Presurgical orthopaedics/nasoalveolar moulding in cleft children: could you, should you, would you?

Abstract

‘Amalgam versus composite’, ‘wisdom tooth coronectomy versus extraction in toto’, ‘wet versus dry bonding’, ‘smooth versus rough implants’, ‘cortical screws versus Mini-plate osteosynthesis’ – there are controversies, myths and mystery in all areas of modern dentistry, even today, in this age of scientific evidence, best practice and big brother. In the cleft world, controversies also abound. In fact, fundamental questions remain unanswered: we still do not know what the best overall treatment protocol is for the child born with a complete unilateral bony cleft lip and palate.1 Little by little, however, the evidence base is enlarging. Centralised UK regional cleft services, knowledge of national and international outcomes, and research protocols all aid the plugging of these gaps in our knowledge, and help us to find the missing pieces of the cleft jigsaw.