Dental and skeletal changes during pressure garment use in facial burns: a systematic review.

OBJECTIVE Concern exists regarding the combined effect of the burn itself in addition to the continuous use of the pressure garments on craniofacial structures. The purpose of this systematic review was to evaluate the available evidence regarding dental and skeletal changes produced during pressure garment use in facial burns. METHODS Several electronic databases were screened for relevant articles and reference lists of pertinent articles were also hand-searched. RESULTS Only a two-part study had the minimal set of criteria sought. They found that children with partial face burns had only a slightly reduced inferior growth of the mandible and an increase protrusion of anterior teeth, which stay unchanged even after discontinuation of the pressure garment. The group of children with total face burns showed changes in the direction of the growth of the mandible, from a normal anterior inferior direction to a more inferior direction, and in the maxillary horizontal growth. A trend of returning toward normality was found thereafter. CONCLUSIONS There is scarcity of studies reporting dentomaxillofacial effects after pressure garment use in facial burns. The level of evidence presented in these articles does not give support to any strong conclusion regarding the craniofacial effects of facial burn management.