Facial Growth in Patients with Apert and Crouzon Syndromes Compared to Normal Children

Objective To evaluate vertical and sagittal facial growth in children with Apert and Crouzon syndromes and compare it to the growth patterns of a nonsyndromic control group. Design Case-control study. Setting Department of Orthodontics, Children's Hospital Erasmus Medical Centre, Sophia, Rotterdam, The Netherlands. Patients, Participants Sixty-two patients (37 patients with Crouzon syndrome and 25 patients with Apert syndrome) born between 1971 and 2001 (age range 3.9 to 32 years) and 482 nonsyndromic children as a control group. Interventions Lateral cephalograms performed prior to any midfacial surgery of 62 patients and 482 nonsyndromic children were traced and horizontal and vertical measurements were digitized. Main Outcome Measures Cephalometric measurements of SNA, SNB, ANB, NSMe, and SN/palatal plane angles and lower facial height ratio. Results Horizontal measurements for the syndromic groups showed no change in SNA angle during growth. SNA angles were lower in patients with Apert syndrome compared to patients with Crouzon syndrome. The syndromic groups showed smaller values for ANB angles compared to the nonsyndromic group. Vertical measurements showed increased lower facial height ratios for the syndromic groups compared to control subjects. There was an increasing counterclockwise rotation of the palatal plane in relation to the anterior cranial base in syndromic patients. NSMe angles among the three groups were not significantly different. Conclusions Based on the growth differences identified, the sagittal and vertical jaw relationships differ in patients with Crouzon syndrome, patients with Apert syndrome, and control subjects. Syndromic patients show aggravation of midfacial underdevelopment and anterior rotation of the mandible.

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Growth Pattern in Skeletal Class I Malocclusion: A Cephalometric Study

Orthodontic Journal of Nepal ◽

10.3126/ojn.v11i1.39088 ◽

2021 ◽

Vol 11 (1) ◽

pp. 49-54

Author(s):

Sujal Amatya ◽

Rabindra Man Shrestha ◽

Shristi Napit

Keyword(s):

Growth Pattern ◽

Strong Correlation ◽

Class I ◽

Facial Growth ◽

Skeletal Class ◽

Facial Height ◽

Lateral Cephalograms ◽

Growth Modification ◽

Cephalometric Study

Introduction: Great emphasis has been given to the evaluation of sagittal apical base relationship in orthodontic diagnosis and treatment planning. The prediction of magnitude and direction of facial growth based on sagittal relationship will help in orthodontic treatment with growth modification. The objective of the study is to assess the growth pattern in skeletal Class I malocclusion. Materials and Method: 104 subjects (52 male and 52 female) with the age between 18-30 years with Class I skeletal relation was selected from lateral cephalograms of patients visiting the Department of Orthodontics, Kantipur Dental College. The ANB angle was measured to assess the sagittal jaw relationship and the Jarabak’s ratio to access the growth pattern. Descriptive statistics were calculated for each parameter. Pearson’s test was done to evaluate the correlation between the parameters. Independent t-test was done to compare Anterior Facial height (AFH), Posterior Facial Height (PFH) and Jarabak’s ratio between male and female subjects. Result: Among the total subjects with skeletal Class I malocclusion; hyperdivergent growth pattern was least (10.57%), followed by normodivergent (18.26%) and hypodivergent growth pattern (71.15%). Mean Jarabak’s ratio for hyperdivergent, normodivergent and hypodivergent growth pattern were 58.65±1.94, 63.98±0.85 and 69.98±4.13 respectively. Very strong correlation was found between AFH and PFH in hyperdivergent (r = 0.821) and normodivergent group (r =0.978). Strong correlation was found in hypodivergent group between AFH and PFH (r =0.743). Also, strong correlation was found in hypodivergent group between PFH and Jarabak’s ratio (r =0.643). Conclusion: Hypodivergent growth pattern was the dominant growth pattern in skeletal Class I malocclusion. PFH influenced the determination of Jarabak’s ratio more than the AFH in hypodivergent growth pattern. Hypodivergent growth pattern is correlated with large SNB angle.

