Klippel-Fiel syndrome with rare presentation of bilateral temporomandibular joint osteoarthritis - A case report.

BACKGROUND: Klippel-Fiel syndrome (KFS) is a rare congenital skeletal disorder characterized clinically by presence of a triad of short neck, limited neck mobility (due to fused cervical vertebrae) and low posterior hair line. It was first described by Maurice Klippel and Andre Feil in 1912. Various skeletal and non-skeletal anomalies may be seen in association with KFS. CASE PRESENTATION: This report aims to highlight orofacial manifestations of a 16-year-old male patient with KFS along with a rare presentation of bilateral osteoarthritic changes in the temporomandibular joint. The treatment planning and execution for such a case has also been described. CONCLUSION: Bilateral osteoarthritic changes of temporomandibular joint have been rarely reported in KFS. This report emphasizes that early diagnosis of various associated anomalies and timely intervention through an interdisciplinary approach is very essential in the management of patients with KFS.

Effect of adjuvant autologous platelet concentrates on secondary repair of alveolar clefts: A systematic review and meta-analysis.

OBJECTIVE: To review the existing evidence on the adjuvant use of autologous platelet concentrates (APCs) with iliac crest bone graft (ICBG) in the reconstruction of the secondary alveolar cleft. METHODS: Electronic databases were searched systematically until November 2022. Clinical trials comparing the three-dimensional radiological outcomes of patients who underwent secondary alveolar bone grafting (SABG) with ICBG and APCs to those with ICBG alone and the radiological outcomes assessed 6 months after surgery were included. Two authors performed the study selection and the assessment of the risk of bias. Meta-analysis was performed using the random-effects model to determine the risk ratio (RR) for developing wound dehiscence and the mean difference (MD) with a 95% confidence interval (CI) for the percentage of newly formed bone. RESULTS: Nine studies (seven RCT and two CCT) were included with a low to high risk of bias. At the 6-month follow-up, the study group revealed insignificant results regarding the percentage of newly formed bone (MD = 6.49; 95% CI: -0.97, 13.94; p = .09; χ2  = 0.01; I2  = 71%). In addition, the overall risk of developing wound dehiscence was lower in the study group (RR = 0.34; 95% CI: 0.15, 0.78; p = .01; χ2  = 0.67; I2  = 0%). CONCLUSION: Currently, there is insufficient evidence to support the adjuvant use of APCs with ICBG on enhanced bone regeneration following secondary alveolar bone grafting. However, combining ICBG and APCs might be beneficial in reducing the risk of developing wound dehiscence.

The challenging management of Moebius syndrome using orthodontic camouflage: A case report.

Moebius syndrome (MS) is a rare congenital neuromuscular disorder characterized by weakness or paralysis (palsy) of abducens and facial nerves, or other cranial nerves which may be affected. Diagnosis, treatment, and dental management of MS patients are focused on treating manifestations like malocclusion, while catering to associated extraoral (neurologic, dermatologic, ocular) complications, aiming to improve their quality of life. Here, we report the case of a 9-year-old female patient with MS who underwent orthodontic camouflage using combined orthopedic-orthodontic therapy using a high-pull chin cup and fixed orthodontic appliance to improve skeletal mal-relation and facial appearance. The outcome displayed great improvement in function and better esthetics, improving not only the patient's but also the family's quality of life. A year's follow-up showed successful maintenance of the achieved results. A multidisciplinary approach in MS not only helps in overcoming the treatment challenges but also provides great psychosocial benefits to these patients.

Evidence Mapping and Quality Analysis of Systematic Reviews on Various Aspects Related to Cleft Lip and Palate.

