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PubMed1981

Longitudinal cephalometric standards from 5 years of age to adulthood.

Most cephalometric standards available in the literature are cross-sectional in nature. In the limited number of longitudinal studies reported, the data were presented on a yearly basis. As a result, the orthodontist was faced with the dilemma of either using one cephalometric standard for both males and females and for all age groups or using a large number of standards, each specific for age and sex. The purpose of the present study was to explore the possibility of developing a limited number of normative cephalometric standards for males and females between 5 years of age and adulthood. The subjects in the study included twenty males and fifteen females with clinically acceptable occlusion and no apparent facial disharmony. All subjects were Caucasians, and none had undergone orthodontic therapy. Seventeen angular measurements and ratios of face heights derived from linear dimensions were examined for significant changes between 5 years of age and adulthood. Five cephalometric standards which can be used by the orthodontist for diagnostic purposes were developed. These standards are specific for sex and applicable within an age range. For the vast majority of cases, only one of these standards need be used by the orthodontist to evaluate the patient before, during, and after orthodontic treatment.

Adolescent↗
PubMed1998

Craniofacial growth in children treated for malignant diseases.

With the improving cure rate in childhood malignancies, increasing interest has been focused on the long-term survivors of childhood cancer and the quality of their life. The severity of long-term disturbances in dental and craniofacial development is dependent on the age of the child at diagnosis, if chemotherapy is combined with radiation or not. With regard to craniofacial development combination chemotherapy has no effects compared with healthy controls, whereas children treated cranial irradiation before 5 years of age exhibit a reduced growth of the mandible. Conditioning before bone marrow transplantation with total body irradiation results in a significantly reduced growth of the craniofacial skeleton. The mandible was four times more radiosensitive compared with the maxilla. With attention to the dental and craniofacial development, occlusion and craniomandibular function, children in risk groups should be followed, and given prophylactic treatment and intervention at appropriate times to reduce the consequences of the disease itself and the therapy given.

Adolescent↗
PubMed2002

Treatment of condylar fractures in children and youths: the clinical value of the occlusal plane orientation and correlation with facial development (case reports).

The relative position of the plane of occlusion to the cranial base determines the direction of the forces generated in the cranium during occlusal function. When the plane of occlusion is level and when the neuromuscular system is in harmony, the vectors of forces created by the closing muscles are directed to the central area of the cranium in a symmetrically balanced way. Unfortunately, TMJ fractures may alter completely this balance with loss of the support to the mandible against the temporal component and loss of the functional effect of the lateral pterygoid muscle on the mandible. Changes in orientation of the occlusal plane may result in facial alteration and asymmetries. In our experience, the restoration of a plan of occlusion orthogonally aligned to the forces of occlusion for a correct transfer of forces through the maxilla to the rest of the cranial bones is essential to allow proper face development. Two, quite similar cases of unilateral, dislocated condylar fracture treated in a different way, will be reported to demonstrate how this can occur. Available clinical data will be illustrated.

Bone Remodeling↗
PubMed1977

A follow-up study of cleft children treated with vomer flap as part of a three-stage soft tissue surgical procedure. Facial morphology and dental occlusion.

The development of the face and jaws in cleft patients, treated with a three-stage surgical procedure including a single layer vomer flap, was studied by analysing cephalometric radiographs and dental casts. The material consisted of 13 patients with complete bilateral cleft lip and palate and 50 cases with complete unilateral cleft lip and palate, operated on 1964--1970. At the follow-up the average patient in both cleft categories demonstrated a maxillary retrognathia and in the unilateral cleft sample also a facial skeletal profile straighter than normal, though not as pronounced as we had found in cases where the vomer flap procedure was accompanied by bone grafting. However, the mean profile for the bilateral as well as the unilateral cleft group was straighter than reported for patients subjected to neither vomer flap nor bone grafting. The occlusal findings confirmed the maxillary growth retardation and similarly placed the present patients at a level between the results of the other two types of surgical regimes. As a side-effect cleft-bridging bone was formed in some part of the hard palate in every second case, though without importance for facial development. In an effort to reduce the restricted mid-facial growth found in the present patients, we have changed our surgical technique and since 1975 excluded the use of vomer flaps.

Bone Transplantation↗
PubMed2000

Management of ectodermal dysplasia in children--an overview.

Oral rehabilitation is often difficult for the young child with ectodermal dysplasia. Most affected children require extensive dental treatment in order to restore their appearance and function. Early intervention also helps children develop a positive self-image. This paper will review the dental management and timing of different treatment modalities for children with ectodermal dysplasia.

Adolescent↗
PubMedDate not supplied

[Long-term results of primary osteoplasty in CLP patients. A cephalometric analysis].

