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PubMed2007

Craniofacial pain as the sole symptom of cardiac ischemia: a prospective multicenter study.

BACKGROUND: Craniofacial pain can be the only symptom of cardiac ischemia. Failure to recognize its cardiac source can put the patient's life at risk. The authors conducted a study to reveal the prevalence of, the distribution of and sex differences regarding craniofacial pain of cardiac origin. METHODS: The authors prospectively selected consecutive patients (N = 186) who had had a verified cardiac ischemic episode. They studied the location and distribution of craniofacial and intraoral pain in detail. RESULTS: Craniofacial pain was the only complaint during the ischemic episode in 11 patients (6 percent), three of them who had acute myocardial infarction (AMI). Another 60 patients (32 percent) reported craniofacial pain concomitant with pain in other regions. The most common craniofacial pain locations were the throat, left mandible, right mandible, left temporomandibular joint/ear region and teeth. Craniofacial pain was pre-ponderantly manifested in female subjects (P = .031) and was the dominating symptom in both sexes in the absence of chest pain. CONCLUSIONS: Craniofacial pain commonly is induced by cardiac ischemia. This must be considered in differential diagnosis of toothache and orofacial pain. CLINICAL IMPLICATIONS: Because patients who have AMI without chest pain run a higher risk of experiencing a missed diagnosis and death, the dentist's awareness of this symptomatology can be crucial for early diagnosis and timely treatment.

Adult↗
PubMed2006

[Suppositional sutural construction and application in the three-dimensional finite element model of craniofacial complex].

OBJECTIVE: The purpose of this study was to explore suppositional sutural construction and protraction in the three-dimensional finite element model of craniofacial complex. METHODS: Combining spiral CT scanning technology with the three-dimensional finite element method, three-dimensional FEM model of craniofacial complex was developed for analysis. In the model, craniofacial sutures were constructed through the MSC. Patran program and different mechanical properties of sutures were applied. Under the same loading condition, bone displacements of the maxilla were calculated. RESULTS: A three-dimensional FE model of craniofacial complex, comprising teeth and craniofacial sutures, was developed. The displacement of the skeletal structures with sutures was significantly larger than that without sutures. CONCLUSIONS: The construction of craniofacial sutures in the three-dimensional finite element model of craniofacial complex could improve the accuracy of finite element model, which set up good foundation for biomechanical studies of craniofacial complex.

Cephalometry↗
PubMed2006

The association between the cervical spine, the stomatognathic system, and craniofacial pain: a critical review.

AIMS: Craniofacial pain is a term that encompasses pain in the head, face, and related structures. Multiple etiologies and factors may be related to craniofacial pain; however, the association between the cervical spine and its related structures and craniofacial pain is still a topic of debate. The objective of this critical review was to present and analyze the evidence of the associations between the cervical spine, stomatognathic system, and craniofacial pain. METHODS: A search of the databases Medline, PubMed, Embase, Web of Sciences, Cochrane Library, Cinahl, and HealthStar was conducted for all publications related to the topic in the English and Spanish languages. Relevant information was also derived from reference lists of the retrieved publications. The key words used in the search were cervical spine, cervical vertebrae, neck pain, neck injuries, neck muscles, craniofacial pain, orofacial pain, facial pain, temporomandibular joint pain, and temporomandibular joint disorders. RESULTS: The search provided information referring to the biomechanical, anatomical, and pathological association between craniofacial pain, the stomatognathic system and the cervical spine. CONCLUSION: The information provided by this review suggests an association between the cervical spine, stomatognathic system, and craniofacial pain, but most of this information is not conclusive and was derived from poor-quality studies (levels 3b, 4, and 5 based on Sackett's classification). Better designed studies are needed in order to clarify the real influence that the cervical spine has in relation to the stomatognathic system and craniofacial pain.

Biomechanical Phenomena↗
PubMed2000

Quantitative approach to identifying abnormal variation in the human face exemplified by a study of 278 individuals with five craniofacial syndromes.

