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PubMedDate not supplied

[Craniometric findings in sickle-cell anemia].

Craniometric measurements have been taken on teleradiographs in lateral and antero-posterior projection of five patients suffering from sickle-cell anaemia. All were Sicilian. The investigations revealed a proportional dysharmony among the various segments of the face, the results of excessive development of the mandibular bone, particularly transversally. This characteristic would appear to be peculiar to patients with homo- and heterozygote haemoglobinopathy.

Adult↗

PubMed1990

Mandibular response to orthodontic treatment with the Bionator appliance.

A group of 20 subjects who underwent successful Bionator treatment was compared with 20 subjects who were treated less successfully with the same appliance. Both groups had similar advancements in their bite registrations, as well as similar treatment times and growth-prediction parameters. Success was judged not on the final occlusion (all patients were treated to a Class I molar relationship) but on the posttreatment position of skeletal pogonion. The successful group experienced 3.5 mm or more of advancement in skeletal pogonion, whereas the less successful group had less than 3 mm of advancement of this point. The two groups were comparable in all features except, as may be expected, total mandibular growth, which was greater in the group with the larger anterior pogonion advancement. The results of this study suggest that persons who have small mandibles (as determined by comparison with published growth standards) may benefit more from functional appliance therapy than patients with normal-sized mandibles. The subjects with delayed growth may experience more mandibular development than those with average growth during treatment under the favorable growth environment created by functional appliance therapy.

Activator Appliances↗

PubMed2006

[The role of the maxillary incisors in the development of the base of the nose. Applications in dento-facial orthopedics].

The neonatal respiratory distress observed in the event of a solitary median maxillary central incisor compels us to reconsider some of the traditional concepts relative to the transverse growth of the nasal level of the face. The "container-contents" connections associating maxillary incisor odontogenesis with the development of the premaxillary and facial envelopes draw the attention to the significant geometrical and mechanical expression of this morphogenesis. They require attributing to the maxillary incisors an important motor role in this development. They lead to granting the ontogenetic bonds, between malocclusions and disturbed nasal breathing, the place they deserve, taking into account the morphological integration combining them. They eventually open a new therapeutic prospect: the optimization of the development of the growing face, with regard to the various tissue mechanics and physiologies, becoming the best guarantor for the prevention of relapse after dentofacial orthopedics.

Animals↗

PubMed2005

Prolonged feeding practice and its effects on developing dentition.

Muscular activity of the lips, cheeks, and the tongue are important factors, which not only guide the occlusal development but also affect the growth of the jaws. Bottle feeding has been known to cause a myriad of changes in the oro-facial development. But the adverse effects of feeding practices with respect to developing dentition has been a subject of controversy. Hence a study was designed with the aim and objectives to check the commonly adopted feeding practices in South Kanara, to compare the occlusion of 3- to 5-year-old children with breast feeding, bottle feeding or combination, and to check whether prolonged feeding has any adverse influence on developing dentition. A total of 250 questionnaires were distributed to parents of 3- to 5-year-old children of which 153 were chosen for recording the impression and for studying the occlusion under various parameters. The results of the study indicated definite potential hazards of prolonged breast and bottle feeding especially with a tendency to develop openbite and posterior crossbite. It also suggested that an early preventive and interceptive approach.

Bottle Feeding↗

PubMedDate not supplied

Retinoid-binding proteins in craniofacial development.

Cephalic neural crest cells are known to form the frontonasal mesenchyme and contribute to the mesenchyme of the visceral arches. Retinoids affect neural crest cells and their derivatives during development, and thus cause craniofacial, thymus, and conotruncal heart malformations. In addition, retinoids induce malformations of the central nervous system (CNS). Retinoic acid (RA) and its congeners accumulate in a saturable manner in neural crest and neural crest-derived cells, in the hindbrain, and the spinal cord of mouse embryos. Cellular retinoic acid-binding protein (CRABP) was localized by immunohistochemistry in the same areas as were the labelled RA congeners. Thus, CRABP and RA congeners were found in the transitional zone between surface ectoderm and neuropeithelium, from where neural crest cells are known to emanate (day 8 1/2). Later, specific labelling was found in the frontonasal mesenchyme and in the visceral arches. Also in the trunk, neural crest cells were labelled. In CNS, strong staining was seen in the rhombomeres (especially numbers 4-6) of the hindbrain and in the spinal cord. Retinol and cellular retinol-binding protein (CRBP) were more evenly distributed, with exception of surface ectoderm, epithelium of gut, and myocardium, where CRBP was specifically expressed. These findings are discussed in relation to the differential expression of nuclear RA receptors and homeobox genes in the craniofacial region and in the hindbrain. It is possible that RA is important for the normal pattern formation in these regions and acts as a morphogen as previously proposed in limb development.

