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PubMed1990

Development of the nose and soft tissue profile.

Cephalometric radiographs from a sample of 64 untreated persons (32 Class I and 32 Class II) were evaluated to determine the amount, direction and timing of facial soft tissue development. Twenty-five parameters were evaluated in the mixed dentition (7 to 9 years), the early permanent dentition (11 to 13 years), and early adulthood (16 to 18 years). Results showed that anteroposterior growth and subsequent increased anterior projection of the nose continued in both males and females after skeletal growth had subsided. However, females had concluded a large proportion of their soft tissue development by age 12 while in males continued growth was noted until age 17 resulting in their having greater soft tissue dimensions for many of the parameters evaluated. During the developmental period, the angular shapes and positional relationships of the nose, lips and chin remained relatively constant for both sexes and was relatively independent of the underlying hard tissues. Treatment planning implications may be drawn from the amounts and timing of the soft tissue development found in this study.

Adolescent↗
PubMedDate not supplied

Treatment planning in Class III malocclusion.

In Class III malocclusion, the overjet is reduced and may be reversed, with one or more incisor teeth in lingual crossbite. In the early mixed dentition, and in older patients with mild skeletal discrepancies, orthodontic treatment usually involves proclining the maxilliary anterior teeth into positive overjet. When the permanent dentition has established, orthodontic therapy is usually aimed at compensating for the underlying mild-moderate Class III skeletal discrepancy by proclining and retroclining the maxillary and mandibular incisors, respectively. In contrast, adolescent and non-growing patients with severe Class III skeletal discrepancies require a combination of orthodontic treatment and orthognathic surgery to correct the underlying skeletal pattern. Adolescent patients with moderately severe skeletal discrepancies require careful treatment planning because they are often at the limits of orthodontic compensation, and further mandibular growth may prevent a stable Class I occlusion from being maintained with growth. In this situation, treatment should be limited to aligning the maxillary arch, accepting that orthognathic surgery will be required to correct the underlying Class III skeletal discrepancy when skeletal growth has been completed. This article will inform dental professionals about the aetiology, assessment, diagnosis and treatment of patients with Class III malocclusions. Specifically, the types of orthodontic treatment that can be completed at the various stages of dental development and skeletal growth will be discussed.

Adolescent↗
PubMed2001

Penetration of the mandibular condyle into the middle cranial fossa: report of a case in a 6-year-old girl.

Reported cases of dislocation of the mandibular condyle into the middle cranial fossa are rare. Treatment of this injury should be individualized and should take in account the age of the patient, growth potential, the degree of glenoid fossa destruction, the risk of ankylosis and the risk of further cranial injury. In children, functional therapy is aimed at helping the restoration of posterior facial height, good occlusal relations and function. Long-term follow-up is mandatory. Surgery may be required later to correct asymmetrical growth or developing ankylosis. This article describes a case of condylar penetration into the middle cranial fossa in a six-year-old child and the treatment performed to minimize consequences on occlusion and facial development.

Accidental Falls↗
PubMedDate not supplied

New genetic approaches to craniofacial growth and malformation in the mouse.

New genetic tools that have been developed in the mouse for the study of genetic variation and molecular biology can be applied to the study of craniofacial growth and malformation. D.W. Bailey (Journal of Heredity, 76:107-114, 1985, 77:17-25, 1986) has used congenic and recombinant inbred strains to identify a large number of genes that result in growth variation in local regions of the mandible. The function of "morphogenes" have not been characterized, but they may act as switches that regulate already recognized structural genes. We have studied the cartilage matrix deficiency (cmd/cmd) mutant mouse and found that their chondrocytes fail to synthesize the cartilage-specific proteoglycan at both protein and mRNA levels. In vitro experiments demonstrate biochemical feedback control in the formation of the cartilage extracellular matrix. Abnormalities of cartilage matrix result in facial clefts and in dental malocclusion in mice. A recombinant plasmid containing the type II collagen promoter and enhancer fused to a reporter gene, chloramphenicol acetyl transferase, has been used to produce transgenic mice. These mice reveal that the type II collagen enhancer controls the high level of tissue-specific expression of the gene. The transgenic mice provide a potential test system for study of development and teratogenesis at the gene level.

Animals↗
PubMed2002

Frontoorbital reconstruction.

The care of the patient with craniosynostosis is perhaps the most challenging problem in craniofacial surgery. The syndromes vary in their presentation and severity; however, many of the structural and functional sequelae have common characteristics. The multifaceted medical problems of these children are particularly well suited to a multidisciplinary team approach to their care. The surgeons must be aware of the most pressing health concerns of these patients and incorporate those concerns into a well-formulated phased plan of comprehensive reconstruction. The overall goals of treatment of syndromic and nonsyndromic craniosynostosis continually should guide the care of these exceptional children. Those goals are to provide a predictable and durable reconstruction that restores facial form, reestablishes symmetry, attains the best results in the least number of operations, and infuses the patient with a sense of emotional and physical health.