In the present paper the long term results of 27 patients with clefts who had undergone primary osteoplasty at 3-10 months are presented in a cephalometric follow-up. A review of the literature shows that in comparison to cleft populations without primary osteoplasty there have been no differences in terms of maxillary development. Therefore primary osteoplasty cannot alone be made responsible for the disturbance of the growth of the maxilla as has been postulated in the early 70s. According to the Tübingen results consistent orthodontic therapy is necessary to prevent developmental anomalies.

Adolescent↗
PubMed1993

[Physiology of craniofacial development].

This topic summarizes basic principles of the development and the postnatal growth of the craniofacial skeleton. The different stages involved in the progressive ossification of facial bones are exposed: the intramembranous ossification, the endochondral (intracartilagenous) ossification and the changes (remodelling and relocation) associated with periosteal and endosteal membranes.

Adolescent↗
PubMed1997

Development, maturation, and aging of the alveolar bone. New insights.

Osteoblasts and bone tissue of the mandibular and maxillary alveolar processes substantially differ from osteoblasts and bone in other parts of the skeleton. These differences are apparent during embryonic development, maturation, and aging of these bones. The cellular and molecular basis for these differences is still not clear, but it is unfolding at record speed.

Aging↗
PubMed1980

Tonsils and adenoids: why the dilemma?

Enlarged tonsils and adenoids have been implicated in dentofacial development and in the developing facial configuration. The growth pattern and the role of these lymphoid tissues are controversial, as are the benefits to be gained by their surgical removel. The diagnosis of enlarged tonsils and adenoids and of mouth breathing is not based on well-defined criteria.

Adenoidectomy↗
PubMed2006

Orthodontics in 3 millennia. Chapter 8: The cephalometer takes its place in the orthodontic armamentarium.

After World War II, cephalometric radiography came into widespread use, enabling orthodontists to measure changes in tooth and jaw positions produced by growth and treatment. Cephalometrics revealed that many malocclusions resulted from faulty jaw relationships, not just malposed teeth, and made it possible to see that jaw growth could be altered by orthodontic treatment. Since 1931, a multitude of analyses have been developed, whereby the face is inscribed in triangles, rectangles, and polygons, permitting the orthodontist to dissect the profile into an array of angular and distance measurements. Those who embraced too quickly these measurements as a panacea soon learned that they are best taken with a grain of good judgment.

Canada↗
PubMed1997

An estimation of craniofacial growth in the untreated Class III female with anterior crossbite.

The literature has little to say regarding the normal growth and development of untreated individuals with Class III malocclusion or anterior crossbite. In part, this paucity of information is because of the relatively low prevalence of these characteristics in European-American populations and the need, recognized by the lay public and health professionals, for treatment of these conditions. Given the absence of true longitudinal data, this study attempts to estimate the growth of the untreated individual with Class III malocclusion and anterior crossbite by evaluating large samples of untreated subjects at distinct developmental stages. Initially the morphologic characteristics of 2074 Japanese female patients who had anterior crossbite were evaluated cephalometrically before treatment. On the basis of the cephalometric analysis, all subjects who did not have a Class III molar relationship were excluded from further analysis, leaving a sample of 1376. The subjects then were classified into seven groups (120-256 subjects per group) according to Hellman's stages of dental development. Descriptive statistics for 28 measurements were calculated. The results of this study imply that the maxilla in Japanese females maintains a retruded relationship to the cranial base and does not become less retrusive with time. In contrast, the mandible is protrusive even in the late deciduous dentition and becomes more protrusive with time, making the discrepancy between the upper and lower jaws progressively more severe. Dental compensations in both arches become increasingly evident as development progresses, and the underlying skeletal and dentoalveolar imbalances also are reflected in the soft tissue profile.

Adolescent↗
PubMed1996

Management of developmental asymmetrical facial growth.

Several aspects of the management of developmental asymmetrical facial growth are addressed. The abnormality is further defined. Methods of examination and assessment of records are discussed. A complicating factor has been the adoption of too many classification systems. With three-dimensional imaging techniques (computed tomography scan and stereophotography) great advancement has been made in efforts at describing the range of variation. Hemifacial microsomia patients are best treated in multidisciplinary centers by competent specialists with the necessary expertise and skills. The procedure followed in the craniofacial center in Rotterdam is described and discussed in relation to current treatment strategies. The success of the treatment of the asymmetrical facial growth depends on the original abnormality, on secondary abnormal development, and on orthodontic and surgical intervention. International cooperation is necessary to compile sufficient statistical data for a scientific evaluation of treatment results and to improve the effectiveness and the efficiency of treatment.

