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Dkk1, -2, and -3 expression in mouse craniofacial development.

The Dickkopf family is important for embryogenesis and postnatal development and growth. Dkk1 is a strong head inducer and knockout of this gene leads to absence of anterior head structures, which are predominantly formed through neural crest migration. During early craniofacial development, Dkk1 to Dkk3 show developmentally regulated expression in a number of elements. However, their expression and roles in late times of craniofacial development are largely unknown. This study focuses on the expression profile of Dkk1-3 on late embryonic and early postnatal stages. It was found that Dkks were involved in a variety of craniofacial developmental processes, including facial outgrowth, myogenesis, osteogenesis, palatogenesis, olfactory epithelium and tooth development; and the expression persisted to postnatal stage in the muscles and bones. Their expression patterns suggest important roles in these processes; further study is warranted to elucidate these roles.

Adaptor Proteins, Signal Transducing↗

Abnormalities of tooth development in pituitary dwarfism.

Roentgenographic studies of the jaws and teeth in a group of forty-eight pituitary dwarfs showed the following abnormalities in the development of the teeth: 1. Delayed shedding of the deciduous teeth. 2. Absence of resorption of the roots of the deciduous teeth at the usual time. 3. Marked delay in eruption of the permanent teeth. 4. Retention of permanent teeth in the maxillary and mandibular shafts. 5. Development of the apical parts of roots of the retained permanent teeth and their growth toward the lower mandibular edge. 6. Displacement of the first molars from the mandibular shaft to rami. 7. Tilting of some of the retained teeth. 8. Small size of the maxilla and mandible with overcrowding of the teeth in these bones. 9. Complete absence of buds of the wisdom teeth, even in patients in the fourth decade of life. 10. Stimulation of development and eruption of the teeth after administration of anabolic drugs. These abnormalities when present in combination depend on growth hormone deficiency since they do not occur in other types of dwarfism.

Adolescent↗

Changes in facial morphology in Macaca mulatta: a cephalometric study from 1.5 to 5 years of age.

A cross-sectional and longitudinal (3.5 years) study on the craniofacial growth of 10 male rhesus monkeys, using metallic implants and a radiographic cephalometric technique based mainly on angular measurements, led to the following observations. (1) Maxilla and mandible were displaced in a forward and downward direction during growth, the sagittal changes being predominant over the vertical changes. (2) Maxillary and mandibular prognathism increased continuously during the whole time span. This increase was twice as great for the maxilla as for the mandible. (3) The inclination of the palatal plane and the mandibular plane changed very little over time. (4) Mandibular form remained constant, but the cranial base showed a significant flattening between approximately 1.5 and approximately 3 years of age. (5) Upper and lower occlusal plane angles changed little over time. (6) The interincisal angle decreased significantly until approximately 3 years of age in relation to the increase in proclination of the permanent incisors in the maxilla and mandible. The intermolar angle remained fairly constant. Changes in some of the variables reported (maxillary and mandibular prognathism, sagittal jaw relationship, mandibular length, interincisal angle, proclination of the upper and lower incisors, and opening of the cranial base angle) occurred as a function of age. The use of angular measurements allowed us to develop a series of templates that will provide a useful tool for a quick check of normal craniofacial morphology at three representative time points.

Aging↗

Influence of growth hormone on the craniofacial complex of transgenic mice.

Growth hormone (GH) secretion affects bone and cartilage physiology. This study investigated the effect of GH on the size of the craniofacial structures and their angular relationship. Three different models of mice with a genetically altered GH axis were used: GH excess (giant), dwarf GH antagonist (dwarf-Ant), and dwarf GH receptor knockout (dwarf-KO) mice. Each model was compared with the corresponding wild type (Wt). Five craniofacial distances were analysed: craniofacial length, upper face height, mandibular anterior height, mandibular ramus length, and mandibular corpus length. In addition, upper and lower incisor lengths and four angular relationships, nasal bone with cranial base, maxillary plane with cranial base, mandibular plane with cranial base, and the angle of the mandible, were determined. Data were analysed by one-way ANOVA. Craniofacial length, upper face height and mandibular corpus length were significantly increased in the giant mice and significantly reduced in the dwarf mice. Mandibular anterior height and mandibular ramus length were significantly affected in the dwarf-KO mice but not in the giant mice. The length of both the upper and lower incisors was significantly increased and reduced in the giant and dwarf-KO mice, respectively. In addition, the angle of the mandible was significantly increased in the giant mice and significantly reduced in the dwarf mice. It is concluded that GH plays a major role in the growth and development of the craniofacial complex by directly and indirectly modulating the size and the angular relationships of the craniofacial structures, including the incisor teeth.

Analysis of Variance↗

Skeletal and dental disturbances in children after facial burns and pressure garment use: a 4-year follow-up.

