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PubMed1984

An allometric network model of craniofacial growth.

This study of cranial skeletal growth kinematics details the conceptual principles underlying the development of an allometric network model of such growth. This model is tested by the analysis of longitudinal rat and cross-sectional human growth data and by comparison of this model with a previously described allometric centered model. It is shown that the network model is superior to the centered model in three ways: (1) The allometric network model permits growth prediction when allometric constants are known; (2) the network model has significantly smaller errors than the centered model; and (3) the network model is capable of displaying growth kinematics of both the neural and facial skulls while in time there are marked transformations, such as relative rotations of two sets of cranial anatomic points.

Adolescent↗
PubMed1992

Middle ear effusion: an orthodontic perspective.

Deviations in facial form are discussed. On the basis of previously published hypotheses, it is suggested that oropharyngeal development may be influenced by the posture, and function of the tongue, lips, and jaws. Attention is drawn to the relationship between a firm tongue to palate swallow, and the pump action of the palatine aponeurosis, which it is suggested is necessary for the aeration of the Eustachian tube. The pump action appears to be reduced in long faced adenoidal children, but clinical evidence suggests that it can be regenerated by early Orthotropics (growth guidance) aimed at directing facial growth forward, instead of downward. Any reduction in the height of the face, facilitates an improved lip seal, without which the downward pattern of facial growth is likely to continue. On occasions when these objectives are achieved it would seem that sufficient room is created to align all 32 teeth, with excellent facial form, and little otolaryngological pathology.

Adolescent↗
PubMed1997

Size and shape of soft-tissue facial profile: effects of age, gender, and skeletal class.

OBJECTIVE: A method for the quantitative and qualitative analysis of the facial soft-tissue profile has been developed, and applied to analyze the pretreatment lateral head films of 240 orthodontic patients aged 8 to 14 years. METHODS: Patients were subdivided for sex, age, and skeletal class. To standardize for different facial sizes, soft-tissue profiles from nasion to pogonion were traced in polar coordinates without modifications of facial shape, and standardized for an equal skeletal vertical dimension. RESULTS: The method allowed a simple and rapid quantitative evaluation of soft-tissue profiles during facial growth. An approximate evaluation of the soft-tissue thickness at nose, lips, and chin was also possible. No particular mathematical knowledge was required at any step of the analysis. CONCLUSIONS: Facial soft-tissue size and shape were influenced by age and sex, and to a minor extent by skeletal class.

Adolescent↗
PubMed1989

[The effect of cervical headgear on the cant of occlusal plane].

With the purpose of investigating the effect of cervical headgear on the cant of the occlusal plane; 7 males and 13 females as the experimental group, 7 males and 13 females as the control group summing up to a total of 40 individuals were included in this study. The experimental group was composed of 20 subjects whose cronological age mean was 9 years 11 months and 13 had skeletal class 1 structures where the remaining 7 had skeletal 2 structures and all had clinically diagnosed as Angle Class II, 1 malocclusion cases while the lack of space in the upper arch was lower than 6 mm. In order to be able to identified the difference which might occur by growth and development, a control group of 20 subjects of which 13 had skeletal class 1, the remaining 7 had skeletal class 2 structures, was included in the study. Cervical Headgear which the outher bows ended at the projection of the distal points of the upper first permanent molars were bent parallel to the occlusal plane was applied to the experimental group. Extraoral force of 600 gr. was applied for 16 hours per day. A total of 80 cephalometric radiographs of all subjects included in this study were taken before and after the research period. The SN/Occ. plane angle which indicates the cant of occlusal plane was traced on the cephalometric radiographs. The cephalometric radiographs taken before and after the research period were locally registered for both maxilla and mandibula separately.(ABSTRACT TRUNCATED AT 250 WORDS)

Cephalometry↗
PubMed1979

Effects of orthodontic intermaxillary class III mechanics on craniofacial structures. Part II - computerized cephalometrics.

The relation between active growth and induced anatomic changes was examined using a computerized cephalometric analysis of ten Class III cases treated with intermaxillary traction. The following can be concluded from this investigation: 1. Mandibular growth was redirected and mandibular opening was observed due to maxillary molar extrusion and counterclockwise rotation of the maxilla. 2. Condylar repositioning was noted to occur in all cases due to the effect of the external pterygoid muscle and a possible translatory movement during mandibular rotation. 3. Counterclockwise palatal development occurred in most of the treated cases through vertical action of the Class III mechanism. 4. The effect of the Class III traction was also observed in the mandibular incisor and molar teeth. The incisors retruded and the molars either were located in the predicted position or farther distally. 5. The soft tissue profile was less concave than the predicted value due to less mandibular growth and more retruded incisors in the treated cases. 6. Evidence was shown that a positive relationship exists between computerized cephalometrics and photoelastic techniques in the analysis of ten treated cases. This relationship is based on the fact that specific changes which took place during treatment were found to be consistent with the results of the photoelastic analysis.