Adolescent↗
PubMed2006

Treatment in the deciduous dentition: four clinical cases.

Early treatment of certain malocclusions is of great importance in orthodontics when normal growth and development is the objective of our therapy. The four cases presented illustrate the three types of malocclusion which must be treated early: cross-bites (transverse), Class III malocclusions (saggital) and open-bites (vertical). In most of these cases there is a deficiency of the maxilla. The maxilla is the template for the mandible in the early stages of development, and for this reason it should be treated early. As Ricketts said concerning early treatment: The crux of the dilemma is the failure to recognize complete maxillary orthopedics in the three planes of space.

Age Factors↗
PubMed1981

Orthodontic management of unilateral cleft lip and palate.

Experimental and clinical findings indicate that unfavorable adaptations of normal structures occur in children with clefts. It is postulated that these deviations from normal development are reversible and can be corrected or prevented by properly designed treatment. On this basis, five hypotheses were formulated and tested on the data from the subjects included in this study. The subjects consisted of 1) 16 children without clefts, 2) eight children who had complete unilateral clefts of the lip and palate but who had not received orthodontic treatment, and 3) 16 children who had complete unilateral clefts of the lip and palate and who had been treated by the described orthodontic procedures. The mean age for each group was 16 years. It was concluded that orthodontic treatment can be designed to : 1) counteract the forces which inhibit development of the maxillary alveolar process horizontally and vertically, 2) partially prevent the reduction in the forward growth of the maxilla, 3) provide adequate jaw and dental arch relationships, and 4) establish and maintain correct position of the maxillary segments.

Adolescent↗
PubMed1982

The ethmoid bone: implications for normal and abnormal facial development.

Deficiencies of the ethmoid and embryologically related bones of the anterior cranium have been observed in patients with abnormalities in development or placement of the orbits and eyes, nose, upper lip, mouth, and palate. Although these facial anomalies are commonly associated with holoprosencephaly, they may occur in other syndromes or as isolated cases with normocephaly. Such facial alterations represent the consequences of aberrant migration of tissues into the region normally occupied by the ethmoid bone, beginning early in the sixth week of gestation. The subtle interplay of forces involved in the normal development of the median face appears to be mediated by the ethmoid bone. This interaction may be perceived by dividing the ethmoid bone into three functional components which correspond to and operate in each of the major anatomic planes.

Cell Differentiation↗
PubMed1995

The role of sutures in normal and abnormal craniofacial growth.

The paper is a shortened version of a paper read at the symposium on craniofacial growth, in which the literature on various aspects of sutures was reviewed. Suture development, structure, growth, and closure are covered, and the response of sutures to orthopedic forces and their role in craniosynostosis exemplified. Rather than being an extensive review, references are included preferably to present diversity in results and methods within the subtitle of the symposium, 'mechanisms and study methods'.

Animals↗
PubMed1989

Effects of primary osteoplasty on facial growth in unilateral cleft lip and palate after ten years of follow-up.

An assessment of X-ray cephalometric studies was carried out in 32 boys and 25 girls with complete unilateral cleft lip and palate aged ten years and operated upon with the technique of primary bone grafting, as well as in 30 boys and 25 girls with the same type of cleft treated with the same methods, but without bone grafting. Individuals with primary osteoplasty had a deficiency of vertical growth of the upper face and a more marked retroinclination of upper incisors. We failed to disclose any other significant differences. Both series had a markedly deficient anterior growth of the maxilla. Thus the introduction of the method of primary bone grafting did not result in an improved development of the upper jaw, just on the contrary some parameters were suggestive that it exerted an adverse effect. Therefore it was not possible to advocate the use of this surgical procedure in the treatment of clefts.

Bone Transplantation↗
PubMed1986

Pre- and postsurgical facial growth in patients with Crouzon's and Apert's syndromes.

Our report deals with 8 patients with Crouzon's and Apert's syndromes followed longitudinally with roentgencephalometric examinations during the growth period. The purpose of the study was to analyze: presurgical facial growth, the displacement of the maxillary complex in connection with Le Fort III advancement, the stability of the surgical result, and postsurgical facial growth. Presurgical facial growth was characterized by lack of maxillary sutural growth and abnormal remodeling of the maxilla. The surgical displacement of the maxilla consisted of an average advancement of about 10 mm and a backward rotation. The maxilla remained stable following surgery. However, onlay bone grafts tended to resorb over the long term. Postsurgical facial growth revealed lack of maxillary displacement with development of exophthalmos, relative mandibular prognathism, and malocclusion. However, it was concluded that the positive effects of early craniofacial surgery in patients with severe forms of Crouzon's and Apert's syndromes outweigh these disadvantages.

Acrocephalosyndactylia↗