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EDITORIAL
Year : 2017  |  Volume : 7  |  Issue : 2  |  Page : 165

Understanding and prevention of orofacial clefting: A myth or possibility?


Director and Consultant Maxillofacial Surgeon, Balaji Dental and Craniofacial Hospital, Chennai, Tamil Nadu, India

Date of Web Publication22-Nov-2017

Correspondence Address:
S M Balaji
Director and Consultant Maxillofacial Surgeon, Balaji Dental and Craniofacial Hospital, Chennai, Tamil Nadu
India
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DOI: 10.4103/ams.ams_181_17

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How to cite this article:
Balaji S M. Understanding and prevention of orofacial clefting: A myth or possibility?. Ann Maxillofac Surg 2017;7:165

How to cite this URL:
Balaji S M. Understanding and prevention of orofacial clefting: A myth or possibility?. Ann Maxillofac Surg [serial online] 2017 [cited 2017 Dec 14];7:165. Available from: http://www.amsjournal.com/text.asp?2017/7/2/165/218971





The incidence of orofacial clefting across the world is showing a different trend in recent past. The trend is different for a different population. In spite of best of the efforts including but not limited to folic acid and other nutritional supplementation, prevention of exposure to infectious agents and second-hand, tobacco smoke, etc., are being aggressively promoted, the sustained efforts are not giving desired results.[1] In India alone, a substantial number of cleft patients live and often do not have access to cleft care. It is estimated that at least about 72,000 people still do not have access to surgery.[2] In spite of the best care, complications do arise after surgeries.[3]

Given this burden of disease, prevention and early diagnosis is the key to prevent such disorders.[1] The Journal of Dental Research recently published a special series of articles focusing on this area, especially on the recent scientific and technical advances in craniofacial development and genetics.[4],[5],[6],[7]

Topics that are of interest to surgeons include contemporary human and animal genetic studies on orofacial clefting, the pathways required for palatogenesis and experimental articles on the periderm structures.[4],[5],[6] Interesting manuscript is that one that describes a potential drug therapy articles that rescue cleft palate in mutant mice via a single gene disorder.[7] While the clinical translation is questionable, it offers immense hope that in coming days the complete set of genes and pathways involved in orofacial clefting will be decoded. The present results, although in animals, offer a clue to the potential of harnessing the power of advanced antibody therapy to cure orofacial clefting even before birth.

As they say, we are living in interesting times. We witnessed the evolution of surgical therapy and saw it reaching its plateau and are probably witnessing the birth and evolution of evidence-based orofacial clefting prevention before birth through advanced molecular biology treatment methods.

Hopefully, the world will be rid of the orofacial clefting soon.



 
  References Top

1.
Kadir A, Mossey PA, Blencowe H, Moorthie S, Lawn JE, Mastroiacovo P, et al. Systematic review and meta-analysis of the birth prevalence of orofacial clefts in low-and middle-income countries. Cleft Palate Craniofac J 2017;54:571-81.  Back to cited text no. 1
[PUBMED]    
2.
Stewart BT, Carlson L, Hatcher KW, Sengupta A, Vander Burg R. Estimate of unmet need for cleft lip and/or palate surgery in India. JAMA Facial Plast Surg 2016;18:354-61.  Back to cited text no. 2
[PUBMED]    
3.
Balaji SM. Unfavorable outcome of unilateral cleft lip repair. Ann Maxillofac Surg 2016;6:3.  Back to cited text no. 3
[PUBMED]  [Full text]  
4.
Papathanasiou E, Trotman CA, Scott AR, Van Dyke TE. Current and emerging treatments for postsurgical cleft lip scarring: Effectiveness and mechanisms. J Dent Res 2017;96:1370-7.  Back to cited text no. 4
    
5.
Richman JM, Schutte BC. Face forward: Gene variants, pathways, and therapies for craniofacial anomalies. J Dent Res 2017;96:1181-3.  Back to cited text no. 5
[PUBMED]    
6.
Li C, Lan Y, Jiang R. Molecular and cellular mechanisms of palate development. J Dent Res 2017;96:1184-91.  Back to cited text no. 6
    
7.
Jia S, Zhou J, Wee Y, Mikkola ML, Schneider P, D'Souza RN, et al. Anti-EDAR agonist antibody therapy resolves palate defects in pax9-/- mice. J Dent Res 2017;96:1282-9.  Back to cited text no. 7
    




 

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