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Titanium implants in maxillofacial reconstruction.

The development of titanium interosseous transmucosal and transcutaneous implants has revolutionized maxillofacial prosthetics. These devices have made possible the successful functional and esthetic rehabilitation of many patients with complex facial defects. An overview covering the development and clinical use of titanium interosseous implants is presented in this article.

Dental Implants↗

The functional matrix hypothesis revisited. 3. The genomic thesis.

Although the initial versions of the functional matrix hypothesis (FMH) theoretically posited the ontogenetic primacy of "function," it is only in recent years that advances in the morphogenetic, engineering, and computer sciences provided an integrated experimental and numerical data base that permitted recent significant revisions of the FMH--revisions that strongly support the primary role of function in craniofacial growth and development. Acknowledging that the currently dominant scientific paradigm suggests that genomic, instead of epigenetic (functional) factors, regulate (cause, control) such growth, an analysis of this continuing controversy was deemed useful. Accordingly the method of dialectical analysis, is employed, stating a thesis, an antithesis, and a resolving synthesis based primarily on an extensive review of the pertinent current literature. This article extensively reviews the genomic hypothesis and offers a critique intended to remove some of the unintentional conceptual obscurantism that has recently come to surround it.

Bone Development↗

Use of skeletal maturation based on hand-wrist radiographic analysis as a predictor of facial growth: a systematic review.

The purpose of this systematic review was to evaluate the predictive value of hand-wrist radiographic assessment of skeletal maturity in estimating facial growth timing and velocity. A search of PubMed, Medline, Cochrane Database of Systematic Reviews, Embase, Web of Sciences, and Lilacs identified 16 articles that met the following inclusion criteria: use of hand-wrist radiographs for skeletal maturation determination, facial growth evaluated through cephalometric radiographs, and cross-sectional or longitudinal studies. Five articles were rejected because of major methodological issues. Most of the remaining articles had small sample size, and there was no report of randomization or method error. Skeletal maturity determined by hand-wrist radiographic analysis was well related to overall facial growth velocity. Maxillary and mandibular growth velocities were related to skeletal maturity, but their relationship was less robust than that for overall facial growth. The available articles have not adequately defined a relationship between cranial base growth velocity and skeletal maturity. Hand-wrist radiographic assessment of skeletal maturity for use in facial growth prediction should include bone staging as well as ossification events. The role of skeletal maturity assessment in clinical and research applications is discussed and recommendations are provided.

Age Determination by Skeleton↗

Log-linear allometry of fetal craniofacial growth in Down's syndrome.

Trisomy 21 develops as a result of nondisjunction of two homologous chromosomes during either the first or second meiotic division. One of the more important consequences of these genetic alterations is the predictable, although variable disturbance in the architecture of the craniofacial region [1]. Postnatal craniofacial morphology has been extensively studied in Down's syndrome (DS). However, little information is available on human prenatal development of the head and face in such patients. The time at which changes in craniofacial phenotype first emerge in Down's syndrome fetuses and at which physical growth begins to diverge from normal is unknown. To explore these questions, we compared prenatal craniofacial growth in 50 Down's syndrome fetuses with that of 555 fetuses judged to be "typical for body weight and age" using the method of log-linear allometry [2].

Cephalometry↗

Growth potential in suture bone inlay grafts: a comparison of vascularized and free calvarial bone grafts.

The present study investigates transsutural growth in vascularized and free calvarial bone grafts and notes the effects of such growth on craniofacial development. The temporalis myoosseous flap served as a model of vascularized graft. In ten 8-week-old dogs, a standardized skeletal defect, including a segment of the zygomatico-maxillary suture, was created. The defect was reconstructed with a vascularized graft in half the animals and a corresponding free graft in the remaining animals. Growth was assessed by means of serial cephalometric radiography and direct osteometry. Vascularized bone grafts demonstrated persistent transsutural growth following transplantation. Growth at the recipient site was preserved, resulting in less restriction of vertical maxillary development.

Animals↗

[A cross-sectional study of the relationship between the ossification of the distal phalanx of the first digit and cranio-facial growth and development].

For correction as well as prevention of malocclusion, information about the bone maturity is very important in treatment planning. In this study, ossification of the distal phalanx of the first digit was used as an indicator of bone maturity. We found significant correlation between this ossification of the phalanx and the cranio-facial development. Stage E2 was reached, on the average, at the age of 6 years 4 months in girls and 8 years 11 months in boys, stage E4 at 12 years 9 months in girls and 14 years 11 months in boys. Girls were ahead of boys, the difference being about two years at both E2 and E4 stages. The degree of the cranio-facial development at stage E2 compared with adults was 83.5% in girls and 83.8% in boys; at stage 4 it was 94.8% in girls and 94.5% in boys. At stages E2 and E4, the cranial base was the most developed, the maxilla was next, and then the mandible. This tendency was found in both boys and girls. A4-Go was the least developed at both E2 and E4 stages. The cranio-facial development in the posterior vertical dimension continued to occur for a long period.

Adolescent↗

[Qualitative research of maturity indicators in children with normal occlusion].

This study was performed on 76 children of both sexes, aged 6-15 years. The cases were distributed in nine age groups. The body weight and high, the dental age, the dental maturity and the skeletal maturity were analysed in every selected case. The results were as follows: the body weight and high, compared with the age groups, showed significantly positive differences; the dental age and dental maturity, compared with the age groups, were in harmony; the skeletal age showed a retarded maturation.

Adolescent↗