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Fetal craniofacial morphometrics: in utero evaluation at 16 weeks' gestation.

Although ultrasound has proved useful in the diagnosis of fetal craniofacial malformations, its success has been based primarily on subjective clinical observations of apparent abnormal fetal structures, their proportions, and unusual features. However, such clinical observations may be misleading and ideally should be validated by standardized quantitative measurements. We describe here an ultrasonographic methodology that has provided quantitative data describing the normal fetal craniofacies at 16 weeks of gestation. This report is part of an ongoing research project directed at describing fetal facial morphology in utero at different gestational ages. Such data can be used to construct growth curves to which observations from suspected abnormal fetuses can be compared. A total of 53 patients were evaluated at 16 weeks of gestation, at which time 24 craniofacial linear and angular measurements were made. The landmarks employed for these measurements were those used in roentgencephalometry so that this fetal data base could be related to postnatal populations. Such data will contribute not only to a description of facial dysmorphogenesis but also to a better understanding of normal facial growth and development. Furthermore, they constitute a useful tool for prenatal diagnosis, gestational aging, growth predictions, and perhaps for as yet relatively unexplored fields such as fetal therapy.

Facial Bones↗

The development of septal and dental deformity from birth.

The findings on the development of dental, facial and septal conditions from birth to about 6 years of age include the following: 1) Septal configuration can be readily tested at birth, and if deformity is present, then deformity will still be present at age 6 years. 2) The internal septal configuration can be categorized into three types: type A: The septum is in the midline. type B: There is unilateral bending or kinking of the septum at the vomerine junction. type C: The septum is deformed to both sides in an S configuration. 3) Height of the palate does not predispose to septal deformity. 4) Dental abnormalities of rotation, compression or crowding of the teeth, asymmetry of width and height of the palate, and shift of the mandibular arch from the midline occur most frequently in cases of type B (88%), much less in type C and least in type A. 5) At birth one can predict that type B babies will have considerably more likelihood of developing occlusal abnormalities than type A babies. 6) The dental abnormalities in many of these subjects are of sufficient degree to expect that malocclusion will undoubtedly develop. Thus the same etiological factors producing septal abnormalities at birth must be considered to be factors producing many malocclusions.

Child↗

Vertical malocclusions: etiology, development, diagnosis and some aspects of treatment.

Vertical malocclusions develop as a result of the interaction of many different etiological factors; one of the most important of these factors is mandibular growth. Variations in growth intensity, function of the soft tissues and the jaw musculature as well as the individual dentoalveolar development further influence the evolution of these malocclusions. This article reviews the most common etiological factors and their possible contribution to the development of vertical malocclusions with special emphasis on the role of mandibular growth in the development of open bite and deep bite. The role of the cephalometric morphological analysis in the differential diagnosis of vertical malocclusion is emphasized. Aspects of orthodontic treatment of vertical malocclusions are illustrated with individual cases.

Adolescent↗

[Factors that affect alignment of upper permanent lateral incisors in early mixed dentition].

The purpose of the present study was to find the factors that affect the alignment of the upper permanent lateral incisors in early mixed dentition. The materials, consisting of dental casts and lateral cephalograms which were taken from 30 children (15 males and 15 females) who had normal occlusion in deciduous dentition and normal permanent central incisor relationship, were divided into three groups, according to the bilateral symmetry alignment of the upper permanent lateral incisors (Group A: Normal alignment, Group B: Linguoversion, Group C: Mesiolinguotorsiversion). The principal component analysis was carried out to clarify the characteristics among the multi-variates, which are upper incisor shape, dental arch form, craniofacial morphology and amount of dento-craniofacial development, in Groups A, B and C. The results obtained were as follows: Group A shows a tendency to be harmonious in upper permanent incisor shape, dental arch form, craniofacial morphology and dento-craniofacial development. Group B shows a tendency to have a larger labio-lingual width of the upper permanent incisors, less anterior arch length development and less forward movement of the upper permanent lateral incisor in the maxilla before eruption. Group C shows a tendency to have a larger mesio-distal width of the upper permanent incisors, less anterior arch width development, longer distance between the upper permanent lateral incisor edge and the nasal floor and more forward and descent movement of the upper permanent lateral incisor in the maxilla before eruption.

Age Factors↗

[The development of the maxillodental system in the fetus and the newborn animal in intrauterine streptococcal infection].

Effects of an intrauterine streptococcal infection induced at different stages of pregnancy on the developing fetus and newborn were studied in non-inbred white rats. The course of denture development was found changed in both fetuses and newborns. A number of functional shifts in the central nervous system and physical status, presenting in the postnatal period, were detected in the experimental animals.

Animals↗

Orthopaedic protraction of the midface in the deciduous dentition. Results covering 3 years out of treatment.

