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PubMedDate not supplied

Postnatal changes in the cranial base in rabbits with congenital coronal suture synostosis.

Cranial base abnormalities are a common correlate of human craniosynostosis, although controversy exists as to whether they are primary malformations or secondary deformities. The current study assesses longitudinal cranial base growth and shape changes in rabbits with congenital coronal suture (CS) synostosis. Data were collected from 96 New Zealand White rabbits: 21 with complete bilateral or unilateral CS synostosis; 33 with partial CS synostosis; and 42 unaffected, "control" litter mates. Serial radiographs were taken at 1.5, 6, 12, and 18 weeks of age. Linear, angular, and shape measurements of the cranial base were compared among the three groups. Results revealed that at 1.5 weeks of age, rabbits with complete synostosis had significantly (P < 0.05) shortened anterior cranial bases, orthocephalic cranial base angeles, and acute, dysmorphic cribriform plate triangular shapes compared to the two other groups. Some significant differences persisted through 18 weeks of age. No significant differences were noted between partially synostosed and normal rabbits at any time period. If partial synostosis represents a continuum of the craniosynostotic phenotype, then the craniosynostosis may be seen as the primary deformity in this model and the cranial base abnormalaties as secondary, deformational changes. However, fetal data are still needed to more clearly delineate the role of the cranial base in this congenital rabbit model. Results reiterate the appropriateness and continued development of these rabbits for modeling cases of familial, human non-syndromic coronal suture synostoses.

Age Factors↗
PubMedDate not supplied

Postpubertal growth and development of the face in unilateral cleft lip and palate as compared to the pubertal period: a longitudinal study.

X-ray cephalometry was used for the assessment of 22 boys and 23 girls with complete unilateral cleft lip and palate who were treated with the same surgical method. They were examined at the age of 10 years and in adulthood. In the group of 13 boys and 15 girls, examined also at the age of 15 years, were analysed intersexual differences of facial growth and development during the postpubertal period and the results were compared with those obtained during the pubertal period. The data showed that in boys facial growth persists after the age of 15 years and in the region of the upper face attains about half the values recorded in the period of puberty, while mandibular growth attains almost the same values as during puberty. In girls the growth is almost terminated but for the lower jaw, where it is still significant though several times slighter than during puberty. In both sexes there is only a minimum growth of maxillary depth and of upper lip height during the postpubertal period, as well as during the pubertal period. The highest growth rate shows the depth of the nose. Because of the intersexual differences in the amount of postpubertal growth, developmental changes in facial configuration do not occur in girls during this period, while in boys a further deterioration of maxillary protrusion, of sagittal jaw relations, and of the upper lip prominence continues, as well as an increase of the flattening of the face. In contrast to the pubertal period in both sexes, a proclination of upper incisors and an improvement of overjet was not attained. Contrary to the pubertal period, in the postpubertal period, intersexual differences in the amount of growth and of the developmental changes in the shape and position of facial characteristics were recorded. Therefore during studies of the growth and development of the face, it is not possible to pool both sexes without some reservations. This holds true in particular in the postpubertal period.

Adolescent↗
PubMed2005

High-dose retinoic acid modulates rat calvarial osteoblast biology.

Retinoic acid has been shown to adversely affect craniofacial development. Cleft palate and craniosynostosis are two examples of craniofacial defects associated with prenatal exposure to this agent. Although the effects of retinoic acid on cephalic neural crest-derived tissues have previously been studied, the specific effects of retinoic acid on the cellular biology of osteoblasts remain unclear. The purpose of this study was to analyze in detail the effects of pharmacologic doses of retinoic acid on the differentiation and proliferation of osteoblasts derived from an intramembranous source. Primary rat calvarial osteoblasts were established in culture and treated with 1 or 10 microM all-trans-retinoic acid. Retinoic acid treatment markedly increased expression of osteopontin up to 48 h after stimulation. Consistent with this early stage of differentiation, both mRNA and protein analysis of FGF receptor isoforms demonstrated a switch in predominance from fibroblast growth factor receptor 2 (fgfr2) to fgfr1. Analysis of PCNA protein confirmed inhibition of proliferation by retinoic acid. To determine whether these alterations in osteoblast biology would lead to increased differentiation, we examined short term [alkaline phosphatase (AP) activity] and long term (von Kossa staining) surrogates of bone formation in vitro. These assays confirmed that retinoic acid increased osteogenesis, with a 4-fold increase in bone nodule formation in cells treated with 10 microM retinoic acid after 28 days. Overall, our results demonstrated that pharmacologic doses of all-trans-retinoic acid decreased osteoblast proliferation and increased differentiation, suggesting that retinoic acid may effect craniofacial development by pathologically enhancing osteogenesis.

