Longitudinal cephalometric standards for the neurocranium in Norwegians from 6 to 21 years of age

The purpose of this study was to establish and describe normative cephalometric standards of the neurocranium (theca cranii and cranial base) for Norwegian males and females from 6 to 21 years of age using lateral cephalograms. The subjects included 35 males and 37 females from the Oslo University Growth Archive with lateral cephalograms taken every third year from 6 to 21 years of age. The total number of lateral cephalograms was 194 from males and 200 from females. All subjects were Caucasian, all had normal occlusion and no apparent facial disharmony, and none had undergone orthodontic therapy. Nineteen measurements and three indices of the neurocranium were analysed longitudinally. Comparisons between the various parameters in the neurocranium of males and females in each age group were performed using the Student's t-test. The size of the neurocranium of females was smaller than that of males throughout the observation period and the differences increased with age, particularly the diameter of the neurocranium (n-l), length of the neurocranium (n-opc), anterior cranial base length (n-s), and posterior cranial base length (s-ba). The cephalometric standards of the neurocranium established in this study can be used as a reference material in investigations of individuals with various craniofacial aberrations and syndromes.     

Post-natal size and morphology of the sella turcica in Williams syndrome

Williams syndrome (WS) is a rare congenital disorder with distinctive craniofacial features, cardiovascular abnormalities, mental retardation, and behaviour characteristics.The purpose of this study was to investigate the size and morphology of the sella turcica on profile cephalograms in a group of individuals with WS. The material consisted of radiographic cephalograms of 62 Norwegian children, adolescents, and adults with an age range of 4.7-44.4 years. The length, depth, and diameter of the sella turcica were measured and the mean values were compared with normal reference material from the Oslo University Craniofacial Growth Archive. In total, the two-dimensional size of the sella turcica in the WS group was smaller in length, depth, and diameter compared with the control group, but only occasionally reached a significance level of 5 per cent (Student's t-test).The morphology of the sella turcica was assessed and five different morphological types were identified; oblique anterior wall, extremely low sella turcica, sella turcica bridging, irregularity (notching) in the posterior part of the dorsum sellae, and pyramidal shape of the dorsum sellae. The occurrence of these morphological types was more frequent in the WS subjects compared with the reference material, except for sella turcica bridging, which was equally frequent. The females with WS had more dysmorphic sella turcicas than males.This study has demonstrated morphological aberrations in the sella turcica in Norwegian individuals with WS, which should be further elucidated in future research and combined with neurological andendocrinological investigations.     

A cephalometric morphometric study of the sella turcica

The purpose of this study was to use quantitative methods to measure the size and shape of the sella turcica and thus establish normative reference standards that could assist in a more objective evaluation and detection of pathological conditions. Standardized lateral cephalograms of 184 healthy Greeks (91 males and 93 females) were used. The age range was between 6 and 17 years. Conventional measurements included three different heights of the sella turcica (anterior, posterior, median), its length, and width, measured in relation to the Frankfort reference line. In addition, the area of sella turcica was calculated. Morphometric methods were used to assess shape. The tracings were superimposed using the Procrustes method, and the average shape was computed. Principal component analysis (PCA) was used to assess shape variability. The data were correlated with centroid size, age, and gender. Unpaired t-tests were used to determine gender differences. Sella height anteriorly was the only variable found to be significantly different between the genders, being larger in females by 0.5 mm. Linear and area measurements were found to be significantly correlated with age, but all correlations were low (r(2) below 8 per cent). Sella turcica shape, as described by PCA, was different between males and females, mainly at the posterior aspect of the sella outline. However, although there was an extensive overlap between the genders, and differences were minimal. Age was not found to be correlated with the shape coefficients, although, in the female group, the first principal component of shape was marginally not significant. Allometry was observed in both genders, the sella showing a tendency towards a flatter and wider shape with increase in size. The results of this study constitute quantitative reference data that could be used for objective evaluation of sella shape.     