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Influence of Vertical Facial Growth Pattern on Herbst Appliance Effects in Prepubertal Patients: A Retrospective Controlled Study

International Journal of Dentistry ◽

10.1155/2020/1018793 ◽

2020 ◽

Vol 2020 ◽

pp. 1-8

Author(s):

Maria Rita Giuca ◽

Marco Pasini ◽

Sara Drago ◽

Leonardo Del Corso ◽

Arianna Vanni ◽

...

Keyword(s):

Growth Pattern ◽

Class Ii ◽

Growth Patterns ◽

Response To Treatment ◽

Controlled Study ◽

Class Ii Malocclusion ◽

Facial Growth ◽

Herbst Appliance ◽

Lateral Cephalograms ◽

Vertical Growth Pattern

Introduction. The Herbst device is widely used for correction of class II malocclusions; however, most of the researches carried out on the Herbst appliance in literature do not take into account patients with a different mandibular divergence. The aim of this study was to investigate the effects of Herbst on dental and skeletal structures and to evaluate possible influence of vertical facial growth patterns. Methods. A retrospective study was conducted on lateral cephalograms of 75 growing patients (mean age: 9.9 ± 1.9 years) with class II malocclusion treated with Herbst. Subjects were divided into 3 groups using the mandibular divergence index (SN and GoMe angle). Cephalometric parameters were evaluated using the modified SO (sagittal occlusion) Pancherz’s analysis. A statistical analysis was conducted to evaluate differences among groups using ANOVA. Results. Our study showed differences in response to treatment depending on patient’s facial vertical growth pattern. Cranial base angle and mandibular rotation were significantly different (p<0.05) between hypodivergent patients and normodivergent patients and between hypodivergent and hyperdivergent subjects. Conclusion. Hypodivergent patients increased their mandibular divergence during treatment to a greater extent than normodivergents; moreover, hyperdivergent patients exhibited a decreased mandibular divergence at the end of the treatment.

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Alveolar and symphysis regions of patients with skeletal class II division 1 anomalies with different vertical growth patterns

European Journal of Dentistry ◽

10.1055/s-0039-1698941 ◽

2012 ◽

Vol 06 (02) ◽

pp. 123-132 ◽

Cited By ~ 6

Author(s):

Elcin Esenlik ◽

Fidan Alakus Sabuncuoglu

Keyword(s):

Normal Subjects ◽

Class Ii ◽

Growth Patterns ◽

Control Group ◽

Skeletal Class ◽

Skeletal Class Ii ◽

Lateral Cephalograms ◽

Division 1 ◽

Main Factor ◽

Class Ii Division 1

ABSTRACTObjectives: The aim of this study was to investigate the alveolar and symphysis region properties in hyper-, hypo-, and normodivergent Class II division 1 anomaliesMethods: Pretreatment lateral cephalograms of 111 young adult female patients with skeletal Class II division 1 anomalies were compared to those of 54 Class I normal subjects (control group). Class II cases were divided into hyperdivergent (n = 58), hypodivergent (n = 19), and normodivergent groups (n = 34). The heights and widths of the symphysis and alveolus and the depth of maxillary palate were measured on the lateral cephalogramsResults: Mean symphysis width was wider in the hypodivergent Class II group than in the other groups, while mean symphysis height was similar among all groups. Maxillary palatal depth, upper incisor angle, upper and lower molar alveolar heights, and Id–Id′ width were also similar among groupsConclusion: Symphysis width is the main factor in the differential diagnosis of Class II division 1 anomaly rather than symphysis height and hypodivergent Class II Division 1 anomaly is more suitable for mandibular incisors movements. (Eur J Dent 2012;6:123-132)

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Two Different Applications of Class II Elastics with Nonextraction Segmental Techniques

The Angle Orthodontist ◽

10.2319/071006-283 ◽

2007 ◽

Vol 77 (4) ◽

pp. 694-700 ◽

Cited By ~ 4

Author(s):

Aslihan Uzel ◽

Ilter Uzel ◽

M. Serdar Toroglu

Keyword(s):

