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PubMedDate not supplied

Familial osteodysplasia.

A family with characteristics that have striking similarities to the syndrome of familial osteodysplasia is reported. The inheritance pattern appears to be autosomal dominant. The typical facies has a lack of vertical facial development and a functional prognathism caused by overclosure of the mandible and opening of the gonial angle. Midfacial hypoplasia and a pointed chin are characteristic. Alveolar and sutural bone growth in the face is diminished and associated with partial dental agenesis. Variable cranial digital markings and possible synostosis are also seen. These typical facial changes are associated with other bony and systemic abnormalities. The long bones have a flask shape and occasionally have increased cortical thickness. The superior pubic ramus is often thin and scoliosis is common. The dermatoglyphic pattern demostrates a distal triradius and small whorl abnormalities. The most significant laboratory values are an increased erythrocyte sedimentation rate and C3 complement found on the erythrocytes. The plasma fibrinogen level was low in all family members.

Adult↗
PubMed2005

A prospective study of the short-term treatment effects of the acrylic-splint rapid maxillary expander combined with the lower Schwarz appliance.

This prospective clinical study evaluated the short-term treatment effects of acrylic-splint rapid maxillary expander in conjunction with lower Schwarz appliance (RME-Sz) therapy to the acrylic-splint rapid maxillary expansion alone (RME-only group). Pretreatment and posttreatment lateral cephalograms were analyzed for 25 RME patients and 19 RME-Sz patients. The average time between films ranged between nine and 12 months. Statistical comparisons of the treatment changes in the RME-only and RME-Sz groups were performed by means of independent sample t-tests (P < .05). The largest difference between the two groups was in lower anterior facial height (LAFH). The normally occurring increase in LAFH was not observed in the RME-only group during the treatment period, indicating that the acrylic-splint expander had a posterior "bite block effect" on the developing craniofacial complex. LAFH increased by 1.7 mm in the RME-Sz group, a value similar to that observed in untreated individuals. Slight forward displacement of the maxilla was observed when RME was used alone, and the sagittal position of the maxilla remained unchanged in the RME-Sz group. A significant amount of intrusion of the maxillary molars (-0.8 mm) was noted in the RME-only group, whereas the maxillary molars were prevented from erupting in the RME-Sz group. The lower dentition showed a significantly greater amount of extrusion in the RME-Sz group than in the RME-only group. Finally, the Sz appliance prevented the mesial movement of the lower molars during the treatment period.

Acrylic Resins↗
PubMed1986

Craniofacial morphology in unilateral cleft lip and palate prior to palatoplasty.

Roentgencephalometric studies were carried out in 30 boys with unilateral cleft lip and palate approximately five years of age, none of whom had had a palatoplasty. A comparison with 27 normal individuals matched in age showed that most basic deviations of the craniofacial configuration recorded in adults developed at an early age, often prior to palatoplasty, i.e., reduced height of the upper face, maxillary dentoalveolar retroinclination, displacement of the upper jaw backwards, widening of some components of the maxillary complex, and a shortening of the mandibular body and ramus associated with changes in the mandibular shape. Only the length of the upper jaw was not reduced. The shortening of this dimension occurred postoperatively at a more mature age. The described basic deviations exerted untoward effects on further facial parameters (proportions, retrusion of the jaws, limitation of anterior growth rotation, maxillomandibular and other interrelations, and malocclusion). The height of the upper lip showed a similar shortening as in adults, but lip thickness was not reduced. There was good prominence of the upper lip.

Cephalometry↗
PubMed1977

[Quantitative analytical registration of body-length growth in man].