The morphology of sella turcica in cleft and non-cleft individuals

Aims and ObjectivesThe aim of the study was to analyze the morphology and expedient the linear dimensions of Sella Turcica among cleft and non-cleft Indian individuals, and then to determine whether differences exist between different study groups.Materials and methodsThe lateral cephalogram of 300 patients (150 cleft and 150 non-cleft), aged 18 to 30 years who reported for various treatments of malocclusions were studied.ResultThe normal morphology of the sella turcica were seen in 85 of the 150 non-cleft individuals which was highest (56.66%) in the non-cleft group, however in the cleft group it was seen in only 16 of the 150 individuals (10.6%). Sella turcica bridge were seen in 10% of the non-cleft subjects, whereas in the cleft group it was seen in 38% of the individuals. A significant difference was seen in the linear measurements of the sella turcica of cleft and no-cleft individuals.ConclusionThe normal morphology of the sella turcica was seen in the majority of the non-cleft individuals. The cleft individuals showed an increased incidence of sella turcica bridging with reduced linear measurements of the sella as compared to the non-cleft individuals.     

Maxillary and sella turcica morphology in newborns with cleft lip and palate.

OBJECTIVE: The first aim was to examine maxillary developmental fields by analyzing bone size parameters within the maxillary bone complex in newborns with unilateral cleft lip (UCL) and unilateral cleft lip and palate (UCLP). The second aim was to evaluate sella turcica morphology in unilateral cleft lip and unilateral cleft lip and palate. SUBJECTS AND METHODS: Axial and profile radiographs from 40 newborns (boy-girl, 1:1) in each group (20 unilateral cleft lip and 20 unilateral cleft lip and palate) were randomly selected among radiographs taken for optimizing treatment planning. Analysis of maxillary bone size was performed on axial radiographs and size parameters were measured. Furthermore, analysis of sella turcica morphology was performed on profile radiographs. The results were divided into groups with normal morphology and severe deviations in the morphology. RESULTS: The maxillary areas were significantly shorter and broader in unilateral cleft lip and palate than in unilateral cleft lip. A profound asymmetry in the maxillary areas was seen in unilateral cleft lip and palate, but not in unilateral cleft lip. In both cleft types, approximately half of the individuals had deviations in sella turcica morphology. The most severe deviations occurred in newborns with unilateral cleft lip and palate. CONCLUSIONS: In newborns with unilateral cleft lip and palate, the maxillary areas are significantly shorter, broader, and more asymmetric than in newborns with unilateral cleft lip. The present study showed that bone structures are a suitable parameter for characterizing the craniofacial developmental fields. Additionally, a high incidence of deviations in sella turcica morphology might indicate that this area is affected in individuals with clefts.     

Longitudinal cephalometric changes in the maxilla, mandible and maxillary-mandibular relationship between 10 and 14 years of age

In the present study, longitudinal growth changes in the maxilla, mandible, and maxillary-mandibular relationship occurring between the ages of 10 and 14 years were evaluated in 19 female and 15 male subjects. All subjects had a clinically-acceptable occlusion, a normal growth pattern, and none had undergone orthodontic treatment. Serial cephalometric radiographs were taken at the ages of 10, 11, 12, and 14 years. The effects of age and sex on the sagittal growth of the jaws were studied by means of variance analysis. The results show that A-Ptm, B-Ptm, Pg-Ptm, A'-Ptm, B'-Ptm, and S-N-Pg measurements were affected by age, and the measurements A-Ptm, A'-Ptm, Wits and ANB by sex. Duncan's multiple range test was applied to those measurements where F values were found to be statistically significant. As a result, it was observed that the greatest growth changes occurred between 12 and 14 years old.     

Longitudinal cephalometric changes in incisor position,overjet, and overbite between 10 and 14 years of age

The purpose of this study was to evaluate the longitudinal growth changes in the incisor position, overjet, and overbite between 10 and 14 years of age. Serial cephalometric radiographs of 63 subjects (31 boys and 32 girls) were taken at the ages of 10, 11, 12, and 14. The effects of age and gender on the incisor positions, overjet, and overbite were investigated by means of variance analysis and least square difference (LSD) tests. The results show that the measurements of overbite, upper incisor-NA (mm), lower incisor-NB (mm), upper incisor-NA (angle), and the interincisal angle were affected by age. The results also show that the measurements of overbite, upper incisor-NA (mm), upper incisor-NA (angle) and upper incisor-SN (angle) were affected by gender.     

