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PubMed1992

[The premaxilla and facial growth 68 years later].

The thesis of Dr Etienne Cadenat on the embryology of cleft-lip dates from 1924. From this epoch onwards it was demonstrated that the human premaxilla had a specific development not corresponding to that of other mammals, in whom the suture between the pre- and post- maxilla is active and participates in the sagittal, transversal and vertical growth of the maxilla. Numerous studies have been undertaken to verify that the human premaxilla does in fact exist, and several have gone as far as to conclude in its non-existence. The author restudied the question from the histologic angle, and showed that the zone of union between premaxilla and maxilla did not contain any histologic elements that could identify a growth suture. Indeed, the spatial orientation of this suture would not allow anteroposterior growth. It can be concluded that the human premaxilla does exist but its specificity has again been demonstrated.

Cranial Sutures↗
PubMed2004

The validity of superimposing oblique cephalometric radiographs to assess tooth movement: an implant study.

Assessment of the exact position of the posterior teeth on lateral headfilms is of limited validity because of the superimposition of the 2 sides. Lateral headfilms are also of limited use for evaluating orthodontic tooth movement, especially in cases of asymmetric mechanics. To solve this problem, the oblique cephalometric radiograph, which brings only 1 side of the image into focus, was introduced. We evaluated whether the projection of the cranial base could be used for evaluating facial growth and whether structures that were stable relative to the implants could be identified and thus replace the implants in future evaluations. Thirty sets of headfilms from growing patients with metallic implants were analyzed. Three types of superimpositions were performed. Displacement of the metallic implants in the maxillary complex and the mandible with respect to the superimposed structures of the cranial base was evaluated. When the development of the lateral parts of the facial skeleton was evaluated in relation to the cranial base, the reproducibility of the superimpositioning was significantly better in the vertical-S(e) = 0.41-than in the horizontal plane of space-S(e) = 1.35). The error of the method when superimposed on the stable structures in the maxillary complex varied between 0.31 and 0.72 and did not differ in the vertical and sagittal directions. In the mandible, the stable structures suggested for superimposition of the lateral headfilms were applicable on the oblique cephalometric radiograph-S(e) = 0.33-0.57. Oblique projection is recommended when individual analysis of the 2 sides is needed.

Adolescent↗
PubMed2003

Computational models of oral and craniofacial development, growth, and repair.

This paper illustrates how biological and clinical problems stimulate research in biomedical informatics and how such research contributes to their solution. The computational models described use techniques from Logic Programming, Machine Learning, Computer Vision, and Biomathematics. They address problems in the development, growth, and repair of oral and craniofacial tissues arising in cell biology, clinical genetics, and dentistry. At the micro-level, the dynamic interaction of cells in the oral epithelium is modeled. At the macro-level, models are constructed of either the craniofacial shape of an individual or the craniofacial shape differences within and between healthy and congenitally abnormal populations. In between, in terms of scale, there are models of normal dentition and the use of computerized expert knowledge to guide the design of dental prostheses used to restore function in partially edentulous patients.

Adult↗
PubMed2005

Predicting the development of jaws in patients with complete unilateral cleft of the lip and palate.

The main objective of this study was to find a predictive multivariate model of jaw development in patients with the most frequent cleft malformation, i.e. complete unilateral cleft lip and palate (UCLP). The prediction is urgently needed from the clinical aspect. It will be possible to detect early adversely developing patients upon whom intensive care and adequate orthodontic treatment could be devoted in good time. The study is based on a long-term cephalometric follow-up of lateral X-rays of 48 boys with UCLP during puberty. Using multivariate methods we investigated the relationship of 75 craniofacial characteristics of size, shape and position during the time interval from 10 to 15 years of age. As the prediction of the development of the jaws in patients with clefts is very complicated, we have attempted to find a reliable predictive system. Sagittal intermaxillary relations can be predicted most accurately in the investigated group by means of the angular dimension Ss-N-Sm (A-N-B angle). We suggest using in clinical practice trinomial equations, the coefficient of determination of which varies round 0.80, and thus the position of the variables can be explained with sufficient accuracy (the coefficient of determination 0.64 is considered in orthodontics a value of predictive significance). The proposed predictive technique was successfully tested in a group of 12 patients with the same diagnosis and therapy.