Animals↗

PubMed1988

[The tongue as a factor in craniofacial growth. 3. The influence of the height and angle of the lower jaw].

In the miniature pig MINI-LEWE partial glossectomy had no significant effects on vertical growth of the lower jaw, growth of the upper jaw or overall skull growth. No relationship was found between age at glossectomy or post-surgical interval and the size of the gonion angle. The tongue, peri-oral muscles and the muscles of the floor of the mouth are in a state of functional equilibrium which changes in the course of development, the influence of either the tongue or the peri-oral muscles increasing as a result. Partial disruption of this state of equilibrium leads to dysgnathia.

Animals↗

PubMed1987

Dental development and the pharyngeal lymphoid tissue.

Because the teeth are housed and develop within the jaws, skeletal development of the maxilla and mandible is a primary factor in the consideration of any problems pertaining to the developing dentition. Growth of the posterior nasal choanae, the maxilla, and the nasopharynx should be evaluated as a unit in assessing the favorable or unfavorable character of the nasopharyngeal region. Both large and small adenoidal tissues should be examined in light of the morphologic character of the nasopharynx (be it small, large, narrow, or wide) and related to the developing maxilla. Variables in size and location of the maxilla and the pharynx will play an important role in the impact that lymphoid tissue will have on the patency of the nasopharyngeal isthmus. Synchronized growth between the normally developing adenoids and the migration of the maxilla away from the cranial base will produce a balanced environment that precludes nasal obstruction by the presence of adenoids. With time, the changes in spatial relationships between the posterior border of the maxilla and the posterior pharyngeal wall plus atrophy of the adenoidal tissue will generally minimize or eliminate the problems of nasal obstruction and mouth breathing. Growth data may be used to evaluate the status, assess progress, measure comparability, determine inheritance patterns, and confer individuality. Unit-trait inheritance of the teeth, alveolar processes, maxilla, mandible, soft-tissue profile, tongue, pharynx, and lymphoid tissues may well produce more definitive answers to the question of the developing dentition and the pharyngeal lymphoid tissue. Finally, at present, no clinician can categorically state that enlarged tonsils or adenoids per se are responsible for abnormal dentition in the absence of other factors.

Adenoids↗

PubMed1985

An analysis of craniofacial form; the need for new analytic techniques.

This study was based on lateral cephalographs of 443 patients aged 7--18 years to determine the effects of age and occlusal (Angle) relationships on craniofacial form. From 33 datum points, 56 linear and angular dimensions were subjected to the multivariate statistical technique termed principal component analysis. This technique not only enabled a number of parameters to be combined together but also computed a series of orthogonal variates (components) accounting for over 90 percent of the total variance. The subsequent analysis of the component scores revealed marked contrasts in craniofacial form not only between age groups but also between different occlusal categories. The interpretation of such data remains controversial, since not only do traditional craniofacial parameters combine both size and shape together, but they are based upon datum points of unknown degrees of homology. This study therefore confirmed the complexity of craniofacial form and demonstrated the need to develop more appropriate analytic techniques with the specific objective of defining shape and shape change.

Adolescent↗

PubMed2001

A study of anthropometric measures before and after external septoplasty in children: a preliminary study.