Longitudinal study of cephalometric soft tissue profile traits between the ages of 6 and 18 years

Objective:To study the longitudinal changes in 19 soft tissue cephalometric traits (according to the Bergman cephalometric soft tissue facial analysis).Materials and Methods:Cephalograms and photographs of 40 subjects (20 male, 20 female, from the Burlington Growth Centre) that were obtained at ages 6, 9, 12, 14, 16, and 18 years were used. Subjects were orthodontically untreated whites and had Class I dentoskeletal relationships (ideal overjet and overbite). Images were obtained with the lips in a relaxed position or lightly touching.Results:Three groups of soft tissue traits were identified: (1) traits that increased in size with growth (nasal projection, lower face height, chin projection, chin-throat length, upper and lower lip thickness, upper lip length, and lower lip–chin length); (2) traits that decreased in size with growth (interlabial gap and mandibular sulcus contour [only in females]); and (3) traits that remained relatively constant during growth (facial profile angle, nasolabial angle, lower face percentage, chin-throat/lower face height percentage, lower face–throat angle, upper incisor exposure, maxillary sulcus contour, and upper and lower lip protrusion).Conclusion:Current findings identify areas of growth and change in individuals with Class I skeletal and dental relationships with ideal overjet and overbite and should be considered during treatment planning of orthodontic and orthognathic patients.     

Cranial base morphology in cleft lip and palate: a cephalometric study from 7 to 18 years of age.

Four cleft lip/palate groups were cephalometrically compared with a noncleft control group using three cranial base dimensions: anterior (ACB) and posterior (PCB) cranial base, and cranial base angle (CBa). The groups were compared by age from 7 to 18 years. The results showed that the cleft lip and/or alveolus group was not different from the control group in the three dimensions. Unilateral and bilateral cleft lip and palate and isolated cleft palate cases were generally shorter in ACB and PCB for most of the growth period, particularly after age 8 to 9 years. The cranial base angle remained similar for all the cleft groups when compared with the noncleft group. These findings support the view that intrinsic tissue defects or errors during embryologic development may result in basicranial abnormalities and orofacial clefting.     

上颌侧切牙先天性缺失与蝶鞍相关性研究

目的 比较上颌侧切牙先天性缺失患者和牙列完整患者的蝶鞍大小,评估鞍桥和上颌侧切牙先天性缺失之间是否存在联系.方法 以上颌侧切牙先天性缺失患者作为试验组,牙列完整者作为对照组,每组各80例.利用Dolphin软件测量蝶鞍的大小,记录蝶鞍鞍桥的钙化程度.结果 两组间的蝶鞍大小除长度以外差异均无统计学意义.试验组与对照组在鞍...     

Incremental growth charts for condylar growth between 6 and 16 years of age.

This study provides sex specific reference data for the incremental growth of the mandibular condyle. The results pertain to a mixed-longitudinal sample of 113 males and 108 females followed annually between 6 and 16 years of age (total of 1647 observations). Growth of condylion was evaluated using naturally stable mandibular reference structures. The mean growth curves were estimated by multilevel models using iterative least squares procedures; between subject variation was estimated based on the sample's percentile distributions. Mean yearly velocities of condylar growth for males ranged between 2.1 and 3.1 mm/year. Growth rates decreased during childhood, increased during adolescence, and attained a maximum of 3.1 mm/year at approximately 14.3 years of age. Females showed a more constant rate of condylar growth during childhood (2.0-2.7 mm/year), a smaller adolescent peak (2.3 mm/year) at approximately 12.2 years and rapid deceleration after the peak. These reference data offer orthodontists an objective means of evaluating growth potential and treatment outcome in individual patients. Charts are provided for evaluating condylar growth of individual patients.     

