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PubMed1989

[Effects of sucking habits on the dentofacial development].

This review gives a description of the significance of the dentofacial development of both thumb- and fingersucking habits and dummy-sucking. Of all children about 60% has had a nonnutrive sucking habit during their youth. Sucking habits can have an influence on both the dental arches separately as well as on the intermaxillary relationship. Prolonged finger- and thumbsucking results in a disturbance of the dentofacial development in the anteroposterior, vertical and transverse directions. Dummy sucking has consequences for the development especially in vertical and transverse directions. With regard to dental complications it is advised to stop finger- and thumbsucking prior to the eruption of the permanent incisors and to stop dummy sucking before three years of age.

Child↗
PubMed1980

Craniofacial analysis of patients with complete clefts of the lip and palate.

The timing of habilitative treatment in the individual with cleft lip and palate has received a great deal of attention, but the most judicious age for performing primary palatoplasty is still a contested issue. Some reports in the literature speak of "early" and "traumatic" surgery as being analogous, while other investigators find early surgery entirely compatible with normal growth and development. Records were obtained on 19 patients with unilateral and 9 with bilateral clefts of the lip and palate operated upon at the same age by the same surgeon and utilizing the same surgical technique. Cephalometric tracings were recorded, measured, and analyzed by an Amdahl 470-V computer. Results indicate that, in both unilateral and bilateral clefts, there is a definite decrease in overall mid-facial growth, both horizontally and vertically, but that there is an apparent tendency for the components of the lower face, especially the mandibular body, to "compensate" for changes in midface development. Although skeletal structures of the cleft subjects are significantly altered when compared to non-cleft control subjects, the general clinical appearance of the patients does not substantiate the criticisms of those opposed to "early" surgical intervention.

Adolescent↗
PubMed1991

The skeletodental adaptations in deep bite correction.

The purpose of this study was to analyze the skeletal and dental changes produced by orthodontic correction of a deep bite. A comparison was made between the adolescents' and the adults' responses in an attempt to observe any differences that accounted for increased stability in a growing patient. Records on 30 patients were analyzed before and after treatment. These patients were divided into two equal groups on the basis of their stage of maturational development. The group of "growers" had an average age of 12.2 years, and the group of "nongrowers" averaged 26.7 years in age. All represented nonextraction cases with an excessive overbite before treatment. Deep bite was corrected by leveling with conventional continuous arch wires. Cervical headgear, Class II, or vertical elastics were used when indicated. On the average, the molars were extruded 4.7 mm in the grower's group. However, the mandibular plane angles did not change during treatment. This finding can be attributed to the greater amount of posterior mandibular development that was observed in growing patients. Even with minimal extrusion of the molars (1.3 mm on average), the adults did not maintain the original mandibular plane angle.

Adaptation, Physiological↗
PubMed1978

Follow-up investigations on operated cleft palates.

Follow-up investigations were made on 98 uni- and bilateral cleft lip and palate patients referred to an orthodonitc therapy. As the patients have been operated by various methods and by different surgeons, the question arose as to whether the timing of the operation still influences the development of the dentition. Early operated patients (uranoplasty) exhibited more often impaired maxillary growth than late operated patients. Orthodontic interventions proved especially successful when applied early and when they were not hindered by cicatrical contractions.

Age Factors↗
PubMed1998

Earlier dental maturation: fact or fiction?

The objective of this investigation was to determine if there is a difference in dental age of maturation between adolescents treated in the 1970s and those treated in the 1990s. Records of 150 Caucasian patients, 8.5 to 14.5 years old and treated in a private orthodontic office between 1972 and 1974, were randomly selected; records of another 150 patients of the same race and age range but treated between 1992 and 1994 were also collected. The percentage of calcification of the mandibular canines was rated according to methods used by Demirjian, who divided tooth development into eight segments, A to H. Using stage G to compare the 1970 and 1990 patient samples, we demonstrated dental age reductions of 1.21 years for males and 1.52 years for females, and a combined reduction of 1.40 years.

Adolescent↗
PubMed2002

Sagittal occlusal relationships and asymmetry in prematurely born children.