Treatment Time ◽

Control Period ◽

Class Ii ◽

Control Group ◽

Treatment Groups ◽

Facial Height ◽

Lateral Cephalograms ◽

Division 1 ◽

The Mean ◽

Class Ii Elastics

Abstract Objective: To evaluate the relative effects of Class II elastics applied directly with utility arches (UAs) or with the Reciprocal Mini–Chin Cup (RMCC) appliance. Materials and Methods: Thirty patients with Class II division 1 malocclusion were included. Fifteen of them were treated with the RMCC appliance and the other 15 treated with Class II elastics on UAs. Lateral cephalograms of an additional 15 untreated persons having the same characteristics as the treatment groups were used as a control group. Results: The mean control period was 10 months. Class I molar and canine relationships were achieved in a mean treatment time of 4.6 months with the RMCC appliance and in 8.5 months with the elastics on UAs. The amount of overjet reduction was 4.7 mm in the RMCC group (87.87% dental) and 5.2 mm in the UA group (80.76% dental). The molar correction was 4.5 mm in the RMCC group (87.36% dental) and 2.0 mm in the UA group (51.47% dental). The anterior lower facial height increased in both of the treatment groups. Conclusions: The RMCC appliance is a valuable alternative for Class II elastic use in Class II cases in which the upper molars need to be moved to the distal more than the upper incisors.

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Prospective study of dentoskeletal changes in Class II division malocclusion treatment with twin force bite corrector

The Angle Orthodontist ◽

10.2319/042312-339.1 ◽

2012 ◽

Vol 83 (2) ◽

pp. 319-326 ◽

Cited By ~ 8

Author(s):

Carlos Henrique Guimarães ◽

José Fernando Castanha Henriques ◽

Guilherme Janson ◽

Marcio Rodrigues de Almeida ◽

Janine Araki ◽

...

Keyword(s):

Class Ii ◽

Control Group ◽

Facial Growth ◽

Lateral Cephalograms ◽

Before And After ◽

Group 2 ◽

In The Beginning ◽

Experimental Group ◽

Observation Period ◽

Mandibular Incisors

ABSTRACT Objective: To evaluate the dentoskeletal changes of Class II malocclusion treatment with the Twin Force Bite Corrector (TFBC). Materials and Methods: The sample comprised 86 lateral cephalograms obtained from 43 subjects with Class II division 1 malocclusion; the subjects were divided into two groups. The experimental group comprised 23 patients with a mean initial age of 12.11 years who were treated with the TFBC for a mean period of 2.19 years. The control group included 40 lateral cephalograms from 20 Class II nontreated patients, with an initial mean age of 12.55 years and a mean observation period of 2.19 years. The lateral cephalograms were evaluated before and after orthodontic treatment in group 1 and in the beginning and end of the observation period in group 2. t-Tests were used to compare the initial and final cephalometric characteristics of the groups as well as the amount of change. Results: The experimental group presented greater maxillary growth restriction and mandibular retrusion than the control group, as well as greater maxillomandibular relationship improvement and greater labial tipping of the mandibular incisors. The results also showed a greater decrease in overbite and overjet in the experimental group, and there were no statistically significant differences in the craniofacial growth pattern between groups. Conclusions: The TFBC promotes restriction of anterior maxillary displacement without significant changes in mandibular length and position and improvement of maxillomandibular relationship without changes in facial growth and significant buccal tipping of mandibular incisors. Class II correction with the TFBC occurred primarily as a result of dentoalveolar changes.

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Facial growth in patients with isolated cleft palate treated with minimal incision technique compared to a normal population—a cephalometric study at 10 and 16 years of age

European Journal of Orthodontics ◽

10.1093/ejo/cjz082 ◽

2019 ◽

Author(s):

Konstantinos Parikakis ◽

Ola Larson ◽

Agneta Karsten

Keyword(s):