We have two objectives in this study: to demonstrate the utility of two summary anthropometric measures for quantifying craniofacial variation and to explore some of their potential uses by physicians and clinical morphologists in general. The Craniofacial Variability Index (CVI) is a summary anthropometric measure of facial "harmony." The mean z-score, based on craniofacial anthropometry, is a measure of overall facial size. Both add an objective component to the assessment of individual facial variation and allow us to place the individual along a scale of continuous variation with predetermined limits of "normality" based on a reference or control series. Our results suggest that these summary measures coincide well with clinical assessments of abnormality in 278 individuals representing five distinct syndromes (Brachmann-de Lange, Prader-Willi, Rubinstein-Taybi, Smith-Magenis, and Sotos), each of which has an associated craniofacial component. Although craniofacial variation is continuous and the normal and syndromic populations overlap to varying degrees, the syndromic cases can be characterized in a variety of ways by using CVI as a measure of facial harmony and Mean-Z as an indicator of overall facial size. Thus, these two-objective measures offer a novel and efficient means of assessing craniofacial variation, whether they are used as tools in the clinical evaluation of subjects or as a means of exploring the nature of craniofacial variation within or between syndromes.

Adolescent↗
PubMed1976

Craniofacial surgery: present and future.

The possibilities for radical craniofacial restructuring have increased dramatically in the past 6 years with the development of craniofacial surgery. The field developed from a background of patients with major craniofacial birth defects allowing orderly planning and expansion to correction of a multitude of other craniofacial structural problems. The procedures concentrate upon changing the skeletal structures using extensive subperiostial dissection of soft tissue, and adding bone to fill in areas of deficiency. There are three grades of complexity in craniofacial procedures. After extensive soft tissue sub-periostial stripping about the orbits and upper face, the simplest form consists of onlay bone grafts. The next most complicated involves osteotomies to shift the face into a more normal position. In its most complicated form, abnormal proportions of bone are removed and the orbits or cranium are shifted into a new or normal position. We have had experience with 69 patients since September, 1972. Thirty-six have had intracranial procedures. Infection has been the most serious problem, and there have been no instances of death or blindness. A number of lesser problems occur. Future applications of craniofacial surgery are appearing with great frequency as more experience is gained with its uses. It has particular application in acute and late reconstruction of patients with traumatic defects about the face. Preventive osteotomies are an area with great potential, by releasing stenotic areas of bone and allowing the developing brain to mold the upper face and orbits. There is also applicability in surgery of tumors about the craniofacial structure and in cosmetic surgery.

Adolescent↗
PubMed1997

Complications of pediatric craniofacial surgery in the Orient: analysis of a 10-year experience.

Numerous reports on the complications of craniofacial surgery have been published in the western world. However, relatively little such information concerning Oriental populations has been documented. We therefore set out to provide a retrospective analysis of all the complications of craniofacial surgery encountered during the 10-year period of 1986 to 1995 at Seoul National University Children's Hospital, the only children's hospital in Korea. Forty-nine children underwent 57 consecutive craniofacial procedures at our institution during 1986 to 1995. A retrospective chart analysis of the frequency and types of complications was performed. Mantel-Haenszel chi-square tests were then calculated for several factors, including age at surgery, duration of surgery, intraoperative losses of hemoglobin and hematocrit, total amount of blood transfusion, and the number of complications according to year, diagnosis, and operative procedure to find any significant correlation with the incidence of complications. Mortality was 1.8%. The major complication rate was 7.0% and included cases of visual loss and persistent cerebrospinal fluid leak. Analysis revealed the presence of several trends, including an increased incidence of complications with increased patient age at surgery, duration of surgery, and intraoperative loss of hematocrit. The number of complications was also noted to increase in cases with complex craniofacial synostosis syndromes (Crouzon's, Apert's Antley-Bixler, etc.) and tumors of the orbit and cranium. Finally, complications were noted to decrease in recent years, most likely due to the increased experience of our craniofacial team. Nevertheless, statistical analysis revealed that the incidence of complications correlated significantly only with increased duration of surgery (p < 0.05). The results of our study indicate that although craniofacial surgery in the Orient carries an inherent risk for significant complications, the risk can be minimized and the rate of mortality and major complications kept to an acceptable level by a careful and experienced craniofacial team. Groups at most risk for complications are those with a long duration of surgery.

Adolescent↗
PubMed2001

Craniofacial distraction osteogenesis: a review of 3278 cases.

