|Embryology - 18 Sep 2018 Expand to Translate|
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- 1 Introduction
- 2 Some Recent Findings
- 3 Textbooks
- 4 Movies
- 5 Development Overview
- 6 Pharyngeal Arch Development
- 7 Face Development
- 8 Embryonic Palate
- 9 Fetal Palate
- 10 Soft Palate
- 11 Postnatal Head Changes
- 12 Animal Palate
- 13 Molecular
- 14 Abnormalities
- 15 Cleft Risk Variants
- 16 References
- 17 Additional Images
- 18 Terms
- 19 External Links
- 20 Glossary Links
The palate anatomically separates the nasal cavity from the oral cavity and structurally has a bony (hard) anterior component and a muscular (soft) posterior component ending with the uvula. The oral side of the palate is covered with a squamous stratified (pluristratified) epithelium. The surface of the hard palate of most mammalian species is further thrown into a series of transversal palatal ridges or rugae palatinae. Both the palatal ridge number and arrangement are also species specific.
Neural crest has a major contribution to the palate development and there are a number of molecular, mechanical and morphological steps in involving the fusion of contributing structures including a key epithelial to mesenchymal transition. In palate formation there are two main and separate times and events of development, during embryonic (primary palate) and an early fetal (secondary palate). This separation of events into embryonic and fetal period corresponds closely to the classification of associated palate abnormalities.
The primary palate is formed by two parts:
- maxillary components of the first pharyngeal arch (lateral)
- frontonasal prominence (midline)
The secondary palate can also be divided in two anatomical parts:
- anterior hard palate - ossified (contributions from the maxilla and palatine bones).
- posterior soft palate - muscular.
|Palate Links: palate | cleft lip and palate | cleft palate | head | Category:Palate|
Some Recent Findings
|More recent papers|
This table shows an automated computer PubMed search using the listed sub-heading term.
References listed on the rest of the content page and the associated discussion page (listed under the publication year sub-headings) do include some editorial selection based upon both relevance and availability.
Travis L Gibson Regarding Maxillary Impaction for the Treatment of Labial Incompetence in Mobius Syndrome. Cleft Palate Craniofac. J.: 2018;1055665618798289 PubMed 30213206
Christopher J Goodenough, Kathryn T Anderson, Kari E Smith, Robert A Hanfland, Nitin Wadhwa, John F Teichgraeber, Matthew R Greives Impact of Cardiac Risk Factors in the Postsurgical Outcomes of Patients With Cleft Palate: Analysis of the 2012-2014 NSQIP Database. Cleft Palate Craniofac. J.: 2018;1055665618799224 PubMed 30213204
Mimis N Cohen Rotation Advancement in Cleft Nose Rhinoplasty-Buccal Mucosal Grafts Serves as a Powerful Tool. Cleft Palate Craniofac. J.: 2018;1055665618799897 PubMed 30213199
Liene Smane, Mara Pilmane Evaluation of the presence of MMP-2, TIMP-2, BMP2/4, and TGFβ3 in the facial tissue of children with cleft lip and palate. Acta Med Litu: 2018, 25(2);86-94 PubMed 30210242
A Quast, J Waschkau, J Saptschak, N Daratsianos, K Jordan, P Fromberger, J L Müller, P Meyer-Marcotty Facial perception of infants with cleft lip and palate with/without the NAM appliance. [Gesichtswahrnehmung von Säuglingen mit Lippen-Kiefer-Gaumen-Spalte mit/ohne NAM-Apparatur.] J Orofac Orthop: 2018; PubMed 30209536
Bartosz J Plachno, Malgorzata Stpiczynska, Piotr Swiatek, Hans Lambers, Vitor F O Miranda, Francis J Nge, Piotr Stolarczyk, Gregory R Cawthray Floral micromorphology of the bird-pollinated carnivorous plant species Utricularia menziesii R.Br. (Lentibulariaceae). Ann. Bot.: 2018; PubMed 30169570
