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An essential overview of orofacial clefting

British Dental Journal volume 234, pages 937–942 (2023)Cite this article

Abstract

An appreciation of the embryologic development of the face is essential to understanding the anatomic variation observed in this phenotypically broad condition. Embryologically, the nose, lip and palate are separated into the primary and secondary palate, which are divided anatomically by the incisive foramen. The epidemiology of orofacial clefting is reviewed together with the contemporaneous cleft classification systems that enable comparisons to be made between international centres for audit and research purposes. A detailed examination of the clinical anatomy of the lip and palate informs the surgical priorities for the primary reconstruction of both form and function. The pathophysiology of the submucous cleft palate is also explored. The seismic impact of the 1998 Clinical Standards Advisory Group report on the organisation of UK cleft care provision is outlined. The importance of the Cleft Registry and Audit Network database in auditing UK cleft outcomes is highlighted. The potential for the Cleft Collective study to establish the causes of clefting, the optimal treatment protocols, and the impact of cleft on patients is tremendously exciting for all health care professionals involved in the management of this challenging congenital deformity.

Key points

  • This paper will discuss the critical knowledge - including the applied surgical anatomy - required to understand the phenotypic spectrum and classification of orofacial clefts.

  • An overview of the embryologic development of the face will form the basis for understanding the subsequent anatomic variations observed with this heterogenous condition.

  • A synopsis of the organisation of cleft services within the UK will be provided, as well as an overview of the UK Cleft Registry and Audit Network database and the Cleft Collective cohort study.

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Author information

Authors and Affiliations

  1. Cleft Fellow, Spires Cleft Centre, John Radcliffe Hospital, Oxford University Hospitals NHS Foundation Trust, Oxford, OX3 9DU, United Kingdom

    Serena V. Martin

  2. Consultant Cleft and Plastic Surgeon, Spires Cleft Centre, John Radcliffe Hospital, Oxford University Hospitals NHS Foundation Trust, Oxford, OX3 9DU, United Kingdom

    Marc C. Swan

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  1. Serena V. Martin
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  2. Marc C. Swan
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Contributions

Serena Martin and Marc Swan both contributed to the concept, content and preparation of this manuscript.

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Correspondence to Marc C. Swan.

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The authors declare no conflicts of interests.

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Martin, S., Swan, M. An essential overview of orofacial clefting. Br Dent J 234, 937–942 (2023). https://doi.org/10.1038/s41415-023-6000-9

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