Craniofacial growth in unoperated craniofacial malformations.

OBJECTIVE: To review current information on craniofacial growth of unoperated patients with craniofacial malformations and stimulate the study of abnormal craniofacial growth through conventional and newer methods. This will lead to improved diagnosis and the understanding of the etiopathogenesis of craniofacial malformations. It is expected that this knowledge will also assist clinicians in planning treatment strategies to better manage these challenging conditions.     

Craniofacial development: the possible mechanisms for some malformations

Normal craniofacial development is reviewed and some mechanisms in the fusion of mammalian facial 'processes' are discussed. The manipulation of environmental factors and effects of teratogens are related to genetic susceptibility of animal models, and extrapolated to craniofacial malformations in man.     

Water fluoridation and congenital malformations: no association.

The incidence of selected congenital malformations in areas with fluoride supplementation of public water supplies was compared with the incidence in areas where the water supply is deficient in fluoride. Comparison of the incidences of several common birth defects (including Down's syndrome) in fluoridated and nonfluoridated areas revealed no substantial or significant differences in which there was a consistent pattern for both sets of data.     

Craniofacial profile angles in caucasians and negroes

This study was based on 50 male and 50 female adult British caucasian and 50 male and 50 female adult British negro cephalographs. These latter, although of West African parentage, had been born and spent the whole of their lives in the United Kingdom. Univariate analysis of individual angles showed that the craniofacial profile angles were, in general, greater in negroes than caucasians. From multivariate analysis of the data, however, significant contrasts between negro and caucasian males and between negro and caucasian females were evident, although within each ethnic group there was no significant sexual dimorphism. This study, therefore, emphasized the value of regarding the craniofacial profile as a whole rather than analysing each angle individually.     

Maternal influences on congenital craniofacial malformations

Congenital craniofacial malformations represent an extremely complex biomedical problem area. The complexity includes early detection, diagnosis, treatment, habilitation, and, of course, prevention. The genetic and environmental issues which appear to interact and result in congenital malformations are becoming better understood. Rapid advances in mouse and human immunogenetics indicate several possible explanations as to why some individuals acquire certain birth defects whereas other individuals do not express congenital malformations. Recent discoveries concerning the major histocompatibility complex (MHC) and associations with a number of human malformations have stimulated interesting speculations concerning genetic and environmental factors which might be responsible for predispositions to congenital malformations. Of particular interest is the possible function of the major histocompatibility complex of the mother during early stages of embryogenesis and how this assembly of genes may confer susceptibility to environmentally induced birth defects in mouse and human reproduction.     

Craniofacial anatomo-morphological profile of black African Ivory Coast children

An African Negro?d ivorian child's facial, cranial, morphological and anatomical profile research The cephalometric study of telerdiography negatives of profile carried out on a sample of 52 Ivorian children from 11 to 14 years old, has shown some particularities which characterize the face and skull architecture. These particular features differentiate the Ivorian from the west Africans and from the French. According to the authors it would be better to establish the Ivorian's specific norms and to consequently adapt the face and tooth orthopedie therapeuties.     

Brazil's Craniofacial Project: genetic evaluation and counseling in the Reference Network for Craniofacial Treatment.

OBJECTIVE: This study is part of Brazil's Craniofacial Project, which is the first initiative for a national characterization of craniofacial healthcare in Brazil. Our main aim was to describe the status of clinical genetics in the Brazilian Reference Network for Craniofacial Treatment. DESIGN: All services (n = 29) listed in the Brazilian Reference Network for Craniofacial Treatment until October 2003 were contacted and invited to complete a questionnaire. Information regarding the general characteristics of the services, availability of genetic services, and genetic service providers was collected. RESULTS: The response rate was 86.2% (n = 25). Thirteen responding teams had clinical geneticists. Teams were predominantly located in the southeast region and affiliated with universities. Family interest in genetic counseling was reported by 95.7% (22/23) of the services. Although 80% of the responding services reported offering genetic counseling, only 45% (9/20) provided genetic counseling guided by clinical geneticists. CONCLUSION: Availability and access to genetic evaluation and counseling are still rudimentary in Brazil. Many services report family interest in genetic counseling, but there are few teams with clinical geneticists. Inclusion of this specialist on craniofacial teams is crucial to patient care. Development of standard guidelines for genetic evaluation of selected craniofacial anomalies and for local genetic counseling (e.g., for nonsyndromic cleft lip or palate) could be an alternative for improving current deficiencies in the system. Strengthening the degree of coordination and communication among craniofacial teams represents another important goal.     

Craniofacial templates for orthodontic case analysis.

