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Protocols in cleft lip and palate treatment: systematic review
Pedro Ribeiro Soares de Ladeira1, Nivaldo Alonso
1School of Medicine, University of São Paulo, São Paulo, SP, Brazil.
Plastic Surgery International
|December 6, 2012
Summary
Few randomized controlled trials (RCTs) exist for cleft treatment, especially surgical repair. More multicenter collaborations are needed for evidence-based cleft care.
Area of Science:
- Craniofacial Surgery
- Evidence-Based Dentistry
- Pediatric Medicine
Background:
- Cleft lip and/or palate treatment lacks robust evidence.
- Clinical decisions often rely on limited randomized controlled trials (RCTs).
Purpose of the Study:
- To identify clinical decisions for cleft treatment supported by RCTs.
- To assess the existing evidence base for various cleft interventions.
Main Methods:
- Comprehensive literature searches conducted in PubMed, Embase, and Cochrane Library.
- Systematic review of identified articles focusing on RCTs related to cleft lip and/or palate treatment.
- Selection of 28 articles deemed adequate for guiding clinical practice.
Main Results:
- A limited number of RCTs were identified for cleft treatment modalities.
- Analyzed interventions included infant orthopedics, pain management (acetaminophen, bupivacaine blocks), osteogenesis distraction, dexamethasone, and BMP-2 assisted alveoloplasty.
- Few RCTs specifically addressed surgical repair of cleft deformities.
Conclusions:
- There is a significant scarcity of high-quality RCTs in cleft treatment, particularly for surgical techniques.
- Increased multicenter collaborations are crucial to standardize treatment and promote evidence-based practices for cleft patients.
