_soomai_2.3.co_2"},{"key":"e_1_3_2_20_2","doi-asserted-by":"publisher","DOI":"10.1597\/1545-1569(1994)031<0056:EAOLMF>2.3.CO;2"},{"issue":"6","key":"e_1_3_2_21_2","first-page":"342","article-title":"Electromyography of perioral muscles in the cleft lip and palate patients with crossbite","volume":"29","author":"Li WR","year":"1994","unstructured":"Li WR, Lin JX, Fu MK. Electromyography of perioral muscles in the cleft lip and palate patients with crossbite. Zhonghua Kou Qiang Yi Xue Za Zhi. 1994;29(6):342--345, 84.","journal-title":"Zhonghua Kou Qiang Yi Xue Za Zhi"},{"key":"e_1_3_2_22_2","doi-asserted-by":"publisher","DOI":"10.1597\/1545-1569_2000_037_0286_csbcwa_2.3.co_2"},{"key":"e_1_3_2_23_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcms.2017.06.012"},{"issue":"1","key":"e_1_3_2_24_2","first-page":"31","article-title":"The influence of lip function on the sagittal and transversal development of the maxilla in cleft patients","volume":"21","author":"G\u00f6z G","year":"1987","unstructured":"G\u00f6z G, Joos U, Schilli W. The influence of lip function on the sagittal and transversal development of the maxilla in cleft patients. Scand J Plast Reconstr Surg Hand Surg. 1987;21(1):31--34.","journal-title":"Scand J Plast Reconstr Surg Hand Surg"},{"key":"e_1_3_2_25_2","doi-asserted-by":"publisher","DOI":"10.1121\/1.1981814"},{"issue":"3","key":"e_1_3_2_26_2","article-title":"Use of botulinum toxin in cheiloplasty: A new method to decrease tension","volume":"17","author":"Gal\u00e1rraga IM","year":"2009","unstructured":"Gal\u00e1rraga IM. Use of botulinum toxin in cheiloplasty: A new method to decrease tension. Can J Plast Surg. 2009;17(3):e1--e2.","journal-title":"Can J Plast Surg"},{"issue":"4","key":"e_1_3_2_27_2","first-page":"405","article-title":"Electromyographic verification of viable muscle tissue following a double-pendulum flap procedure for surgical repair of bilateral cleft lip","volume":"12","author":"Moceri LM","year":"1975","unstructured":"Moceri LM, McClung JA, Kapetansky DI. Electromyographic verification of viable muscle tissue following a double-pendulum flap procedure for surgical repair of bilateral cleft lip. Cleft Palate J. 1975;12(4):405\u2013408.","journal-title":"Cleft Palate J"},{"key":"e_1_3_2_28_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00056-013-0193-5"},{"key":"e_1_3_2_29_2","doi-asserted-by":"publisher","DOI":"10.1177\/10556656231201235"},{"issue":"2","key":"e_1_3_2_30_2","first-page":"537","article-title":"An important morphological feature of the face: Upper lip length","volume":"60","author":"Negru\u0163iu BM","year":"2019","unstructured":"Negru\u0163iu BM, Vaida LL, Todor BI, Judea AS, Lile IE, Moca AE, , Judea-Pusta CT. An important morphological feature of the face: Upper lip length. Rom J Morphol Embryol. 2019;60(2):537\u2013541.","journal-title":"Rom J Morphol Embryol"},{"key":"e_1_3_2_31_2","doi-asserted-by":"publisher","DOI":"10.1002\/cre2.725"},{"issue":"5","key":"e_1_3_2_32_2","first-page":"371","article-title":"Electromyography study on complete bilateral cleft lip after reparation","volume":"13","author":"Zheng PH","year":"2004","unstructured":"Zheng PH, Wei FC, Zheng JW, Song DH, Zhang KH. [Electromyography study on complete bilateral cleft lip after reparation]. Shanghai Kou Qiang Yi Xue. 2004;13(5):371\u2010374.","journal-title":"Shanghai Kou Qiang Yi