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PubMed1992

Differential growth of the female face in the anteroposterior dimension.

This study contrasts the growth rates of the craniomaxillary and mandibular dimensions. Longitudinal data from lateral head cephalograms of 18 female subjects, between 3 and 18 years old, were used. All of the subjects had yearly cephalograms available and none had received orthodontic treatment. Four linear distances included anterior cranial base, maxillary length and mandibular length and four angular measurements included ANS-S-N, ANS-N-S, Gn-S-N and Gn-N-S. The mandible lagged in size by 4 years relative to anterior cranial base length and by 2 years relative to maxillary length at 5 years of age. There was an incremental gradient of growth from S-N downward to Ar-Pog such that dimensions successively showed a greater relative amount of growth during the entire period of development. The proportional displacement of nasion and anterior nasal spine maintained a constant S-N-ANS angle. The increase in angle S-N-Gn was due to proportionally greater increase in mandibular length relative to anterior displacement of nasion. The different rates of dimensional increments from anterior cranial base to mandible result in differential growth affecting the spatial relationship of maxilla and mandible in the sagittal plane. Skeletal discrepancies in maxillomandibular relationships between 4 and 10 years of age is a normal transient developmental characteristic.

Adolescent↗

PubMed1997

Different approaches to anchorage: a survey and an evaluation.

Orthodontic treatment outcome is often compromised by the loss of anchorage. The forces acting on the anchorage unit have, however received surprisingly little attention, and the loss of anchorage is most frequently expressed in the sagittal occlusal relationship. The present paper discusses the interaction between vertical and sagittal components of dentofacial development, and the importance of taking vertical forces into consideration is stressed. The biological background for anchorage is reviewed, i.e., the impact on the cellular reaction of the periodontal ligament around the teeth of the anchorage unit from the orthodontic force system and from occlusion. A new rigid appliance consisting of two occlusal splints connected with transpalatal arches is introduced. The advantage of using the patient's sense of occlusion as part of anchorage by means of this appliance is demonstrated in a number of case presentations.

Adult↗

PubMed1992

Growth patterns of the nasolabial region: a morphometric study.

Age-related growth changes in the nasolabial region were analyzed through six measurements taken between 1 year and 18 years of age in 1,593 North American Caucasians. By 1 year of age, the length of the cutaneous portion of the upper lip and the width of the nose showed the highest levels of development compared with their adult size, 80.3 and 79.5%, respectively. By 5 years, the developmental level of the nasolabial region except nasal tip protrusion approached their maturation level. Our nasal measurements indicated that growth of the nose between 5 and 18 years was significantly greater than that of the upper lip, which revealed significantly greater growth increments between 1 and 5 years of age. The cutaneous upper lip height reached its adult size in 3-year-old females (12.7 mm) and 6-year-old males (14.4 mm). Nose width and height were fully developed in females by age 12 and in males by age 14 or 15. Rapid growth occurred in the upper lip, nose height, and nasal tip protrusion between the ages of 1 and 4 years. Knowledge of these age-related morphologic variations within the nose and upper lip may be useful in planning the time and type of reconstructive surgery and in anticipating further change in the operated regions after the surgical reconstruction.

Adolescent↗

PubMed2000

[Direct and indirect effects of medication (including chemotherapy) and irradiation on the pulp].

A direct or indirect effect of the intake of medication on the pulp itself has not yet been described in the literature. The effect of local anesthetics on the pulp, on the other hand, has been documented. Although local anaesthesia has been employed in dentistry for many years, most investigations of its action have only considered the effect on the nerves within the pulp using traditional methods. Recently it has become clear that the nerves and blood vessels of the pulp do not act in isolation but are closely related. In this respect it has been shown that there exists a direct relationship between the length of the flow cessation and the concentration of vasoconstrictor used. Therefore care should be taken when using vasoconstrictors especially where pulpal injury is apt to occur when dental procedures such as full crown preparations are performed immediately following a ligamental injection. The anaesthetic efficacy of intraosseous injection is well documented. The effect, however, on the dental pulpal circulation still remains subject of further investigation. Radiotherapy involving the oral cavity and salivary glands and chemotherapy (in a lesser degree) induce alterations in the oral tissues and the salivary gland functions. Some of these side effects are transient. However there are side effects such as the xerostomia which are very drastic for the dentition resulting in radiation caries and dental hypersensitivity. Tooth anomalies in the developing dentition are also described. Due to the rapid progression of the radiation caries a monitoring of the oral cavity with strict application of preventive measurements and systematic follow-up can reduce the incidence of the complications. Unfortunately most of the patients belonging to this group consult with the complications of their radiotherapy and chemotherapy. In this respect endodontic treatment of the severely decayed teeth is an important part of dental treatment. Moreover, extraction is regularly contraindicated as osteoradionecrosis is then one of the major sequels.