Alkaline Phosphatase↗
PubMed1999

Finite-element morphometry of soft tissue morphology in subjects with untreated Class III malocclusions.

Soft tissue dynamics may contribute to maxillomandibular allometry (size-related changes in shape) associated with the development of Class III malocclusions. Lateral cephalographs of 124 prepubertal European American children were traced and 12 soft tissue landmarks were digitized. Resultant geometries were normalized, and Procrustes analysis established the statistical difference (p<0.001) between mean Class III and Class I configurations. Comparing the Class III configurations with normals for size-change, color-coded finite element analysis revealed a superoinferior gradient of positive allometry of the Class III facial nodal mesh. A conspicuous area of negative allometry (approximately 40%) was localized near soft subspinale, with a approximately 70% increase in size in the mental region. For shape-change, the Class III facial mesh was isotropic, except in the anisotropic circumoral regions. Conventional cephalometry revealed that about 50% of linear and 75% of angular parameters differed statistically (p<0.001). Soft tissue dynamics during early postnatal development may contribute to the development of Class III malocclusions.

Case-Control Studies↗
PubMedDate not supplied

The pattern of facial growth before and during puberty, as shown by French-Canadian girls.

The results are reported for an analysis of longitudinal sequences of lateral head X-rays of 50 Montreal girls, taken annually between the ages of 6 and 15 years. Mean size changes for distances within the cranial base, the maxilla and the mandible, as well as those outlining the facial polygon, are displayed on a common proportional scale based on mean sizes at 15 years old. Mean growth velocities are displayed on both a chronological age scale and on one relative to the individual age of peak growth velocity in stature. A distinct facial pattern of growth is established, In terms of the proportion of final size achieved during childhood, it is below the cranial pattern, but above the general skeletal one. This facial pattern shows a pubertal peak in growth, but one quantitatively less important than that for stature. The timing of the two peaks is closely aligned, although the evidence favours a slightly later development for the face. The mandibular ramus provided the sole exception to this common facial pattern, though some questions on maxillary growth remain open.

Adolescent↗
PubMed2001

The functional treatment of anterior-open bite: three case reports.

Functional treatment of three skeletal open-bite patients with Bionator, Frankel IV and Posterior bite-block appliances is presented. Pretreatment and post treatment records were evaluated. Correction of malocclusion by changing direction of the mandibular development, adaptive bony development of the condyle, vertical development in posterior region, an increase in ramus length, a decrease in the lower facial height were observed in this report. The results of functional treatment of three appliances had different effect mechanisms.

Cephalometry↗
PubMed2004

Skeletal and occlusal characteristics in mouth-breathing pre-school children.

This study verified the influence of chronic mouth breathing on dentofacial growth and developmental in pre-school children. The study evaluated 73 children, both sexes, ranging from 3 to 6 years of age. After the otorhinolaryngological breathing diagnosis, 44 mouth-breathing children and 29 nasal-breathing children were compared according to facial and occlusal characteristics. The skeletal pattern measurements SN.GoGn, BaN.PtGn, PP.PM, Ar-Go, S-Go indicated a tendency to mouth-breathing children presenting a dolicofacial pattern. According to occlusal characteristics, only the intermolar distance showed a significant correlation with a narrow maxillary arch in mouth-breathing subjects. Based on the results of this study, mouth-breathing can influence craniofacial and occlusal development early in childhood.

Analysis of Variance↗
PubMed1995

Basicranial synchondroses and the mandibular condyle in craniofacial growth.

Basicranial synchondroses are remnants of the fetal chondrocranium and thus represent primary cartilage, whereas the chondral part of the mandibular condyle, for example, develops unattached to the chondrocranium, as secondary cartilage. The two cartilage groups show differences in structure and cell proliferation pattern, and yet both are endowed with tissue-separating qualities.

Animals↗
PubMedDate not supplied

Ankyloglossia and its influence on maxillary and mandibular development. (A seven year follow-up case report).

The consequences of not treating improper tongue function may be very important as this organ can influence face development and dental therapy. The role of the tongue in the development of the skeletal structures of the face has been considered in different perspectives over the years. For some, the tongue adapts to the "tongue box," for others the "tongue box" has been created and stabilized by the morphogenetic action of the tongue during development and growth. A case of ankyloglossia treated with lingual frenectomy and followed clinically and radiologically for seven years is reported. Spontaneous upper arch expansion occurred and therefore orthodontic treatment following surgical intervention was unnecessary.

Child↗
PubMed1989

Nasorespiratory function and orofacial development.

The controversy over whether altered development of orofacial structures arises purely from expression of genetic potential or is influenced by environmental factors is reviewed. Resolving this controversy will determine the need for early intervention to permit nasal respiration and for orthodontic treatment.