Xue"},{"key":"e_1_3_2_33_2","doi-asserted-by":"publisher","DOI":"10.1097\/SCS.0000000000004587"},{"key":"e_1_3_2_34_2","doi-asserted-by":"publisher","DOI":"10.2209\/tdcpublication.40.195"},{"key":"e_1_3_2_35_2","doi-asserted-by":"publisher","DOI":"10.1097\/SCS.0000000000007836"},{"key":"e_1_3_2_36_2","doi-asserted-by":"publisher","DOI":"10.1097\/00006534-196212000-00005"},{"issue":"4","key":"e_1_3_2_37_2","first-page":"260","article-title":"Attempt at evaluation of functional conditions in the region of cleft lip (employing EMG and EEG examinations)","volume":"10","author":"Spinadel L","year":"1968","unstructured":"Spinadel L, Drechsler B, Lastovka M, Lesn\u00fd I. Attempt at evaluation of functional conditions in the region of cleft lip (employing EMG and EEG examinations). Acta Chir Plast. 1968;10(4):260\u2010266.","journal-title":"Acta Chir Plast"},{"key":"e_1_3_2_38_2","doi-asserted-by":"publisher","DOI":"10.1597\/1545-1569_1994_031_0173_eacfip_2.3.co_2"},{"key":"e_1_3_2_39_2","doi-asserted-by":"publisher","DOI":"10.1597\/1545-1569_1995_032_0323_fuoeac_2.3.co_2"},{"issue":"3","key":"e_1_3_2_40_2","article-title":"Use of botulinum toxin in cheiloplasty: A new method to decrease tension","volume":"17","author":"Cueva Ga\u013arraga IM","year":"2009","unstructured":"Cueva Ga\u013arraga IM. Use of botulinum toxin in cheiloplasty: A new method to decrease tension. Can J Plast Surg. 2009;17(3):e1\u2010e2.","journal-title":"Can J Plast Surg"},{"key":"e_1_3_2_41_2","doi-asserted-by":"publisher","DOI":"10.1007\/s10103-019-02819-z"},{"key":"e_1_3_2_42_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.joms.2007.05.027"},{"issue":"1","key":"e_1_3_2_43_2","article-title":"Electromyographic evaluation of superior orbicularis oris muscle activity in patients with complete cleft lip and cleft palate before and after vestibuloplasty using carbon dioxide laser therapy","volume":"13","author":"Yassaei S","year":"2022","unstructured":"Yassaei S, Aghili H, Salarpour E, Dehghan Dehnavi A. Electromyographic evaluation of superior orbicularis oris muscle activity in patients with complete cleft lip and cleft palate before and after vestibuloplasty using carbon dioxide laser therapy. J Lasers Med Sci. 2022;13(1):e67.","journal-title":"J Lasers Med Sci"},{"issue":"1","key":"e_1_3_2_44_2","first-page":"38","article-title":"Evaluation of the electromyographic activity of masticatory and perioral muscles in cleft lip and palate patients","volume":"56","author":"Tun\u00e7ay S\u00d6","year":"2019","unstructured":"Tun\u00e7ay S\u00d6, Esenlik E, Koyuncuo\u01e7lu H. Evaluation of the electromyographic activity of masticatory and perioral muscles in cleft lip and palate patients. Cleft Palate Craniofac J. 2019;56(1):38.","journal-title":"Cleft Palate Craniofac J"},{"key":"e_1_3_2_45_2","doi-asserted-by":"publisher","DOI":"10.1001\/archfaci.8.3.221"}],"container-title":["The Cleft Palate Craniofacial Journal"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/10556656251391504","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/10556656251391504","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/10556656251391504","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T13:12:45Z","timestamp":1790773965000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/10556656251391504"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,11,17]]},"references-count":44,"journal-issue":{"issue":"9","published-print":{"date-parts":[[2026,9]]}},"alternative-id":["10.1177\/10556656251391504"],"URL":"https:\/\/doi.org\/10.1177\/10556656251391504","relation":{},"ISSN":["1055-6656","1545-1569"],"issn-type":[{"value":"1055-6656","type":"print"},{"value":"1545-1569","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,11,17]]}}}