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Growth characteristics of the premaxilla and orthodontic treatment principles in bilateral cleft lip and palate.

Sixty-three individuals with complete bilateral cleft lip and palate (BCLP) were studied. In 51 of these subjects no surgical set-back or early bone grafting procedures were done. In the other 12 subjects early surgical procedures to reduce the prominence of the premaxilla had been done. In the larger group the premaxilla was, on the average, protrusive until age 12, after which it gradually became more retrusive. By the end of the growth period the premaxilla was not excessively protrusive in any of these subjects. It was concluded that it is advantageous for the premaxilla in individuals with BCLP to be protrusive during most of the growth period, since the premaxilla grows forward at a slower rate than the mandible. In the 12 subjects with premaxillary surgery, midface retrusion was demonstrated at an early age. The forward growth of the premaxilla in these individuals was slower than in the BCLP without premaxillary surgery and all 12 subjects developed rather severe midface retrusion. Orthodontic treatment principles for four different stages of craniofacial and dental development have been outlined.

Adolescent↗

Cleidocranial dysplasia: craniofacial morphology in adult patients.

The aim of the study was to carry out a detailed quantitative analysis of craniofacial morphology in a relatively large sample (N = 35) of adult patients with cleidocranial dysplasia (CCD) in order to contribute to the understanding of the characteristic craniofacial abnormalities. Roentgencephalometric films in the lateral, frontal, and basal projections were analyzed and mean facial diagrams for the lateral and frontal films were produced based on registration of 216 reference points. In the calvaria an increased width and a relatively more prominent frontal region were found. In the cranial base the most significant findings were reduced width, a cranial displacement of the clivus and sella, and an anteriorly facing foramen magnum. The orbital openings were high and narrow and nearly all patients had hypoplasia or aplasia of the nasal bones. The maxilla and mandible were reduced in height and width and the mandible was anteriorly inclined. It was concluded that all craniofacial regions are affected in CCD. Based on the present and previous studies, it is suggested that the abnormal craniofacial morphology in CCD may be explained by the skeletal dysplasia, combined with early cranial deformation and dysplastic and compensatory skeletal growth. Thus, the findings lead to the comprehension that several primary and secondary causal factors are involved in craniofacial morphogenesis in CCD, and that knowledge of early development is important when etiology and pathogenesis in a syndrome is searched for.

Adolescent↗

Development of the squamosomandibular articulation in the Mongolian gerbil (Meriones unguiculatus). II. Succinate dehydrogenase activity.

Succinate dehydrogenase activity has been studied, according to the method of Nachlas et al. (1957), in the developing tissues forming the squamosomandibular articulation in the Mongolian gerbil from its inception through the sixty postnatal day. Increased activity was observed in the chondroblasts, osteoblasts and mesenchymal tissues of the developing articulation. The chondroclasts of the developing mandibular condyle displayed intense reaction as did the osteoclasts of the developing bony articulation. Succinate dehydrogenase activity appeared to be related to the functional maturity of the cellular elements of the developing joint.

Animals↗

[Individual overbite behavior between the deciduous and permanent dentition].

Manuals and relevant publications give rise to the impression that the formation of the overbite in the incisor region throughout its development is a process easy to overlook. Impressions of 108 cases were taken, one of the deciduous dentition and one of the permanent dentition 13 years later. A mathematic-statistical analysis of objective measurable morphological dentition criteria were made and discussed. This shows that neither from the degree of overbite nor from any other feature of the deciduous dentition a prognosis concerning the extent of the final overbite of the permanent dentition can be derived. Changes throughout the development of the overbite are predominant. There are only little correlative coherencies among the morphological symptoms that can be applied quickly and easily for the prognosis in the clinical inspection. For estimating the development tendency longterm individualized observations are necessary.

Adolescent↗

A study of the long term results achieved by the Gillies Fry procedure.

Renewed interest in delayed closure for cleft palate subjects revealed that no evaluation had been undertaken of patients who underwent the original Gillies Fry procedure. In the present investigation, 10 subjects operated upon prior to 1948 according to the Gillies Fry recommendations were evaluated for facial development, occlusal relationship, speech performance and velopharyngeal seal. Comparison of the cephalometric findings with accepted norms and examination of study casts gave encouraging results for facial and occlusal development. Speech quality covered a wide range of attainment, the best being rated highly. Endoscopic examination demonstrated regular velopharyngeal seal during swallowing but only one subject who regularly achieved velopharyngeal seal in speech. It was concluded that, although some claims for the procedure may have been a little enthusiastic, advantages accrued from it which were not accorded by other surgical approaches of the time, particularly so far as facial development and occlusion were concerned.

Adult↗

Treatment effects of Fränkel, activator and extraoral traction appliances.