The aim of this investigation was to examine the effect of pre-term birth on sagittal occlusal relationships. The subjects were 328 prematurely born white and black children and 1804 control children who participated in the cross-sectional study of the Collaborative Perinatal Project (USA) in the early 1960s and 1970s. Dental examinations, including dental casts and photographs, were performed at the age of 6-12 years. The sagittal occlusion of the permanent molars and the canine relationship was recorded by examining and measuring the hard stone casts. The pre-term and comparison groups were divided by sex and race. A significantly greater prevalence of pre-normal canine relationships was found in the pre-term group than in the controls (P < 0.001). The incidence of a bilateral symmetrical canine relationship was 60.3 per cent in both the pre-term and control groups, but in the pre-term group the girls had better symmetry than the boys. Asymmetry occurred significantly more often on the left side (P < 0.001), especially in the control boys, but this was not so clear in the pre-term group. The prevalence of mesial molar occlusion was greater in the pre-term group. These results suggest that premature birth and the consequent exceptional adaptation from intra- to extra-uterine nutrition may influence dental occlusal development. This emphasizes the importance of early functional activity and differences in masticatory muscle activity and the largely unknown phenomenon of early catch-up growth. Individual differences in neonatal factors, in the need for intubation and other medical care are also of importance. Pre-term birth may also interfere with the development of symmetry and lateralization.

Black People↗
PubMed1994

Facial growth and development in unilateral cleft lip and palate during the period of puberty: comparison of the development after periosteoplasty and after primary bone grafting.

X-ray cephalometry was used in studies of facial growth and development carried out in 32 males with complete unilateral cleft lip and palate. They underwent primary periosteoplasty and were examined at the ages of 10 and 15 years. The results were compared with the development of the face in a longitudinal study of 20 males with the same type of cleft who were operated with a primary bone graft. The series with periosteoplasty showed a more marked proclination of the upper dentoalveolar component with the restoration of a positive overjet, as compared to a persistent anterior crossbite in the males with bone grafts. The lower jaw showed a larger protrusion, while individuals with bone grafts were characterized at the ages of 10 and 15 years by a larger posterior rotation of the mandible. The growth of the maxilla did not differ between series. In both series, there was a marked reduction in the growth of maxillary depth and of upper lip height, while the highest growth rate showed parameters of nasal prominence. An increasing mandibular protrusion and maxillary retrusion resulted in an impairment of sagittal jaw relations and in the flattening of the face, both of which occurred in almost all patients. The rotation of the lower jaw was not correlated with either the convexity of the face, sagittal jaw relations, or an overjet. The independence of developmental changes of selected characteristics at their initial state documented the impossibility of predicting the development of the face on the basis of a single x-ray examination at a given stage of development. Fixed appliances promoted a more marked proclination of upper incisors and the alveolar process than removable appliances, but they exerted no direct action on the other facial parameters studied.

Adolescent↗
PubMed1999

Progress toward understanding craniofacial malformations.

Significant advances in the study of the human face have revealed the genetic and gene-environment bases of numerous common and rare craniofacial disorders. Classification of craniofacial malformations based on clinical phenotypes is sometimes quite different from the genetic findings of patients. Different mutations in a single gene can cause distinct syndromes, and mutations in different genes can cause the same syndrome. The extracellular signaling molecule SHH, fibroblast growth factor receptors, and transcription factors GLI3, MSX2, and TWIST are discussed as examples of molecules involved in interrelated signal transduction networks regulating craniofacial development. Progress in the understanding of normal and abnormal craniofacial development, through the study of morphoregulatory signaling pathways, has benefited from multifactorial approaches recommended 40 years ago at the National Institute of Dental Research-sponsored landmark Gatlinburg Conference. The utilization of biochemistry, protein structure analyses, tissue culture, and animal model systems for developmental genetics has resulted in remarkable scientific advances. The evolutionary conservation of morphoregulatory pathways has revealed the homology of genes associated with human craniofacial malformations and their counterparts that regulate the morphogenesis of fruit flies. The continued investments in basic, translational, and patient-oriented research regarding normal and abnormal craniofacial development will translate into substantial improvements in the prevention, diagnosis, and treatment of craniofacial diseases and disorders.

