Anthropometric Study of Facial Morphology in Northern Thai Population Aged 1 to 18 Years Old to Inform the Timing of Craniofacial Reconstruction

Objective: To determine normal range of craniofacial structures, compare between male and female and establish growth curves in subjects aged 4 to 18 years old. Moreover, to determine normal range of craniofacial structures in subpopulation aged 1 to 3 years old. Materials and Methods: The present study was a cross-sectional study including 388 healthy subjects consisted of 363 subjects aged 4 to 18 years old and 25 subjects aged 1 to 3 years old. Both groups were Northern Thai. All subjects were measured to record the craniofacial anthropometry and established the growth curves in 6 regions including head, face, orbit, nose, labio-oral and ears. Results: In the population aged 4 to 18 years old, upper vermillion height of males was 9.03±2.92 mm. while in females was 8.45±2.38 mm (p=0.039). Left auricular length of males was 57.22±5.33 mm, while in females was 55.89±4.59 mm (p=0.011). Right auricular length of males was 57.40±5.35 mm, while in females was 55.91±4.75 mm (p=0.006). In the population aged 1 to 3 years old, left palpebral fissure of male was 10.42±2.45 mm, while in females was 8.27±1.43 mm (p=0.041). The trend in morphological face height was stable after 13 years old. The trend in physiognomical face height, binocular width, mouth width, and auricular height was stable after 16 years old. The trend in forehead height, mandible width, and nasolabial angle was stable after 18 years old. Conclusion: Each of the parameters showed a tendency to be stable at a specific cut-off age. Therefore, craniofacial reconstruction should be carried out after the specific cut-off ages identified in the results. Keywords: Facial anthropometry; Anthropometrics; Craniofacial; Northern Thai

Sequencing of panfacial fracture repair

Panfacial fractures involve multiple fractures of the upper, middle, and lower thirds of the face. In management of panfacial fractures, the individual fracture techniques and approaches described in the previous chapters in Section 7 are combined to restore bony continuity of the facial skeleton and provide an aesthetic and functional drape of the overlying soft tissues. The aim in treatment of panfacial fractures is to restore the anatomical buttresses of the face in three dimensions, thus restoring vertical face height, horizontal width, and anteroposterior projection.

Morphometric characteristics of skull and face parameters in fetuses and newborns

Modern science has a significant number of diagnostic methods: craniological, anatomical, ultrasound, radiological. The development of new research methods, such as ultrasound and X-ray methods (magnetic resonance imaging), forms the concept of ultrasound and X-ray norms at different stages of human development. Now it is important to study the anatomical variability of people, morphometric characteristics, relationships of organs, anatomical structures, their parts at all stages of human development. The purpose of the work is to establish normative morphometric parameters of the skull and face in fetuses and newborns, followed by construction of mathematical models. The study was performed on 57 preparations of human fetuses 4-10 months and 7 newborns using adequate anatomical methods: macropreparation, topographic anatomical sections, computed tomography, craniometry. The main parameters of the facial and cerebral skull were measured with the help of a centimeter tape, a thick, sliding compass and a caliper. Statistical analysis of the obtained data was performed using a licensed program RStudio. It is established that according to the graphs of the average values of the parameters of the skull and face, there are two periods of accelerated and two periods of slow development. For transverse skull length, face width and skull height, two periods of accelerated development from the 6th to the 8th month of fetal development and from the 9th month of fetal development to the neonatal period and two periods of delayed development from the 5th to the 6th months and from the 8th to the 9th month of fetal development were revealed. For the total height of the face – periods of accelerated development – from the 4th to the 6th month of fetal development and from the 7th to the 9th month of fetal development, periods of delayed development – from the 6th to the 7th month of fetal development and from the 9th month of fetal development to the neonatal period. On the basis of arithmetic mean data of transverse skull length, face width, skull height, total face height, models for predicting normative morphometric parameters in fetuses and newborns are constructed. The constructed models will serve as a norm for the subsequent determination of certain morphometric deviations to establish variants of the structure and malformations of the skull and face. Thus, our systematized data on the features of spatio-temporal transformations of morphometric parameters of transverse skull length, face width, skull height, total face height with subsequent construction of mathematical models will contribute to the individualization of the norm, improvement of early diagnosis methods and development of new methods for surgical correction of congenital defects of the skull and face.

Cephalometric comparison of dentofacial parameters between Yemeni and Caucasian adults

Objective: The purposes of this research were to establish cephalometric standards for Yemeni adults and to compare them with those of the Caucasians. Material and Methods: 100 Yemeni students (fifty males, mean age of 23.6 ± 2.1 years, and fifty female, mean age of 21.5 ± 3.1 years) with normal occlusions and wellbalanced faces were involved in the study. Inclusion criteria were a class I malocclusion with minor or no crowding, the whole teeth is present except third molars and no previous orthodontic, orthopedic or maxillofacial surgery treatment. Five angular and eighteen linear measurements were used for the skeletal, dental and soft tissue analysis. All participant’s lateral cephalometric radiographs were evaluated. The average values and standard deviations for all the angles and linear measurements were determined. The differences for each measurement between the Yemeni and Caucasian participants were calculated using unpaired t–tests. Results: Yemeni subjects had a more retrognathic mandibular positions (P< 0.05), protrusive mandibular incisors (P< 0.01), more protruded lip positions (P < 0.01), deeper mentolabial sulci (P< 0.01) and a steeper mandibular planes (P< 0.001) compared to the Caucasians. Yemeni females had a larger lower face height than Caucasian females (P< 0.001). Conclusions: The study provides specific standards for Yemeni adults and shows that the Yemenis had different skeletal and dentoalveolar cephalometric standards in comparison with Caucasians. Keywords Cephalometric comparison; Skeletal and dental features; Yemeni norms.