Cephalometry↗
PubMed1997

Variation of nasal respiratory pattern with age during growth and development.

The purpose of this study was to determine changes in nasal respiratory pattern with growth and development, particularly to determine the age where upper airway growth ceases. The results on 361 healthy subjects, aged 7 to 24 years, based on aerodynamic measurements during rest breathing, showed clear differences between inspiratory and expiratory phases. Nasal airflow rate and cross-sectional area increased and oral-nasal pressure and nasal resistance decreased with age up to the age of 16, levelling by the age of 20 years. The body size and gender had effect only on nasal airflow rate. This study suggests that the measurements of the nasal respiratory pattern, determining impaired nasal airway, should be done during inspiration and using age-related assesment from a healthy population until the age of 16 years. From then on, guidelines for adults are applicable.

Adolescent↗
PubMed2000

Change in the inclination of the occlusal plane during craniofacial growth and development.

The aim of this study was to examine the change in the occlusal plane inclination that takes place during craniofacial growth relative to various facio-cranial reference lines, as well as to find possible differences in means between sexes, to determine if there were correlations among variables, and to find out which of the parameters were the most reliable in determining the occlusal plane inclination. The investigation was carried out on 192 lateral radiographs of subjects divided into five age groups. The radiographs were traced and six angular roentgencephalometric variables were analysed by using different reference lines: cranial base (OLNS), Frankfort horizontal (OLFH), maxillary base (OLPL), mandibular base (OLML), anterior face height (OLNM) and posterior face height (OLSGO). It could be concluded that the change in occlusal plane inclination shows anterior rotation (left profile) during growth. The most significant change of the occlusal plane inclination was found using variables OLPL, OLFH and OLNS. There were no significant differences according to sex. Small but significant correlations were found between all investigated variables, except OLML.

Adolescent↗
PubMed1995

Tensor analysis of facial growth in males.

This longitudinal study examines in detail the facial development of 18 untreated, male children with acceptable occlusions. The children were examined in the prepubertal period (age range 7-10 years) and again in their late teens (15-19 years of age). A tensor analysis, which permits the computation of differences in form (that is in size and shape) without specifically measuring either, was employed to describe the facial changes which occurred during this time interval. Values for the x and y co-ordinates of 16 hard and four soft tissue landmarks were determined at each stage. Customized software allowed both graphical and numerical examination of the mean changes over time between 28 triads of points, covering skeletal, dental, and soft tissue elements. The analysis confirmed previous work in describing facial change but was more sensitive than conventional cephalometry, especially where landmarks were evaluated outside the traditional sella-nasion framework.

Adolescent↗
PubMed1991

Long-term effects of the Herbst appliance in relation to the treatment growth period: a cephalometric study.

The aim of this study was to analyse the long-term effects of Herbst treatment on the dentofacial complex with special reference to the growth period in which the patients were treated. The sample consisted of 40 male subjects with a Class II, division 1 malocclusion treated successfully with the Herbst appliance for an average period of 7 months. The patients were reinvestigated at the end of the growth period, on average 6.6 years (SD = 1.0 years) after therapy. Nineteen patients were treated before the maximum of pubertal growth (prepeak), 15 at the maximum (peak) and 6 after the pubertal growth maximum (post-peak). Sagittal skeletal and dental changes occurring during and after Herbst treatment were evaluated on lateral radiographs in centric occlusion. At the time of follow-up examination no group differences were seen in sagittal dental arch relationships. During the follow-up period after Herbst treatment maxillary and mandibular growth development were favourable and comparable in all three groups: mandibular growth exceeding maxillary growth by an average of 4.3 mm (SD = 2.4 mm). For natural reasons, however, the amount of jaw growth during the follow-up period was larger in the subjects treated before the maximum of pubertal growth than in the subjects treated at the later stages. The conclusion of this study was that the growth period in which Herbst treatment was performed did not seem to have any conclusive effect on the long-term results. However, in order to favour occlusal stability after treatment and to reduce the time of post-treatment retention, Herbst therapy in the permanent dentition at or just after peak height velocity of growth is recommended.

Activator Appliances↗
PubMed1994

[Profile modifications induced by orthodontic forces studied by an analysis of the nasolabial angle].

The authors have studied the development modifications of the facial profile subsequent to the different types of headgear focusing attention on the nose-labial angle variations. This study has evaluated separately the orthopedic action of the headgear measuring the variations of the columella inclination as regards the Frankfurt horizontal plane and the orthodontic action measuring the variation of the filter inclination as regards the Frankfurt horizontal plane. The study of the profile pictures of 20 patients in II Class I division treated with extra-oral traction and edgewise therapy showed that; while the high headgear determined a slight change of growth orientation in the nasal component of the nasal-jaw complex directing it upwards; the cervical headgear instead; determined a considerable descent of the nose with a consequent anti-aesthetic result.

