Background: Alveolar bone reconstruction with recombinant protein has several advantages, including less surgical timing, and reduced infection. This systematic review aims to assess the efficacy of recombinant human bone morphogenetic protein-2 (rhBMP-2) as a treatment modality for children with cleft lip and palate compared to the conventional iliac crest bone grafting approach. Methods: For current systematic review and meta-analysis, five electronic databases, namely, MEDLINE/PubMed, the Cochrane Central Register of Controlled Trials (CENTRAL), ClinicalTrials.gov, Web of Science, and ScienceDirect, were searched. The primary outcome measured in this review was bone volume and height after alveolar bone reconstruction surgery. The Risk of Bias Tool 2 assessed the risk of bias for randomized control trials and the Risk of Bias tool for non-randomized trials of interventions for non-randomized studies. By evaluating pooled meta-analysis, the mean difference was calculated. GRADE uncertainty of evidence was performed to assess the certainty of the results. Results: Of 230 identified studies, 6 randomized and 2 non-randomized studies were included in the current review. The average bone volume was higher among the rhBMP-2 group at 61.11% ± 24.6% than the iliac crest group at 59.12% ± 18.59%. The calculated mean bone height was higher in the iliac crest group at 78.65% ± 14.38% than in the rhBMP-2 group at 67.5% ± 5.45%. The risk of bias reported in the studies was low to moderate. The result of the meta-analysis supported using rhBMP-2 in alveolar bone reconstruction; however, no significant association was found (mean difference: −1.24; confidence interval: −4.14 to 1.67). Conclusions: The calculated meta-analysis reported no significant difference, and the quality of evidence measured was also moderate. Hence, more clinical trials are required to support using rhBMP-2 as an alternative to traditional techniques for treating cleft lip and palate.

This study evaluated the efficacy of various cleaning protocols on two nickel–titanium (NiTi) file systems—RaCe EVO(RE) and EdgeFile X7(EE)—using scanning electron microscopy (SEM) and energy-dispersive X-ray spectroscopy (EDX). Eighty-four NiTi files (42RE, 42EE) were divided into seven groups (n = 12), including a group with unused, sterilized files and a group of used files without cleaning. The remaining files were subjected to simulated clinical use, followed by different cleaning methods, such as soaking in sodium hypochlorite (NaOCl), ethanol wiping (with or without magnification), enzymatic spray, and enzymatic solution. SEM images were imported into ImageJ to quantify surface changes, while EDX assessed elemental composition. The p-value was set to ≤0.05 for significance. Apart from the unused files, calcium and phosphorus—indicators of dentin debris—were present in all groups, especially those cleaned with enzymatic spray (p ≤ 0.0001). Their percentage in RE files soaked in NaOCl or wiped with ethanol was statistically lower than the positive control (p ≤ 0.0001). Post-use, all files showed significantly higher surface asymmetry in Groups 2 and 6 (p = 0.001). Cleaning efficacy depends on the type of NiTi file. RE files responded well to both wiping and soaking, while EE required soaking for effective debris removal. Enzymatic spray was ineffective.