{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,6]],"date-time":"2026-04-06T04:58:42Z","timestamp":1775451522934,"version":"3.50.1"},"reference-count":85,"publisher":"MDPI AG","issue":"7","license":[{"start":{"date-parts":[[2026,4,4]],"date-time":"2026-04-04T00:00:00Z","timestamp":1775260800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"FCT\u2014Funda\u00e7\u00e3o para a Ci\u00eancia e a Tecnologia","award":["UID\/00285\/2025"],"award-info":[{"award-number":["UID\/00285\/2025"]}]},{"name":"FCT\u2014Funda\u00e7\u00e3o para a Ci\u00eancia e a Tecnologia","award":["LA\/P\/0112\/2020"],"award-info":[{"award-number":["LA\/P\/0112\/2020"]}]},{"award":["UID\/00285\/2025"],"award-info":[{"award-number":["UID\/00285\/2025"]}],"id":[{"id":"https:\/\/ror.org\/00snfqn58","id-type":"ROR","asserted-by":"publisher"}]},{"award":["LA\/P\/0112\/2020"],"award-info":[{"award-number":["LA\/P\/0112\/2020"]}],"id":[{"id":"https:\/\/ror.org\/00snfqn58","id-type":"ROR","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Applied Sciences"],"abstract":"<jats:p>Background: Cleft lip and\/or palate (CLP) is a common craniofacial malformation with aesthetic, functional, and psychosocial impacts. Although surgical repair is performed early in life, scar tissue formation may intensify maxillary deformities. Presurgical orthopedic interventions have therefore been introduced to optimize anatomical conditions prior to surgery. This scoping review aimed to systematically map presurgical orthopedic approaches described in the literature for patients with CLP. Methods: A Scoping Review was conducted in accordance with PRISMA-ScR guidelines. The protocol was registered in the Open Science Framework. Searches were performed in PubMed, Embase, Web of Science, and Cochrane databases without language or date restrictions. Two independent reviewers assessed the articles and extracted data. Results: A total of 207 studies were included, with a predominance of case series, case reports, and cohort studies, reflecting a generally low level of evidence. Nasoalveolar molding (NAM) was the most frequently reported intervention, while other appliances such as the Hotz plate and Latham device were considerably less represented. Across studies, reported outcomes included reduction of the alveolar cleft, improved nasal symmetry, and facilitation of feeding; however, variability in protocols and outcome measures limited comparability. Conclusions: The available evidence is heterogeneous and largely based on observational designs, which restricts definitive conclusions regarding the comparative effectiveness of presurgical orthopedic approaches. The predominance of NAM in the literature may reflect clinical preference rather than superior evidence, highlighting the need for standardized protocols and higher-quality studies.<\/jats:p>","DOI":"10.3390\/app16073542","type":"journal-article","created":{"date-parts":[[2026,4,6]],"date-time":"2026-04-06T03:11:28Z","timestamp":1775445088000},"page":"3542","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Presurgical Orthopedic Interventions in Cleft Lip and Palate: A Scoping Review of Current Approaches and Evidence Distribution"],"prefix":"10.3390","volume":"16","author":[{"given":"Ana Catarina","family":"Machado","sequence":"first","affiliation":[{"name":"Faculty of Medicine, University of Coimbra, 3000-075 Coimbra, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3283-5104","authenticated-orcid":false,"given":"In\u00eas","family":"Francisco","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, University of Coimbra, 3000-075 Coimbra, Portugal"},{"name":"Institute of Orthodontics, Faculty of Medicine, University of Coimbra, 3000-075 Coimbra, Portugal"},{"name":"Coimbra Institute for Clinical and Biomedical Research (iCBR), Area of Environment Genetics and Oncobiology (CIMAGO), Faculty of Medicine, University of Coimbra, 3000-075 Coimbra, Portugal"},{"name":"Laboratory for Evidence-Based Sciences and Precision Dentistry, University of Coimbra, 3000-075 Coimbra, Portugal"},{"name":"Clinical Academic Center of Coimbra (CACC), Hospitais da Universidade de Coimbra, 3004-561 Coimbra, Portugal"},{"name":"Centre for Mechanical Engineering, Materials and Processes (CEMMPRE), Advanced Production and Intelligent Systems (ARISE), University of Coimbra, 3030-788 Coimbra, Portugal"},{"name":"Centre for Innovative Biomedicine and Biotechnology (CIBB), University of Coimbra, 3000-075 Coimbra, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9269-5417","authenticated-orcid":false,"given":"Carlos Miguel","family":"Marto","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, University of Coimbra, 3000-075 Coimbra, Portugal"},{"name":"Coimbra Institute for Clinical and Biomedical Research (iCBR), Area of Environment Genetics and Oncobiology (CIMAGO), Faculty of Medicine, University of Coimbra, 3000-075 Coimbra, Portugal"},{"name":"Laboratory for Evidence-Based Sciences and Precision Dentistry, University of Coimbra, 3000-075 Coimbra, Portugal"},{"name":"Clinical Academic Center of Coimbra (CACC), Hospitais da Universidade de Coimbra, 3004-561 Coimbra, Portugal"},{"name":"Centre for Mechanical Engineering, Materials and Processes (CEMMPRE), Advanced Production and Intelligent Systems (ARISE), University of Coimbra, 3030-788 Coimbra, Portugal"},{"name":"Centre for Innovative Biomedicine and Biotechnology (CIBB), University of Coimbra, 3000-075 Coimbra, Portugal"},{"name":"Institute