Pressure garment use alters facial growth during rehabilitation after a facial burn injury. We previously studied 3 children with full facial burns and 3 children with partial facial burns who wore pressure garments for 1 year, and we found that maxillary horizontal growth and mandibular anterior-inferior growth are inhibited during the time of pressure garment use. The purpose of this follow-up study was to prospectively document skeletal and dental changes after pressure garment use was discontinued. We found that although the growth and development of the facial bones seem to return to normal, lasting changes remain. The use of pressure garments after skin grafting is still recommended. However, it is also recommended that an orthodontist be included in the team of burn care specialists for children with facial burns to monitor facial and dental development. Close attention to facial development during and after pressure garment use is necessary to maintain normal dental and facial relationships.

Burns↗

Dentofacial morphology in adolescent or early adult patients with cleft lip and palate after a treatment regimen that included vomer flap surgery and pushback palatal repair.

Dentofacial morphology was evaluated in 94 adolescent or early adult patients born with unilateral or bilateral cleft lip and palate. As well as lip closure, the primary treatment included vomer flap surgery and pushback palatal repair. Roentgencephalometric measurements as well as classification of the patients into different classes of dentofacial deformity indicated development of bimaxillary retrognathia with severe midfacial deficiency in about a quarter of the cases. Our results were similar to those reported by other teams who used similar surgical regimen.

Adolescent↗

[Repair of hard cleft palate with absorbable membranes made by poly-DL-lactic acid: a feasibility study].

OBJECTIVE: To investigate the feasibility and clinical results of applying poly-DL-lactic acid (PDLLA) biomembranes in cleft palate repair. METHODS: 68 cleft palate patients were divided into study group and control group. The traditional surgical method was used to control group to close the soft cleft palate, and the PDLLA biomembrane was used to study group and implanted into the surgical gap between the periosteum and bone at the hard palate, and fixed with suture. The duration, blood loss at operation, post-operative complication, wound healing and recovery were recorded and compared to conventional cleft palate repair. RESULTS: Operations were successfully completed on all 34 patients. Wound healing of soft palate and uvula was uneventful with no incidence of fistula or dehiscence. The primary healing on tissue defect of hard palate occurred in 29 patients, secondary healing occurred in 3 patients, permanent fistula between the oral cavity and the nasal cavity occurred in only one patients, and 3 patients left over fistula on alveolar process. Compared to traditional cleft palate repair, blood loss and incidence of fistula on alveolar process were decreased; the average surgical time was 89.25 minutes and was not prolonged; and there was no significant increase in post-operative complication. CONCLUSION: Hard cleft palate repair with PDLLA biomembranes is safe, simple and practical with good clinical results and is beneficial to minimize the bad influences towards the development and growth for maxilla of cleft palate patients.

Absorbable Implants↗

The Don Spring Memorial Oration--Part II: early management of the developing Class III malocclusion.

It was apparent from Dr Turley's presentation that many cases, previously thought to be untreatable by conventional orthodontic means, can be managed with a high degree of success using the techniques described. It is hoped that this overview of management of the developing Class III malocclusion will provide a rationale, a means and a reason for all of us to feel comfortable in treating these interesting and sometimes difficult cases.

Age Factors↗

Differences between facial configuration and development in complete and incomplete unilateral cleft lip and palate during the prepubertal period.

Mixed-longitudinal roentgencephalometric data were used for the determination of differences between the configuration and development of the face in complete and incomplete unilateral cleft lip and palate at the age of 8 to 12 years. As compared to incomplete clefts patients with complete clefts had a reduced height of the upper face and thus also of the face as a whole and an increased width of the nasal cavity. These findings were in agreement with the situation in adults, but contrary to adults we failed to disclose any difference in the depth of the maxilla and thus there were also no differences of the retrusion of the upper jaw, sagittal jaw relations, facial convexity, occlusion of incisors and the prominence of the upper lip. The thickness of the upper lip did not differ as well. The global results showed that the differences between facial configuration in these two types of clefts were much smaller up to the onset of puberty than in adults. Throughout the investigated period of time the growth and development of the investigated parameters proceeded identically in both forms of clefts. The reduction of upper face height in complete clefts confirmed an early, probably prenatal origin of this deviation from normal.

Cleft Lip↗

The use of twins in dentofacial genetic research.

A literature review is given on the different results obtained with twin and family studies in relationship to the development and structure of the dentofacial complex. Recent advances in twin and family studies are mentioned. Attention is focused on functional components considered to be of primary importance in craniofacial growth.

Cleft Palate↗

Growth and development: hereditary and mechanical modulations.

Growth and development is the net result of environmental modulation of genetic inheritance. Mesenchymal cells differentiate into chondrogenic, osteogenic, and fibrogenic cells: the first 2 are chiefly responsible for endochondral ossification, and the last 2 for sutural growth. Cells are influenced by genes and environmental cues to migrate, proliferate, differentiate, and synthesize extracellular matrix in specific directions and magnitudes, ultimately resulting in macroscopic shapes such as the nose and the chin. Mechanical forces, the most studied environmental cues, readily modulate bone and cartilage growth. Recent experimental evidence demonstrates that cyclic forces evoke greater anabolic responses of not only craniofacial sutures, but also cranial base cartilage. Mechanical forces are transmitted as tissue-borne and cell-borne mechanical strain that in turn regulates gene expression, cell proliferation, differentiation, maturation, and matrix synthesis, the totality of which is growth and development. Thus, hereditary and mechanical modulations of growth and development share a common pathway via genes. Combined approaches using genetics, bioengineering, and quantitative biology are expected to bring new insight into growth and development, and might lead to innovative therapies for craniofacial skeletal dysplasia including malocclusion, dentofacial deformities, and craniofacial anomalies such as cleft palate and craniosynostosis, as well as disorders associated with the temporomandibular joint.