Craniofacial Features in Richieri-Costa-Pereira Syndrome

Objective: Patients with Richieri-Costa-Pereira syndrome (RCPS) present severe craniofacial alterations and frequently require orthodontic and surgical procedures. Thus, this study aims to describe the craniofacial relationships in patients with RCPS. Design: Panoramic radiographs and lateral cephalometric teleradiographs of 7 patients with RCPS and 7 age- and sex-matched nonsyndromic patients were analyzed. Cephalometric measurements were used to determine the size of apical bases, the relationship between them, the pattern of craniofacial growth, and the facial heights of the patients. Interobservers’ concordance was verified by intraclass coefficient. For comparison between the groups, paired t test was employed. P values <.05 indicated statistical significance. Results: Average age of patients with RCPS was 18.5 years. Six patients were female. All patients with RCPS had Pierre-Robin sequence while 2 also presented cleft mandible. Most patients with RCPS had missing lower central incisors (100%), lower lateral incisors (85.7%), lower second premolars (85.7%), and/or upper lateral incisors (57.1%). Concordance between observers was excellent for all cephalometric measurements (0.87-0.99). Patients with RCPS presented severe craniofacial alterations when compared to control group: sella–nasion–B point (SNB) angle (73.8o ± 4.86o vs 78.85o ± 4.53o, P = .029), maxillary length (7.89 cm ± 0.58 cm vs 16.36 cm ± 0.75 cm, P = .001), mandibular length (9.90 cm ± 0.46 cm vs 20.61 cm ± 0.45 cm, P = .001), upper anterior face height (5.41 cm ± 0.50 cm vs 9.40 cm ± 0.47 cm, P = .001), lower anterior face height (5.48 cm ± 0.75 cm vs 11.66 cm ± 0.55 cm, P = .001), and posterior face height (6.70 cm ± 0.33 cm vs 13.65 cm ± 1.06 cm, P = .001). There was no difference in SNB, A point–nasion–B point, pogonion–nasion–B point, and mandibular place angles between the groups ( P > .05). Conclusion: Patients with RCPS present deficient development of maxilla and mandible when compared with nonsyndromic patients.

Genetic and environmental components of vertical growth in mono- and dizygotic twins up to 15–18 years of age

ABSTRACT Objectives To determine the additive genetic and environmental contributions to the vertical growth of craniofacial structures. Materials and Methods The sample consisted of 64 untreated monozygotic (44 male, 20 female) and 61 untreated dizygotic twins (32 male, 29 female). Lateral cephalograms taken at 15 and 18 years of age were traced to analyze the sella-nasion–nasal line angle (SN-NL), nasal line–mandibular line angle (ML-NL), sella-nasion–mandibular line angle (SN-ML), sella-nasion–sella-gnathion angle (Y-axis), posterior face height/anterior face height (PFH/AFH), and lower anterior face height/anterior face height (LAFH/AFH). The genetic and environmental components of variance were analyzed with structural equation modeling for multilevel mixed effects. Results At 15 years of age, strong dominant genetic control was seen for NL-ML (81%), LAFH/AFH (73%), and Y-axis (57%), whereas strong additive genetic components were found for PFH/AFH (78%), SN-NL (58%), and SN-ML (57%). Unique environmental factors accounted for 18–42% of observed variance, with SN-NL being affected the most (42%). At 18 years of age, only LAFH/AFH (86%) was under strong dominant genetic control, whereas the remainder were under additive genetic influence. The sole exception was SN-NL, which changed from additive to unique environmental influence. Conclusions Either additive or dominant genetic components were found at 15 or 18 years of age for most vertical variables. Environmental factors accounted for about 10–40%, with SN-NL being mostly affected.