Tiago Turri de Castro Ribeiro, Mariana Chaves Petri Feitosa, Rogério Almeida Penhavel, Renata Sathler Zanda, Guilherme Janson, Reinaldo Mazzottini, Daniela G Garib Extreme maxillomandibular discrepancy in unilateral cleft lip and palate: Longitudinal follow-up in a patient with mandibular prognathism. Am J Orthod Dentofacial Orthop: 2018, 154(2);294-304 PubMed 30075931
Heng Xie, Li Xue, Wei Hua, Bangsheng Jia, Liang Zhang, Li Li Whole genome sequencing and 6-year follow-up of a mother and daughter with frontometaphyseal dysplasia associated with keratitis, xerosis, poikiloderma, and acro-osteolysis: A case report. Medicine (Baltimore): 2018, 97(28);e11283 PubMed 29995760
Jingyuan Li, Yuan Yuan, Jinzhi He, Jifan Feng, Xia Han, Junjun Jing, Thach-Vu Ho, Jian Xu, Yang Chai Constitutive activation of hedgehog signaling adversely affects epithelial cell fate during palatal fusion. Dev. Biol.: 2018; PubMed 29981310
Arvin Shahbazi, András Grimm, Georg Feigl, Gábor Gerber, Andrea Dorottya Székely, Bálint Molnár, Péter Windisch Analysis of blood supply in the hard palate and maxillary tuberosity-clinical implications for flap design and soft tissue graft harvesting (a human cadaver study). Clin Oral Investig: 2018; PubMed 29961140
- The Developing Human: Clinically Oriented Embryology (8th Edition) by Keith L. Moore and T.V.N Persaud - Moore & Persaud Chapter Chapter 10 The Pharyngeal Apparatus pp201 - 240.
- Larsen’s Human Embryology by GC. Schoenwolf, SB. Bleyl, PR. Brauer and PH. Francis-West - Chapter 12 Development of the Head, the Neck, the Eyes, and the Ears pp349 - 418.
- week 4 - pharyngeal arch formation, first pharngeal arch contributes mandible and maxilla.
- week 6 - 7 - primary palate formation maxillary processes and frontonasal prominence.
- week 9 - secondary palate shelves fuse, separating oral and nasal cavities.
- (week 4) - pharyngeal arch formation in rostrocaudal sequence (1, 2, 3, 4 and 6)
- First pharyngeal arch - upper maxillary (pair) and lower mandibular prominences
- Late embryonic period - maxillary prominences fuse with frontonasal prominence forming upper jaw (maxilla and upper lip)
Pharyngeal Arch Development
Major features to identify for each: arch, pouch, groove and membrane. Contribute to the formation of head and neck and in the human appear at the 4th week. The first arch contributes the majority of upper and lower jaw structures.
- Pharynx - begins at the buccopharyngeal membrane (oral membrane), apposition of ectoderm with endoderm (no mesoderm between).
- branchial arch (Gk. branchia= gill)
- arch consists of all 3 trilaminar embryo layers
- ectoderm - outside
- mesoderm - core of mesenchyme
- endoderm - inside
- Mesenchyme invaded by neural crest generating connective tissue components
- cartilage, bone, ligaments
- arises from midbrain and hindbrain region
Begins week 4 centered around stomodeum, external depression at oral membrane
5 initial primordia from neural crest mesenchyme
- single frontonasal prominence (FNP) - forms forehead, nose dorsum and apex
- nasal placodes develop later bilateral, pushed medially
- paired maxillary prominences - form upper cheek and upper lip
- paired mandibular prominences - lower cheek, chin and lower lip
The frontonasal process (FNP) forms the majority of the superior part of the early face primordia. It later fuses with the maxillary component of the first pharyngeal arch to form the upper jaw. Failure of this fusion event during the embryonic period leads to cleft lip. Under the surface ectoderm the process mesenchyme consists of two cell populations; neural crest cells, forming the connective tissues; and the mesoderm forming the endothelium of the vascular network.
A chicken developmental model study has identified a specific surface region, the Frontonasal Ectodermal Zone (FEZ), initially induced by bone morphogenetic proteins that appears to regulate the future growth and patterning of the frontonasal process. The specific frontonasal ectodermal zone was located in the frontonasal process ectoderm flanking a boundary between Sonic hedgehog (SHH) and Fibroblast growth factor 8 (FGF8) expression domains.