Animals↗
PubMed1990

[Analysis of various craniofacial architectural types using the ontogenic approach of humanization].

A new concept of craniofacial growth and of the physiology of membranous sutures provides new insight into the different craniofacial architectural types encountered in modern Man. This is based on the hypothesis that cranial sutures reflect certain biodynamic laws pertaining to a phenomenon of craniofacial contraction that took place in the course of development over the ages. At present, craniofacial biodynamics is the sole concept capable of shedding light on matters such as the evolution of the skull, its diversification and transformation down from the primeval primates.

Animals↗
PubMed1995

Abnormal craniofacial growth.

Treatment of patients with craniofacial (CF) anomalies necessitates knowledge about normal CF growth and how it deviates in the abnormal state. There are different basic types of CF anomalies and various kinds of aberrations that influence CF development. These factors might help to explain why patients display growth variations. The effect of surgery on subsequent development is significant, but the heterogeneity among patients with regards to the morphology, etiology, and pathogenesis of the anomalies could also explain certain growth results. Roentgencephalometric findings related to CF growth in three different groups of anomalies are discussed.

Cephalometry↗
PubMed1979

[Disturbances in development of the maxilla following interstitial radium therapy for a facial rhabdomyosarcoma at the age of 3 years (author's transl)].

Radium therapy at the age of 3 years for an embryonic rhabdomyosarcoma of the paranasal fold resulted in severe cutaneous lesions but also relatively limited disturbances of growth of the corresponding maxilla: inclusion of the underlying canine and version of neighbouring teeth, very incomplete development of the nearest dental roots, absence of air filling of the maxillary sinus. The relatively slight nature of these developmental disturbances is certainly related to the techniques of interstitial radium therapy developed and used at the Gustave Roussy Institute. Routine orthodontic study of the cases of children surviving after treatment of a malignant tumor of the face would undoubtedly offer even more precise information concerning therapeutic indications.

Child↗
PubMed1980

[The human cartilaginous mesethmoid (author's transl)].

The existence of a cartilaginous facial structure, the mesethmoid, has been demonstrated in the newborn human infant. This structure is the peri- and post-natal tissue developed from the embryonic cartilaginous nasal capsules. Unrecognized during facial development, the cartilaginous mesethmoid, partly because of its multidirectional growth, is responsible for frontonasomaxillary osteomembranous centrofacial morphogenesis. Practical aspects are discussed, and studies to determine the post-natal structures derived from the mesethmoid are in progress.

Cartilage↗
PubMed1979

[Interferences with the development of the jaws and teeth in mixed dentition].

On the basis of results from animal experiments, the authors emphasize a series of factors interfering considerably with tooth eruption. It is dealt with tooth eruption disorders and dental malformations due to premature loss of teeth, fused deciduous teeth, certain dystrophies, submersion of deciduous teeth, dysembryoplasias, and rickets.

Dentition, Mixed↗
PubMed1986

Nasal respiratory function and craniofacial growth.

Nasal respiratory function and its relationship to growth development of the craniofacial structure has been a subject of interest and controversy for over 100 years. The otolaryngologist as the primary physician with responsibility of managing the upper respiratory tract is obviously most intimately involved with diagnosis and treatment of upper respiratory tract problems. To further evaluate the evidence regarding causes of craniofacial growth, a study was done involving pretreatment orthodontic subjects and their manifestation of classic signs of adenoid facies ("long-face syndrome"). Randomly selected were 106 subjects, ranging in age from 6 to 13 years, for evaluation of the facial features and medical history associated with long-face syndrome. No conclusive proof was found that nasal respiratory obstruction alters facial growth development. Studies of the nasal respiratory function need to be done utilizing clear definitions of respiratory mode and objective; reproducible techniques of measuring respiratory modes must be employed. Highly selected orthodontic patients can benefit from adenoidectomy and/or tonsillectomy.

Adolescent↗
PubMed1975

New guiding principles in the treatment of clefts.