Effects of Enlarged Adenoids on Craniofacial Growth in Bangalore Population – A Cross-Sectional Cephalometric Study

Background and Objectives: The purpose of the present cross-sectional study was to determine the effects of enlarged adenoids on the growth pattern of maxilla and mandible and to evaluate the relationship between airway size and lip strain. Methods: Pre-treatment lateral cephalograms of twenty-five children (10 boys, 15 girls) were taken. The children selected for the study were in the age group of 5 – 13 years (mean age of 10 years) during the year 2008- 11. All the tracings were made on 75µm lacquered polyester acetate tracing papers using a 0.05” lead pencil. This study assessed the associations of upper lip strain and upper pharynx size with selected cephalometric measures. The data was analyzed using SPSS (Statistical Package for Social Science, Ver.10.0.5) package. Results: The increased upper lip strain was associated with a forwardly placed maxilla, increased mandibular plane angle and upper pharynx size was associated with decrease in mandibular size (mandibular corpus size), increase in gonial angle (Ar-Go-Gn), decrease in middle third of face (N- ANS) and increase in lower jaw anterior face height (ANS- Me). Also, the dental effect of increase in the degree of mandibular incisor proclination relative to mandibular plane was observed. Conclusion: With an increase in upper-lip strain and decreased upper pharynx size, forward maxillary placement, retrognathic mandible, downward and backward rotation of the mandible, decreased middle third of face, increase in lower anterior face height and increase in degree of mandibular incisor proclination relative to mandibular plane were observed. It was inferred from the present study that a decreased upper airway affects the craniofacial skeletal growth pattern in children.

Anthropometric Analysis of the Growth Proportions of the Head and Face in Koreans.

The present study is to identify primarily the morphological characteristics in the growth proportion of the head and face for young Korean (8~24 years) and compare the magnitude of growth changes to the sex-related differences. Total 1,255 were divided into 3 age groups: childhood (8~10 years), adolescence (14~16 years), and young adult (20~24 years). The anthropometric assessments were performed with 11 landmarks on the head and facial dimensions. The standardized frontal and lateral head and face photographs were analyzed the craniofacial growth proportions and morphological features for the comparison of both sexes. The noteworthy differences of anthropometric measurements between sexes with growing were noted on the lower head height (22.6%, 17.8%), midface height (22.0%, 19.6%), lower face height (23.5%, 14.7%), and face length (21.1%, 14.9%), face breadth (14.8%, 11.3%) of males and females, respectively. Whereas the upper head height (7.9%, 6.0%) and upper face height (4.2%, 0%, respectively) were less growing features. The most remarkable changes are the dimension of midface height and lower face height in both sexes. The present study could demonstrate a fundamental example to elucidate the sex-related dimensional differences for the analysis of the growth proportion of both sexes in Koreans.

Lip height estimation in a southern African sample

INTRODUCTION: The South African Police Service frequently relies on craniofacial approximation and superimposition to assist in identifying unknown deceased individuals. Standards to estimate lip height are however limited. Findings from this study share medical applications. Aims and objectives: Establish reliable standards for estimating lip height using dentoskeletal measurements. METHODS: Cone-beam CTs comprising 124 black and 39 white southern African adults were assessed. A series of dimensions were recorded using a DICOM viewer with an inbuilt measuring tool. Relationships between hard tissue structures (maxillary, mandibular and total central incisor heights, their corresponding root lengths, face height (N-Gn), and nose height (N-Sn)) and respective overlaying soft tissues (upper, lower and total lip heights) were evaluated. RESULTS AND CONCLUSIONS: Statistically significant differences were observed between population, sex and age groups. A selection of regression equations to estimate lip height was calculated that included population, sex and approximate age (20-39 and 40+ years) for improved goodness-of-fit (r2-value). Regression models using face height produced the strongest multiple correlation (r-value) and goodness-of-fit (r2-value). Validation testing indicated that regression models often improved upon mean measurements, while offering a degree of individuality that mean values do not.

Skeletal changes in patients with mandibular prognathism after mandibular set back and bimaxillary surgery: A comparative cephalometric study

Bacground/Aim. Recently, maxillary and bimaxillary surgery gained the primacy in the surgical correction of class III deformities. The aim of this investigation was to compare the changes in the skeletal relationships in patients with mandibular prognathism after bimaxillary surgery. Methods. The study included 70 subjects divided into three groups. Twenty class III patients of the experimental group 1 underwent bilateral sagittal ramus osteotomy and twenty patients of the experimental group 2 were subjected to bimaxillary surgery. The control group consisted of 30 subjects with skeletal class I and physiological occlusion. Cephalometric research was conducted on 110 lateral cephalometric radiographs made in subjects of the experimental groups 1 and 2 before and after surgery and in subjects of the control group. Using the computer program ?Dr. Ceph?, 30 linear and angular skeletal variables were analyzed on each radiograph. Results. Bimaxillary osteotomies changed most of variables that characterize the mandibular prognathism. The changes in the sagittal plane included the significant increase of sella-nasion to the A point (SNA) angle (by 4? on the average) and the A point to B point (ANB) angle (6?), and significant reduction in angles sellanasion to the B point (SNB) (3?), gonial angle (ArGoMe) (8?), gonial angle inferior (NGoMe) (6.2?), and Bj?rks sum (7?). The vertical relationships were normalized by significant reduction in overall anterior face height N-Me (by 5 mm on the average), the lower anterior face height ANS-Me (4 mm), significant increase in the total posterior face height S-Go (2.5?3 mm), lower posterior face height PNS-Go (4 mm), and significant reduction of the basal and mandibular plane angles. Conclusion. Compared to the isolated mandibular operations, bimaxillary surgery changes more efficiently the sagittal and vertical skeletal relations in patients with class III deformities and harmonizes more successfully the entire skeletal facial profile.