Anesthetics, Local↗

PubMed1992

Craniofacial development in myotonic dystrophy.

Anthropometric, cephalometric, and dental data from 23 subjects (12 males and 11 females) afflicted with myotonic dystrophy were compared to similar data from normal subjects who participated in the Iowa Facial Growth Study. A two by two analysis of variance showed that myotonic subjects differed from normal subjects in headlength, head breadth, cephalic index, bizygomatic face width, nosebreadth, maxillary arch widths, palatal depth, anterior and posterior face heights, cranial base lengths, cranial base angles, and other cephalometric measures. Sex differences were observed for many of the variables. It is hoped that these findings will assist clinicians who treat patients having this disorder.

Adolescent↗

PubMed1977

A vertical cephalometric analysis of the human craniofacial complex.

A vertical analysis involving ten linear measurements was developed to localize skeletal and dentoalveolar dysplasias. The measurements are of biologic relevance, reflecting the amount of growth harmony or disharmony to the examination and record-taking time. The vertical dimensional analysis uses the age- and sex-related University of Michigan mean values for comparative data for each measurement. Ratios were computed for a five-unit proportional analysis. Both analyses were applied to assess the vertical problems of three female patients. The analyses detected specific areas of dysplasia for each patient.

Adolescent↗

PubMed1996

Quantification of facial morphology using stereophotogrammetry--demonstration of a new concept.

OBJECTIVES: The purpose of this study was to introduce stereophotogrammetry as a three-dimensional registration method for quantifying facial morphology and detecting changes in facial morphology during growth and development. METHODS: Using stereophotogrammetry, three-dimensional (3-D) co-ordinates for the bilateral landmarks Exocanthion and Cheilion and the midsagittal landmark Pronasale were determined in 10 subjects to ascertain the reproducibility of the method, and in 59 children to detect changes in facial morphology due to growth and development. Linear and angular measurements were calculated by means of the 3-D co-ordinates in order to quantify facial morphology. Significant differences were determined by means of analyses of variance (MANOVA). RESULTS: During the observation period, significant (P < 0.01) changes in facial morphology were determined for the linear measurements. Advantages and disadvantages of current registration methods are discussed. CONCLUSION: It is concluded that stereophotogrammetry is a suitable 3-D registration method for quantifying and detecting developmental changes in facial morphology.

Analysis of Variance↗

PubMed2006

Dentofacial features of children with distal occlusions, large overjets, and deepbites in the early mixed dentition.

INTRODUCTION: The aim of this investigation was to analyze craniofacial morphology in children with distal bites, large overjets, and deepbites in the early mixed dentition. METHODS: The sample comprised 486 Finnish children who are participating in an ongoing clinical trial. Cephalograms were obtained at the deciduous-mixed dentition interphase for the baseline of the trial. The mean age of the children was 5.1 years (SD, 2.6; range, 4.0-7.8 years). RESULTS: Subjects with bilateral distal steps of > or =1 mm compared with normal had long midfaces (P <.05), short and retrusive mandibles (P <.05), small maxillomandibular differentials (P <.001), convex profiles (P <.01), retrusive mandibular incisors (P <.01), and large interincisal angles (P <.001). Children with overjets of > or =4 mm had retrusive mandibles (P <.001), long maxillae and midfaces (P <.001), small maxillomandibular differentials (P <.001), convex profiles (P <.001), and protrusive maxillary and retrusive mandibular incisors (P <.001). Children with deepbites (overbites of > or =4 mm) had short and retrusive mandibles (P <.05), long midfaces (P <.001) and maxillae (P <.05), small maxillomandibular differentials (P <.001), convex profiles (P <.01), retrusive mandibular incisors (P <.001), and large interincisal angles (P <.001). No differences were found in the length of anterior cranial base, the position of maxilla relative to cranial base, lower facial height, and facial axis angle between any malocclusion group and normal children. All correlations between the occlusal and skeletal characteristics were low, suggesting only weak associations at this stage of development. CONCLUSIONS: These results indicate that the early dentofacial features of children with distal occlusions, large overjets, and deepbites differ from normal values. However, the skeletal patterns of these 3 malocclusion types showed considerable similarities, with long but neutrally positioned maxillae, retrusive mandibles, small maxillomandibular differences, convex profiles, retrusive mandibular incisors, and large interincisal angles, but normal growth directions and lower facial heights as common features.