OBJECTIVE: To test the hypothesis that surgery on the growing nasal septum does not adversely affect nasal and midfacial dimensions. DESIGN: Paired study. SETTING: Tertiary care center. PARTICIPANTS: Children treated consecutively during a 4-year period; all had significant nasal obstruction and cosmetic disfigurement secondary to skeletal septal deformities. INTERVENTION: Nasal septal surgery (using an external approach), in which the quadrilateral cartilage was removed, remodeled, and reinserted as a free graft. OUTCOME MEASURES: Anthropometric linear measurements and indexes of the face and nose preoperatively and postoperatively; nasal dorsum length, nasal height, nasal dorsum index, nasal tip protrusion, columellar length, facial height, face width, upper face height, facial index, nose-upper face height index, and columellar length-nasal tip protrusion index. Continuous measurements were transformed into ordered categories with reference to normative data. Data were analyzed using Wilcoxon signed rank sum test (alpha level of.05) and by applying the Bonferroni adjustment for multiple testing. RESULTS: Twenty-six children were studied (12 females and 14 males); age at surgery ranged from 4.5 to 15.5 years (mean age, 9.5 years); average age at postoperative measurement, 12.5 years; mean follow-up, 3.1 years. Only nasal dorsum length (P =.007) and nasal tip protrusion (P =.04) were decreased by a statistically significant level before the Bonferroni adjustment. The change was not considered clinically significant. Thus, relative to age-appropriate norms, the dimensions of the nose and midface and their proportionality did not change after surgery. CONCLUSIONS: Appropriate nasal septal surgery involving excision and subsequent reinsertion of a remodeled segment of the quadrilateral cartilage has no deleterious effects on development of the nose and midface. We question the absolute dogma that nasal surgery in children must always be avoided.

Adolescent↗

PubMed1982

The interplay between sagittal and vertical growth factors. An implant study of activator treatment.

Changes in sagittal jaw relationship are dependent on an interplay between a series of basal and dentoalveolar changes in both sagittal and vertical planes. The present article uses the implant method to examine and discuss this interrelationship as well as condylar growth and, in addition, comments on the relative value of accepted methods of expressing sagittal jaw relationship. The interplay between vertical and horizontal dentoalveolar, sutural, and condylar changes occurring relative to the occlusal plane in nineteen patients treated by means of activator was studied quantitatively by means of the implant method. Changes in the sagittal jaw relationship were evaluated by means of the change in ANB angle and utilizing the "Witts appraisal" with a modified occlusal plane construction. Change in sagittal jaw relationship was studied by means of a correlation analysis and shown to be largely dependent on the spatial development of the mandible; the latter was positively correlated to vertical condylar development and maxillary horizontal development but negatively correlated to increase in vertical sutural and dentoalveolar parameters. Vertical condylar development was also demonstrated to influence the rotational pattern of mandibular development. The clinical importance of controlling vertical development, sutural as well as dentoalveolar, in the treatment of sagittal discrepancies was stressed through the findings of the present study.

Activator Appliances↗

PubMed1997

Long-term effects of Herbst treatment on the mandibular incisor segment: a cephalometric and biometric investigation.

The purpose of this study was to analyze mandibular incisor changes during and after Herbst treatment with respect to tooth inclination and anterior crowding. The sample consisted of 24 Class II, Division 1 subjects (15 boys and 9 girls) treated with Herbst appliance. Dental casts and lateral head films from before and after treatment, 6 months after treatment and at the end of the growth period (at least 5 years after treatment) were analyzed. During treatment, the lower incisors were proclined (ILi/ML) an average of 10.8 degrees and the incisal edge (li) moved anteriorly by 3.2 mm. The available space and the irregularity index in the lower anterior region were in general unaffected by therapy. During the first posttreatment period of 6 months, the lower incisor inclination (ILi/ML) recovered an average of 7.9 degrees and the incisal edge (li) moved posteriorly by 2.5 mm. However, the available space was almost unchanged. During the second posttreatment period, i.e., from 6 months after treatment to the end of growth, the lower incisor inclination remained on average unchanged in relation to the mandibular plane (ILi/ML) but the teeth retroclined in relation to the nasion-sella line (ILi/NSL). The available space decreased (mean 0.8 mm, p < 0.01) and the irregularity index increased (mean 2.0 mm, p < 0.01). The correlation between changes in the ILi/NSL and in the NSL/ML angles was moderate (r = -0.57, p < 0.01), indicating that the reduction in the ILi/NSL angle was partly a result of anterior mandibular growth rotational changes. In conclusion, it can be said that the proclination of the lower front teeth during Herbst treatment did not result in incisor crowding after treatment. In a long-term perspective, the development of incisor crowding was thought to be associated with normal craniofacial growth changes.