Adolescent↗
PubMed1997

A comparison of sonically derived and traditional cephalometric values.

The roentgenocephalometric technique is the standard used by orthodontists to assess skeletal, dental, and soft-tissue relationships. However, this technique exposes patients to radiation, preventing orthodontists from taking frequent cephalograms to assess growth and to monitor treatment. Recently, the Dolphin Imaging Company developed the DigiGraph, a nonradiographic cephalometric method that uses sound waves and mathematical algorithms, and consequently does not expose patients to radiation. But the DigiGraph's accuracy as a cephalometric alternative has not been adequately investigated. The purpose of this study was to compare the values obtained by traditional cephalometrics with those obtained by the DigiGraph technique for 30 well-known measurements, and then to assess the repeatability (intraobserver comparison) and reproducibility (interobserver comparison) for both techniques. Eighteen of the 30 measurements had mean differences that were statistically significant (p > .0067). Regression plots generally illustrate low correlations for the measurements, although Ricketts' esthetic line (upper and lower lip) and Steiner's soft-tissue convexity reveal strong linear relationships between the two methods. Additionally, the radiographically generated measurements showed greater repeatability and reproducibility.

Adolescent↗
PubMed2003

Maxillary volume growth in childhood.

Nasomaxillary abnormalities in form, position, and development in children are often prominent features of craniosynostosis, and in particular, craniofacial dysostosis. While attempting to quantitatively assess the volumetric maxillary deficiency in these patients, it became apparent that there was no "normal" reference range for maxillary volumes throughout childhood that could be used for comparison. The aim of this study was to generate a model for measuring maxillary volume and subsequent changes throughout childhood. The technique of segmentation was applied to magnetic resonance images obtained in 55 healthy children (30 boys, 25 girls), aged 1 month to 184 months (15.33 years). Maxillary volumes were plotted against age for boys and girls to create a model for normal maxillary growth during the first 15 years of life. Maxillary volumes were larger in boys at all ages. However, the pattern of maxillary growth in boys and girls was similar and could be divided into three periods, each lasting approximately 5 years. During the first 5 years of life, there is a steady increase in maxillary volume, at the end of which the maxilla has reached 53 percent of the volume recorded at 15 years. There is an accelerated rate of growth between 5 and 11 years, which corresponds to the development and eruption of the permanent dentition. Thereafter, until the age of 15 years, the rate of growth of the maxilla plateaus. Maxillary volume in the first 12 months of life is, on average, 29 cm3 in boys and 25 cm3 in girls. By 15 years of age, it has increased to an average of 73.0 cm3 in boys and 59.4 cm3 in girls (an increase by a factor of 2.5 in boys and 2.4 in girls). The difference between the two sexes is statistically significant for the entire series (boys: mean maxillary volume = 56.55 cm3, SD = 24.61; girls: mean maxillary volume = 40.68, SD = 17.69, p = 0.009, one-way analysis of variance).

Adolescent↗
PubMed1976

Graphic reconstructions of craniofacial structures during secondary palate development in rats.

Lateral and ventral graphic reconstructions of coronally sectioned rat fetuses at four stages of secondary palate development were made to illustrate the size, form, and spatial relations of craniofacial structures at each stage, and to indicate changes between stages. The results illustrated extensive changes in the nasomaxillary and tongue-mandibular complexes and spatial relations in the oronasal cavity during this 2-day period. During closure of the palate the palatine processes and molar dental laminae moved medially, the vertical dimension between the cranial base and Meckel's cartilage increased, and the Meckel's cartilage changed in shape from a "U" to a "V". During the 2-day period extensive increases in anteroposterior and vertical dimensions and limited changes in lateral dimensions resulted in a change in shape of the complete orofacial region. More extensive investigations, preferably quantitative, of the changes shown are indicated to identify the relative contribution of various craniofacial components and to establish the role of differential growth in secondary palate closure.

Animals↗
PubMed1995

[The importance of hand x-rays for the treatment of skeletal dysgnathias].

This study demonstrates the importance of X-rays of the hand in assessing skeletal changes in jaw relationships. The study is based on a follow-up examination of 53 patients with skeletal class II,1-, skeletal class II,2-, class III and skeletal open bite malocclusions who had been treated orthodontically. Statistical analysis of the growth parameters found a significant correlation between chronological age and skeletal age with considerable deviations depending on sex. At the end of the treatment period it was observed that 34% of all patients had not reached the end of puberty and had not achieved a mature level of growth. During the post-therapeutical period, growth was found on average to be 2.4% in the girls and up to 4.7% in the boys. When looking at the influence of growth and therapy, the patient group with skeletal class II,1 malocclusion exhibited at both therapeutical and post-therapeutical examinations a very positive development both in the horizontal and vertical basal relation of the jaw with a significant increase in mandibular length and in anterior lower facial height. On the other hand the class II,2 cases exhibited significantly reduced lower facial height, which can probably be considered to be a causal factor in the 70% relapse rate after completion of orthodontic treatment. In class III malocclusions the horizontal jaw relationship was stabilized throughout the orthodontic treatment period, however, following treatment a progressive alteration became apparent. The results achieved in this study add weight to the importance of taking skeletal maturation factors into consideration in patients with skeletal jaw discrepancies. These factors are useful in prognosticating the therapeutical goal to be achieved, the degree of stability during treatment, and the chances of relapse following treatment.