The nascent field of craniofacial distraction osteogenesis has not yet been subjected to a rigorous evaluation of techniques and outcomes. Consequently, many of the standard approaches to distraction have been borrowed from the experience with long bones in orthopedic surgery. The ideal "latency period" of neutral fixation, rate and rhythm of distraction, and consolidation period have not yet been determined for the human facial skeleton. In addition, because the individual craniofacial surgeon's experience with distraction has generally been small, outcomes and meaningful complication rates have not yet been published. In this study, a four-page questionnaire was sent to 2476 craniofacial and oral/maxillofacial surgeons throughout the world, asking about their experiences with distraction osteogenesis. Information about the types of cases, indications for surgery, surgical techniques, postoperative management, outcomes, and complications were tabulated. Of 274 respondents (response rate, 11.4 percent), 148 indicated that they used distraction in their surgical practice. One hundred forty-five completed surveys were entered into a database that provided information about 3278 craniofacial distraction cases. Statistical analyses were performed comparing the rates of premature consolidation, fibrous nonunion, and nerve injury, on the basis of the use of a latency period and different rates and rhythms of distraction. In addition, the rates of all complications were determined and compared on the basis of the number of distraction cases performed per surgeon. The results of the study clearly show a wide variation in the surgical practice of craniofacial distraction osteogenesis. Although the cumulative complication rate was found to be 35.6 percent, there is a pronounced learning curve, with far fewer complications occurring among more experienced surgeons (p < 0.001). The presence of inferior alveolar nerve injury as a result of mandibular distraction was much lower for respondents whose distraction regimens consisted of no more than 1 mm of distraction per day (19.5 percent versus 2.4 percent; p < 0.001). No evidence was found to support the use of a latency period or to divide the daily distraction regimen into more than one session per day. Conclusions could not be drawn from this study regarding the length of the consolidation period. Overall, the surgeon-reported outcomes are comparable with those published for other craniofacial procedures, despite the higher incidence of complications. Although conclusions made on the basis of a subjective questionnaire need to be interpreted cautiously, this study has strength in the large numbers of cases reviewed. Because of the anonymity of responses, it has been assumed that surgeons who responded to the survey reported accurate numbers of complications and successful outcomes. Finally, additional clinical and animal studies that will be of benefit in advancing the field of craniofacial distraction osteogenesis are outlined.

Craniofacial Abnormalities↗
PubMed2006

Stereolithography for craniofacial surgery.

Advances in computer technology have aided in the diagnostic and clinical management of complex congenital craniofacial deformities. The use of stereolithographic models has begun to replace traditional milled models in the treatment of craniofacial deformities. Research has shown that stereolithography models are highly accurate and provide added information in treatment planning for the correction of craniofacial deformities. These include the added visualization of the complex craniofacial anatomy and preoperative surgical planning with a highly accurate three-dimensional model. While the stereolithographic process has had a beneficial impact on the field of craniofacial surgery, the added cost of the procedure continues to be a hindrance to its widespread acceptance in clinical practice. With improved technology and accessibility the utilization of stereolithography in craniofacial surgery is expected to increase. This review will highlight the development and current usage of stereolithography in craniofacial surgery and provide illustration of it use.

Child↗
PubMed1999

Progress toward understanding craniofacial malformations.

Significant advances in the study of the human face have revealed the genetic and gene-environment bases of numerous common and rare craniofacial disorders. Classification of craniofacial malformations based on clinical phenotypes is sometimes quite different from the genetic findings of patients. Different mutations in a single gene can cause distinct syndromes, and mutations in different genes can cause the same syndrome. The extracellular signaling molecule SHH, fibroblast growth factor receptors, and transcription factors GLI3, MSX2, and TWIST are discussed as examples of molecules involved in interrelated signal transduction networks regulating craniofacial development. Progress in the understanding of normal and abnormal craniofacial development, through the study of morphoregulatory signaling pathways, has benefited from multifactorial approaches recommended 40 years ago at the National Institute of Dental Research-sponsored landmark Gatlinburg Conference. The utilization of biochemistry, protein structure analyses, tissue culture, and animal model systems for developmental genetics has resulted in remarkable scientific advances. The evolutionary conservation of morphoregulatory pathways has revealed the homology of genes associated with human craniofacial malformations and their counterparts that regulate the morphogenesis of fruit flies. The continued investments in basic, translational, and patient-oriented research regarding normal and abnormal craniofacial development will translate into substantial improvements in the prevention, diagnosis, and treatment of craniofacial diseases and disorders.

Animals↗
PubMed1991

Craniofacial dysostosis. Staging of reconstruction and management of the midface deformity.

