Methods: Electronic databases, grey literature, and reference list searches were conducted. The inclusion criteria were longitudinal (treatment) studies with at least 6 months follow-up evaluating midfacial advancement with LFIII osteotomy in patients with SMH due to craniofacial synostosis syndromes (e.g., Apert, Crouzon, Pfeiffer, and Saethre-Chotzen). Full articles were retrieved from abstracts or titles that appear to meet the inclusion criteria or lacked sufficient detail for immediate exclusion. Once full articles were collected they were again reviewed considering more detailed inclusion criteria for a final selection decision. Distance of advancement as well as short and long-term stability were evaluated on lateral cephalograms. Due to the quality of the obtained data, only a qualitative analysis was performed. A methodological quality assessment tool was utilized.
Results: 11 studies were finally selected (5 retrospective clinical trials and 6 case series studies). The methodologic quality was low in all the studies. All the finally included studies demonstrated LFIII osteotomy as an effective technique in management of SMH. The initial assessment of the data showed that the horizontal relapse was less than 20% in six studies.
Conclusions: Midfacial advancement with LFIII osteotomy is an effective technique and has good short and long-term stability in patients with SMH.