If there is underdevelopment of the upper jaw, the current Bergen concept indicates a period of orthopaedic/orthodontic treatment of cleft lip and palate patients at 6-7 years of age. A fixed quad-helix-appliance is used in combination with a facial mask. The result is retained with a fixed palatal arch. A preliminary follow-up study on sagittal growth and development in 30 patients is reported. By treating early, a more basal response is obtained, and several years of more correct function is gained.

Cephalometry↗

Case report: developmental characterization of skeletal Class III malocclusion.

Skeletal Class III malocclusion is usually characterized by a steep mandibular plane angle, obtuse gonial angle, overdeveloped mandible, underdeveloped maxilla, and a small cranial base angle which may displace the glenoid fossa anteriorly to cause a forward positioning of the mandible. These factors are generally thought to contribute to the development of skeletal malocclusion as well as facial deformities, and are believed to originate from genetic and/or environmental factors. The posterior discrepancy is an important etiological factor in the development of a skeletal Class III malocclusion because it affects the occlusal plane. This idea must be amended for an appropriate clinical approach to the treatment of Class III malocclusion.

Adolescent↗

Epithelial-mesenchymal transformation during craniofacial development.

Epithelial to mesenchymal phenotype transition is a common phenomenon during embryonic development, wound healing, and tumor metastasis. This transition involves cellular changes in cytoskeleton architecture and protein expression. Specifically, this highly regulated biological event plays several important roles during craniofacial development. This review focuses on the regulation of epithelial-mesenchymal transformation (EMT) during neural crest cell migration, and fusion of the secondary palate and the upper lip.

Animals↗

[Oromaxillofacial teratogenic effects of heavy and light drugs].

Effects of drugs administration on the growth and development of the cervical-maxillar-facial region were studied. Drugs as ASA are possible etiological factors in embryo-fetal deaths and fetal facial malformations in animals.

Abnormalities, Drug-Induced↗

Alternation of the magnetic resonance signals characteristic of mandibular condyles during growth.

OBJECTIVE: In a previous study, we named the magnetic resonance imaging (MRI) signal that is characteristic of mandibular condyles in growing children the "double contour-like structure" (DCLS). In the current study, we evaluated the alternating appearance and disappearance of the DCLS in children as they grow to elucidate the significance of the DCLS. STUDY DESIGN: In 11 subjects who were 9-14 years old at the time of the first examination, MRI characteristics of mandibular condyles were sought from fast spin-echo intermediate-weighted images; 2 or 3 years later, repeat MRI were obtained from the same subjects. RESULTS: At the second examination, 10 of the 16 DCLSs detected at the first examination had disappeared. A significant relationship was found between the alternation of the DCLS and the bone marrow conversion from red to yellow in mandibular condyles. Alternation of the DCLS tended to coincide with eruption of the permanent maxillary second molars. The DCLS was also shown to appear as a hypersignal on T2-weighted images. CONCLUSIONS: Double contour-like structure signals in mandibular condyles appeared and disappeared as children grew, and these signal alternations may be useful as a criterion for the staging of mandibular condyle development in children. Possible constituents of the DCLS may be hypervascular loose fibrous tissue and a proliferation of cartilage.

Adolescent↗

Growth, development, and aging of orofacial tissues: neural aspects.

Neural factors influence post-natal growth, development, and aging throughout the body. This influence may be mediated through sensory or motor effects interacting with endocrine and immunological factors. Growth effects may be expressed directly by sensory or motor nerves on the tissue or indirectly by motor function. Direct neutrotrophic effects have been well-documented in the development of striated muscle, the taste bud, and the amphibian limb. Evidence for a trigeminal neurotrophic effect on tooth development and facial development is lacking. Growth disturbances of the jaws consequent to lesioning of the trigeminal nerve are due most likely to functional disturbances rather than neutrotrophism. Examples of function impact on orofacial growth are abundant. Oral and facial target tissues, like those elsewhere in the body, determine the nature of the target tissue innervation and its central organization. Central effects consequent to tooth loss or dental pulp entirpation are well-documented. Inflammation and pain may exert growth effects through release of "wound hormones" or secondarily to somatic and autonomic effects. There is evidence that vasoactive intestinal peptide (VIP) and calcitonin gene-related peptide (CGRP) elaborated from sympathetic and parasympathetic neurons may have a modulatory role in growth. While the effects of longstanding motor pathologies on skeletal growth are well-known, concomitant sensory deficits and soft tissue disturbances have not been examined. However, the pathological models beg the question of normal regulation. While muscle develops in the absence of innervation, neurotrophic effects are clearly identified. Little is known about the interaction of simple and complex motor behavior on growth. Regulation of growth is frequently visualized within a form-function paradigm. For example, anterior open bites have been seen as the consequence of tongue thrusting or tongue thrusting as a consequence of open bites. Low tonic forces in posture are thought to be more important in the development of both the face and the dental alveolar complex than the higher intermittent forces in mastication and swallowing. The need for an active (reflex) contribution to growth at the TMJ is in dispute.(ABSTRACT TRUNCATED AT 400 WORDS)

Face↗

Assessing growth and development of the facial profile.