Cleft Palate ◽

Normal Population ◽

Treated Group ◽

Craniofacial Morphology ◽

Control Group ◽

Facial Growth ◽

Minimal Incision ◽

Lateral Cephalograms ◽

Incision Technique ◽

Isolated Cleft Palate

Summary Objective To evaluate the result of a novel palatoplasty (minimal incision technique) for closure of an isolated cleft palate (ICP) at 10 and 16 years of age, concerning facial growth, compared to a normal population. Subjects Treated group: 55 non-syndromic Caucasian children born with an ICP between 1987 and 2001. The children were treated surgically with a one-stage palatoplasty at a mean age of 13 months. Control group: 110 Caucasian children with normal occlusion with no history of clefts or orthodontic intervention. Method The treated children (25 boys, 30 girls) were matched (gender and age) with the children in the control group. A retrospective evaluation at 10 (mean 10.5) and 16 (mean 16.0) years of age was performed by analysis of lateral cephalograms. Fifteen variables were evaluated. Ninety-nine per cent confidence intervals were calculated. Two-way factorial ANOVA and mixed-model analysis were performed. Results Treated patients compared to the control group showed: at 10 years of age, smaller mandible (P = 0.001) and reduced posterior upper and total face heights (P ≤ 0.001); at 10 and 16 years of age, a retrognathic (P ≤ 0.001), smaller (P ≤ 0.006) and with an increased posterior inclination of the maxilla (P < 0.001), as well as a retrognathic mandible (P ≤ 0.006). Conclusion The craniofacial morphology at 10 and 16 years of age in patients born with an ICP and treated with the minimal incision technique differs compared to the morphology of a normal control group born without a cleft. Retrognathic maxillas and a smaller and posteriorly inclined maxilla were found in the treated group.

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Craniofacial, oral, and cervical morphological characteristics in Japanese patients with Apert syndrome or Crouzon syndrome

European Journal of Orthodontics ◽

10.1093/ejo/cjaa015 ◽

2020 ◽

Author(s):

Yukiho Kobayashi ◽

Kenji Ogura ◽

Rina Hikita ◽

Michiko Tsuji ◽

Keiji Moriyama

Keyword(s):

Cervical Vertebrae ◽

Morphological Characteristics ◽

Two Dimensions ◽

Small Sample ◽

Open Bite ◽

Apert Syndrome ◽

Dental Arch ◽

Crouzon Syndrome ◽

Lateral Cephalograms ◽

Midfacial Hypoplasia

Summary Background and objectives Mutations in the fibroblast growth factor receptor 2 (FGFR2) gene are responsible for both Apert syndrome (AS) and Crouzon syndrome (CS). These diseases share phenotypic characteristics, including midfacial hypoplasia and premature fusion of the calvarial suture(s). Given the extensive range of craniofacial growth and developmental abnormalities, management of these patients requires a multidisciplinary approach. This study aimed to compare craniofacial, oral, and cervical morphological characteristics in Japanese orthodontic patients with AS or CS. Subjects and methods Lateral cephalograms, orthopantomograms, dental casts, medical interview records, facial photographs, and intraoral photographs of 7 AS patients and 12 CS patients on initial visits were used in this study. Cephalometric analyses were performed, and standard scores were calculated based on age- and sex-matched Japanese standard values. Results Cephalometric analysis revealed that AS patients had significantly more severe maxillary hypoplasia in two dimensions and increased clockwise mandibular rotation. Additionally, cleft of the soft palate, anterior open bite, severe crowding in the maxillary dental arch, and congenitally missing teeth occurred more frequently among AS patients. Multiple fusions between cervical vertebrae C2, C3, C5, and C6 were observed in the AS patients. Limitations Small sample size. Conclusions/implications Our study shows that AS patients have more severe craniofacial and maxillofacial deformities than CS patients.

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Cephalometric Standards for Polish 10-Year-Olds with Normal Occlusion

The Angle Orthodontist ◽

10.2319/011207-14.1 ◽

2008 ◽

Vol 78 (2) ◽

pp. 262-269 ◽

Cited By ~ 17

Author(s):

Barbara Obloj ◽

Piotr Fudalej ◽

Zofia Dudkiewicz

Keyword(s):