Airway Obstruction↗
PubMed1987

Effect of thyroid hormone and epidermal growth factor on tactile hair development and craniofacial morphogenesis in the postnatal rat.

The facial region of the developing rat is surrounded by seven highly innervated hair follicle groups, of which the lateral tactile hairs have an invariant position between the palpebral fissures and the developing external ears. In this study, we tested the ability of triiodothyronine (T3) or epidermal growth factor (EGF) to alter the direction of lateral tactile hair growth in neonatal rats. To quantitate this effect, we measured the angular displacement of the lateral hairs from the sagittal plane in photomicrographs of 36 six-day-old littermate Sprague-Dawley rats treated on postnatal days 0-5 with saline, T3 (100 ng/g body weight), or EGF 500 ng/g body weight. Midline angular displacements were as follows: control, 45.8 degrees +/- 1.7; T3, 40.9 degrees +/- 1.7; EGF, 59.8 degrees = 2.1; mean +/- SEM, P less than .05 versus controls for T3 and EGF. In addition, the timing of specific topological events of craniofacial development, ie, incisor eruption, ear canal opening, and eyelid unfusion, was compared for the various treatment groups. Thus, at the dosages tested, 1) both hormones accelerate incisor eruption (T3 greater than EGF), 2) EGF is a much more potent accelerator of palpebral morphogenesis than T3, 3) EGF retards while T3 accelerates external ear development, and 4) both hormones elicit a comparable degree of somatic growth retardation. These data provide quantitative evidence in the neonatal rat of differences as well as similarities between two powerful craniofacial morphogens.

Animals↗
PubMed2003

Impact of nasal airway obstruction on dentofacial development and sleep disturbances in children: preliminary notes.

Respiratory disorders in the upper respiratory tract during sleep are most often part of a continuous pathological process of long standing. Schematically, three clinical syndromes with increasing severity are described: breathing with the mouth open, snoring and sleep apneal hypopnea syndrome. Obstructive sleep apnea syndrome (OSAS) is a subtle, but severe sleep disorder of early childhood. It is often difficult to detect and may have long-term consequences, including failure to thrive, behavioral disturbances, developmental delay, and cor pulmonale. These conditions always include a functional maxillofacial perturbation, which may be associated with a constitutional or acquired morphological disorder. Pediatric dentists must be aware of the problems connected with mouth breathing and OSAS (obstructive sleep apnea syndrome) in children as any delay in diagnosis and treatment may cause prolonged morbidity. They also have a role in the diagnosis and co-management of these patients because the signs and symptoms may be recognizable in the dental practice. Besides the medical approach itself, the treatment sometimes is surgical, always orthopedic: the earlier it is initiated, the more effective, simple and unrestraining it is. The aim of this work is to focus attention on the early diagnosis and prevention of these pathologies. Diagnostic guidelines will be illustrated.

Bottle Feeding↗
PubMed1980

Early and late surgery in craniofacial dysostosis: a longitudinal cephalometric study.

Longitudinal clinical and cephalometric case studies are presented for two groups of patients with craniofacial dysostosis. The first sample includes two infants who underwent an extensive stripping procedure that was extended inferiorly to involve not only the coronal, but also the sphenozygomatic suture. The second sample includes two adolescents with midfacial hypoplasia who underwent a fronto-orbital-maxillary advancement. The extensive cranial stripping procedure had a favourable impact upon growth and development of the craniofacial structures, and longitudinal studies suggest the importance of promoting the growth potential of the bones contiguous to the affected sutures. Craniofacial surgery performed on adolescents results in a dramatic translocation of the skeletal and soft-tissue structures of the face. In contrast to early surgical intervention in infants in whom growth of the effected areas essential to the development of face and cranium was crucial, late surgery appeared to have little, if any, impact upon the development of the craniofacial skeletal structures that had been operated on.

Adolescent↗
PubMed2000

A new approach in maxillary molar distalization: intraoral bodily molar distalizer.