Measured values concerning the body hight growth process of male human beings, and reaching from praenatal to adult state are taken from anthropometric literature. After a discussion of the mathematical tools for description (differential equation, analytical function), and of the problems connected with subdividing the whole growth period in subsequent periods the results of numerical adjustments of growth functions to measured courses of these subperiods are presented. The obtained goodness of fit is excellent so that for the purpose of formal quantitative description of the whole growth process a set of mathematical functions is available. Each of these expressions is effective only in the time interval of the corresponding growth subperiod. This set of mathematical functions will provide a objective basis for further investigations, especially for comparisons between populations, and for a mathematical analysis of acceleration phenomena in development. In the last part of the paper a mathematical-phenomenological model for the growth process is sketched. The main features of this model consist in a subdividing of the whole process in growth parts with a biological meaning, and in a mathematical description of these parts which are mutually independent but superposing one with another. Therefore the number of growth parts and also of mathematical terms are determined by biological (theoretical or phenomenological) arguments. Now each of these calculated function terms is valid for the whole time intervals in which the body hight growth process performs. The entirety of all these terms gives a seamless steady description of the changes of the growth variable in time.

Adolescent↗
PubMedDate not supplied

Facial development, continuous tooth eruption, and mesial drift as compromising factors for implant placement.

The replacement of teeth lost by children because of trauma can be an important indication for early implant therapy. Osseointegrated dental implants, like ankylosed teeth, alter position as growth-related changes occur within the jawbones (displacement, remodeling, mesial drift). Facial growth of the child and even of the adolescent, as well as the continuous eruption of the adjacent anterior teeth, create significant risk of a less favorable esthetic and/or functional outcome. For patients with a normal facial profile, the placement of an implant should be postponed until growth is complete. For patients with a short or long face type, further growth, especially the continuous eruption of adjacent teeth, creates a serious risk even after the age of 20 years, as illustrated by some recent clinical studies. This review aims to explain these phenomena and provides some recommendations for implant placement.

Adolescent↗
PubMed1994

Treatment effects on facial development in patients with unilateral cleft lip and palate.

Retrospective studies into the effects of some aspects of treatment on facial development were based on x-ray films obtained in 58 men with unilateral cleft lip and palate operated on by palatal pushback. Because of mandibular retroposition, individuals subjected to systematic orthodontic treatment had better sagittal jaw relations and occlusion of incisors than insufficiently treated patients. The retroposition was attained with orthodontic proclination of upper incisors leading to a positive overjet and retraining the anterior development of the mandible. In patients with complete clefts operated on at about 6 years of age, sagittal jaw relations were more favorable than in those who had surgical repair at 4 years of age. The superior results in the group operated at a later age were due, in part, to the slighter retrusion of the maxilla. These differences were not apparent in incomplete clefts nor in patients with isolated cleft palate reported earlier. On the basis of these observations, a differentiated approach was proposed for determining the most convenient age for palatoplasty, according to individual types of clefts and their extent. The findings provided evidence of the essential role of orthodontic therapy for the configuration of the lower face in clefts.

Adult↗
PubMed1984

Hypertelorism and the median cleft face syndrome. An embryological analysis.

A microscopical study of the early and late development of the face was performed in 77 human embryos and fetuses. After the transformation of both nasal placodes, via nasal grooves, into the nasal tubes the ectoderm of the face is closed superficially and the early development of the face (less than or equal to 17 mm crown-rump length (C-RL)) is terminated. Between the nasal tubes the internasal groove is present. Furthermore these embryos show physiologically a flat nose and hypertelorism. During the late development (greater than or equal to 17 mm C-RL) of the face the internasal groove disappears due to the outgrowth and differentiation of the nasal septum in the frontocaudal direction. Simultaneously (17-27 mm C-RL) the distance between the eyes decreases relatively, because of a relative lag in transverse growth. The differentiation of the facial mesenchyme into bone centres starts in the same period. From this embryological point of view the major anomalies of the median cleft face syndrome (hypertelorism--orbital as well as interorbital--and cranium bifidum occultum, median cleft nose, median cleft prolabium and median cleft premaxilla), can be classified as secondary or late, i.e., differentiation, defects.

Bone Diseases, Developmental↗
PubMedDate not supplied

Cytochemical identification of HSP110 during early mouse facial development.