Adolescent↗
PubMed2002

Class III treatment opportunities.

If a developing Class III occlusion is noted at any of the four stages outlined above, it would appear that there should be a logical contemporary approach to long-term treatment, based not only on anecdotal clinical opinion, but also on historical and contemporary research evidence. If all clinicians are aware of these stages and the potential directions in which management might proceed, the treatment of Class III occlusions should not necessarily be seen to be the difficult or heroic undertaking that it might perhaps have been in the past. Well-aligned teeth, a good functioning occlusion and pleasing facial appearance should be achievable. There will, however, be differences in approach to the management for individual patients, depending not only on the opinions of clinicians, but also on the needs and wishes of those patients and their families.

Adolescent↗
PubMed1988

The relationship between patency of the maxillary sinus and craniofacial growth in the rabbit.

Numerous researchers report the interaction between deviant respiratory patterns (airway obstruction) and craniofacial growth. Many of these studies consisted of cephalometric evaluations of children with enlarged adenoids, obstruction turbinates, or other nasal obstructions. Other experimental studies of the airway's influence on growth include studies that have induced nasal obstruction in animals by plugging the external nares. No investigations were found that examined the role of the paranasal sinuses in craniofacial growth by filling a sinus in growing animals. Furthermore, nothing appears in the literature that considers the paranasal sinuses in the oronasopharyngeal functional matrix theory. The purpose of this study was twofold: (1) to determine the effect of decreasing the pneumatization of the maxillary sinus on ultimate craniofacial growth and development, and (2) to determine the effect on future morphology by obturating a growing sinus. New Zealand white weaning rabbits were used as the experimental animals. Unilateral maxillary sinuses were injected in 18 animals--nine animals were injected on the right side and nine on the left. Eight rabbits served as controls: five received left-side and three right-side sham injections. Dorsal view cephalometric radiographs were taken at (1) the start, (2) at three progress intervals, and (3) at the end of the experiment. Dried skull direct measurements also were performed at the conclusion of the experiment. No statistical significance was found when comparing right and left sides within groups or when comparing any measurement between groups. This demonstrated that filling the maxillary sinuses had no effect on craniofacial growth; the sinuses grew normally in all animals.

Animals↗
PubMed1990

Pharyngeal flap and facial growth.

The present study addressed two questions. Does the skeletal pattern of children with cleft lip and palate who require a pharyngeal flap differ from children with similar clefts who do not? Following a pharyngeal flap does the pattern of facial development change? Skeletal form prior to pharyngeal flap was compared using cephalograms in 52 subjects with unilateral cleft lip and palate (UCLP) who subsequently received a superiorly based pharyngeal flap and 52 UCLP controls matched for sex and age. The flap group had slightly smaller maxillary length and anterior face heights and greater mandibular protrusion (p less than 0.5) before the pharyngeal flaps were done. Preoperative and five year (minimum) postoperative records were analyzed for 29 early pharyngeal flap cases and 29 matched controls. Subsequent growth demonstrated some assimilation of the flap group with the controls, but repeated measures analysis of variance failed to identify any important differences in growth after pharyngeal flap, suggesting that the superiorly based pharyngeal flap carries no systematic risk of interference with facial growth.

Adolescent↗
PubMed1989

[The use of spring-loaded posterior bite-block in the treatment of open-bite].

The treatment objectives of open-bite cases which occurs as a result of the excess vertical growth of nasomaxillary complex, increase in the upper and lower posterior vertical dentoalveolar development, downward and backward growth of the mandible are restraining of the growth capacity of these regions and leading the growth of the mandible on the horizontal plane. One of the treatment alternatives of these cases is the spring-loaded posterior bite block; a functional orthopedic appliance. In this case report which the effects of spring-loaded posterior bite block therapy on craniofacial and dentoalveolar structures have been shown; three cases having chronological ages of 9 years 8 months; 10 years 4 months and 10 years 1 month were presented and the treatment results were discussed. The common effects of spring-loaded posterior bite-block therapy observed in three cases are; the restraint of the vertical growth of the maxilla and of both lower-upper posterior dentoalveolar structures, change in the growth pattern of the mandible from vertical towards horizontal plane.

Child↗