The objectives of our study were to achieve bodily molar distalization, avoid distal tipping of molars, eliminate the need for patient cooperation (no headgear, no elastics, and no esthetic and social concern), and finally to minimize the treatment period and maximize the treatment efficiency. The study was carried out on 5 males and 10 females, a total of 15 patients. Mean age for the study group was 13.53 years. Dentally, all the patients had Class II molar relationship on both sides. The patients were in permanent dentition, second molars were erupted, and the lower dental arch was well aligned. Patients showed normal or sagittally directed growth pattern. Lateral cephalograms and study models were taken and analyzed before and after molar distalization. In the present study, in order to achieve maxillary molar distalization, a new intraoral appliance was developed. The intraoral bodily molar distalizer (IBMB) was composed of 2 parts: the anchorage unit and the distalizing unit. The anchorage unit was a wide Nance button, and the active unit consisted of distalizing springs. The springs had 2 components: the distalizer section of the spring applied a crown tipping force, while the uprighting section of the spring applied a root uprighting force on the first molars. A total of 230 g of distalizing force was used on both sides. After the distal movement of the first molars, the cephalometric results of 15 patients showed the following. Maxillary first molars were moved distally by an average of 5.23 mm (P <.001) without tipping or extrusion. Maxillary first premolars were moved 4.33 mm mesially (P <.001), tipped 2.73 degrees distally (P <.05), and extruded by 3.33 mm (P <.001). Maxillary central incisors were proclined by an average of 4.7 mm (P <.001) and tipped 6.73 degrees labially (P <.01). Model analysis showed that maxillary first molars were not rotated, and intermolar distance did not change after distal movement of molars. In conclusion, unlike most of the other molar distalization mechanics, this newly developed device achieved (1) bodily distal movement of maxillary molars and (2) eliminated dependence on patient cooperation and did not require headgear wear for molar root uprighting.

Adolescent↗
PubMed1989

Presurgical orthopaedic treatment using hard plates.

Our concept in the treatment of unilateral clefts of lip, alveolus and palate includes early maxillary orthopaedic treatment starting immediately after birth until the end of the first year of life and the surgical closure of the lip at three months and of the soft palate at twelve months. Hard palate and alveolus are closed after three years by secondary osteoplasty in the alveolar region. The appliance is made of hard acrylic resin and is adjusted monthly to allow for growth. It thus encourages passive orthopaedic guidance of maxillary growth. The local compatibility of the plate was excellent and the acceptance by the children created no problems until tooth eruption. Follow-up studies were conducted on twenty children treated in this way until three years of age. After the first year results show a good and harmonious arch alignment without any collapse of the alveolar segments. The cleft narrows and the steepness of the palatal slope flattens. This maxillary development is arrested after suspension of orthopaedic treatment, and a slight collapse of the alveolar segments is observed.

Acrylic Resins↗
PubMed1994

The role of pressure on regulation of craniofacial bone growth.

The regulatory role of pressure on growth and differentiation of the craniofacial skeleton is largely unknown. We devised an experimental model to determine if the graded application of pressure could exert a trophic influence on craniofacial bone, allowing deliberate alteration and reshaping of the facial skeleton. To examine this question, 18 kittens were used to determine the adverse morphological sequelae after orbital evisceration and to compare the ability to remedy such facial deformity with the use of an inert implant or pressure-induced tissue expansion. In addition to detailed craniometric measurements of the cranial, orbital, and midfacial regions, histological analyses as well as radiographic and gross morphological comparisons were evaluated. Our results demonstrate a severe asymmetry and constriction in the orbital and midfacial regions resulting from orbital evisceration in the growing kitten. Placement of an inert implant will help to ameliorate only some of these adverse sequelae, whereas graded application of pressure appears to direct craniofacial bone growth, resulting in normal bony histology and improved facial form. We affirm that regional growth disturbances can alter normal facial development and that the regulatory role of pressure on bone growth can be exploited to dynamically correct abnormal craniofacial anatomy.

Analysis of Variance↗
PubMed1978

A cephalometric study of patients with cystic fibrosis.

Children with cystic fibrosis have skeletal maturation and epiphyseal anomalies similar to those in children with nutritional problems. However, these patients have been found to have normal somatic development if treatment is begun early. In a group of children with cystic fibrosis undergoing medical treatment, cephalometric measurements compared favorably with those established by normal standards.

Adolescent↗
PubMed1989

[Vertical development of the jaw in cases of trisomy 21: interaction of form and function].

With reference to lateral tele-X-rays of 1896 patients with trisomy 21 in the period from birth up to the 14th year of life, the vertical development of the face was analysed. 1154 healthy children of the same age serve as control group. Particular attention is paid to the question as to the importance of parafunctional forces which derive from the lingual protrusion typical for trisomy 21. In the context of the statistical analysis, group differences were tested by means of analysis of variance. There were the following results: the hypoplastic development of the midface also involves the vertical dimension. There is a reduced caudal development of the maxilla; the horizontal positioning of the maxilla is only altered slightly in that the maxilla is depressed somewhat less posteriorly; the mandible shows a slightly hypoplastic development, and the mandibular angle is slightly reduced in size; an increased presence of a vertical growth type is not found; the parafunctional force deriving from the lingual protrusion do not have any demonstrable effect on the vertical skeletal development, but bring about a bialveolar protrusion of the incisors; the frontal vertical open bites found in trisomy 21 are mainly dento-alveolar in nature.

Adolescent↗