Adolescent↗
PubMed1976

Biology of the rice rat (Oryzomys palustris natator) in a laboratory environment. IX. Preweaning growth of the skull.

The pattern of skull growth of the rice rat (Oryzomys palustris natator) over the pre-weaning period of development reveals a characteristic triphasic outline which stems, in part, from the interplay of the external environment and the genetic endowment. Within the triphasic spectrum the neural skull growth exhibits an accelerated rate of growth during the early phases which eventually reverses to a rapid deceleration in the final phase. In contrast, the facial skull growth shows increased growth rate following the decline of the neural group, eventually reaching a slow linear deceleration. Thus the neural components appear to be synchronised to the brain growth while the facial elements gain a new and greater impetus following the neural decline. The general growth of the skull throughout these changes, i.e. triphasic and neural/facial, continues to show a basic slow linear increase.

Animals↗
PubMed2001

A longitudinal electromyographic study of the postnatal maturation of mastication in the rabbit.

At 2 weeks of age, infant rabbits show chewing movements that resemble those of the adult animal. Previous studies have shown that, at that stage, the accompanying masticatory motor pattern is clearly similar to the suckling motor pattern. As early as 4 weeks, chewing muscle activity is indistinguishable from the adult chewing motor pattern. These reports suggest that the adult chewing motor pattern is developed from the suckling motor pattern. In this study, the chewing motor pattern in the intermediate period (between 2 and 4 weeks of age) was investigated by means of fine-wire electromyography and jaw tracking. Maturation of masticatory movements was found to have two phases. Maximum gape increased in the first few days and was followed by strong development of transverse jaw excursions after the age of 17 days. The increase in jaw excursions was brought about by changes in motor behaviour and facilitated by the development of smooth occlusal surfaces. The changes in motor behaviour were: (1) the level of activity of the balancing-side muscles became more equal to that of the working side; (2) the timing of digastric muscle activity became asymmetrical at the age of 17 days; (3) the peak activity of masseter, temporalis, medial pterygoid and lateral pterygoid muscle portions was gradually shifted or prolonged into the power-stroke phase. It can be concluded that the masticatory contraction pattern shifts from one derived from the suckling contraction pattern at the age of 14 days to one almost similar to the adult chewing pattern at the age of 23 days.

Animals↗
PubMed1991

Biomechanical and clinical changes of the craniofacial complex from orthopedic maxillary protraction.

The present study was designed to investigate biomechanical and clinical changes in the craniofacial complex resulting from orthopedic maxillary protraction by means of finite element and cephalometric analyses, respectively. An analytical model developed from a young human dry skull was used for finite element analysis. Three principal stresses were determined in the complex and its sutures. For evaluating morphological changes of patients, lateral cephalograms taken before and after maxillary protraction therapy were analyzed. Tensile stresses were produced in the maxillary and zygomatic bones in an anterior direction with corresponding compressive stresses in a perpendicular direction. In the sutural systems, compressive stresses were induced by counter-clockwise rotation of the complex. Cephalometric investigation demonstrated that significant improvement of the maxillo-mandibular relationship was obtained by maxillary protraction, however, maxillary growth and repositioning were not as great when compared to mean growth in the control group.

Adolescent↗
PubMed1992

Facial growth during adolescence in early, average and late maturers.

The relative stage of maturity of a child may be determined by comparing the child's hand-wrist radiograph to known standards of skeletal development. Hand-wrist radiographs of 70 adolescents were used to categorize the individuals by skeletal maturation into early, average and late maturation groups using the Fishman SMA method of assessment. The rates of mandibular and maxillary growth relative to the last stages of the pubertal growth spurt were measured. Statistical evaluation of the data was performed using an analysis of variance. The magnitude of change in growth increments of the mandible was greater in the late maturers than in the early or average maturers. Incremental differences in growth between the maxilla and mandible during the last stages of puberty were noted, with the mandible growing significantly more than the maxilla.

