Effects of labial adhesion on maxillary arch dimensions and nasolabial esthetics in cleft lip and palate: a systematic review.

Labial adhesion is a preliminary surgical lip approximation used in the early management of unilateral and bilateral cleft lip and palate. Our objective was to evaluate its effects on the maxillary arch dimensions and nasolabial esthetics by means of a systematic review. The literature search (1955-2016) was based on MEDLINE via PubMed, Web of Science, EMBASE, and the Cochrane Library. Studies with labial adhesion as a single preliminary step for definitive lip closure, in combination with nasoalveolar molding or in combination with infant orthopedics were considered eligible. Fifteen articles were identified (1978-2015), including 587 patients who underwent labial adhesion. Reduction in alveolar cleft width was between 60.9% and 100% in unilateral cases and between 47.5% and 100% in bilateral cases. Reduction in palatal cleft width was between 28.4% and 59.8% in unilateral cases and between 37.5% and 50.5% in bilateral cases. No conclusive results could be drawn about the effect on nasolabial esthetics. This systematic review comprises the available literature of the last 50 years about labial adhesion. It showed reduction of alveolar and palatal cleft width after a treatment with labial adhesion with or without infant orthopedics. The treatment effect on nasolabial esthetics, especially in the long term, remains unclear.