The study of growth and development of the facial profile is of interest to clinicians and researchers in the fields of pediatric dentistry, orthodontics, and craniofacial surgery, enabling diagnosis, planning, and evaluation of treatment. Until recently, craniofacial studies addressed facial growth, facial asymmetry, and gender differences by examining changes in size. However, size changes alone do not represent fully the complicated process of craniofacial growth which also involves changes in shape. The shape of the facial profile can now be quantified with Fourier analysis, contributing to a better understanding of growth. A combination of recently developed methods, such as 3-dimensional facial morphometry and Fourier analysis, should allow a more comprehensive knowledge of growth and development of the craniofacial structures, including the facial profile. This article examines various methods for assessing facial growth and development currently available with particular reference to the facial profile, and addresses the value of Fourier analysis in assessing shape changes.

Adolescent↗

Homeobox genes and the vertebrate head.

Several Drosophila genes important in the control of embryonic development contain a characteristic sequence of DNA, known as the homeobox. Homeobox sequences are also present in a family of vertebrate genes, which may therefore have regulatory roles during vertebrate embryogenesis. In this article, data concerning the spatial patterns of vertebrate homeobox gene expression are discussed in relation to recent descriptive and experimental analyses of head development. It is concluded that the patterns of gene expression are consistent with homeobox genes having roles in anteroposterior positional specification within the developing brain and possibly the neural crest. The data are not clearly consistent with these genes having direct roles in controlling the patterns of cranial segmentation, although further studies may reveal whether vertebrate segments are units of developmental specification.

Animals↗

Developmental relationship between premaxillary-maxillary suture patency and anterior nasal spine morphology.

An important factor in determining the bony morphology of the human nasal capsule is the area of the antero-inferior region of the cartilaginous septum at the level of the anterior nasal spine (ANS). Since man is unique among mammals and the primates in developing an anterior nasal spine, the present study was designed to learn more about ANS morphology and its developmental relationships to other midfacial structures. Since well documented racial differences exist in ANS morphology and facial prognathism between black and white populations, developmental osteologic data from these groups were used to examine premaxillary morphology. Cleaned and dried skulls from 93 black and 97 white specimens, ranging in age from 8 weeks prenatally to 8 years, were examined to assess ANS morphology and premaxillary-maxillary suture status. Chi-square analysis reveals that white specimens exhibit a significantly (p less than 0.05) higher frequency of fused or fusing premaxillary-maxillary sutures and a more prominant ANS compared to black specimens by 24 weeks prenatally. Significant (p less than 0.001) relationships are also noted between the degree of suture fusion and ANS prominance. Findings from the present study suggest that the distinctive racial variations in midfacial profiles are established early in fetal development (by the second trimester) and maintained postnatally. Results from the present study also appear consonant with associations predicted by a septal-mediated traction model of midfacial growth.

Black People↗

[Orthodontic prophylaxis].

The problems related to the prevention of dental anomalies are very complex. They include the health care for the expectant mother and become evident above all if one considers the long period of development during which the dentition must be protected against adverse causative effects. The developmental phases of the orofacial system from birth to the time at which the permanent anteriors begin to erupt are set forth and measures are deduced that may contribute to the reduction of malformations. It is emphasized that orthodontic prophylaxis will be efficient only if the causative relationships, the conditions of development and the efficiency of the measures taken are realized correctly and evaluated according to high standards.

Breast Feeding↗

The influence of perennial allergic rhinitis on facial type and a pilot study of the effect of allergy management on facial growth patterns.

Perennial rhinitis with an allergic component (PRAC) in association with chronic mouthbreathing has been thought to cause skeletal open-bite facial type and narrow transverse facial dimensions. The object of this study was to supply data for this theory and to determine if allergy management would alter the course of facial growth. When a group of children, aged 5 to 10 years, with PRAC was compared with a matched control sample, a significantly larger palatomandibular angle and lower anterior facial height were found for the PRAC group. Transverse cephalometric measurements showed significantly narrower bilateral orbital breadth, bizygomatic, and binasal dimensions (narrower face) of the PRAC patients compared with the control sample. A pilot study of twelve PRAC patients who received 2 1/2 years of allergy management revealed no significant dento-facial dimensional change. This study suggests that PRAC with chronic mouthbreathing can alter the development of the midface. Whether allergy therapy can prevent or change this is as yet uncertain.

Cephalometry↗