Fabricating a face: the essence of embryology in the dental curriculum

The current explosive growth in developmental biology, fuelled by the almost completed sequencing of the human genome, is bound to have a profound impact upon the practice of medicine and dentistry in the twenty-first century. No other discipline more accurately reflects this impact than embryology, which combines the basic and clinical sciences of genetics, ontogeny, phylogeny, teratology, and syndromology into the essence of modern medical and dental practice. The advent of in vitro fertilization, chorionic villus sampling, amniocentesis, prenatal ultrasonography, intrauterine surgery, and stem cell therapy has vaulted the previously esoteric subject of embryology into clinical consciousness. All these aforementioned procedures require an intimate knowledge of the different stages of development. The alphabet soup of acronyms that now peppers papers proclaiming the genetics and characteristics of various growth factors and cytokines (e.g., FGF, TGFalpha) are all based upon an understanding of the developmental mechanisms occurring in the embryo and subsequently in wound healing and oncology. Congenital abnormalities ranging from lethal syndromes to dental malocclusions cannot be diagnosed, treated, cured, or prognosticated upon without a sound conceptualization of embryology. Computer technology has revolutionized the understanding and teaching of embryology by portraying developmental phenomena as three-dimensional model images in sequential depictions of changes proceeding in the fourth dimension of time. Embryology must now form the essential core of the basic sciences in medical and dental curricula. Future dental practice will become rooted in the genetics and morphogenesis of facial fabrication.