Apoptotic cell death constitutes a common phenomenon observed during development. This process plays an important role in the regulation of cell populations and in early differentiation of embryonic organs. Several teratologic situations are considered as resulting in a dramatic increase of the apoptotic process. In mammalian cells, heat shock proteins (HSPs), expressed or increased in response to various stresses, act as molecular chaperones in physiological conditions. In order to determine specific histochemical markers of apoptotic cells in normal craniofacial development, we observed the expression of stress proteins (HSPs) 70, 86, and 110. The apoptotic pattern of mesectodermal cell death areas was confirmed using both nuclear staining (Feulgen) and specific labeling of DNA fragmentation (TUNEL). These areas are localized in the proximal parts of the first and second visceral arches. They are located in mesectodermal and ganglionic cells. Apoptotic mesectodermal populations strongly express HSP110, as shown by the cytochemical identification of HSP110 and by double staining HSP110-TUNEL, suggesting that this protein could be considered as a new marker for apoptotic embryonic cells, and could be used in further teratologic studies to better quantify induced cell death.

Animals↗
PubMed1995

Sinus and facial growth after pediatric endoscopic sinus surgery.

OBJECTIVE: To determine the effect of functional endoscopic sinus surgery (FESS) on facial skeletal growth in children. DESIGN: Prospective randomized controlled animal study; retrospective histopathologic study of pediatric FESS specimens. SETTING: Academic tertiary referral medical center. PARTICIPANTS: Eight newly weaned piglets; uncinate and ethmoid bone of FESS specimens from 84 children. INTERVENTIONS: The piglets underwent unilateral FESS. When they had developed to nearly adult size, computed tomography was used to compare facial and sinus development between the surgical and nonsurgical sides. The paranasal sinus contents from children were histologically examined to analyze bone types with respect to patient age. OUTCOME MEASURES: Sinus development and facial skeletal growth after FESS in piglets; histologic maturity of sinus bone in children. RESULTS: Facial growth in piglets was significantly reduced on the side treated by FESS. When compared with the side that did not undergo the operation, growth reached only 57% in the maxillary sinus and 65% in the ethmoid region. Children younger than 9 years had woven (immature) bone; children 9 years and older had predominantly lamellar (mature) bone. CONCLUSIONS: This preliminary study shows that even limited surgery in the anterior ethmoid region can affect sinus and facial growth in the piglet. Review of corresponding human histologic specimens suggests that further investigation is warranted to rule out the possibility of facial and sinus growth disturbance after this surgery in children.

Adolescent↗
PubMed1998

Interrelationships of brain, cranial base and mandible.

The purpose of this study is to evaluate the neural and masticatory growth factors that contribute to the development of the cranial base. Cephalometric and submentovertex (SMV) radiographs of 66 adult human skulls, of Caucasian (India) origin and unknown gender were used in this study. Results indicate that the cranial base, posterior to the foramen caecum, develops in response to brain growth. The part anterior to the foramen caecum develops in response to the mandible. Our findings indicate that: 1. the glabella instead of the nasion should be considered as the most anterior point of the cranial base. Mandibular dimensions (the height and the length) have a better correlation with CG than CN. 2. Instead of a single parameter, sella-nasion (SN), two parameters, the foramen caecum-glabella (CG) and the foramen caecum-sella (CS) should be considered. In cephalometry the more stable line CS, rather than SN, can be used for registration of successive radiographs; 3. The typical mandibular retrognathia, and/or the decrease in the posterior height (ascending ramus) of a Class II malocclusion could be explained by their positive correlation with SB (sella-basion) and the negative correlation with angle GSB.

Adult↗
PubMed1989

[Maxillo-mandibular sagittal relations in the lateral facial examination].

For the purpose of developing a clinical method of facial examination that could permit a determination of the skeletal position of the upper jaw and the mandible, a sample of 70 teleradiographies of individuals among 8 and 18 years of both sexes was analyzed. The anteroposterior relationship of the maxila to the cranium was analyzed through perpendiculars from skin points Nasion, Glabela and Subnasal to the Frankfurt horizontal plane and it was found that Glabela was 2 mm behind Subnasal. The anteroposterior position of the mandible related to the maxila was studied on a perpendicular to Tragion-Subnasal plane descended from point Subnasal and it was found that the labiomental fold was coincident with this perpendicular. A new clinical method using a square rule leaned on the cheek using these reference points is recommended.

