The past two decades have seen major advancements in our understanding of the genomic basis of craniofacial development, and have led to significant improvement in identification of the genes and gene variants associated with dentofacial deformities. Synthesis of advances in craniofacial genetics with applied-translational research in orthodontics treatment should provide a basis for development of precision orthodontics. As has taken place in the development of precision medicine in general, precision orthodontics will provide a foundation for major improvement in treatment of malocclusion and dentofacial deformities through assessment of gene variants and orthodontic treatment on an individual, case-by-case basis. Five sequentially-related axioms will be presented as bases for the idea of a modern synthesis of concepts from genomics and dentofacial orthopedic treatment of malocclusion and more profound craniofacial deformities. At the outset, it should be emphasized that throughout the history of orthodontics, efficacy of treatment of dentofacial deformities has always been based on contemporary understanding of the basic mechanisms of craniofacial development and growth (axiom 1). However, it is often not fully appreciated that a) craniofacial phenotype includes not just dentofacial form, but also the rate and amount of growth possible; and b) that craniofacial growth not only varies normally during ontogeny but also as a result of the activity of abnormal, or at least less desirable gene variants (axiom 2). Therefore, it should also be stressed that the capability of patients to response to orthodontic treatment should be considered as part of the phenotype (axiom 3) and should be taken into consideration when planning dentofacial orthopedic treatment (axiom 4). Finally, the possibility of underlying variation of normal genetic polymorphisms for key regulatory factors may be a significant factor affecting the outcome of clinical orthodontic research on the effectiveness of dentofacial orthopedics (axiom 5).


Learning Objectives
After this lecture, you will be able to understand more about the axioms of craniofacial growth and their relevance for advances in treatment of dentofacial deformities
After this lecture, you will be able to understand more about the role of genomics in craniofacial development and potential for treatment of dentofacial deformities
After this lecture, you will be able to understand more about the relevance that “precision medicine” has for emerging development of “precision orthodontics”