Adolescent↗

PubMed2000

Craniofacial asymmetry and temporomandibular joint internal derangement in female adolescents: a posteroanterior cephalometric study.

Unilateral or bilateral pathology of the osseous components of the temporomandibular joint (TMJ) can result in pronounced facial asymmetry because of dissimilar size and shape of the right and left sides of the mandible. To date, it is unknown whether abnormalities of the soft tissues of the TMJ are associated with greater than normal craniofacial asymmetry. In this study, we investigated the amount of craniofacial asymmetry in female orthodontic patients with unilateral or bilateral TMJ internal derangement (TMJ ID) relative to the amount in female patients without TMJ ID. The total sample consisted of 80 female adolescents. Bilateral TMJ magnetic resonance images were used as a database for objectively scoring the severity of TMJ ID. Craniofacial asymmetry was measured from posteroanterior cephalograms. Females with bilateral TMJ ID had significantly greater asymmetry in the vertical position of the antegonion. If the TMJ ID was more advanced on the right side, the ipsilateral ramus was shorter, resulting in significant asymmetry in this region. In all other craniofacial regions, the amount of asymmetry was not significant between females with normal TMJs and those with TMJ ID. The results indicate that a female orthodontic patient with bilateral TMJ ID or unilateral right TMJ ID may present with or develop a vertical mandibular discrepancy.

Adolescent↗

PubMed1995

Stage-dependent effects of ethanol on cranial neural crest cell development: partial basis for the phenotypic variations observed in fetal alcohol syndrome.

Fetal alcohol syndrome (FAS) is characterized by growth retardation, mental deficiencies, and numerous craniofacial and neuronal anomalies; the type and severity of these defects may be related to the time and dose of maternal ethanol exposure. Ethanol administered during presomitic stages results in the typical FAS craniofacial phenotype and is accompanied by a loss of cranial neural crest cells (CNCCs) through ethanol-induced cell death. However, the stage-specific effects of ethanol on the CNCC population is unknown. We examined the effects of ethanol on CNCC populations by treating in ovo chick embryos with a single ethanol dose (0.43 mmol/egg) at various stages of CNCC development, and corresponding to the first 3-4 weeks of human gestation. Ethanol treatment induced cell death and reduced CNCC populations in patterns consistent with observed dysmorphologies of CNCC-derived cranial structures. The precise population affected was dependent on the timing of ethanol exposure. Treatment at gastrulation or neurulation induced cell death and losses of CNCC populations, particularly those in rostral positions, and resulted in more severe craniofacial defects. In contrast, treatment at early somitic stages (4-16 somites) induced cell death, primarily within caudal CNCC populations, but resulted in less severe craniofacial defects, suggesting an increased capacity for recovery. These results suggest that there are distinct developmental windows during which the CNCCs may be particularly susceptible to ethanol-induced cell death. We conclude that ethanol exposure seems to affect specific events adversely during neural crest development. The timing of embryonic ethanol exposure relative to CNCC development could account, in part, for the heterogenous craniofacial defects observed in FAS.

Age Factors↗

PubMed1993

A six-center international study of treatment outcome in patients with clefts of the lip and palate: evaluation of maxillary asymmetry.

This investigation was carried out by the European Cleft Lip and Palate Research Group. The purpose of this part of the investigation was to compare and evaluate maxillary asymmetry in children born with complete unilateral cleft lip and palate treated at cleft palate centers with different surgical management. Posteroanterior radiographs from three of the six participating centers were included in the investigation. Statistically significant differences were found in the symmetry of the anterior part of the maxillary complex. Children with a primary bonegrafting procedure involved in their primary treatment procedure had a more symmetric dentoalveolar development. Children from centers with primary surgical procedures including a vomer plasty and no involvement of the alveolar process had a more asymmetric development with a tilted premaxilla and a deviating inclination of the central incisors.

Analysis of Variance↗

PubMed1994

Development of overjet and dentoskeletal relations in unilateral cleft lip and palate before and during puberty.