Adolescent↗
PubMed1989

[Cauhépé-Fieux syndrome. Interception in the deciduous dentition of mid-face hypoplasia].

Inadequate transverse development of the milk dentition alveolar arcade (Cauhepe-Fieux syndrome) may have important effects on the constitution of facial architecture and in the medium term require orthognathic surgery. The acquisition of dental arcade contact on deglutition is only possible after normalization of the dimensions of the arch of the palate. The recommended suture inducing prosthesis should obligatorily include intercalating molar plates designed to overcome inadequate occlusion during treatment (on average 9 months). Both stimulation of growth at the level of the intermaxillary suture in this age group, and the stability of the results obtained, have been demonstrated after a period of follow up of more than 10 years taking into account the cybernetic aspects of the studies carried out by Professor Petrovic.

Child, Preschool↗
PubMed1988

The growth and development of the soft tissues of the human face.

The complexity of shape, soft nature of the facial tissues and the sensitivity of the eyes make their accurate direct measurement difficult. Short base stereophotogrammetry is three dimensional and non-invasive. This technique was used to measure the faces of 52 like-sexed twins between the ages of 9 and 16 years in a mixed longitudinal study. Certain vertical and horizontal parameters defining the eyes, the nose, the mouth and overall facial shape were remeasured and plotted for this study. Relative to the intercanthal line, the alae of nose and angles of mouth are displaced by growth, on or very near to straight lines which were not parallel, indicating a small change of proportion between nose and mouth. Their steepness is a measure of the dominance of vertical over lateral growth. Knowledge of normal growth changes will help to predict soft tissue changes produced by orthodontic or surgical treatment in the faces of children.

Adolescent↗
PubMed2005

Determinants of successful treatment of bimaxillary protrusion: orthodontic treatment versus anterior segmental osteotomy.

The purpose of this study was to investigate the differences in initial skeletal, dental, and soft tissue characteristics of bimaxillary protrusion (BP) patients to determine poor or good results with orthodontic treatment (OT) or anterior segmental osteotomy (ASO) with extraction of four first premolars. Lateral cephalometric radiographs of 46 adult Korean females with BP were analyzed before treatment (T0) and after treatment (T1). According to the measurements at T1, patients were classified into group 1 (poor result with OT, n = 12), group 2 (good result with OT, n = 11), group 3 (poor result with ASO, n = 5), and group 4 (good result with ASO, n = 18). Sagittal, vertical, dental, and soft tissue variables were measured. The differences at T0 among the four groups were compared by one way analysis of variance test and verified by Scheffe's multiple comparison test. Stepwise discriminant analysis was performed to find decisive predictors. Skeletal class II malocclusion tendency, less developed chin, and vertical facial growth pattern were related with group 1. Overly uprighted and less protrusive upper and lower incisor, near normal interincisal angle (IIA), less protrusive upper lip, and more obtuse lower nasolabial angle (NLA) were related with group 3. IIA, U1-NA distance, combination factor, interlabial gap, lower NLA, pterygomaxillary fissure-N, and posterior nasal spine-anterior nasal spine were selected as significant variables for discriminating the four groups. The percentage of correctly classified cases was 91.3%. In particular, the discriminant function showed the highest accuracy in the prediction of group 4. These variables and discriminant functions contributed to the differential diagnosis on BP to make a procedural decision between OT and ASO.

Adult↗
PubMed1996

Fourier analysis of cephalometric shapes.

Craniofacial growth and development involve both size and shape variations. Shape variations can be assessed independently from size using mathematical methods such as the Fourier series. A method for the reconstruction of outlines starting from selected landmarks and for their Fourier analysis has been developed and applied to analyze the age differences in shape in the tracings of the Bolton standards (lateral view) from 1 to 18 years of age. The size-independent shape of the Bolton standard at 18 years was larger at the chin, at the gonion, and in the anterior cranial base than the shape at 1 year of age. Conversely, the younger shape was larger in the middle part of face, corresponding roughly to the maxillary bone, than the older shape. When standardized for size, growth thus seemed to modify craniofacial shape with progressive lengthening and narrowing. This shape effect was largely overwhelmed by the very evident size increments, and it could be measured only using the proper mathematical methods.