Human primary palate
|Secondary palate, fusion in the human embryo in week 9. This requires the early palatal shelves growth, elevation, and fusion. There are many fusion events occurring during this period between each palatal shelf, to the primary palate, and also to the nasal septum.
Fetal Palate Growth (second trimester)
Fetal week 9 (GA week 11) hard palate fusion
Ventral aspect of hard palate of human embryo of 80 mm
The soft palate mechanism of closure has not yet been determined, with several existing theories. A recent study of embryos from the late embryonic-early fetal period (54 to 74 days post-conception) has identified the timing of soft palate closure.
- 57 days - Late embryonic (Carnegie stage 23), epithelial seam present throughout the soft palate
- 64 days - Early fetal (Week 9), epithelium only persists in the most posterior regions of the soft palate
Postnatal Head Changes
Head Growth continues postnatally with fontanelle initially allowing head distortion on birth and early growth. These bony plates remain unfused to allow growth, puberty growth of face.
The palate also grows postnatally through childhood and becomes more elevated (arched) forming the "palatine vault", with different (but insignificant) growth between the genders.
- Links: Postnatal Development
- E11 - protrude from bilateral maxillary processes
- E12.5 - secondary palatal development begins
- E12.5-E14 - grow vertically along the developing tongue
- E14.5 - they elevate, meet, and fuse at the midline, to form an intact palate shelf, reflex opening and closing movements of the mouth
- E15.5 - palatal fusion is complete, mesenchymal condensation followed by osteogenic differentiation occurs.
Mouse (E13.5) Palatal Shelf Wnt5a, Osr2 and Pax9 Expression.
|Mouse ruga pattern (E16)||Mouse - Spry1 cleft palate|
Newborn dog with cleft palate
- Links: Bone Morphogenetic Protein
The way in which the upper jaw forms from fusion of the smaller upper prominence of the first pharyngeal arch leads to a common congenital defect in this region called "clefting", which may involve either the upper lip, the palate or both structures.
|Australian Palate Abnormalities (2002-2003)|
|Cleft lip with or without cleft palate (9.2 per 10,000 births) ICD-10 Q36.0, Q36.1, Q36.9, Q37.0–Q37.5, Q37.8, Q37.9|
| A congenital anomaly characterised by a partial or complete clefting of the upper lip, with or without clefting of the alveolar ridge or the hard palate. Excludes a midline cleft of the upper or lower lip and an oblique facial fissure (going towards the eye).
|Cleft palate without cleft lip (8.1 per 10,000 births) ICD-10 Q35.0–Q35.9|
| A congenital anomaly characterised by a closure defect of the hard and/or soft palate behind the foramen incisivum without a cleft lip. This anomaly includes sub-mucous cleft palate, but excludes cleft palate with a cleft lip, a functional short palate and high narrow palate.
|Global Orofacial Cleft Rate (1950 - 2015)|
| This data is from a study of the published data (1950 - 2015)
International Classification of Diseases - Cleft Palate
Cleft lip and cleft palate (Q35-Q37)
Use additional code (Q30.2), if desired, to identify associated malformations of the nose. Excludes Robin's syndrome ( Q87.0 )
|Q37||Cleft palate with cleft lip|
|Q37.0||Cleft hard palate with bilateral cleft lip|
|Q37.1||Cleft hard palate with unilateral cleft lip|
|Cleft hard palate with cleft lip NOS|
|Q37.2||Cleft soft palate with bilateral cleft lip|
|Q37.3||Cleft soft palate with unilateral cleft lip|
|Cleft soft palate with cleft lip NOS|
|Q37.4||Cleft hard and soft palate with bilateral cleft lip|
|Q37.5||Cleft hard and soft palate with unilateral cleft lip|
|Cleft hard and soft palate with cleft lip NOS|
|Q37.8||Unspecified cleft palate with bilateral cleft lip|
|Q37.9||Unspecified cleft palate with unilateral cleft lip|
|Cleft palate with cleft lip NOS|
Embryonic Human Cleft Palate
|Stage16 (ventral view)|
|Cleft Lip Genes|
| Midline Cleft Lip Genes
Cleft Lip (+/− cleft palate) Genes
(Data: Congenital Malformations Australia 1981-1992 P. Lancaster and E. Pedisich ISSN 1321-8352)
Cleft Risk Variants
Two genes were identified from a recent genome-wide study.