of Experimental Pathology, Faculty of Medicine, University of Coimbra, 3004-531 Coimbra, Portugal"},{"name":"Institute of Integrated Clinical Practice, Faculty of Medicine, University of Coimbra, 3004-531 Coimbra, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8937-361X","authenticated-orcid":false,"given":"Raquel","family":"Travassos","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, University of Coimbra, 3000-075 Coimbra, Portugal"},{"name":"Institute of Orthodontics, Faculty of Medicine, University of Coimbra, 3000-075 Coimbra, Portugal"},{"name":"Coimbra Institute for Clinical and Biomedical Research (iCBR), Area of Environment Genetics and Oncobiology (CIMAGO), Faculty of Medicine, University of Coimbra, 3000-075 Coimbra, Portugal"},{"name":"Laboratory for Evidence-Based Sciences and Precision Dentistry, University of Coimbra, 3000-075 Coimbra, Portugal"},{"name":"Clinical Academic Center of Coimbra (CACC), Hospitais da Universidade de Coimbra, 3004-561 Coimbra, Portugal"},{"name":"Centre for Mechanical Engineering, Materials and Processes (CEMMPRE), Advanced Production and Intelligent Systems (ARISE), University of Coimbra, 3030-788 Coimbra, Portugal"},{"name":"Centre for Innovative Biomedicine and Biotechnology (CIBB), University of Coimbra, 3000-075 Coimbra, Portugal"}]},{"given":"Catarina","family":"Nunes","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, University of Coimbra, 3000-075 Coimbra, Portugal"},{"name":"Institute of Orthodontics, Faculty of Medicine, University of Coimbra, 3000-075 Coimbra, Portugal"},{"name":"Coimbra Institute for Clinical and Biomedical Research (iCBR), Area of Environment Genetics and Oncobiology (CIMAGO), Faculty of Medicine, University of Coimbra, 3000-075 Coimbra, Portugal"},{"name":"Laboratory for Evidence-Based Sciences and Precision Dentistry, University of Coimbra, 3000-075 Coimbra, Portugal"},{"name":"Clinical Academic Center of Coimbra (CACC), Hospitais da Universidade de Coimbra, 3004-561 Coimbra, Portugal"},{"name":"Centre for Mechanical Engineering, Materials and Processes (CEMMPRE), Advanced Production and Intelligent Systems (ARISE), University of Coimbra, 3030-788 Coimbra, Portugal"},{"name":"Centre for Innovative Biomedicine and Biotechnology (CIBB), University of Coimbra, 3000-075 Coimbra, Portugal"}]},{"given":"Catarina","family":"Oliveira","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, University of Coimbra, 3000-075 Coimbra, Portugal"},{"name":"Institute of Orthodontics, Faculty of Medicine, University of Coimbra, 3000-075 Coimbra, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6154-4173","authenticated-orcid":false,"given":"Anabela Baptista","family":"Paula","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, University of Coimbra, 3000-075 Coimbra, Portugal"},{"name":"Institute of Orthodontics, Faculty of Medicine, University of Coimbra, 3000-075 Coimbra, Portugal"},{"name":"Coimbra Institute for Clinical and Biomedical Research (iCBR), Area of Environment Genetics and Oncobiology (CIMAGO), Faculty of Medicine, University of Coimbra, 3000-075 Coimbra, Portugal"},{"name":"Laboratory for Evidence-Based Sciences and Precision Dentistry, University of Coimbra, 3000-075 Coimbra, Portugal"},{"name":"Clinical Academic Center of Coimbra (CACC), Hospitais da Universidade de Coimbra, 3004-561 Coimbra, Portugal"},{"name":"Centre for Mechanical Engineering, Materials and Processes (CEMMPRE), Advanced Production and Intelligent Systems (ARISE), University of Coimbra, 3030-788 Coimbra, Portugal"},{"name":"Centre for Innovative Biomedicine and Biotechnology (CIBB), University of Coimbra, 3000-075 Coimbra, Portugal"},{"name":"Institute of Integrated Clinical Practice, Faculty of Medicine, University of Coimbra, 3004-531 Coimbra, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2615-2929","authenticated-orcid":false,"given":"Francisco","family":"Vale","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, University of Coimbra, 3000-075 Coimbra, Portugal"},{"name":"Institute of Orthodontics, Faculty of Medicine, University of Coimbra, 3000-075 Coimbra, Portugal"},{"name":"Coimbra Institute for Clinical and Biomedical Research (iCBR), Area of Environment Genetics and Oncobiology (CIMAGO), Faculty of Medicine, University of Coimbra, 3000-075 Coimbra, Portugal"},{"name":"Laboratory for Evidence-Based Sciences and Precision Dentistry, University of Coimbra, 3000-075 Coimbra, Portugal"},{"name":"Clinical Academic Center of Coimbra (CACC), Hospitais da Universidade de Coimbra, 3004-561 Coimbra, Portugal"},{"name":"Centre for Mechanical Engineering, Materials and Processes (CEMMPRE), Advanced Production and Intelligent Systems (ARISE), University of Coimbra, 3030-788 Coimbra, Portugal"},{"name":"Centre for Innovative Biomedicine and Biotechnology (CIBB), University of Coimbra, 3000-075 Coimbra, Portugal"}]}],"member":"1968","published-online":{"date-parts":[[2026,4,4]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"209","DOI":"10.1002\/tera.10088","article-title":"Birth order and oral clefts: A meta analysis","volume":"66","author":"Vieira","year":"2002","journal-title":"Teratology"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"238","DOI":"10.1016\/j.ajodo.2013.10.024","article-title":"Interdisciplinary treatment for an adult with a unilateral cleft lip and palate","volume":"146","author":"Ma","year":"2014","journal-title":"Am. 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