BACKGROUND: Management of cleft lip and palate is interdisciplinary. An evidence-mapping approach was envisaged to highlight the existing gaps in this field, using only the highest level of evidence. OBJECTIVES: To conduct evidence mapping and quality analysis of systematic reviews and meta-analyses related to any aspect of cleft lip and palate. SEARCH METHODS: The cleft lip and palate field was divided into 9 domains and 50 subdomains and a method of categorization of systematic reviews was established. A comprehensive search strategy was carried out in seven databases along with the search of gray literature and references of included articles. SELECTION CRITERIA: Systematic reviews related to any aspect of cleft lip and palate, conducted by a minimum of two reviewers, with a comprehensive search strategy and adequate quality analysis were included. DATA COLLECTION AND ANALYSIS: A self-designed, pre-piloted data-extraction sheet was used to collect information that was analyzed through an expert group discussion. Quality analysis was performed using ROBIS-I, AMSTAR 2, and the PRISMA checklist. RESULTS: A total of 144 systematic reviews published between 2008 and 2022 were included. The largest number of these could be categorized in the therapeutic domain (n = 58). A total of 27% of the studies were categorized as inconclusive, 40% as partially conclusive, and 33% as conclusive. As per ROBIS-I, 77% of reviews had high risk of bias while 58% were graded as critically low in quality as per AMSTAR 2. The majority of systematic reviews showed low reporting errors. CONCLUSIONS: The majority of systematic reviews related to cleft lip and palate relate to therapeutic and prognostic domains and show high risk of bias and critically low quality regardless of the source journal. The results of this paper might serve as a starting point encouraging authors to carry out high-quality research where evidence is lacking. REGISTRATION: A multidisciplinary expert-group formulated an a priori protocol, registered in Open Science Framework (DOI 10.17605/OSF.IO/NQDV2).

A Rare Incidence of Nonsyndromic Mandibular Incisor Agenesis in a Three-generation Family: Case Report and Literature Review.

Hypodontia is an inherited condition involving the absence of one to six teeth. The permanent dentition is the most frequently affected; however, it may also affect the primary dentition. A congenitally missing tooth (CMT) is the most common dental abnormality, with the missing mandibular second premolar, maxillary lateral incisor, maxillary second premolar, and mandibular central incisor accounting for 90% of CMT in hypodontia studies. The etiology of CMT has been attributed to environmental and genetic contributing factors, with the latter having a strong influence. It may occur in isolation or in association with syndromes. Congenitally missing mandibular incisor is more common in the Asian population and females. Depending on the number and location of missing teeth, hypodontia may be a considerable issue for the clinician since it may impact occlusal balance, mastication, speech, and esthetics and often requires a multidisciplinary approach. Missing mandibular incisors are of particular interest to orthodontists because of the possibility of mandibular retrognathism, the potential for the development of malocclusion, and difficulty in achieving a balanced occlusion. This case report describes the skeletal and dental features of a nonsyndromic familial occurrence of missing mandibular incisors in three generations. A comprehensive literature search was also performed to review the familial cases with missing mandibular incisors. How to cite this article: Selvaraj M, Sennimalai K, Samrit VD, et al. A Rare Incidence of Nonsyndromic Mandibular Incisor Agenesis in a Three-generation Family: Case Report and Literature Review. Int J Clin Pediatr Dent 2023;16(2):388-395.

Assessment of Skeletal Maturation in Nonsyndromic Cleft and Non-cleft Children-A Comparative Study.

The study aims to determine the difference in the skeletal maturation of unilateral cleft lip and palate (UCLP) and non-cleft children. This study also attempts to determine sexual dimorphism in attaining skeletal maturation between UCLP and non-cleft children. This was a retrospective, cross-sectional study. The total sample consisted of the lateral cephalogram of 131 UCLP (62 female and 71 male) children and 500 (274 female and 226 male) non-cleft children. The reviewer used the Baccetti method (2005) to review all the cephalograms for the cervical vertebrae maturation (CVM) stages. T -test was used to compare the mean chronological age and skeletal maturation of cleft and non-cleft children at each CVM stage. There was no significant difference in the mean chronological age and skeletal maturation status of UCLP and non-cleft children. There was no significant difference in skeletal maturation based on sex. The intraobserver assessment showed 80% and 85% kappa agreement, signifying absolute agreement. The correlation coefficient between chronological age and CVMIs was 0.86 ( P <0.001) in cleft children and 0.76 ( P <0.001) in non-cleft children, which was highly significant. The study indicates no significant difference in the skeletal maturation of UCLP and non-cleft children and no sex-related difference.

A pattern of microbiological colonization of orthodontic miniscrew implants.