Brain↗
PubMed1999

Evaluation of orbital stress dissipation in pediatric and adult skulls using electronic speckle pattern interferometry.

OBJECTIVES: To measure and quantitatively compare the degree of force dissipation in pediatric and adult skulls subjected to similar dynamic forces. DESIGN: An anatomical study using electronic speckle pattern interferometry, which allows generation of displacement vectors after application of a force. SUBJECTS: Five human skulls (3 pediatric and 2 adult). INTERVENTION: Each skull was subjected to a reproducible and quantifiable force created by a steel ball pendulum striking a precise periorbital focus: (1) infraorbital foramen, (2) supraorbital notch, (3) malar eminence, and (4) nasofrontal suture. Electronic speckle pattern interferometry was used to construct interferogram fringe patterns to determine skull regions with the greatest degree of displacement. RESULTS: Interferogram analysis revealed that the adult skull has a tendency to dissipate force with minimal resultant displacement. In contrast, the pediatric skulls demonstrated greater displacements (ie, increased fringe density) at the same periorbital foci. CONCLUSIONS: The pediatric skull dissipates periorbital stress differently than the adult skull, as illustrated by quantitative interferogram analysis. This finding parallels clinical data that demonstrate a varying pattern of fractures in pediatric and adult skulls related to craniofacial development.

Adult↗
PubMed1995

Craniofacial development in rats with early resection of the zygomatic arch.

Eighty-two-day-old male Wistar rats were selected to study the pattern of craniofacial growth following resection of the zygomatic arches. Rats were divided into three groups: group I (n = 14), the control group; group II (n = 15), with unilateral resection of the zygomatic arch; and group III (n = 8), with bilateral resection. Direct dry skull and cephalometric measurements show increased facial projection and decreased transverse facial width on the side of the resected arch. If the results are extrapolated to the growth pattern of patients with the Treacher Collins syndrome, we can conclude that the zygomatic arch acts as a "moderator" in the morphologic development of the face.

Animals↗
PubMed2004

Three-dimensional analysis of maxillary and mandibular growth increments.

OBJECTIVE: To analyze changes in the facial, maxillary, and mandibular skeleton in the vertical, sagittal, and transverse dimensions during an orthodontically relevant period of dentofacial development (i.e., between 7 and 15 years of age). SUBJECTS AND METHOD: This longitudinal study comprised posteroanterior (PA) and lateral cephalograms at 7, 9, 11, 13, and 15 years of 18 untreated Class I subjects with good occlusion. Transverse growth (width) was analyzed on the basis of PA cephalograms and sagittal (depth) and vertical (height) growth by means of lateral cephalograms. For each linear measurement, mean percentage increases were calculated relative to the size at 7 years of age. RESULTS AND CONCLUSIONS: Between 7 and 15 years of age, in the whole facial skeleton and the maxilla, percentage increases were most pronounced in the vertical dimension when compared with the sagittal and transverse dimensions. In the mandible, the largest percentage increases were found in both sexes for vertical growth of the ramus, followed by sagittal growth (body length) and then mandibular width. In the sagittal dimension, development was more pronounced in the mandible (at pogonion more than at B point) than in the maxilla (A point). With respect to vertical growth, percentage increases in posterior face height exceeded the increases in anterior face height. When facial shape changes were analyzed between 7 and 15 years of age in both sexes, the ratio facial height/facial width increased and the ratio facial depth/ facial height decreased, which points toward an age-related increasing influence of vertical development.

Adolescent↗
PubMed1975

[Studies of longitudinal section on jaw development and resulting conclusions for orthodontic treatment planning in the deciduous dentition].

From a 11 years' longitudinal study of the tooth development in 93 children conclusions are drawn as to the planning of orthodontic treatment in the deciduous dentition. In accepting the task of orthodontic treatment, the dentist assumes a very responsible function which he will only master if he knows the various patterns of dental development. The difficulties of a prognosis as to dental development in an individual child are exemplified by the evaluation of dental findings obtained at the different years of life.

Cephalometry↗
PubMed2001

Condylar fractures treatment in children and youths: influence on function and face development (a five year retrospective analysis).