The effects of the Fränkel appliance on the treatment of Class II, Division 1 malocclusion were compared with the activator, high-pull headgear, cervical traction and a control group. A sample of 16 Fränkel cases treated in the mixed dentition was tested in four craniofacial areas, with findings as follows: a. Maxillae, no significant horizontal effect b. Mandibular length, significantly increased c. Lower face height, widely variable effects. d. Less upper molar eruption and more lower molar eruption. Although the findings of this study should be interpreted as tentative, they do show the Fränkel appliance to have some different mean effects on the craniofacial complex. Variability is a most important aspect of the findings of this study. Future studies must deal not only with mean changes, but with the Fränkel appliance's variable effects on differential individuals. Optimal application of this appliance requires judgment in case selection and careful analysis of progress, using adequate follow-up records and a firm knowledge of normal growth and development of the craniofacial complex.

Activator Appliances↗

Sox9 mRNA expression in the developing palate and craniofacial muscles and skeletons.

BACKGROUND: SOX9 is a critical transcription factor for chondrogenesis and sex determination. Haploinsufficiency mutations of Sox9 in humans lead to campomelic dysplasia. Inactivation of Sox9 in the craniofacial region of mice results in an absence of endochondral bones and in malformation of other structures. This suggests that Sox9 plays multiple roles in craniofacial development and these remain to be elucidated. In order to study the functions of Sox9 in craniofacial development, a preliminary expression examination was performed. MATERIAL AND METHODS: To detect the expression of Sox9 mRNA, antisense riboprobe was synthesized by in vitro transcription. Radioactive in situ hybridization was performed on sagittal and coronal sections of mice head from organogenesis to the early postnatal stage. RESULTS: It was found that Sox9 was expressed in multiple stages and distinct processes. Besides the expression in cartilage, it was seen in the fusing stage of palatogenesis. Sox9 was also present during differentiation and maturation of craniofacial muscles. In addition, it was observed in intramembranous skeletal elements at restricted sites and stage. CONCLUSIONS: The expression pattern suggests that Sox9 serves broad roles in craniofacial development.

Animals↗

[Results of cephalometric-anthropometric measurements of the nasal profile of patients with ClassII/1 anomalies].

Appropriating to a study of literature about norm values for the judgement of nasal profils we investigated with the help of a metric analysis by 100 patients with Angle-Class II/1-anomalies mean values of the lengths of the darsum and the base of the nose, the distance Glabella-Pogonion, the naso-labial angle, the naso-frontal angle, and the naso-mental angle. Norm values and existing values of girls and boys with Class II/1-anomalies were compared and allowed conclusions to the development of the nasal profile.

Cephalometry↗

Orthodontic anomalies and differences in gnathometric variables in twins.

Actuality of gnathometric measurements by means of plaster casts persisting to the present days is stressed and the major research of the kind in twins mentioned. The study included 96 pairs of twins of both sexes (36 monozygotic and 60 dizygotic). Both qualitative and quantitative variables were evaluated and the results computer-processed. For most parameters evaluated, statistical processing revealed a markedly higher compatibility in monozygotes than in dizygotes. This held particularly true for types and severity of anomalies as well as for all qualitative variables, with the exception of over bite, overjet, class and class severity. The maxilla-related variables were shown to be highly genetically determined, which might be explained by the dynamics of mandibular movements and, possibly, a stronger effect of external factors on its growth and development.

Adolescent↗

[The functional regulator (FR II)].

The Frankel II appliance which is used in Angle Class II Division 2 cases, establish sagittal, vertical and transversal development of the jaws by keeping away the perioral muscles as in the other functional regulators. The difference between FR II and FR I appliances is the design of canine wires. After 8 months of FR II treatment of the 11 year old Class II Div. 2 patient with 5 mm. overbite, as the overbite decreased by 3 mm., the FMA angle increased and a transversal and sagittal development was established in both upper and lower jaws.

Activator Appliances↗

[Importance of posterior tooth-to-denture base discrepancy in the development of skeletal open-bite malocclusion].

This paper describes the relationship between the development of skeletal open-bite malocclusion and the tooth-to-denture base discrepancy. The cases which have a severe skeletal open-bite malocclusion are presented to evaluate the causing factor of the anterior open-bite. The anterior open-bite was associated with inferiorly positioned maxillary molars caused by the squeezing out effect of the tooth-to-denture base discrepancy, especially those in posterior part of dentition (posterior discrepancy), which provided a less steep maxillary occlusal plane in the denture frame. It was suggested that the posterior discrepancy induced a descending movement of the posterior teeth followed by a change of the occlusal plane and this effect of the posterior discrepancy was important factor in developing anterior open-bite malocclusion.

Cephalometry↗