Induction and Prevention of Cleft Lip, Alveolus and Palate and Neural Tube Defects with Special Consideration of B Vitamins and the Methylation Cycle

Abstract

Previous studies on the development of cleft lip, alveolus, palate, and velum and neural tube defects have revealed several shared multifactorial causes. Both anomalies emerge at different times during embryonic development and are not associated with each other unless there is a genetic component to the etiology. Vitamin deficiency disorders are one of several factors contributing to the etiology of these anomalies.Vitamins B6, folic acid and B12 play an essential role in the methylation cycle. A lack of or deficiency in these vitamins thus has severe consequences for the organism, especially the unborn child. Due to its short half-life, vitamin B6 is particularly important for undisturbed embryogenesis and should be taken along with folic acid as a periconceptional supplement to prevent embryonic deformities. This paper is intended to provide the orthodontist (as a member of the interdisciplinary cleft team) with an overview of the issues and etiological significance of vitamin B deficiencies as possible inducers of these embryopathies. This may encourage comprehensive counselling, particularly of parents of children born with deformities who wish to have more children.

Cleft lip and cleft palate: a disease with multiple risk factors in a pregnant woman

“…6 Risk factors such as maternal smoking, maternal age, alcohol consumption, gender, medicinal drugs, viral infection and exposure to teratogens during early pregnancy have previously been investigated. [1][2][3][4][5][6][7] Researchers have proposed some other theories to explain the origin of CLP. Other associated factors are the antiepileptic drugs usage, maternal (toxoplasmosis, rubella, cytomegalovirus, herpes simplex TORCH) infections, nutritional deficiencies (especially folic acid) during pregnancy, and consanguineous marriage between the parents.…”

“…[1][2][3][4] Disease has a major impact especially on the affected individual, their families and society that needs long rehabilitation between birth and adulthood. The effects on an individual's speech, hearing, appearance, social integration and psychology can lead to long-lasting adverse outcomes for health and wellbeing.…”

Malonylcarnitine in Newborns with Non‐syndromic Cleft Lip with or without Cleft Palate

“…The relatively high and fluctuating frequency of orofacial clefts is attributable to the sensitivity of facial development to enviromental exposures? (Weingartner et al, 2007). It is well-accepted that orofacial cleft may be caused by the simultaneous interaction of the several genetic factors and environmental conditions.…”

“…Associations between maternal diabetes mellitus, hyperhomocysteinemia, and chemicals exposures, which are known to affect both antioxidant systems as well as free radical generation, and an increased risk of having a child with orofacial cleft, have been reported (Spilson et al, 2001;Weingartner et al, 2007). Carnitine has antioxidant activity that combines both free radical scavenging and metalchelating properties (Abdelrazik et al, 2009).…”

“…Population-based estimates of the prevalence of CL/P are 4 to 13 per 10 000 births (Vanderas, 1987). Moreover, about 12% of all embryos or fetuses aborted nowadays have an orofacial cleft (Weingartner et al, 2007). The etiology of these defects is complex and associated with both genetic and environmental factors.…”