Crouzon's and Apert's syndromes are the most common of the craniofacial dysostosis syndromes. A team approach is required to achieve effective patient management. The team evaluation begins shortly after birth and follows the patient through infancy, childhood, and adolescence into early adulthood. The role of each team member varies according to the patient's age and individual circumstances. For example, in infancy and early childhood, constant combined reassessment by the pediatrician, neurosurgeon, ophthalmologist, neuroradiologist, and craniofacial surgeon is essential. Later in adolescence, the role of the ophthalmologist, neuroradiologist, and neurosurgeon becomes less important, whereas that of the orthodontist, speech pathologist, maxillofacial surgeon, and psychosocial team becomes more dominant. Major craniofacial centers should be encouraged to develop protocols for patient management and to follow a consistent prospective process of collecting data. Meeting these objectives allows us to learn from the past. During the past decade since the introduction of the modern era of craniofacial surgery by Tessier in 1967, craniomaxillofacial surgery has advanced in many ways: through the use of autogenous cranial bone grafts for onlay or interpositional use; refinements in bone stabilization techniques that include miniplate and microplate and screw fixation rather than direct wires; the reintroduction of creative osteotomies for the management of midface deficiency (monobloc and monobloc bipartition); the development of CT scanning techniques applied to the craniofacial skeleton for both qualitative and quantitative measurement; and the presence of the dedicated craniofacial anesthetist whose meticulous monitoring, airway management, and fluid replacement allows for the safe execution of complex total midface osteotomies. The recognition of the need for a staged surgical approach to the correction of the deformities caused by Apert's and Crouzon's syndromes has clarified reconstructive goals and allowed the surgeon to take advantage of differential craniofacial growth patterns similar to those used to help the patient with congenital cleft lip and palate defects. By continuing to define our rationale for the timing of surgical intervention--for example, using cranial vault surgery in infancy to relieve increased intracranial pressure and papilledema; total midface advancement in childhood to further increase intracranial and orbital volume, improve nasal airflow, occlusion, and body image; and orthognathic surgery in adolescence to improve occlusion, speech, and aesthetics--we can avoid unproductive surgery and select the optimal timing for surgical intervention to maximize long-term functional and aesthetic results.

Acrocephalosyndactylia↗
PubMed2003

Scaling relationships between craniofacial sexual dimorphism and body mass dimorphism in primates: implications for the fossil record.

Craniofacial remains (the most abundant identifiable remains in the fossil record) potentially offer important information about body size dimorphism in extinct species. This study evaluates the scaling relationships between body mass dimorphism and different measures of craniofacial dimorphism, evaluating taxonomic differences in the magnitude and scaling of craniofacial dimorphism across higher taxonomic groups. Data on 40 dimensions from 129 primate species and subspecies demonstrate that few dimensions change proportionally with body mass dimorphism. Primates show general patterns of greater facial vs. neurocranial and orbital dimorphism, and greater dimorphism in lengths as opposed to breadths. Within any species, though, different craniofacial dimensions can yield very different reconstructions of size dimorphism. There are significant taxonomic differences in the relationships between size and craniofacial dimorphism among primate groups that can have a significant impact on reconstructions of body mass dimorphism. Hominoids tend to show lower degrees of facial dimorphism proportional to size dimorphism than other primates. This in turn implies that strong craniofacial dimorphism in Australopithecus africanus could imply very strong body size dimorphism, conflicting with the relatively modest size dimorphism inferred from postcrania. Different methods of estimating the magnitude of size dimorphism from craniofacial measurements yield similar results, and yield comparatively low percent prediction errors for a number of dimensions. However, confidence intervals for most estimates are so large as to render most estimates highly tentative.

Animals↗
PubMed1999

Obstructive sleep apnoea in acromegaly: the role of craniofacial changes.

Obstructive sleep apnoea (OSA) is due to craniofacial changes and acromegaly. The question addressed by this study was whether growth hormone (GH) induced craniofacial changes might explain persisting OSA despite endocrine inactivity in acromegaly. Nineteen patients treated for acromegaly were examined cephalometrically for craniofacial changes and polysomnographically for OSA. Twelve patients proved to have OSA with an apnoea/hypopnoea index >15; seven patients showed no evidence of OSA at all. With respect to the endocrinological parameters, there were no differences between the two groups that would explain the presence or absence of OSA. Neither group differed with respect to sex, age, or body mass index. Craniofacial changes were predominantly found in the mandible. The group with OSA proved to have increased vertical, dolichofacial growth compared to those without OSA. Consecutively, in the OSA group the posterior airway space was narrowed, and the hyoid was displaced more caudally. Thus, it seems that craniofacial structures of patients with acromegaly and persisting obstructive sleep apnoea are different from those without obstructive sleep apnoea. Surgical corrections of pertaining acromegaly-induced craniofacial changes should be performed with an awareness of the individual craniofacial condition so as not to enhance obstructive sleep apnoea.

