Gene Regulatory Networks and Signaling Pathways in Palatogenesis and Cleft Palate: A Comprehensive Review.

Palatogenesis is a complex and intricate process involving the formation of the palate through various morphogenetic events highly dependent on the surrounding context. These events comprise outgrowth of palatal shelves from embryonic maxillary prominences, their elevation from a vertical to a horizontal position above the tongue, and their subsequent adhesion and fusion at the midline to separate oral and nasal cavities. Disruptions in any of these processes can result in cleft palate, a common congenital abnormality that significantly affects patient's quality of life, despite surgical intervention. Although many genes involved in palatogenesis have been identified through studies on genetically modified mice and human genetics, the precise roles of these genes and their products in signaling networks that regulate palatogenesis remain elusive. Recent investigations have revealed that palatal shelf growth, patterning, adhesion, and fusion are intricately regulated by numerous transcription factors and signaling pathways, including Sonic hedgehog (Shh), bone morphogenetic protein (Bmp), fibroblast growth factor (Fgf), transforming growth factor beta (Tgf-ß), Wnt signaling, and others. These studies have also identified a significant number of genes that are essential for palate development. Integrated information from these studies offers novel insights into gene regulatory networks and dynamic cellular processes underlying palatal shelf elevation, contact, and fusion, deepening our understanding of palatogenesis, and facilitating the development of more efficacious treatments for cleft palate.

Comparison of two treatment protocols in children with unilateral complete cleft lip and palate: Tridimensional evaluation of the maxillary dental arch.

OBJECTIVE: The aim of this study was to evaluate the dimensional alterations of the maxillary dental arches after lip repair in children with unilateral complete cleft lip and palate of two different protocols. MATERIAL AND METHODS: The sample was composed of 94 digital models and divided in two groups: Group I - 23 children, (protocol 1) - with presurgical orthopedic intervention: Hotz plate; Group II - 24 children, (protocol 2) - without presurgical orthopedic intervention. The three dimensional images of the maxillary arch were obtained before lip repair (stage 1) and at approximately 1 year of age (stage 2). Interstages changes for each group were evaluated using dependent t test and Wilcoxon test, and in the intergroup were used independent t test, and Mann-Whitney test. RESULTS: The comparison of the dimensional alterations of dental arches between the two protocols exhibited differences: in the stage 1, the intercanine was smaller in Group II; in the stage 2, the anterior cleft width, the intercanine and the anteroposterior cleft were smaller in Group II. CONCLUSION: The results reported here suggest that the use of infant orthopedic plate as applied in protocol 1 may favor correct arch form establishment in infants with unilateral complete cleft lip and palate.

Aspecto psicológico en los padres de recién nacidos y lactantes menores con labio fisurado y/o paladar endido / Psychological aspect in parents of newborns and infants with cleft lip and / or palate

El labio fisurado y/o paladar hendido es una de las malformaciones congénitas más comunes en el ser humano, constituyendo uno de los problemas de salud pública más importantes en la consulta odontopediátrica. Los padres de niños y niñas con esta patología pueden presentar alteraciones desde el punto de vista físico y psicológico. Por lo tanto, la presente investigación tuvo como finalidad describir el aspecto psicológico en los padres de recién nacidos y lactantes menores con labio fisurado y/o paladar hendido que acudieron al servicio de Odontopediatría y Cirugía Pediátrica en el Instituto Autónomo Hospital Universitario de Los Andes (IAHULA), durante el período Enero - Diciembre 2007. La investigación fue de tipo descriptiva, transeccional, que utilizó como método de estudio el suministro de encuestas para la identificación de la situación socioeconómica, los niveles de bienestar psicológico, el estado - rasgo de ansiedad y la presencia de síntomas depresivos. Los resultados permitieron concluir que las variables dependientes estudiadas se vieron modificadas en la conducta de los padres ante esta patología

A cleft lip and/or palate is one of the most common congenital malformations in human beings, effectively making it one of the most important public health issues in odontopediatrics. It is worth noting that parents with kids who present this pathology can suffer from physical and psychological anguish caused by the condition; and that is why this study had as its main purpose the description of the level of the psychological wellbeing of the parents whose kids suffered from the pathology at hand examined at the Odondopediatrics and Pediatric Surgery inside the Autonomous University Hospital of Los Andes (IAHULA) between January - December 2007. This investigation was descriptive and trans-sectional in nature and utilized surveys to identify the socioeconomic situation, stress level, psychological wellbeing, the existence of anxiety, and the presence of symptoms of depression amongst parents. The conclusion offered by this research study was one in which, amongst all dependent variables, changes in stress levels had no bearing on the subjects while all the other variables affected the behavior of parents of cleft palate/lip children