Breathing through the nose with the mouth shut is essential for the normal development of the facial region related to the mouth and nasal cavities and for the normal development of the two cavities named. Surgical treatment of unilateral total cleft practised hitherto calls for the closure of a cleft in the lip and a cleft in the alveolar ridge at the same surgical intervention. In the great majority of cases a combined intervention closes the respiratory pathway, which was established through the cleft nasal floor and alveolar ridge after birth. From the first surgical intervention on, the child is forced to breathe through the mouth. The disruption of the normal functional development mechanism causes the formation of the characteristic physiognomy of a child with a cleft. The correct treatment as presented in this paper, must consistently observe, in addition to other no less important principles, the primary principle: it is essential for a child with cleft to be made to breathe through the nose with the mouth shut, as soon as possible. The operative plan of treatment must help a child with a cleft to create, by utilizing the natural development abilities, and with minimal application of trauma, the same conditions for the functional development mechanism as are possessed by a healthy child of the same age. The enclosed evidence proves the validity of the described guiding rules, and affirms again the well known principle that only normal function produces normal form.

Alveolar Process↗
PubMed1995

Delayed development of an ectopic frontal sinus mucocele after pediatric cranial trauma.

We describe the delayed occurrence of a frontal sinus mucocele 14 years after the original trauma. The patient presented with a laterally displaced, enlarging mass that encroached on the dura. The sterile mucocele was removed, and the cranial defect was reconstructed with methyl methacrylate and wire mesh. Our experience confirms the known but rarely observed late development of a mucocele after pediatric facial trauma. To prevent the sequela of mucocele development, the mucosa of the rudimentary frontal sinus in the pediatric patient must be carefully sought and ablated during reconstructive procedures of the forehead when traumatic injury significantly disrupts the normal bony anatomy.

Adult↗
PubMed1977

Early surgery for isolated craniofacial dysostosis. Improvement and possible prevention of increasing deformity.

We describe our experiences with craniofacial surgery at less than 9 months of age in 8 patients with isolated craniofacial dysostosis. We believe that the early release (preferably before the age of 6 months) of the constricting forces in bound or underdeveloped areas of bone will allow subsequent better development of these faces. The molding and expansile influences of the rapidly developing brain and eyes can exert a greater effect on facial growth. The operations are easier and more rapidly performed than those in older children, and no distant bone grafts are necessary.

Age Factors↗
PubMed1998

Three-dimensional analysis of cleft palate topology in newborn infants with reference to the cranial skeleton.

OBJECTIVE: To describe a method of determining the three-dimensional topology of the palatal crest relative to a reproducible anthropomorphic coordinate system in newborn infants with unilateral cleft palate. For this purpose, physical models of the maxilla and face were analyzed by computer morphometry. DESIGN: The study was limited to infants referred to the craniofacial center during the first 11 days after birth. SETTING: The study was performed at a craniofacial center servicing a large geographic area. PARTICIPANTS: The method was applied to 12 infants with unilateral cleft lip, alveolus, and palate (eight patients with left-side clefts and four with right-side clefts). MAIN OUTCOME MEASURES: The three-dimensional topology of the palatal crest referenced to an anthropometric coordinate system was the primary outcome measure. The anthropometric reference system is defined by the tragus points and the midpoint of a line connecting the endocanthia. RESULTS: The topology of the maxillary crests of the patients was characterized by considerable variability. The center of the premaxilla as defined by the attachment of the frenulum was frequently displaced by several millimeters from the midsagittal plane. The displacement was to the left in infants with right-side clefts and to the right in infants with left-side clefts. The premaxilla can be rotated by more than 30 degrees relative to the normal position. No significant retroposition of the minor segment as determined by the location of the tuber points was found. Several morphometric anomalies were found to be correlated linearly. CONCLUSIONS: We propose that the morphologic deviations are in part caused by the neuromotor activity of the tongue and of the interrupted M. orbicularis oris. The data can serve as the starting point for a longitudinal study of craniofacial development in children with cleft palate and for studies on the efficacy of different therapeutic approaches.

Alveolar Process↗