{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T16:40:55Z","timestamp":1791996055317,"version":"4.4.0"},"reference-count":87,"publisher":"MDPI AG","issue":"21","license":[{"start":{"date-parts":[[2021,10,20]],"date-time":"2021-10-20T00:00:00Z","timestamp":1634688000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Significant treatment variation exists in the Netherlands between teams treating patients with cleft lip, alveolus, and\/or palate, resulting in a confusing and undesirable situation for patients, parents, and practitioners. Therefore, to optimize cleft care, clinical practice guidelines (CPGs) were developed. The aim of this report is to describe CPG development, share the main recommendations, and indicate knowledge gaps regarding cleft care. Together with patients and parents, a multidisciplinary working group of representatives from all relevant disciplines assisted by two experienced epidemiologists identified the topics to be addressed in the CPGs. Searching the Medline, Embase, and Cochrane Library databases identified 5157 articles, 60 of which remained after applying inclusion and exclusion criteria. We rated the quality of the evidence from moderate to very low. The working group formulated 71 recommendations regarding genetic testing, feeding, lip and palate closure, hearing, hypernasality, bone grafting, orthodontics, psychosocial guidance, dentistry, osteotomy versus distraction, and rhinoplasty. The final CPGs were obtained after review by all stakeholders and allow cleft teams to base their treatment on current knowledge. With high-quality evidence lacking, the need for additional high-quality studies has become apparent.<\/jats:p>","DOI":"10.3390\/jcm10214813","type":"journal-article","created":{"date-parts":[[2021,10,20]],"date-time":"2021-10-20T21:29:46Z","timestamp":1634765386000},"page":"4813","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":67,"title":["Clinical Practice Guidelines on the Treatment of Patients with Cleft Lip, Alveolus, and Palate: An Executive Summary"],"prefix":"10.3390","volume":"10","author":[{"given":"Aebele B.","family":"Mink van der Molen","sequence":"first","affiliation":[{"name":"Department of Plastic and Reconstructive Surgery, University Medical Center Utrecht, 3584 CX Utrecht, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Johanna M. M.","family":"van Breugel","sequence":"additional","affiliation":[{"name":"Department of Plastic and Reconstructive Surgery, University Medical Center Utrecht, 3584 CX Utrecht, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nard G.","family":"Janssen","sequence":"additional","affiliation":[{"name":"Department Maxillo Facial Surgery and Dentistry, University Medical Center Utrecht, 3584 CX Utrecht, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ronald J. C.","family":"Admiraal","sequence":"additional","affiliation":[{"name":"Department of Oto-Rhino-Laryngology, Radboud University Medical Center, 6500 HB Nijmegen, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Leon N. A.","family":"van Adrichem","sequence":"additional","affiliation":[{"name":"Department of Plastic and Reconstructive Surgery, University Medical Center Utrecht, 3584 CX Utrecht, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Frank","family":"Bierenbroodspot","sequence":"additional","affiliation":[{"name":"Department Maxillo Facial Surgery, Isala, 8025 AB Zwolle, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dirk","family":"Bittermann","sequence":"additional","affiliation":[{"name":"Department Maxillo Facial Surgery and Dentistry, University Medical Center Utrecht, 3584 CX Utrecht, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marie-Jos\u00e9 H.","family":"van den Boogaard","sequence":"additional","affiliation":[{"name":"Department of Clinical Genetics, University Medical Center Utrecht, 3584 CX Utrecht, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pieter H.","family":"Broos","sequence":"additional","affiliation":[{"name":"Knowledge Institute of the Federation of Medical Specialists, 3528 BL Utrecht, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Janet J. M.","family":"Dijkstra-Putkamer","sequence":"additional","affiliation":[{"name":"Department of Speech Therapy, Medical Center Leeuwarden, 8934 AD Leeuwarden, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martine C. M.","family":"van Gemert-Schriks","sequence":"additional","affiliation":[{"name":"Academic Dentistry Center (ACTA), 1081 LA Amsterdam, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrea L. J.","family":"Kortlever","sequence":"additional","affiliation":[{"name":"Knowledge Institute of the Federation of Medical Specialists, 3528 BL Utrecht, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chantal M.","family":"Mou\u00ebs-Vink","sequence":"additional","affiliation":[{"name":"Department of Plastic and Reconstructive Surgery, Medical Center Leeuwarden, 8934 AD Leeuwarden, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Henriette F. N.","family":"Swanenburg de Veye","sequence":"additional","affiliation":[{"name":"Department Medical Psychology, University Medical Center Utrecht, 3584 CX Utrecht, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nanouk","family":"van Tol-Verbeek","sequence":"additional","affiliation":[{"name":"Association of Educationalists in the Netherlands, 3527 GV Utrecht, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christl","family":"Vermeij-Keers","sequence":"additional","affiliation":[{"name":"Dutch Association for Cleft Palate and Craniofacial Anomalies, 3643 AE Mijdrecht, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hester","family":"de Wilde","sequence":"additional","affiliation":[{"name":"Department of Speech Therapy, University Medical Center Utrecht, 3584 CX Utrecht, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8172-0090","authenticated-orcid":false,"given":"Anne Marie","family":"Kuijpers-Jagtman","sequence":"additional","affiliation":[{"name":"Department of Orthodontics, University Medical Center Groningen, University of Groningen, 9713 GZ Groningen, The Netherlands"},{"name":"Department of Orthodontics and Dentofacial Orthopedics, School of Dental Medicine, Medical Faculty, University of Bern, CH-3010 Bern, Switzerland"},{"name":"Faculty of Dentistry, Universitas Indonesia, Jakarta 10430, Indonesia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2021,10,20]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"173","DOI":"10.1597\/08-150","article-title":"Ten years recording common oral clefts with a new descriptive system","volume":"48","author":"Luijsterburg","year":"2011","journal-title":"Cleft Palate-Craniofac. 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