This study aims to identify potential variants in the TP63–IRF6 pathway and GREM1 for the etiology of non-syndromic orofacial cleft (NSOFC) among the Vietnamese population. By collecting 527 case–parent trios and 527 control samples, we conducted a stratified analysis based on different NSOFC phenotypes, using allelic, dominant, recessive and over-dominant models for case–control analyses, and family-based association tests for case–parent trios. Haplotype and linkage disequilibrium analyses were also conducted. IRF6 rs2235375 showed a significant association with an increased risk for non-syndromic cleft lip and palate (NSCLP) and cleft lip with or without cleft palate (NSCL/P) in the G allele, with p_allele values of 0.0018 and 0.0003, respectively. Due to the recessive model (p = 0.0011) for the NSCL/P group, the reduced frequency of the GG genotype of rs2235375 was associated with a protective effect against NSCL/P. Additionally, offspring who inherited the G allele at rs2235375 had a 1.34-fold increased risk of NSCL/P compared to the C allele holders. IRF6 rs846810 and a G-G haplotype at rs2235375–rs846810 of IRF6 impacted NSCL/P, with p-values of 0.0015 and 0.0003, respectively. In conclusion, our study provided additional evidence for the association of IRF6 rs2235375 with NSCLP and NSCL/P. We also identified IRF6 rs846810 as a novel marker associated with NSCL/P, and haplotypes G-G and C-A at rs2235375–rs846810 of IRF6 associated with NSOFC.

This report highlights the long-term management of velopharyngeal insufficiency (VPI) and misarticulation in an 18-year-old male with unilateral cleft lip and palate. Despite primary and secondary surgeries, persistent VPI required a speech appliance and intensive therapy to address glottal stops and pharyngeal fricatives. While therapy eliminated these errors, residual VPI continued to impact speech intelligibility. Reassessment revealed that while some misarticulations persisted , the patient retained speech improvements from prior therapy , allowing for partial substitutions of target sounds . This case emphasizes the role of speech therapy in managing misarticulation despite unresolved VPI and highlights the need for ongoing multidisciplinary care.

Submucous cleft palate (SMCP) is a type of cleft lip and/or palate that is often diagnosed based on speech symptoms caused by velopharyngeal insufficiency and is frequently accompanied by complications. Although both surgery and speech therapy are treatment options, reports vary according to appropriate timing and suitability. At our hospital, patients who opted against surgery underwent speech therapy with positive results. This study aimed to evaluate the progression of velopharyngeal function (VPF) over time in non‐operated patients with SMCP to formulate a new treatment approach. Fifty‐three patients with SMCP who underwent VPF evaluation and over 1 year of speech therapy at the Cleft Lip and Palate Center of Aichi Gakuin University Dental Hospital between 2002 and 2022 were included. The patients were classified into with‐complications and without‐complications groups, and data on VPF evaluation, therapy duration, and progress were collected. Twenty patients experienced complications, while 33 did not. In the without‐complications group, a significant improvement in VPF was observed after speech therapy. At the lowest VPF, five patients required surgery, but by the final evaluation, all patients experienced improvements, with no case of “poor.” Conservative treatment through long‐term speech therapy demonstrated significant improvement in velopharyngeal function for non‐complicated SMCP cases, suggesting it as a viable alternative to surgery in selected patients. This study highlights the clinical relevance of conservative speech therapy as a cost‐effective, accessible alternative to surgery, particularly in resource‐limited settings, offering comparable outcomes in non‐complicated SMCP cases and potentially reducing healthcare burdens.

Background/Objectives: Non-syndromic cleft lip with or without palate (NSCL/P) is a common, multifactorial congenital anomaly. As genetic associations can be population-specific, this study aimed to investigate single-nucleotide polymorphisms (SNPs) in the VAX1, MAFB, and WNT3 genes for association with NSCL/P in a Japanese cohort. Methods: A case–control study was conducted with 310 Japanese patients with NSCL/P and 308 ethnically matched healthy controls from Aichi Gakuin Dental Hospital. We genotyped SNPs rs7078160 (VAX1), rs13041247 (MAFB), and rs3809857 (WNT3) using TaqMan assays. Associations were assessed using chi-squared tests, with results stratified by sex and corrected for multiple comparisons using the Bonferroni method. Results: The VAX1 rs7078160 A allele was significantly associated with an increased risk for NSCL/P (OR = 1.67, p < 0.00001). The association was particularly strong in females (OR = 1.93, p < 0.00001) but not significant in males after correction. The MAFB rs13041247 variant showed a nominal protective association with the NSCLO subtype that was not significant after Bonferroni correction. No significant association was found for WNT3. A notable gene–gene interaction was observed, where carrying risk alleles for both VAX1 and MAFB significantly increased overall NSCL/P risk (OR = 2.65, p = 0.00008). Conclusions: VAX1 rs7078160 is a significant risk factor for NSCL/P in the Japanese population, with a pronounced female-specific effect. A synergistic interaction between VAX1 and MAFB elevates disease risk, whereas WNT3 was not implicated in this cohort. These findings underscore the population-specific genetic architecture of NSCL/P.

Background: Non-syndromic orofacial clefts (NSOFCs) are one of the common congenital malformations in Vietnam, with 1.4 per 1000 live births, with notable sex differences in occurrence. This case–control study aims to investigate potential sex-specific interactions of WNT3 and NOG polymorphisms across NSOFC subtypes in a Vietnamese population. Methods: A total of 720 participants were separated into 4 groups with a male/female ratio of 1:1 (160 individuals with cleft lip and palate (NSCLP), 160 with cleft lip only (NSCLO), 160 with cleft palate only (NSCPO), 240 healthy controls). Two single-nucleotide polymorphisms (SNPs), rs3809857 and rs227731, were genotyped by using the StepOnePlus Real-Time PCR System. Results: The most significant findings were found in the male NSCLO group under a recessive model of WNT3 rs3809857 after applying Bonferroni correction, as a five-fold protective factor with OR = 0.18 (95% confidence interval: 0.05–0.64, p = 0.0033). Additionally, the weak or moderate protective association between rs3809857 and male NSCLP was found with p < 0.05 under the dominant model. However, there were no significant findings in the female NSOFC subtypes associated with WNT3. Conversely, NOG rs227731 results showed a weak increased risk in female NSCLO and NSCPO with p < 0.05. Conclusion: this study identified the critical role of WNT3 rs3809857 in reducing NSCLO risk in males. These findings support the potential influence of sex as a modifying factor in the genetic susceptibility to non-syndromic orofacial clefts.