Adolescent↗
PubMed1990

[Orthodontic treatment in a cleft palate-cleft lip case with severe maxillary collapse].

The cleft lip and palate cases are the most frequently seen congenital deformities. Retardation of the maxillary development and collapse are the most significant characteristics in these cases. It is aimed to correct the functions like mastication, deglutition and speech which were disturbed due to anatomic deficiency and to obtain an acceptable occlusion and esthetics, by means of the therapy. As much as the preoperative orthopedic procedures applied just after the birth, the orthopedic and orthodontic appliances used in mixed and permanent dentition periods affect the prognosis in these cases. The purpose of the treatment in permanent dentition is to correct the malocclusion and to prepare the dentition to prosthetic restorations. In this article the orthodontic treatment of a case in permanent dentition, with cleft palate and lip characterized with severe maxillary collapse will be presented.

Adolescent↗
PubMed1978

The vomero-premaxillary suture--a neglected growth site in mid-facial development of unilateral cleft lip and palate patients.

The growth capacity of the vomero-premaxillary suture (VPS) was analysed as this growth site, sometimes exposed during cleft surgery, is usually unrecognized in the patient's mid-facial development. Metallic implants were inserted on both sides of the suture in eight infants with unilateral cleft lip and palate at the time of the first surgery. The patients were followed roentgencephalometrically to the age of three years. Growth between the vomer and premaxilla was recorded in every case, with growth being especially marked during the first year of life. The horizontal increment of growth between the pins was greater than the vertical increment. On the basis of these findings, it was proposed that surgery which seriously impedes or stops growth in the VPS is likely to be an important factor in the etiology of the mid-facial retrusion that is sometimes seen in patients with unilateral cleft lip and palate.

Bone Transplantation↗
PubMed1985

The common developmental origin and phylogenetic aspects of teeth, rugae palatinae, and fornix vestibuli oris in the mouse.

Positional and temporal information is of fundamental importance in understanding the morphogenesis of dentition. In order to determine the fate of epithelial cells localized within specific epithelial thickened regions of the forming mouse maxilla, we analyzed serial histological sections in the frontal plane mouse embryos of 12-15 days' gestation. The epithelial thickening of the oral surface of the maxilla from 12-day embryos was spatially delineated and termed the odontogenic epithelial zone (OEZ). Beginning with 12-day embryos, analyses of camera lucida drawings indicated that the OEZ dissociates into anterior (diastema region) and posterior (molariform tooth organ region) epithelial aggregates that form plate-like configurations. The epithelial plates subsequently divide in a mediolateral direction into the epithelial anlagen of rugae palatinae, teeth, and fornix vestibuli oris superior. The medial and lateral parts of the m1 epithelial anlage are situated in dorsal continuation of both the dental and vestibular laminae of the diastema region. The anlage appears to be of dual origin. The fornix vestibuli oris superior develops from two parts: in the rima oris region from the lip-furrow lined with the vestibular lamina, and in the cheek region from the cheek-furrow in place of fusion of the maxillary and mandibular outgrowths. In 15-day embryos with well-formed secondary palates, the rugae occur, numbering nine on each palatal process. The m1 enamel organ cup excavation is positioned between the level of the fifth extending to the seventh rugae. It appears that the division of the maxillary outgrowth oral epithelial covering into rugae as well as into the dentition anlage is closely related. It is suggested that rugae, the vestibulum oris, and the dentition are developmentally and functionally related, and appear to have a common precursor in both ontogenesis and phylogenesis.

Animals↗
PubMed2004

Genetics of cleft lip and palate: syndromic genes contribute to the incidence of non-syndromic clefts.