INTRODUCTION: Current orthodontic literature reveals a lack of studies on bacterial colonization of orthodontic miniscrew implants (MSI) and their role in the stability of MSI. This study aimed to determine the pattern of microbiological colonization of miniscrew implants in 2 major age groups, to compare it with the microbial flora of gingival sulci in the same group of patients and to compare microbial flora in successful and failed miniscrews. METHODS: The study involved 102 MSI placed in 32 orthodontic subjects in 2 age groups: (1) aged ≤14 years and (2) aged >14 years. Gingival and peri-mini implant crevicular fluid samples were collected using sterile paper points (International Organization for Standardization no. 35) >3 months and processed by conventional microbiologic culture and biochemical techniques. A microbiologist characterized and identified the bacteria, and the results were subjected to statistical analysis. RESULTS: Initial colonization was reported within 24 hours, with Streptococci being the dominant colonizer. The relative proportion of anaerobic bacteria over aerobic bacteria increased over time in peri-mini implant crevicular fluid. Group 1 had greater Citrobacter (P = 0.036) and Parvimonas micra (P = 0.016) colonizing MSI than group 2. Failed MSI showed a significantly higher presence of Parvimonas micra (P = 0.008) in group 1 and Staphylococci (P = 0.008), Enterococci (P = 0.011), and Parvimonas micra (P <0.001) in group 2. CONCLUSIONS: Microbial colonization around MSI is established within 24 hours. Compared to gingival crevicular fluid, peri-mini implant crevicular fluid is colonized by a higher proportion of Staphylococci, facultative enteric commensals and anaerobic cocci. The failed miniscrews showed a higher proportion of Staphylococci, Enterobacter, and Parvimonas micra, suggesting their possible role in the stability of MSI. The bacterial profile of MSI varies with age.

Comparative evaluation of nasolabial appearance of unilateral cleft lip and palate patients by professional, patient and layperson using 2 aesthetic scoring systems: A cross sectional study.

OBJECTIVE: To compare the perspective of healthcare providers (orthodontists), cleft patients and laypersons in judging nasolabial aesthetics in patients with complete unilateral cleft lip, with or without cleft palate (UCL ± P) using 2 scoring systems. DESIGN: This cross-sectional study was conducted in a tertiary care government hospital. PATIENTS: Photographic records of 100 patients with complete UCL ± P from the age group of 5-18 years (mean age-12.2 ± 3.93 years) were included in this study. METHOD: Photographic records of 100 patients with complete UCL ± P from the age group of 5-18 years were included. A panel of 3 orthodontists, 3 laypersons and 3 cleft patients rated nasolabial aesthetics using 2 scoring systems i.e. Asher-McDade index (AMAI) and Cleft Aesthetic Rating Scale (CARS). Spearman's split-half reliability, Intra-class correlation coefficient and Cronbach's alpha were computed to measure internal consistency and reliability. Inter-panel agreement between pair of groups was determined by means of Spearman correlation coefficient. RESULTS: Estimated reliability of CARS for 3 raters in each panel was in moderate agreement for orthodontists and cleft patients (0.849 and 0.810). Good repeatability and agreement were recorded with moderate to high intra-panel reliability for all parameters of both AMAI and CARS. Overall inter-panel agreement was moderate for both AMAI and CARS. Pair-wise inter-panel agreement showed a moderately positive correlation in both scales (AMAI and CARS) by cleft patients and professionals. CONCLUSION: CARS index can be reliably used for assessment of nasolabial aesthetics by cleft patients, professionals and lay persons on 2D facial photographs. Patients were more critical than clinicians and laypersons using both indices (CARS and AMAI) as they are more self-aware and conscious. Thus, a clear communication between clinician and patient regarding expectations, perception and satisfaction with surgical results is strongly recommended.

Effect of leukocyte-platelet-rich fibrin (L-PRF) on the rate of orthodontic tooth movement and expression of various biomarkers in gingival crevicular fluid.

OBJECTIVES: To assess the outcome of leukocyte-platelet-rich fibrin (L-PRF) on the rate of maxillary canine retraction and its correlation with the levels of Receptor activator of nuclear factor kappa-B ligand (RANKL), osteoprotegerin (OPG), and RANKL:OPG in the gingival crevicular fluid (GCF) during comprehensive orthodontic treatment. SUBJECTS AND METHODS: Eighteen females who required all 1st premolars extraction for the correction of their class I bimaxillary protrusion malocclusions were included. The L-PRF plugs were placed in the experimental side 1st premolar extraction sockets. Canine retraction was performed by sliding mechanics. Canine retraction was assessed from the maxillary study models prepared just before the extraction (T0) and then at 1 week (T1), 2 weeks (T2), 4 weeks (T3), and 8 weeks (T4) after the 1st premolar extraction and placement of L-PRF plugs. The concentrations of RANKL and OPG in the GCF were evaluated at T0, T1, T2, T3, and T4. RESULTS: In experimental sides, the amount of canine retraction was statistically more during the T0-T1, T1-T2, and T2-T3 periods. The mean concentration of RANKL at T1, T2, and T3 was significantly more in the experimental sides. The mean concentration of OPG was significantly less in the experimental sides at T2, T3, and T4. The RANKL:OPG was significantly more in the experimental sides at T1, T2, T3, and T4. No significant correlation was found between amount of canine retraction and concentration of RANKL and OPG and RANKL to OPG ratio in GCF. CONCLUSIONS: The L-PRF accelerated the rate of maxillary canine retraction by 0.28 mm over an 8-week period. The L-PRF favored the local osteoclastogenesis by enhancing the RANKL and suppressing the OPG concentrations. There was no significant correlation between the rate of maxillary canine retraction and expression of RANKL, OPG, and RANKL:OPG in GCF. TRIAL REGISTRATION: The Clinical Trials Registry of India (Reg. No. CTRI/2020/10/028390, Date-13.10.2020).

