Abstract
Cleft lip and/or cleft palate (CLP), a major craniofacial structural birth defect occurring in humans,has a prevalence of rate of 0.18−0.20% in newborns in Japan. Patients with CLP require complex interdisciplinary care, including nursing, plastic surgery, maxillofacial surgery, otolaryngology, speech therapy, audiology, psychological and genetic counseling, orthodontics, and dental treatment, as well as others. For an effective clinical approach, clinical specialists must communicate as team members to provide CLP treatment. A pediatric dentist is an important member of the CLP treatment team and can organize appropriate management, referral, and follow-up examinations for oral care throughout the life of the patient. On the other hand, a basic science approach is also important to evaluate CLP occurrence and investigate means of prevention. We have focused on soft palate development using mice. Velopharyngeal insufficiency causes severe functional difficulties in swallowing and speech,which are deeply associated with quality of life for CLP patients. Histological analysis has shown that cranial neural crest cells comprise the palatal mesenchyme found throughout the anterior and posterior axis of the palate. During soft palate development, neural crest cells express periostin in the posterior region. Furthermore, periostin expression is regulated by TGF-β signaling. Our results suggest that periostin, an extracellular matrix, plays an important role in palatal muscle development during palatogenesis via TGF-β signaling. Additional research is needed to elucidate the specificity of soft palate development using a mouse model. Better understanding of the mechanism of soft palate development will provide new therapeutic approaches for CLP patients.