Clefts of the lip and/or palate (CL/P) are among the most common birth defects worldwide. The majority are non-syndromic where CL/P occurs in isolation of other phenotypes. Where one or more additional features are involved, clefts are referred to as syndromic. Collectively CL/P has a major clinical impact requiring surgical, dental, orthodontic, speech, hearing and psychological treatments or therapies throughout childhood. The etiology of CL/P is complex and thought to involve both major and minor genetic influences with variable interactions from environmental factors. Using a combination of gene targeting technology and traditional developmental techniques in both mouse and chick, significant progress has been made in the identification of numerous genes and gene pathways critical for craniofacial development. Despite this, it has been a particular source of frustration that mutation screening of specific candidates, association studies and even genome-wide scans have largely failed to reveal the molecular basis of human clefting. Nevertheless, some important findings have recently come from studies involving syndromic forms of the disorder. These include several genes which have now been shown to contribute a major effect on the etiology of CL/P. Furthermore, these genes can also be used to demonstrate a significant overlap between syndromic and non-syndromic CL/P. The study of these syndromic genes and their molecular pathways will provide a useful and informative route with which to gain a better understanding of human craniofacial pathology.

Cleft Lip↗
PubMed1994

The prediction of restoration of a positive overjet in unilateral cleft lip and palate.

X-ray cephalometric studies were carried out repeatedly in 92 individuals with unilateral cleft lip and palate at the age of 10 and 15 years with investigations of a possible restoration of a positive overjet in relation to the development of sagittal interalveolar relations. On the basis of this analysis was constructed a nomogram which according to the age of the patient allows to use a single easily determined X-ray cephalometric parameter for the estimation of the risk of a failure of the management aimed at the restoration of a positive overjet. The system includes critical boundaries which should be attained in the course of the treatment for the restoration of a positive overjet and it provides the possibility to check the effects of all therapeutic procedures. The simple application of the nomogram and the easy collection of data (the age and sagittal interalveolar relations) allow its use in the clinical practice as a component of the documentation on the management of the patient.

Adolescent↗
PubMed2005

Development and testing of multilevel models for longitudinal craniofacial growth prediction.

INTRODUCTION: The aims of this study were to (1) develop longitudinal growth curves that would allow individual variations to be accurately modeled and (2) use these models to predict craniofacial growth changes in children with varying amounts of longitudinal data available. METHODS: Based on a sample of 159 girls (994 cephalograms) and 128 boys (947 cephalograms), multilevel population models were derived. Polynomial models of the population's growth curve were derived for the measurements MPA, Me-X, Me-theta, Me-Y, and Me-R. Angular and horizontal measures (MPA, Me-X, and Me-theta) were described by simpler, second-order models, and vertical measures (Me-Y and Me-R) were described by more complex, fifth-order models. RESULTS: Decreases in MPA during childhood and increases in Me-theta during adolescence could be explained by the relative contributions of the horizontal (Me-X) and vertical (Me-Y) movements of menton. There was greater anterior movement of menton during childhood and greater inferior movement during the adolescent growth spurt. By using varying numbers of longitudinal cephalograms between 6 and 10 years of age, the models were used to predict subjects' craniofacial growth changes from ages 10 to 15. Based on correlations, root mean squared error, and percent accuracy, individual growth predictions for the various measures were found to be highly accurate on an independent subsample drawn from the larger sample and on an independent validation sample. Correlations between predicted and actual values on the sample used to develop the models ranged from 0.81 to 0.95. Accuracy was best for the measurements that changed the most during the prediction period (Me-Y and Me-R), with accuracies between 83% and 90%. More longitudinal data did not increase the predictive accuracy for all measurements. The models that were least accurate (Me-X, MPA, and Me-theta) showed the greatest improvement in prediction accuracy with more longitudinal data. These improvements ranged from 1.6% to 15%. CONCLUSIONS: Longitudinal growth curves based on multilevel procedures can accurately describe population and individual growth curves, and 5-year predictions with this method are highly accurate and externally valid.