Acromegaly↗
PubMed2003

Craniofacial imaging informatics and technology development.

PURPOSE: 'Craniofacial imaging informatics' refers to image and related scientific data from the dentomaxillofacial complex, and application of 'informatics techniques' (derived from disciplines such as applied mathematics, computer science and statistics) to understand and organize the information associated with the data. METHOD: Major trends in information technology determine the progress made in craniofacial imaging and informatics. These trends include industry consolidation, disruptive technologies, Moore's law, electronic atlases and on-line databases. Each of these trends is explained and documented, relative to their influence on craniofacial imaging. RESULTS: Craniofacial imaging is influenced by major trends that affect all medical imaging and related informatics applications. The introduction of cone beam craniofacial computed tomography scanners is an example of a disruptive technology entering the field. An important opportunity lies in the integration of biologic knowledge repositories with craniofacial images. CONCLUSION: The progress of craniofacial imaging will continue subject to limitations imposed by the underlying technologies, especially imaging informatics. Disruptive technologies will play a major role in the evolution of this field.

Databases as Topic↗
PubMed2002

Applications of a new carbonated calcium phosphate bone cement: early experience in pediatric and adult craniofacial reconstruction.

Hydroxyapatite cements have recently been employed as bone substitutes in craniofacial reconstruction. They are easily applied, nonresorbable, available in unlimited quantity, and eliminate donor-site morbidity. Norian CRS (craniofacial repair system) is a new carbonated calcium phosphate paste that is unique in that it more closely resembles bone than do traditional hydroxyapatite pastes. Norian is a low-order crystalline apatite soluble at a low pH, facilitating its resorption and replacement by host bone. The cement was first used for craniofacial surgery in North America at the Children's Hospital of Philadelphia. This report presents the authors' experience with this bone substitute in both pediatric and adult craniofacial reconstruction. Sixteen adult and pediatric patients underwent craniofacial reconstruction involving the use of carbonated calcium phosphate paste for correction of defects that required from 5 to 110 g of carbonated calcium phosphate paste (mean, 28.5 g). The patients were all followed for a minimum of 14 months. Minor complications included one case of infection and two cases involving cement microfragmentation. In the authors' experience, carbonated calcium phosphate paste has proved to be an excellent alloplastic material for osseous augmentation and reconstruction in the craniofacial skeleton. Few problems were encountered using this material; no significant morbidity was encountered. Although this material seems to be promising as a bone substitute, further follow-up will be necessary to evaluate its potential role in craniofacial surgery.

Adolescent↗
PubMed1997

Craniofacial growth in short children born small for gestational age: effect of growth hormone treatment.

The effects of growth hormone (GH) therapy in children have yet to be completely catalogued. In the present study, the effect of high-dose GH treatment on craniofacial growth was evaluated once yearly in 21 pre-pubertal, non-GH-deficient children born small for gestational age. These children were randomly allocated to be either untreated or treated with GH at a daily subcutaneous dose of 0.2 or 0.3 IU/kg for 2 yrs. The group consisted of 12 girls and 9 boys with a mean age of 5.1 yr (range, 2 to 8 yr), bone age of 3.4 yr, and height SDS of -3.6. At the start of the study, all children showed an overall delay of craniofacial growth. This cohort of short children born small for gestational age showed a small SNB angle and a large ANB angle; all other angular measurements were within normal range. GH treatment accelerated growth in several craniofacial components, especially the posterior total facial height, the cranial base length, and the overall mandibular length. The increase of the mandibular length increased the SNB angle; no other angular measurements were affected. Age at start of treatment differently influenced the increase in posterior and total cranial base length, the increase in mandibular corpus length, and the position of the mandible in relation to the cranial base. Although GH treatment for 2 yrs led to a craniofacial growth acceleration, the position of the mandible in relation to the cranial base and the craniofacial size in lateral aspect were not normalized in the majority of the GH-treated children. No signs of disproportional growth were evidenced after 2 yrs of high-dose GH treatment. In conclusion, short pre-pubertal SGA children display an overall delay of linear craniofacial growth and a retrognathic mandible. High-dose GH treatment over 2 yrs leads to craniofacial catch-up growth, which is pronounced in regions where interstitial cartilage is involved and results in a less convex face in profile.