Quantitative Evaluation of Pentraxin-3 in Peri-Miniscrew Implant Crevicular Fluid in Patients Undergoing Orthodontic Treatment: A Prospective Study.

OBJECTIVE: To assess the levels of Pentraxin-3 (PTX3) in peri-miniscrew implant crevicular fluid (PMICF) before and after orthodontic force application Material and Methods: This study included 40 miniscrew implants (MSI) sites in 11 orthodontic patients with high arch discrepancy requiring first premolar extraction using maximum anchorage mechanics for the retraction of anterior teeth. After alignment, the en-masse anterior retraction was carried out using the MSI-supported direct anchorage method. PMICF was collected from the crevice of MSI using Periopaper strips 1.2µl (Oraflow Inc. USA) after one hour, 24 hours, and three weeks of MSI insertion and after one hour, 24 hours, seven days, three weeks, and six weeks of the force application. Samples were quantitatively analyzed for PTX3 levels through enzyme-linked immunosorbent assay (ELISA). RESULTS: The trend in the change of PTX3 levels was evaluated using the Wilcoxon signed-rank test. The mean concentration of PTX3 immediately after MSI insertion was 1.19 ng/ml, significantly higher than after 3 weeks after MSI insertion (0.72 ng/ml), which may correspond to the baseline. After loading, the mean PTX3 concentration increased significantly with the peak at 24 hrs (1.28 ng/ml), followed by a gradual decline till the completion of the study (0.5 ng/ml). CONCLUSION: After MSI insertion, a rise in PTX3 levels in PMICF suggests an underlying inflammatory process. The slow decline in PTX3 level and return to the baseline after loading suggests an adaptive bone response to the stimulus.

Development and validation of risk of bias tool for the use of finite element analysis in dentistry (ROBFEAD).

There has been a systematic review of studies that used FEA in dental sciences, but no adequate risk of bias (RoB) analysis technique has been developed. Therefore, the development and validation process of RoB in studies using the finite element analysis in dentistry (ROBFEAD) tool is described. In the first phase of development, the scope of the tool and possible modifications were covered, and validation was done in the second phase. The developed tool comprised 6 domains and a total of 22 guiding questions in these domains. This article proposes the development and validation of ROBFEAD, a tool for measuring RoB in finite element research in dentistry.

Effects of RME on Hearing in UCLP Patients: A Pilot Study.

OBJECTIVE: To assess the changes in hearing after rapid maxillary expansion (RME) and at the end of 6 months retention period in complete unilateral cleft lip and palate (UCLP) patients using pure tone audiometry and tympanometry test. DESIGN: Prospective pilot study. SETTING: Tertiary health care teaching hospital in New Delhi. PATIENTS: This study was conducted on 6 UCLP patients in the age range of 6-14 years with normal ear anatomy. All 6 patients had undergone primary repair of cleft lip and palate and required no more than 5 mm expansion in the intermolar region. INTERVENTION: RME was done using a Hyrax expander with daily activation of one-quarter turn per day for a period of 15-20 days (0.25 mm per day). MAIN OUTCOME MEASURE: Audiometry and tympanometry readings at the baseline as compared to the post expansion and at the end of 6 months retention period. RESULTS: There were no significant changes in the hearing levels on the audiometry test after RME on the cleft side (p-value -0.51) and the noncleft side ear (p-value -0.26). No significant changes were observed in the middle ear volume on the tympanometry test after RME on the cleft side (p-value -0.09) and the noncleft side ear (p-value -0.28). CONCLUSION: There was no improvement or deterioration in the hearing levels after RME and at the end of 6 months retention period in UCLP patients as evaluated using pure tone audiometry and tympanometry test. Hence RME may be undertaken in UCLP patients safely in terms of hearing is concerned.