Adolescent↗
PubMed1997

Effect of upper-airway passages on craniofacial growth in an animal model: a pilot study.

OBJECTIVE: The process of postnatal growth and development of the face and skull is of major interest to otolaryngologists. Surgery is often considered as an option for the treatment of benign and malignant tumours, traumatic facial deformities, and congenital abnormalities of the head and neck in children and adolescents. The extent of surgery and the type of reconstruction is frequently influenced by concerns about the potential effect on future craniofacial growth. Surgery is also sometimes recommended as a method to influence facial growth as in tonsillectomy and adenoidectomy for 'adenoid facies syndrome.' There are a number of different theories concerning the factors that influence the growth of the face and cranium. None of these is universally accepted. The predominant theory is the functional matrix theory. This study was designed to evaluate the validity of this theory in an animal model. A new animal model had to be developed to perform the study. This pilot study was then conducted. METHOD: A laryngotracheal separation procedure was performed on juvenile goats. This effectively eliminated the use of the upper airway by the animals, thereby removing one of the major functional matrices from the model. The animals were allowed to grow. A control group was used, and comparisons were made between the two groups. RESULTS: The results of the study suggest that the functional matrix theory is not valid in this experimental model. CONCLUSIONS: Further research is required to confirm this finding. This would have important implications for our understanding of the biology of craniofacial growth and have clinical ramifications for otolaryngologists and other clinicians with an interest in the head and neck.

Adolescent↗
PubMed1988

Effects of nasal obstruction on facial development.

The relationship between nasal obstruction and facial growth is controversial. Much of the controversy relates to the lack of sophistication in quantifying nasal versus oral respiration and the lack of longitudinal data. Nevertheless, a number of studies in laboratory animals, nonhuman primates, and humans have shown a relationship between nasal airway obstruction and aberrant facial growth. In monkeys, occlusion of the nares with silicon plugs triggered deviant muscle function and altered morphogenesis. In general, the nasally obstructed animals had longer faces and unusual dental malocclusions. In human studies allergic, mouth-breathing children have longer, narrower faces and retrognathic jaws, compared with control subjects. Medical intervention has not been shown to influence the pattern of facial growth in children with allergies. Surgical therapy to relieve nasal airway obstruction in children (whether adenoidectomy or turbinectomy) has not been shown to predictably affect ultimate facial form. Therefore, although an increasing body of literature demonstrates a relationship between nasal airway obstruction and facial growth, the clinician should be cautious in prescribing aggressive therapy or in promising dramatic results.

Adenoidectomy↗
PubMed1996

Quantitative evaluation of correlation of skull morphology in families in an attempt to predict growth change.

The purpose of the present study was to obtain quantitative values for human skull structures in a cross-sectional analysis of offspring and their parents. The offspring were classified into three groups according to age. For each of 11 maxillo-facial and nine dento-alveolar structural angular measurements, the mean and SD were calculated for each set of paternal, maternal, midparent and offspring. The standard deviation unit (SDU) values were calculated from the disparity between the measured value in a given individual, i.e. father, mother, midparent, offspring, and their corresponding group mean value. Three disparity values (D.v.), expressed by the difference between the SDU values in each pair (father-offspring, mother-offspring and midparent-offspring), were developed to evaluate the degree of familial resemblance for each of 20 morphometric measurements, and the differences among these values in three age groups were then investigated. The similarity ratio (S.r.), expressing the degree of correlation to the father and mother, was derived by processing the D.v. The relationship between the maxillo-facial S.r. and the dento-alveolar S.r. was analysed in each age group. There were significant differences between the D.v. in families and those in unrelated control groups. Consistency between the S.r. for maxillo-facial and that for dento-alveolar measurements was found in the older age groups. It is concluded that individual growth of skull morphology might be more predictable using the present method.

Adolescent↗