1. Age-, sex-, and growth-type-specific craniofacial templates represent a practical approach to orthodontic case analyses and craniofacial growth. 2. The Burlington Growth Centre Cephalometric Analysis is a practical adjunct to treatment planning. 3. This cephalometric analysis, which combines many analyses, is an assessment of the relative proportions of the face in length, width, and height (static analysis) and an estimation of the future changes (dynamic analysis). 4. As an aid in diagnosis, the template and/or analysis in conjunction with a cephalogram, with provide information pertaining to (q) cranial base length angle, (b) upper and lower face height and maxillary and mandibular height, (c) size and proportions of the facial bones, both anteroposteriorly and in width, (d) denture relationship, both anteroposteriorly and in width, and (e) expected general growth changes.     

Craniofacial morphology: a principal component analysis.

A series of 56 measurements was derived from lateral cephalometric radiographs of a large sample of subjects. These measurements were subjected to a principal-component analysis which resulted in a series of six components (factors). These factors, represented in general terms and in rank order of their percentage sample variability were as follows: Factor 1. Vertical facial characteristics Factor 2. Anteroposterior aspects of facial morphology Factor 3. Midfacial and dental protrusion Factor 4. Relationship of the mandible and dentition to the profile Factor 5. Horizontal base-line relationships (internal or deep) Factor 6. Maxillary incisor relationships These principal components and the variables contained within them were shown to have sex and age interactions. A longitudinal study of the principal component changes with age was then undertaken. Demonstrable age changes were verified for Factors 1, 2, and 3, and Factors 1 and 3 were observed to show patterns of change which were statistically different from each other and the remaining principal components. An orthodontically treated sample of patients was also assessed for factor changes. Factors 1 and 2 were found to show statistically reliable changes resulting from treatment and/or growth. The remaining four factors showed no statistically supportable alteration. The data-reduction method involving a principal-component analysis would seem to have potential research and clinical applications.     

Craniofacial and dental manifestations of triple X syndrome associated with congenital hypothyroidism: a case report

Triple X syndrome (47,XXX) is a numerical chromosomal alteration that affects 1/1,000 women, in which the woman is born with an extra X chromosome. Some oral changes have been reported in the literature, as hypodontia, influence on deposition of crown enamel and discrepancies in cephalometric measurements. Other systemic complications may lead to oral abnormalities similar to those seen in triple X patients, such as congenital hypothyroidism (CH). This paper reports a triple X syndrome case associated with CH later treated. Besides delay in cognitive and intellectual development, the patient had changes in teeth development and in cephalometric measurements with deficiencies in the maxilla and mandible. This is the first report of a triple X syndrome associated with CH. Both conditions may result in changes in dentofacial development.     

Craniofacial development in myotonic dystrophy.

Anthropometric, cephalometric, and dental data from 23 subjects (12 males and 11 females) afflicted with myotonic dystrophy were compared to similar data from normal subjects who participated in the Iowa Facial Growth Study. A two by two analysis of variance showed that myotonic subjects differed from normal subjects in headlength, head breadth, cephalic index, bizygomatic face width, nosebreadth, maxillary arch widths, palatal depth, anterior and posterior face heights, cranial base lengths, cranial base angles, and other cephalometric measures. Sex differences were observed for many of the variables. It is hoped that these findings will assist clinicians who treat patients having this disorder.     

Craniofacial clefting and sutural dystopia.

Sutural anomalies in conjunction with craniofacial clefting are unusual. A case of median frontal clefting is presented in which there was an absence of a normal metopic suture and replacement by paramedian frontal sutures. The association of an underlying brain anomaly, with attendant surgical difficulties, is noted, as are the radiological techniques of preoperative diagnosis.     

Craniofacial growth: evolving paradigms

Aims:

Numerous theories about craniofacial growth have been formulated in the last century. The most influential hypotheses were: genetic, synthetic and functional matrix revisited. Moreover, a large number of experts from different fields tried to explain craniofacial growth and its developmental mechanisms, in order to deliver the best treatment possible to orthodontic patients. The aim of this review is to summarize recent concepts on craniofacial growth, overlap these theories with the development of the general scientific knowledge, and suggest a more integrated multidisciplinary person-based approach.

Methodology:

MEDLINE, EMBASE, Pubmed, CINAHL and Google Scholar were screened from inception to February 2014 for relevant papers. Grey literature was considered as part of the search.

Conclusions:

The influence of new scientific discoveries and intuitions about craniofacial growth produced further insights in orthodontics care, shifting the paradigm from a pre-determined, sectorial treatment to an individualized, multidisciplinary patient-centered approach aiming to enhance the quality of orthodontic assistance.