Sugar-sweetened beverage consumption and socioeconomic status: A systematic review and meta-analysis.

BACKGROUND: Sugar-sweetened beverages (SSB) are an independent risk factor for obesity and other non-communicable diseases. Socioeconomic status (SES) is one of the key drivers for the purchase and consumption of SSBs among children and adults; however, there is a lack of strong evidence. This study aims to determine the association between SES and consumption patterns of SSBs across populations. RESULTS: The review was conducted according to PRISMA guidelines. PubMed, MEDLINE, Scopus, EMBASE, LILACS, Web of Science, Cochrane, and CINHAL databases were searched for relevant articles until 2022. Participants included children, adolescents, and adults who consumed different SSBs and were assessed based on their SES. The random-effects model was used to obtain the pooled odds ratio (OR). Twenty-one studies (152,070 participants) met the inclusion criteria. The risk of bias was assessed using the Newcastle-Ottawa tool, with the majority of the studies indicating medium to high quality. Eight ORs from four studies (34,454 participants) were considered for meta-analysis. Results showed those belonging to high SES had 48% lower odds of consuming the SSBs (OR 0.52; 95% CI: 0.42-0.61; p = 0.017). The overall quality of evidence was ascertained using GRADE criteria, illustrating a moderate certainty of evidence between SSB consumption and SES. CONCLUSION: Meta-analysis suggests that SES influences the consumption pattern of SSBs, with high SES having lower odds of SSB consumption.

Cone-Beam Computed Tomographic Assessment of Maxillary Sinus Characteristics in Patients With Cleft Lip and Palate: A Systematic Review and Meta-Analysis.

The aim of this systematic review and meta-analysis was to evaluate the maxillary sinus characteristics of patients with cleft lip and palate (CLP).The study included manuscripts which met the following criteria: (1) study of individuals with CLP in any age group or gender and (2) study of individuals in whom assessment of maxillary sinus characteristics had been done by cone-beam computed tomography. Studies with (1) individuals having special health-care needs and (2) individuals with any syndrome affecting the development of the head and neck were excluded.In total, 11 articles were included in the review, based on the inclusion and exclusion criteria. Pooled maxillary sinus volume (MSV) on the cleft sides of patients with unilateral cleft lip and palate (UCLP) was found to be 9433.14 mm3 (95% CI, 7453.99-11 412.30), which was significantly smaller than that of controls. The meta-analyses also revealed significantly reduced MSV on the cleft sides of patients with UCLP. The differences between cleft and noncleft sides of the patients with UCLP were not found to be statistically significant. Strength-of-evidence was found to be moderate in 4 characteristics, along with 10 out of 11 articles showing low risk-of-bias.It was concluded that MSV was reduced and mucosal thickening was increased/present in patients with CLP as compared with controls. The differences between MSV of cleft and noncleft sides of the patients with UCLP could not be established. However, heterogeneity was found in terms of sample size, stratification of samples by age, and evaluation of some confounding factors.

Global Trends in Knowledge, Attitude, and Awareness of Orthodontists Regarding the Management of Patients with Cleft lip and/or Palate: A Systematic Review.

The aim of the present systematic review was to assess the trends in knowledge, attitude, awareness, and practice among orthodontists regarding the management of patients with cleft lip and/or palate.An a priori protocol was developed as per the best practices of evidence-based medicine and registered in Prospero (CRD42022306107). The literature search was conducted electronically, using MeSH-terms, keywords, and Boolean-operators "AND" and "OR" in different combinations in multiple databases and screening of titles and abstracts followed by full-text evaluation was performed. The risk of bias (ROB) was assessed using Joanna Briggs Institute critical appraisal checklist.Five studies were included in the qualitative synthesis and three of them showed a high ROB. When participants were questioned about which other specialists worked in the cleft team in addition to the orthodontists, 84% of them in one study reported it to be general dentists. Furthermore, the absence of an interdisciplinary team was reported in two studies from Africa. When asked about the percentage of their practice devoted to the care of patients with cleft lip and palate (CLP) one study reported that 52% of orthodontists had treated <10 such patients in their entire career.The present systematic review highlights the lack of knowledge and experience among orthodontists and orthodontic residents regarding the management of patients with CLP. Efforts must be made to design validated questionnaires and conduct methodologically sound studies in different geographical locations to develop adequate modules for improving the knowledge of orthodontists in this domain.