Changes in facial morphology in Macaca mulatta: a cephalometric study from 1.5 to 5 years of age

A cross-sectional and longitudinal (3.5 years) study on the craniofacial growth of 10 male rhesus monkeys, using metallic implants and a radiographic cephalometric technique based mainly on angular measurements, led to the following observations. (1) Maxilla and mandible were displaced in a forward and downward direction during growth, the sagittal changes being predominant over the vertical changes. (2) Maxillary and mandibular prognathism increased continuously during the whole time span. This increase was twice as great for the maxilla as for the mandible. (3) The inclination of the palatal plane and the mandibular plane changed very little over time. (4) Mandibular form remained constant, but the cranial base showed a significant flattening between approximately 1.5 and approximately 3 years of age. (5) Upper and lower occlusal plane angles changed little over time. (6) The interincisal angle decreased significantly until approximately 3 years of age in relation to the increase in proclination of the permanent incisors in the maxilla and mandible. The intermolar angle remained fairly constant. Changes in some of the variables reported (maxillary and mandibular prognathism, sagittal jaw relationship, mandibular length, interincisal angle, proclination of the upper and lower incisors, and opening of the cranial base angle) occurred as a function of age. The use of angular measurements allowed us to develop a series of templates that will provide a useful tool for a quick check of normal craniofacial morphology at three representative time points.     

A cone beam computed tomographic evaluation of the size of the sella turcica in patients with cleft lip and palate

Objective: Changes in the size of the sella turcica are frequently related to pathologies and syndromes. The aim of this was to compare the sella turcica dimensions in patients with unilateral and bilateral cleft lip and palate and non-cleft subjects.

Methods: Cone beam computed tomography (CBCT) images of three groups consisted of 20 patients with unilateral cleft lip and palate; 20 patients with bilateral cleft lip and palate and a control group consisting of 20 non-cleft subjects were the research population in this pilot study. The sella turcica linear dimensions in terms of length, depth and diameter were measured for all subjects. One-way ANOVA test was used to determine any significant differences among the three groups for the measured parameters.

Results: The length, depth and diameter of sella turcica were found to be significantly smaller in the unilateral and bilateral groups compared with the normal age and gender matched group. No significant differences were found in the measured variables between the unilateral and bilateral cleft patients.

Conclusion: CBCT images showed a greater likelihood of abnormal sella turcica dimensions in patients with unilateral and bilateral cleft lip and palate. Therefore, the sella turcica dimensions may have an intrinsic relationship to the cleft condition.     

Dentocraniofacial morphology of 21 patients with unilateral cleft lip and palate: a cephalometric study.

OBJECTIVE: To assess the skeletal and dental craniofacial proportions of unilateral cleft lip and palate patients who were operated upon using the Malek technique, and compare them with a normal group to highlight the effect of surgical correction on craniofacial development during growth. DESIGN: Retrospective. METHODS: The cleft palate was closed using the Malek technique in a single operation at 3 months for 11 patients (complete closure of lip and palate) and in a two-stage operation for 10 patients (soft palate at 3 months, lip and hard palate at 6 months). Comparisons were made with a normal control group. Angular and linear measurements of anterior and posterior dimensions of the upper and lower compartments of the face were measured in the 7th and 12th years. RESULTS AND CONCLUSION: No significant differences were observed between the two groups of palate technique repair, although significant differences were observed between craniofacial dimensions of normal versus cleft lip and palate patients. At a skeletal level, the maxilla and mandible were retrusive relative to the cranial base in the cleft lip and palate group. In fact, there was a backward rotation of the palatal plane with repercussions on the maxillo-mandibular complex position. Furthermore, the maxilla was shorter than in normal patients, whereas the mandible was normally shaped. The upper incisors were retroclined and they locked the lower incisors in linguoversion. There was a posterior skeletal deficit of the respiratory compartment, compensated by more marked posterior maxillary alveolar growth. Facial growth in cleft lip and palate patients followed the same pattern, but was delayed compared with normal patients.     