Animals↗

Assessment of mandibular growth by skeletal scintigraphy.

Accurate assessment of facial skeletal growth remains a major problem in craniomaxillofacial surgery. Current methods include 1) comparisons of chronologic age with growth histories of the patient and the family, 2) hand-wrist radiographs compared with a standard, and 3) serial cephalometric radiographs. Uptake of technetium-99m methylene diphosphonate into bone is a reflection of current metabolic activity and blood flow. Therefore, scintigraphy with this radiopharmaceutical might serve as a good method of assessing skeletal growth. Thirty-four patients, ranging in age from 15 months to 22 years, who were undergoing skeletal scintigrams for acute pathologic conditions of the extremities, were used to develop standards of uptake based on age and skeletal maturation. The results indicate that skeletal scintigraphy may be useful in evaluation of mandibular growth.

Adolescent↗

Principles of dentofacial orthopedics.

The differences in the response of patients to the same orthodontic treatment are, to a great extent, the result of variability in the direction and rate of craniofacial growth. Furthermore, there is currently little scientific evidence that the temporary improvement of skeletal relationships from orthopedic appliances will alter the craniofacial skeleton on a permanent basis. However, contemporary literature is beginning to show that certain appliances may be more effective than others at a specific point in the growth process. Timing of treatment in a patient is becoming of increased clinical importance. A review of the anatomy of palatal expansion indicates that expansion is much greater in the anterior portion of the palate, in both horizontal and vertical planes. Assessment of skeletal maturity for treatment timing and growth prediction is most commonly performed with the hand/wrist radiograph. A new method is presented which uses epiphyseal and diaphyseal widths and fusion of selected phalanges to determine the relative position of the individual on the pubertal growth curve. Skeletal maturity assessment is a traditional attempt to judge physiological development. The future of craniofacial growth assessment lies in the development of physiological measurements which are both replicable and valid and clinically feasible. The data from these studies provides information to allow better quantitative diagnosis and treatment as well as objective assessment of the treatment outcome.

Adolescent↗

The effect of ethnicity and age on palatal size and shape: a study in a northern Chilean healthy population.

Race and ethnicity influence the form of the human craniofacial complex in varying ways. The aim of the present investigation was to quantify the effects of ethnicity (mestizos, Aymara, non-Aymara), age (adolescents and adults), and sex on the form (size and shape) of the hard palate in normal Native American individuals. From the dental casts of 51 individuals with a complete permanent dentition, the x, y, and z coordinates of several standardized palatal landmarks were obtained with a computerized 3-dimensional digitizer. Palatal landmarks were used to derive a mathematical equation for palatal shape in the frontal and sagittal planes. Palatal width and length, frontal and sagittal heights, sagittal slope, and deviation of the raphe from the midline were also calculated. In the Aymara subjects, there was no effect of sex on palatal size, but there was an effect on palatal shape independent of size, especially with respect to male growth. Indeed, female palates apparently did not change their shape between adolescence and adulthood, while male palates increased their posterior "height." Overall, the 3 ethnic groups appeared to possess similar palatal size, with small significant differences. In the adult individuals, ethnicity did not seem to influence palatal shape. In contrast, adolescent males showed differences: non-Aymara subjects had the "highest" palatal shape, Aymara the "lowest," and mestizos an intermediate position. In conclusion, ethnicity does not seem to be a factor of major variability of human hard palate morphology, at least in the present 3 northern Chilean groups, as already found for dental arch shape. Age probably has a larger effect, particularly in the posterior part of the palate, where the eruption of the second and third molars between adolescence and young adulthood may play a role. A further development of the present investigation may involve larger samples of individuals from different ethnic groups.

Adolescent↗

Cephalometric evaluation of Class II malocclusions in transitional dentition.

Studying malocclusion during active growth period is important because this period has the maximum impact on dentofacial structures. The present study comprises of computerised cephalometric evaluation of 100 North Indian children in the age group of 9-12 years, with 50 children in normal occlusion group. The samples were segregated according to sex with 25 females and 25 males in each group. It was concluded from the study that changes or deviations in SNB, Saddle, Articular and Gonial angles are the potential indicative factors in the development of a class II malocclusion and that class II pattern is associated with short and posteriorly placed mandible in relation to the cranial base.

Age Factors↗

[Jaw evolution and function of mastication].

Gnathostomata improved the brachial cartilages of Agnahta into jaws. At the same time, such a jaw formation resulted not only in the development of eye, nose, and ear for searching foods but also in the development of brain which regulates the functions of these sense organs and mastication muscles. In this paper, we described about the muscles, mouth, tongue, and jaw which participate in mastication from a view point of morphology and molecular biology.

Animals↗