Roentgencephalometry was used for the assessment of the development of clinically important facial characteristics in complete unilateral cleft lip and palate during the prepubertal and pubertal period. Thirty-one patients aged 8 and 11 years and 30 patients aged 11 and 14 years were examined repeatedly. All of them were operated upon and orthodontically treated with the same methods. An unfavorable development of facial convexity, sagittal jaw relations, configuration of the soft profile, and of the prominence of the upper lip occurred during both periods. An improvement of overjet that was attained during the prepubertal period showed a renewed impairment during the period of puberty. The impairment was not caused by the higher facial growth rate, but was attributable to the exhaustion of the compensation and adaptation mechanisms of the dentoalveolar component of the upper jaw produced by the preceding orthodontic therapy. The development of sagittal jaw relations and of facial rotation was not related to the initial patterns of these characteristics, but the possibility of an improvement of the inclination of upper incisors and of overjet was influenced by their initial pattern. During the prepubertal period the development of overjet was not related to the development of sagittal jaw relations or of mandibular growth rotation, as was the case during puberty.

Adolescent↗

PubMed2000

Cranial base and facial skeleton asymmetries in individuals with unilateral cleft lip and palate.

OBJECTIVE: Individuals with unilateral cleft lip and palate (UCLP) manifest a plethora of phenotypic characteristics, including asymmetric development of the middle and lower facial skeleton. The purpose of this study was to retrospectively investigate the development of cranial base asymmetries in patients with UCLP noted on posteroanterior cephalometric radiographs. METHODS: Thirty individuals with UCLP and 64 controls participated in this study. Medial and lateral cranial base asymmetries were analyzed on frontal cephalometric radiographs relative to three developmental stages. Furthermore, the development of horizontal and vertical lower facial asymmetry in these patients with UCLP was assessed in relation to cranial base, nasomaxillary, and dentoalveolar structures. RESULTS: Individuals with UCLP demonstrated cranial base asymmetries that did not significantly differ from individuals without cleft. In addition, lower facial asymmetry in patients with UCLP correlated with horizontal lower facial and dentoalveolar asymmetries but not with cranial base or nasomaxillary structures. CONCLUSIONS: No significant vertical cranial base asymmetries were detected in patients with UCLP. Horizontal lower facial asymmetry appeared to develop in close relation to the vertical asymmetries of mandibular fossae and dentoalveolus.

Adolescent↗

PubMed2002

Visualization of individual growth-related craniofacial changes based on cephalometric landmark data: a pilot study.

OBJECTIVE: An approach based on Euclidean distances between cephalometric landmarks is presented (1) to visualize and localize the individual shape changes of the complex craniofacial skeleton during growth and (2) to depict the individual dynamic behavior of developmental size and shape changes. PATIENTS AND METHOD: Growth-related craniofacial changes were investigated exemplarily for two male orthodontically untreated subjects from the Belfast Growth Study on the basis of lateral cephalograms at 7, 9, 11, 13, and 15 years. The interlandmark distances among seven skeletal cephalometric landmarks served as a database for the study. A modified Karhunen-Loève decomposition based on orthogonal modes and time-dependent scalar amplitudes was used to describe the growth process. The individual shape changes of the various craniofacial regions were visualized by allocation of colors to the respective distances, and overdrawn representations were reconstructed by means of multidimensional scaling. RESULTS AND CONCLUSIONS: This visualization technique allows anatomical regions to be characterized with respect to reduced or strengthened growth, compared with pure size changes. The clinically relevant mechanisms of craniofacial changes are visualized (e.g., shifts in the anteroposterior or vertical dimensions of the jaws in relation to cranial base and structural imbalances during development). In addition, overdrawing the effects of shape change on the skeletal structures gives a more readily comprehensible impression of the growth process. Taking account of the methodical limitations of this approach (e.g., the restrictions concerning the number of landmarks), the clinician may take advantage of this technique in orthodontic or surgical diagnostics to gain additional insight into the individual complex size and shape changes during development along with their dynamic behavior.

Adolescent↗

PubMed1987

[Functional morphology of the maxillo-mandibular system in the mini-Lewe minipig. 4. Functional analysis of the masticatory muscles at various ages].

The percentage of dry weight distribution of the jaw muscles is described, and muscle growth is calculated by means of second degree homogeneous linear differential equations with constant coefficients. The components of the chewing muscles are calculated from the parallelogram of forces on the basis of their dry weights. Changes in the shape of the skull during postnatal development leads to an increase in the adductive components and a reduction of the protractive components. Changes in the reaction, medial tensile, lateral tensile and depressive components are minor.

Aging↗