The shape and size of the sella turcica in skeletal Class I, Class II, and Class III Saudi subjects

The purpose of this study was to describe the shape and measure the size of the sella turcica in Saudi subjects with different skeletal types. Lateral cephalometric radiographs of 180 individuals (90 males and 90 females) with an age range of 11-26 years were taken and distributed according to skeletal classification; 60 Class I, 60 Class II, and 60 Class III. The sella turcica on each radiograph was analysed and measured to determine the shape of the sella, in addition to the linear dimensions of length, depth, and diameter. A Student's t-test was used to calculate differences in linear dimensions, while a one-way analysis of variance was performed to study the relationship between skeletal type and sella size. The results show that the sella turcica presented with a normal morphology in the majority of subjects (67 per cent). No significant differences in linear dimensions between genders could be found. When age was evaluated, significant differences were found between the older (15 years or more) and the younger (11-14 years) age groups at the 0.01 and 0.001 levels for length, depth, and diameter. Sella size of the older age group was larger than in the younger age group. When skeletal type was compared with sella size, a significant difference was found in the diameter of sella between the Class II and Class III subjects (P < 0.01). Larger diameter values were present in the skeletal Class III subjects, while smaller diameter sizes were apparent in Class II subjects (multiple comparison tests). When gender, age, and skeletal type were all compared with the size of the sella (regression analyses), age was significantly related to a change of length (P < 0.01) and diameter (P < 0.001). Sella shape and dimensions reported in the current study can be used as reference standards for further investigations involving the sella turcica area in Saudi subjects.     

Adult craniocervical and pharyngeal changes--a longitudinal cephalometric study between 22 and 42 years of age. Part II: Morphological uvulo-glossopharyngeal changes.

The purpose of this study was to investigate, by cephalometric means, longitudinal alterations in uvulo-glossopharyngeal morphology in adult males and females, at three different ages with 10-year intervals, and to compare the changes between the two genders. The material consisted of three series of cephalograms of 26 males and 24 females, with approximately a 10-year interval between each series. Alterations with age in males and females included: 1 An increase in the length, thickness, and sagittal area of the soft palate, with a more upright position for both genders. 2 A more upright tongue position and caudally-extended tongue mass for both sexes was found, and the sagittal area of the tongue was significantly increased only in males. 3 There was a decrease in the sagittal dimension of the oropharynx, and at the minimal distance between the base of the tongue and the posterior pharyngeal wall in both males and females. The overall significant inter-sex differences, over a 20-year period, were that males showed a more upright tongue position and more caudally-extended tongue mass, a greater reduction in sagittal dimension of the minimal pharyngeal airway space, a greater increase in the sagittal area of the soft palate, and an increase in the tongue area.     

6453名17～21岁青年人恒牙发育异常的调查

目的调查青年人恒牙牙齿形态和数目异常的状况。方法2002至2004年对3所北京高校6453名17～21岁学生进行恒牙数目和形态异常的调查。对不同性别和不同牙位发育异常的患病率进行卡方检验，并对2种牙齿异常伴发的情况进行卡方检验。结果牙齿数目和形态异常的总患病率为16．07％。女性锥形牙或桶状牙、畸形中央尖和先天缺牙的患病率高于男性，差异有统计学意义（P〈0．05）。牙内陷、锥形牙或桶状牙好发于上颌侧切牙，畸形中央尖好发于下颌第二前磨牙，融合牙和先天缺牙好发于下颌切牙，差异均有统计学意义（P〈0．01）。锥形牙或桶状牙与先天缺牙伴发的比率高，差异有统计学意义（P〈0．01）。结论各种牙齿数目和形态异常的患病率、性别差异和好发牙位与以往的研究基本相符。但锥形牙或桶状牙、畸形中央尖的女性患病率均高于男性。     

Longitudinal posteroanterior changes in transverse and vertical craniofacial structures between 10 and 14 years of age

Longitudinal growth changes in the transverse and vertical craniofacial dimensions occurring between 10 and 14 years of age were evaluated in 22 female and 23 male subjects. All subjects were healthy, had a clinically acceptable occlusion, and had not received orthodontic or orthopedic therapy before. Serial cephalometric radiographs were taken at ages 10, 11, 12, and 14 years. In studying the P-A cephalograms, seven transverse and five vertical measurements were used. The effects of age and sex on the transverse and vertical growth of the craniofacial structures were investigated by means of analysis of variance and Bonferroni multiple comparison test. The results of the study revealed that all measurements studied were affected by age, and cranial, facial, nasal, and maxillary widths were affected by sex. The most pronounced age-related increases occurred in the mandibular width for transverse measurements and in the total facial height for vertical measurements in both sexes during this study.