To evaluate relationship between consequences of TMJ fractures in children and disturbed facial skeleton growth, 46 children (18 girls, 28 boys), who were 14 years of age or younger and had undergone combined clinical and radiolographic examination for five years were retrospectively analyzed. Imaging studies were performed to investigate symptoms that included, either individually or in various combinations, pain, mechanical TMJ disfunction and facial skeleton abnormalities. The children were divided into two groups: those belonging to the former had been treated by functional orthopedic method alone, while the others had just been treated by physiotherapy. Both TMJs were normal in the patients treated functionally and they all showed normal facial structure, while different types of alterations (ranging from inflammatory to mechanical and structural ones) were observed in the others. We concluded that therapeutic procedures adopted after TMJ fractures in children are essential in minimizing consequences on occlusion and facial development.

Adolescent↗
PubMed2005

Evaluation of the outcomes of 7 Class II treatments 40 years later.

AIM: To show that starting treatment of Class II malocclusions around the time of peak height velocity at adolescence enables the orthopedic and fixed appliance steps to be merged into a single continuous phase, leading to good outcomes with long-term stability. METHODS: Seven patients with Class II malocclusions began treatment in the mid- 1960s with cervical headgear and bite plate, followed immediately by fixed appliances. Photographs and study casts were obtained for the same 7 patients approximately 40 years later. RESULTS: The stability of individual cases was considered to be good over the 40-year period. Crowding changes in the mandibular incisor region were minimal. CONCLUSION: A two-step single-phase treatment for Cass II malocclusions during adolescence has proved to be an efficient approach throughout many years of orthodontic practice. Furthermore, by using ossification markers, the individual child's growth potential can be estimated. This knowledge leads to greater efficiency by developing a positive, purposeful, and more confident approach to the management of Class II cases.

Adolescent↗
PubMed1991

[Median inter-incisor line. Clinical symptomatology].

Since unilateral mastication causes asymmetry of mouth and face, a child's interincisal midline can reveal the first signs of alteration of masticatory function. Early detection of the functional pathology, preferably before it has established itself as such, allows the clinician to correct it by means that are relatively unburdensome for the patient, thereby forestalling severe organic alteration and favouring proper, balanced occlusal development. Centering the mandible in stable centric occlusion, together with simple treatment promoting alternating bilateral mastication, allows the correct development of the growing patient's stomatognathic system.

Centric Relation↗
PubMed1990

[The effects of solid or liquified diet on the submandibular glands of mice with age].

The influence of properties of the diets on the retardation of growth of the jaw bones and masticatory muscles has been established. As the intake of liquid foodstuffs increases in the human diet, it is considered possible that these liquid diets may retard the growth of human salivary glands. 180 newborn C3H/He strain male mice were divided into solid and liquid diet groups and then the development and aging of the submandibular glands were observed both in function and morphologically until 60 weeks of age. The following results were obtained: 1. No differences could be detected in body length and body weight of the mice between solid and liquid diet groups. The wet weight of the liver in the liquid diet group was significantly larger than the solid diet group, which suggested that the liquid diet may have accelerated metabolic functions. Additionally, masticatory muscles of the liquid diet group were significantly smaller than the solid diet group which suggested growth retardation of the masticatory organ. 2. The submandibular gland wet weight and its DNA content in the liquid diet group were lower than in the solid diet group during the experimental period. This suggested that the number of cells and their ability to divide was diminished. The wet weight of glands per unit DNA content showed an increase in cell size during the adult period. 3. The alpha-amylase activity and total protein content of the submandibular glands in the liquid diet group were lower than in the solid diet group. This suggested that the saliva secretory function and protein synthesis were depressed, in agreement with the low number of cells detected. 4. The differentiation of the acinar cells and convoluted tubule cells of the liquid diet group was retarded and the 60 weeks subgroup showed hypertrophy of the convoluted tubule cells, disappearance of the secretory granules and a decrease in the number of acinar cells. 5. Slight stromal fibrosis was observed with increasing age (60 weeks) with no difference between the two groups. 6. This suggested that when mice were fed a liquid diet, the development of salivary glands was retarded and also aging changes occurred more rapidly.

Aging↗
PubMed1978

Early maxillary orthopedics in CLP cases: guidelines for surgery.

Two samples of complete cleft cases between five and seven years of age are compared (11 UCLP + 9 BCLP versus 21 UCLP + 12 BCLP). The same early orthopedic procedures were applied to all cases, but surgical management differed for the two groups: "classical" surgery (lip 3 months, palate 2--2 1/2 years) versus delayed conservative surgery (lip 6 months, soft palate 18 months, hard palate 6--8 years). It is evident that early maxillary orthopedic treatment is of little consequence for long-term development unless concomitant surgery complies with growth and functional requirements. In contrast to "classical" surgery, palatal closure in two steps is more favourable to skeletal growth and does not interfere to any relevant degree with speech development.

Activator Appliances↗