Normative Data ◽

Cranial Base ◽

Facial Height ◽

Perpendicular Distance ◽

Anterior Cranial Base ◽

Normal Occlusion ◽

Lateral Cephalograms ◽

Facial Proportions ◽

Angle Point ◽

Gender Specific

Abstract Objective: To establish gender-specific normative data for Polish children at the age of 10 years. Materials and Methods: Thirty-nine boys and 34 girls (mean age 10.37, SD = 0.52) of Polish ethnicity were selected based on the following criteria: Class I molar relationship, lack of crossbite or scissor-bite, positive overjet and overbite less than 5 mm, adequate amount of space in both dental arches, no visible asymmetry, and good facial proportions. Lateral cephalograms of each subject were scanned and analyzed with the use of NemoCeph NX2005 software. Descriptive statistics (mean and standard deviation) were calculated for all measured variables. Independent t-tests were performed to assess the intergender differences. The results were compared to the published norms of other white populations. Normative data were presented in the tables. Results: Intergender differences included anterior cranial base length (sella-nasion), total and lower anterior facial height (nasion-menton and ANS-menton, respectively), posterior facial height (sella-gonion), SNA angle, point A to nasion perpendicular distance, pogonion to nasion perpendicular distance, and facial axis. Conclusions: Polish 10-year-old boys had a larger anterior cranial base, and larger total anterior, lower anterior and posterior facial heights than girls. The maxillae and chin protrusion were more pronounced in girls.

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Evaluation in Arch Width Variations among Different Skeletal Patterns in District Solan Population

Dental Journal of Advance Studies ◽

10.1055/s-0039-1677890 ◽

2018 ◽

Vol 6 (02/03) ◽

pp. 112-117

Author(s):

Isha Aggarwal ◽

Sumit Chhatwalia ◽

Sanjay Mittal ◽

Mandeep Bhullar ◽

Divya Singla

Keyword(s):

Growth Pattern ◽

Growth Patterns ◽

Dental Arch ◽

Facial Growth ◽

Group Iii ◽

Arch Width ◽

Group I ◽

Lateral Cephalograms ◽

Relationship Of ◽

Alveolar Arch

Abstract Introduction The facial growth pattern differs from individual to individual, and the variations in it are quite high. The assessment of relationship of dental arch dimensions with the facial growth pattern is essential for proper diagnosis and treatment planning. Aim The purpose of this study was to evaluate and compare the dental and alveolar arch widths in patients with varying facial growth patterns in Distt. Solan population. Materials and Methods Pretreatment lateral cephalograms and dental study models of 45 patients with age group between 16 and 30 years were included in the study. Patients were divided into three groups: group I (normodivergent), group II (hypodivergent), and group III (hyperdivergent) on the basis of y-axis, Jarabak ratio, and SN-MP (Sella-Nasion–mandibular plane) angle. Interpremolar and intermolar dental and alveolar arch widths were measured and compared for all the three groups. Results The results showed that the dental and alveolar arch widths were increased in hypodivergent patients and decreased in hyperdivergent patients, which was not statistically significant. Conclusion It was concluded that the dental and alveolar arch dimensions increased as the facial pattern became horizontal.

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Changes in Hyoid Position Following Treatment Of Class II Division1 Malocclusions with A Functional Appliance

Journal of Clinical Pediatric Dentistry ◽

10.17796/jcpd.33.1.lj3133w7275718kr ◽

2008 ◽

Vol 33 (1) ◽

pp. 81-84 ◽

Cited By ~ 5

Author(s):

S. Yassaei ◽

M. Sorush

Keyword(s):

Hyoid Bone ◽

Class Ii ◽

Growth Patterns ◽

Vertical Dimension ◽

P Value ◽

Facial Growth ◽

Functional Appliance ◽

Horizontal Dimension ◽

Lateral Cephalograms ◽

Significant Difference

Objective: The aim of this study was to determine change of hyoid bone position following treatment with functional appliance in patients with class II division 1 malocclusion. Design: This study performed on pre and post treatment lateral cephalograms of 28 patients with class II div I malocclusion treated with Farmand functional appliance on average of 11 months. The range of age of girls was 10–13 years and boys 11–14 years. To study the results, t test and Pearsons correlation coefficient were used. Results: Hyoid bone shifted significantly (P.value < 0.01) forward in horizontal dimension and non significantly upward in vertical dimension. There was no significant difference between three groups in facial growth patterns with respect to hyoid bone position alterations in horizontal dimension but was significant between horizontal and vertical growth pattern in vertical dimension. (P value < 0.05). There was significant correlation between decrease of ANB angle with forward movement of hyoid bone. Conclusion: Following treatment with Farmand functional appliance, significant changes occur in the position and anterior displacement of the hyoid bone.

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