- MAFB is expressed in the mouse palatal shelf.
- ABCA4 is a member of a superfamily of transmembrane proteins, and mutations in ABCA4 play a major role in the etiology of Stargardt disease and related retinopathies. Gene produces an ATP-binding cassette (ABC) superfamily trans-membrane protein
Ten most frequently reported Birth Anomalies
- Hypospadias (More? Male movie | Genital Abnormalities - Hypospadia)
- Obstructive Defects of the Renal Pelvis (More? Renal System - Abnormalities)
- Ventricular Septal Defect (More? Cardiovascular Abnormalities - Ventricular Septal Defect)
- Congenital Dislocated Hip (More? Musculoskelal Abnormalities - Congenital Dislocation of the Hip (CDH))
- Trisomy 21 or Down syndrome - (More? Trisomy 21)
- Hydrocephalus (More? Hydrocephalus)
- Cleft Palate (More? Palate_Development)
- Trisomy 18 or Edward Syndrome - multiple abnormalities of the heart, diaphragm, lungs, kidneys, ureters and palate 86% discontinued (More? (More? Trisomy 18)
- Renal Agenesis/Dysgenesis - reduction in neonatal death and stillbirth since 1993 may be due to the more severe cases being identified in utero and being represented amongst the increased proportion of terminations (approximately 31%). (More? Renal System - Abnormalities)
- Cleft Lip and Palate - occur with another defect in 33.7% of cases.(More? Palate Development | Head Development)
A recent study of periconceptional folate supplementation using the Cochrane Pregnancy and Childbirth Group's Trials Register (July 2010) identified no statistically significant evidence of any effects on prevention of cleft palate and cleft lip at birth.
- Mima J, Koshino A, Oka K, Uchida H, Hieda Y, Nohara K, Kogo M, Chai Y & Sakai T. (2013). Regulation of the epithelial adhesion molecule CEACAM1 is important for palate formation. PLoS ONE , 8, e61653. PMID: 23613893 DOI.
- Nelson ER, Levi B, Sorkin M, James AW, Liu KJ, Quarto N & Longaker MT. (2011). Role of GSK-3β in the osteogenic differentiation of palatal mesenchyme. PLoS ONE , 6, e25847. PMID: 22022457 DOI.
- San Miguel S, Serrano MJ, Sachar A, Henkemeyer M, Svoboda KK & Benson MD. (2011). Ephrin reverse signaling controls palate fusion via a PI3 kinase-dependent mechanism. Dev. Dyn. , 240, 357-64. PMID: 21246652 DOI.
- Beaty TH, Murray JC, Marazita ML, Munger RG, Ruczinski I, Hetmanski JB, Liang KY, Wu T, Murray T, Fallin MD, Redett RA, Raymond G, Schwender H, Jin SC, Cooper ME, Dunnwald M, Mansilla MA, Leslie E, Bullard S, Lidral AC, Moreno LM, Menezes R, Vieira AR, Petrin A, Wilcox AJ, Lie RT, Jabs EW, Wu-Chou YH, Chen PK, Wang H, Ye X, Huang S, Yeow V, Chong SS, Jee SH, Shi B, Christensen K, Melbye M, Doheny KF, Pugh EW, Ling H, Castilla EE, Czeizel AE, Ma L, Field LL, Brody L, Pangilinan F, Mills JL, Molloy AM, Kirke PN, Scott JM, Scott JM, Arcos-Burgos M & Scott AF. (2010). A genome-wide association study of cleft lip with and without cleft palate identifies risk variants near MAFB and ABCA4. Nat. Genet. , 42, 525-9. PMID: 20436469 DOI.