Adolescent↗
PubMed1983

A longitudinal study of delayed periosteoplasty to the cleft alveolus.

The effects of delayed periosteoplasty were studied longitudinally from 5 to 17 years of age in 35 consecutive cases (24 boys and 11 girls) with clefts involving the maxillary alveolar process. The mean age at operation was 6.4 years. In patients younger than 7 years of age at the time of delayed periosteoplasty, good bone formation developed in 80%, compared with 47% after infant periosteoplasty. After delayed periosteoplasty the formation of new bone continued an average of 5 years postoperatively. The frequency of anterior crossbite was lower than that reported for other Scandinavian cleft lip and palate materials of the same age and type of cleft. Cephalometric analysis indicated that growth of the facial skeleton of the patients in the present material was well within the limits reported for the above-mentioned Scandinavian materials subjected neither to periosteoplasty nor to bone-grafting. The results indicate that delayed periosteoplasty might be a superior method in the reconstruction of the alveolar cleft in young individuals.

Adolescent↗
PubMed1985

Dentofacial maturation of untreated normals.

Cephalometric head films from a sample of 65 untreated normal persons were evaluated to determine the nature and extent of the normal dentofacial maturation process. Thirty-four parameters were examined in the mixed dentition (9 to 10 years), the early permanent dentition (12 to 13 years), and early adulthood (19 to 20 years). Results showed the importance of maxillary development, particularly in the vertical plane, as it was associated with the amount and direction of sagittal mandibular growth. "Late mandibular growth" was found to be a forward (bite-closing) rotation of the mandible that occurred after the cessation of vertical maxillary growth. Condylar growth amount and direction were influential in determining the degree of sagittal mandibular change. The degree of forward (bite-closing) mandibular rotation was strongly associated with the amount of both maxillary and mandibular molar eruption. Incisor positions were found to remain relatively constant, showing compensations for the amount and direction of skeletal growth. No correlations or predictions of clinical value were found between the cephalometric parameters examined and previously recorded dental-cast variables.

Adolescent↗
PubMed1977

Facial and visceral arch development in the mouse embryo: a study by scanning electron microscopy.

The morphogenesis of the face and visceral arch region were studied by scanning electron microscopy in 63 mouse embryos between 8 and 13 days post coitum. The developmental stages were determined by reference to Theiler's (1971) scheme for the categorization of the normal stages of development. After the cervical fold is formed (stage 12) the mandibular primordium appears (stage 13) followed by the primordia of arches II and III (stage 14 with arch IV forming last (stage 15). Arches II, III and IV regress in reverse order, with no evidence that a cervical sinus pouch is formed. Placodes of the sensory ganglia from cranial nerves 7, 9 and 10 are formed in the first, second and third visceral grooves respectively. Formation of the external auditory meatus and its surrounding tubercles were also observed. Morphogenesis of the upper face is dominated by the midsagittal grove, which extends into the stomatodeum; and by the medial nasal, lateral nasal and maxillary processes. The temporal changes in shape and the interrelationships of the structures mentioned are described in detail.

Animals↗
PubMed1997

Association between facial height development and mandibular growth rotation in low and high MP-SN angle faces: a longitudinal study.

Two groups of children with low (n = 29) and high (n = 29) MP-SN angles were followed longitudinally from 6 to 15 years of age. The purpose was to thoroughly examine associations between vertical craniofacial growth and mandibular growth rotation. Correlations between dimensional and rotational variables occurred in different variable pairs in the two groups and changed with age. Increase in posterior lower facial height distinguished itself by being consistently positively correlated with forward matrix rotation irrespective of mandibular plane angle or age. The same applied to increase in ramus height. Increase in lower anterior facial height was, surprisingly, weakly correlated with mandibular rotation, but strongly and positively correlated with increase in corpus length. Overdevelopment of lower anterior facial height in high angle cases occurred because the steep mandibular plane directed corpus growth more downward than normal, not because the mandible rotated backward.

Adolescent↗