Age Determination by Skeleton↗
PubMed2000

The role of serotonin and neurotransmitters during craniofacial development.

Several neurotransmitters, in particular serotonin (5-HT), have demonstrated multiple functions during early development and mid-gestational craniofacial morphogenesis. Early studies indicated that 5-HT is present in the oocyte, where it appears to function as a regulator of cell cleavage. Later, it has a significant role during gastrulation, during which there are significant areas of 5-HT uptake in the primitive streak. Subsequently, in association with neurulation, 5-HT uptake is seen in the floor plate of the developing neural tube. During neural crest formation and branchial arch formation, 5-HT has been demonstrated to facilitate cell migration and stimulate cell differentiation. During morphogenesis of the craniofacial structures, 5-HT stimulates dental development and may aid in cusp formation. All of the most commonly prescribed antidepressant drugs inhibit serotonin uptake, yet they do not appear to cause major craniofacial malformations in vivo. Given the wide spectrum of effects that 5-HT has during development, it is difficult to understand why these anti-depressants are not major teratogens. Redundancy within the system may allow receptor and uptake pathways to function normally even with lower than normal levels of circulating serotonin. Serotonin-binding proteins, that are expressed in most craniofacial regions at critical times during craniofacial development, may have a buffering capacity that maintains adequate 5-HT tissue concentrations over a wide range of 5-HT serum concentrations. Dental development appears to be particularly sensitive to even small fluctuations in concentrations of 5-HT. Therefore, it may be that children of patients who have received selective serotonergic re-uptake inhibitors (such as Prozac and Zoloft) or the less selective tricyclic anti-depressant drugs (such as Elavil) would be at a higher risk for developmental dental defects such as anodontia and hypodontia. In this review, the evidence supporting a role for 5-HT during mammalian craniofacial development is discussed. A series of models is proposed that may explain how the craniofacial effects of 5-HT are mediated.

Animals↗
PubMed2006

Craniofacial tissue engineering by stem cells.

Craniofacial tissue engineering promises the regeneration or de novo formation of dental, oral, and craniofacial structures lost to congenital anomalies, trauma, and diseases. Virtually all craniofacial structures are derivatives of mesenchymal cells. Mesenchymal stem cells are the offspring of mesenchymal cells following asymmetrical division, and reside in various craniofacial structures in the adult. Cells with characteristics of adult stem cells have been isolated from the dental pulp, the deciduous tooth, and the periodontium. Several craniofacial structures--such as the mandibular condyle, calvarial bone, cranial suture, and subcutaneous adipose tissue--have been engineered from mesenchymal stem cells, growth factor, and/or gene therapy approaches. As a departure from the reliance of current clinical practice on durable materials such as amalgam, composites, and metallic alloys, biological therapies utilize mesenchymal stem cells, delivered or internally recruited, to generate craniofacial structures in temporary scaffolding biomaterials. Craniofacial tissue engineering is likely to be realized in the foreseeable future, and represents an opportunity that dentistry cannot afford to miss.

Absorbable Implants↗
PubMed1990

Appropriate animal models for craniofacial biology.

The use of animal models in craniofacial biology has helped make significant contributions toward the clinical and surgical management of patients with craniofacial disorders. The present paper discusses some problems associated with choosing appropriate animal models for research in human craniofacial morphology and offers suggestions for determining the most appropriate model. Three levels of appropriate animal model choices are suggested: (1) the "generic mammalian" animal model, useful for investigating the problems of bone biology and generalized mammalian craniofacial growth mechanisms; (2) the "phylogenetically closer" animal model, useful for investigating the influence of experimental manipulations on the general primate craniofacial growth pattern; and (3) "fitting" the appropriate animal model to specific regional craniofacial growth patterns or anatomic conditions of interest. The continued, intelligent use of animal models in craniofacial investigations depends heavily on understanding and appreciating the information that can be derived from the "appropriate" animal model.

Animals↗