Analysis of Variance↗

PubMed1991

Facial growth rotation--reflections on definition and cause.

The phenomenon of growth rotation of the jaws during facial development is examined by means of profile roentgencephalometric analysis of a male subject followed from age 4 years to adulthood, with reference to metallic implants and stable natural bony structures. The rotation of the corpora of the jaws, termed total rotation, and its components, matrix and intramatrix rotation, are defined. A description is given of the compensatory remodelling process. The concept of facial growth rotation as essentially a primary phenomenon is supported by a report of an identical facial rotation pattern in growing Macaca mulatta, suggesting that facial growth rotation is common in primates.

Adolescent↗

PubMed1989

[Morphofunctional studies of the masticatory apparatus].

Biophysical studies of the orofacial system require a profound knowledge of the development and morphology of the skull. The skull is the result of phylogenetic and ontogenetic evolution. A great number of multifarious factors have effects on the growth of the skull. In animal experiments the effects of some of these factors on pre- and postnatal craniofacial growth as well as the resulting maintenance of the functional balance have been analyzed. These basic research findings will be a contribution to our understanding of the factors influencing and controlling maxillocranial growth and will aid us in evaluating their inherent laws.

Adaptation, Biological↗

PubMed1984

Maxillary traction splint: a cephalometric evaluation.

Orthodontists are particularly interested in knowing exactly what skeletal and dental changes are produced by headgear. With headgear and fixed appliances, part of the observed change is due to the headgear, part to the fixed appliances, and part to growth. Since the maxillary traction splint moves the teeth en masse, the dentoskeletal changes are due primarily to the headgear force. Selective mandibular dental changes can be produced by adjusting the mandibular occlusal contacts against the splint. In this study forty-seven patients with maxillary dentoalveolar protrusions and Class II, Division 1 malocclusions were treated with orthopedic headgear that attached to a full-coverage maxillary occlusal splint. Fifty-two patients were selected as a control for evaluation of growth changes versus treatment changes. Lateral cephalograms were taken before and after treatment, and the sagittal skeletal and dental changes were evaluated and quantified. The results of the investigation revealed (1) the establishment of a Class I posterior occlusion, (2) a significant overjet reduction, averaging 4.24 mm, (3) inhibition of vertical development of the maxilla and slight intrusion of the maxillary dentition, (4) overbite reduction by leveling of the mandibular dentition, (5) no indication that mandibular growth is accelerated, and (6) no significant increase in the mandibular plane angle. The maxillary traction splint is an effective means of correcting maxillary dentoalveolar protrusion in growing patients prior to fixed appliance therapy. The second phase of treatment with fixed appliances is necessary for individual tooth positioning and for detailing the occlusion.

Adolescent↗

PubMed1991

[Changes in the value of the mandibular angle and its segments during growth].

The mandibular angle, an important roentgenocephalometric parameter, undergoes marked changes during growth and development. The dynamics of alterations of the entire mandibular angle and its two segments was studied in a sample of 200 roentgenograms of eugnathic subjects divided into homologous age groups at 10-year scale intervals to the adult age. For each age group, three roentgenocephalometric variables were statistically processed. Results, presented numerically and graphically, led to a conclusion that the size of the mandibular angle and its superior segment decreased considerably in a defined period of time. A decrease in the values of all variables was clearly seen in both adolescence and postadolescence.

Adolescent↗

PubMed1984

Management of early nasal injuries with long term follow up.

Postnatal nasal injury occurring before full growth results in certain changes in the development of the nose and of the face. An assessment of the role of the cartilaginous nasal septum in this growth has been attempted by observing adults who had dissolution of the cartilaginous septum in childhood. The immediate management of long term follow up care of patients so afflicted is discussed. Also observed into adult life were several patients on whom lateral, medial or transverse osteotomies or combinations of these had been performed in childhood to determine if such procedures interfered with growth of the nose and face.

Abscess↗

PubMed2002

Functional rehabilitation using orthognathic surgery, bone transplants and implants after irradiation of malignancy in early childhood.