Nasolabial appearance in unilateral cleft lip and palate patients: A comparison of aesthetics using two scoring systems: A cross-sectional study.

OBJECTIVE: The objective of the study was to assess nasolabial aesthetics in patients with complete unilateral cleft lip, with or without cleft palate (UCL ± P) using two scoring systems. DESIGN: A cross-sectional study conducted in a tertiary care government hospital. PATIENTS: Photographic records of 91 patients with complete UCL ± P from the age group of 5-18 years (mean age = 13.2 ± 3.14 years) were included. METHOD: A panel of three orthodontists with varying experience in cleft management rated nasolabial aesthetics using two scoring systems, that is Asher Mc-Dade index (AMAI) and Cleft Aesthetic Rating Scale (CARS). Intraclass correlation coefficient, Fleiss' kappa and Cronbach's alpha were used to measure the internal consistency amongst three raters and Spearman-Brown formula was used for measuring overall reliability. Time required for assessment of each photograph was compared with ANOVA. RESULTS: Overall, both AMAI and CARS showed high reliability and outcome assessment with good inter-rater reliability and internal consistency, when used independently by orthodontists having varied experience. Statistically significant difference was present in time taken for assessment of nasolabial aesthetics with CARS index (8.75 ± 1.65 seconds) as compared to AMAI (18.62 ± 3.49 seconds). CONCLUSION: Asher Mc-Dade index and CARS are equally reliable and consistent for the assessment of nasolabial aesthetics in patients with UCL ± P. However, considerably less time was taken for the assessment using CARS index as compared to AMAI. The use of CARS index is recommended for the initial assessment and screening of patients by orthodontists using two dimensional photographs.

Binder's syndrome: A narrative review.

AIM: The classical features of Binder's syndrome (BS) have been widely reported, yet there is a lack of information on diagnostic and treatment challenges. Therefore, we aimed to review the literature on various aspects, including the role of a multidisciplinary approach in the management of BS. METHODS: A thorough literature search was performed on PubMed, Scopus, Embase, Ovid, Web of Science, EBSCOhost, and Google Scholar using the keywords"Maxillonasal dysplasia", "Maxillonasal dysostosis", "nasomaxillary hypoplasia", "Binder type", "Binder syndrome", "Binder phenotype", and "OMIM 155050". In addition, the articles published in the English language from the inception of the database until June 2021 were considered. RESULTS: The search of different databases yielded 958 publications, out of which 145 relevant articles were reviewed. The studies were categorised by year of publication, study design, and theme. Most of the studies were case reports (42%) followed by case series (19%). The most reported topic was based on different surgical techniques (42%). Finally, the results were synthesised into a narrative review. CONCLUSIONS: The need for a multidisciplinary approach involving clinicians from different specialities is highlighted. Future research is warranted to develop concrete clinical guidelines for the management of this syndrome.

How Informative Is YouTube Regarding Feeding in Infants with Cleft Lip and Palate?

OBJECTIVE: To assess the characteristics of popular videos on YouTube about the feeding of infants with cleft lip and palate (CLP) and analyze the adequacy of information provided by them. DESIGN: A cross-sectional design was used. METHODS: YouTube was systematically searched for consecutive relevant videos about the feeding of infants with CLP, using predefined keyword combinations, without any limitations on language or duration. Scrutiny of the top 50 videos for each keyword combination was performed and a self-designed data-extraction sheet was used. A content adequacy index was developed by an expert group, and used to assess content adequacy, classifying it into categories from excellent to poor. RESULTS: From an initial retrieval of 200 videos, 42 were included in the final assessment. The videos originated from nine different countries, with more than half coming from the USA and in English. Five of the videos came from the channel of the American Cleft Palate-Craniofacial Association. Content adequacy analysis showed that no video could be classified as excellent, while 33.3% were classified as optimal, 21.4% as suboptimal and 45.2% as poor. CONCLUSIONS: The content adequacy of the majority of videos on YouTube, relating to the feeding of infants with CLP was inadequate, with only one third of them achieving optimal content adequacy. Efforts must be made to develop informative and standardized videos for social media and video-sharing platforms, perhaps through professional associations to ensure that families with an infant with CLP receive appropriate information.