- Welsh IC, Hagge-Greenberg A & O'Brien TP. (2007). A dosage-dependent role for Spry2 in growth and patterning during palate development. Mech. Dev. , 124, 746-61. PMID: 17693063 DOI.
- Foppiano S, Hu D & Marcucio RS. (2007). Signaling by bone morphogenetic proteins directs formation of an ectodermal signaling center that regulates craniofacial development. Dev. Biol. , 312, 103-14. PMID: 18028903 DOI.
- Diewert VM & Lozanoff S. (1993). A morphometric analysis of human embryonic craniofacial growth in the median plane during primary palate formation. J. Craniofac. Genet. Dev. Biol. , 13, 147-61. PMID: 8227288
- BURDI AR. (1965). SAGITTAL GROWTH OF THE NASOMAXILLARY COMPLEX DURING THE SECOND TRIMESTER OF HUMAN PRENATAL DEVELOPMENT. J. Dent. Res. , 44, 112-25. PMID: 14245486 DOI.
- Danescu A, Mattson M, Dool C, Diewert VM & Richman JM. (2015). Analysis of human soft palate morphogenesis supports regional regulation of palatal fusion. J. Anat. , 227, 474-86. PMID: 26299693 DOI.
- Yang ST, Kim HK, Lim YS, Chang MS, Lee SP & Park YS. (2013). A three dimensional observation of palatal vault growth in children using mixed effect analysis: a 9 year longitudinal study. Eur J Orthod , 35, 832-40. PMID: 23314328 DOI.
- Almaidhan A, Cesario J, Landin Malt A, Zhao Y, Sharma N, Choi V & Jeong J. (2014). Neural crest-specific deletion of Ldb1 leads to cleft secondary palate with impaired palatal shelf elevation. BMC Dev. Biol. , 14, 3. PMID: 24433583 DOI.
- P. Lancaster and E. Pedisich, Congenital Malformations Australia 1981-1992, ISSN 1321-835.
- Vipawee Panamonta, Suteera Pradubwong, Manat Panamonta, Bowornsilp Chowchuen Global Birth Prevalence of Orofacial Clefts: A Systematic Review. J Med Assoc Thai: 2015, 98 Suppl 7;S11-21 PubMed 26742364
- Dixon MJ, Marazita ML, Beaty TH & Murray JC. (2011). Cleft lip and palate: understanding genetic and environmental influences. Nat. Rev. Genet. , 12, 167-78. PMID: 21331089 DOI.
- Rastogi MV & LaFranchi SH. (2010). Congenital hypothyroidism. Orphanet J Rare Dis , 5, 17. PMID: 20537182 DOI.
- Cite error: Invalid
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- De-Regil LM, Fernández-Gaxiola AC, Dowswell T & Peña-Rosas JP. (2010). Effects and safety of periconceptional folate supplementation for preventing birth defects. Cochrane Database Syst Rev , , CD007950. PMID: 20927767 DOI.
Indian J Plast Surg. 2009 October; 42(Suppl):Cleft Lip and Palate Issue
Dudas M, Li WY, Kim J, Yang A & Kaartinen V. (2007). Palatal fusion - where do the midline cells go? A review on cleft palate, a major human birth defect. Acta Histochem. , 109, 1-14. PMID: 16962647 DOI.
Ferguson MW. (1988). Palate development. Development , 103 Suppl, 41-60. PMID: 3074914
Hay ED. (1995). An overview of epithelio-mesenchymal transformation. Acta Anat (Basel) , 154, 8-20. PMID: 8714286
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- Prof Virginia Diewert - Professor of Orthodontics, University of British Columbia, who recently visited the Lab and helped with content, organisation and development of the Palate Development section.
- Medline Plus - Cleft Lip and Palate
- Better Health Channel - Cleft palate and cleft lip
- March of Dimes Birth Defects Foundation - Cleft Palate
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Cite this page: Hill, M.A. (2018, September 18) Embryology Palate Development. Retrieved from https://embryology.med.unsw.edu.au/embryology/index.php/Palate_Development
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