Functional rehabilitation has been carried out in four young patients by use of orthognathic surgery, bone grafting and implants. All four patients had been successfully treated for malignant tumours in the midface during early childhood by use of full dose irradiation. Retarded growth of the maxilla together with missing root formation of permanent teeth prevented the alveolar process to develop. Bimaxillary osteotomies with inlay bone graft have been made in two cases and maxillary osteotomy le Fort I with interpositional and inlay grafting in two individuals. Implants surgery has been made in a second stage surgery. A total of eighteen implants has been inserted and during five years follow-up two implants have been lost (survival rate 90%). All patients have been successfully rehabilitated with fixed bridge prosthesis.

Adolescent↗

PubMed1996

Effect of growth and development on human soft tissue facial shape: a Fourier analysis.

Size plays a distorting role in the estimation of facial morphology, because it can mask more subtle shape differences. The conventional metric approach provides adequate quantitative information about size only, ignoring the problems of shape definition. Mathematical methods, such as the Fourier series, allow a correct quantitative analysis of shape and its changes. Methods to reconstruct outlines, starting from selected landmarks, and to allow Fourier analysis of these outlines have been developed. These techniques were applied to analyze the age and gender variations in shape of the soft tissue facial contour (frontal plane projection) in a group of 144 healthy children, aged 6 to 7 years and 9 to 10 years. The mean contours differed for both size and shape; Fourier analysis corrected for the size discrepancy and separated the contributions of size and shape to the global morphology. In particular, the sine component (asymmetry) of the soft tissue facial contour was influenced by both age and gender.

Cephalometry↗

PubMed2006

Ontogeny of facial dimorphism and patterns of individual development within one human population.

Based on a longitudinal study of radiographs of the Denver Growth Study, we investigated the morphological development of individual and gender differences in the anterior neurocranium, face, and basicranium. In total, 500 X-rays of 14 males and 14 females, each with 18 landmarks and semilandmarks, were digitized and analyzed using geometric morphometric methods. Sexual dimorphism in shape and form is already present at the earliest age stage included in the analysis. However, the nature of dimorphism changes with age. Four factors apper to contribute to cranial sexual dimorphism in human postnatal development: 1) initial, possibly prenatal, differences in shape; 2) differences in the association of size and shape; 3) male hypermorphosis; and 4) some degree of difference in the direction of male and female growth trajectories. Studying changes in individuals, we find a low correlation between newborn and adult morphology, while 3-year-olds already show a high correlation with their adult form. We conclude that the adult pattern of interindividual difference in facial form in a single human population is established within the first few years of life.

Child, Preschool↗

PubMed1988

Patterns of vertical growth in the face.

The purpose of this study was to examine the patterns of facial growth development in subjects with skeletal open-bite and skeletal deep-bite faces. Longitudinal data based on lateral cephalometric radiographs of 16 male and 16 female subjects, ages 3 through 18 years, were used. These subjects were selected on the basis of lower face height as a percentage of total face height. Persons exhibiting extreme values were selected to create four groups with eight subjects in each group. Curves of absolute and incremental growth for total anterior face height, upper anterior face height, lower anterior face height, posterior face height, and ramal length were analyzed statistically and graphically. It was established that the anterior dimensions of the face demonstrated typologically divergent patterns of development in open- and deep-bite faces. Further, the posterior dimensions of the face did not discriminate between these two typological groups. The female open-bite subjects were earliest in the timing of the adolescent growth spurt, followed in succession by deep-bite female subjects, open-bite male subjects, and finally the deep-bite male subjects. The clinical implications of these observations pertain to the timing of orthodontic treatment, the length of retention period, and the prediction of adult occlusal status during the mixed dentition.

Adolescent↗

PubMed1980

Condylar trauma and facial asymmetry: an experimental study.

Surgical intracapsular concylar fractures were initiated on young monkeys followed by prolonged intermaxillary fixation in an effort to create facial asymmetry and induce temporomandibular joint ankylosis. Implanted head positioners and metallic bone markers were used to document developing facial asymmetry in all animals. Vertical opening capabilities were fully recovered and the procedures had no discernible functional impact. Slight limitation of movement persisted only in the translation of the damaged condyles. It was concluded that trauma followed by long term fixation had no effect in promoting ankylosis or significant limitation of jaw movement. It is suggested that when considering the role of trauma in the aetiology of ankylosis, attention be given to those factors which may complicate an existing trauma.

Animals↗