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.
Machado et al. (Sat,) studied this question.