A comparative study of craniofacial measurements between Ryukyuan and mainland Japanese females using lateral cephalometric images

Using lateral cephalometric images, we compared the skeletal and soft tissue configurations of Ryukyuan and mainland Japanese females. We collected lateral cephalometric images of 30 females each from Okinawa Island and mainland Japan. Sixty landmarks were plotted on each image. Then, based on the coordinates of the landmarks, 68 distances and 34 angles were calculated according to orthodontic and anthropometric methods. We confirmed that the Ryukyuans have a smaller height in the upper and midfacial region than the mainland Japanese. Moreover, our findings indicate that, compared with the mainland Japanese females, the Ryukyuan females clearly have the following features: (1) a shallower mandibular notch, (2) an anterior-inclined symphysis of mandible, and (3) a smaller depth from upper lip to incisors. We also found that an anterior-inclined mandibular corpus and incisors are associated with a smaller distance between the surfaces of the upper lip and teeth and with a more protruded lip shape

Age-dependant cephalometric standards as determined by multilevel modeling

Introduction: The purpose of this study was to evaluate the feasibility of constructing age-dependant cephalometric standards for white subjects by using 3 data sets. Methods: The data sets were the samples from the Fels Longitudinal Study (United States), the Michigan Growth Study (United States), and the Nijmegen Growth Study (The Netherlands). The 3 mixed-longitudinal samples provided data for 218 girls and 231 boys between 9 and 14 years of age and were compared based on 4 cephalometric angles: SNA, SNB, ANB, and SN/GoMe. Curve-fitting and statistical comparisons were performed with multilevel modeling procedures. Results: All 4 angles showed linear changes over time. SNA and SNB increased, whereas ANB and SN/GoMe decreased. Based on paired-sample comparisons, the samples displayed statistically significant (P <0.05) differences for 50% of the growth velocities and 8% to 17% of the intercepts (size of the angle at 11 years). The SNA and SNB angles showed small and inconsistent differences across the samples. The ANB angle for the Fels boys decreased less than in the other 2 samples. The Nijmegen and Fels girls had the greatest and the least decreases, respectively, in the SN/GoMe angle. Most sample differences decreased over time. Conclusions: Based on the growth differences identified, we concluded that sagittal and vertical jaw relationships have different patterns of growth in different samples of white subjects; indiscriminate pooling of data, to create age-dependant cephalometric standards for white subjects is not recommended

Reliability of maximum bite force measurements in age-varying populations

Summary In order for bite forces to be used clinically, they must be reliable. While bite force transducers are accurate and precise during bench tests, widely varying reliabilities of intra-oral bite forces have been reported when measured in human subjects. Because few studies have reported total reliability, the clinical use of intra-oral bite forces measurements remains questionable. The purposes of this study were to (i) estimate total reliability, including both within- and between-session reliabilities, of repeated maximum incisor and molar bite force measurements and (ii) demonstrate how extraneous variation affects reliability by comparing estimates for which the effects of age have and have not been controlled. A sample of 28 healthy subjects with Class I normal occlusion (seven subjects in each of four age groups: 5, 8, 11 and 14 years) performed two sessions approximately 90 min apart. Each session consisted of three maximum voluntary bites at three bite positions (incisor and right and left molars). For each bite position, between-subject variance (true variance), between-session variance and within-session variance were calculated using Multilevel modelling procedures. The variances were used to estimate between-session reliabilities, within-session reliabilities and total reliabilities. Within-session reliabilities were substantially higher than between-session reliabilities, which in turn was higher than total reliabilities at all bite positions. Reliabilities were highest at the incisor bite position. Not controlling for age effects substantially overestimated total reliability at all bite positions. After controlling for age effects, total reliabilities of repeated maximum bite forces were low to moderate. © 2009 Blackwell Publishing Ltd

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

Are maximum bite forces of subjects 7 to 17 years of age related to malocclusion?

Objective: To determine the effects of occlusion on maximum bite force of growing subjects. Materials and Methods: Incisor and first molar bite force of children and adolescents was evaluated. Four cohorts were measured annually for 3 years, starting at approximately 7, 9, 12, and 15 years of age, respectively. The initial sample included 182 females and 198 males; there were 130 subjects with normal occlusion, 111 with Class I malocclusion, and 139 with Class II malocclusion. Multilevel analyses were performed to model the growth changes and compare groups. Results: Maximum bite force increased significantly (P < .05) over time. Incisal forces peaked at 14.3 and 15.3 years of age for females and males, respectively. Maximum molar bite force peaked at 16 years for both males and females. Subjects with normal occlusion had significantly higher bite force than subjects with malocclusion. Maximum molar bite force exhibited a significant testing effect, with forces increasing 2.6 kg each year that the tests were repeated. Conclusions: Malocclusion has a detrimental effect on bite force. Changes in maximum bite force are also due to age, sex, and repeated testing

Mandibular asymmetry in patients with the Crouzon or Apert Syndrome

The aim of this study was to describe directional and fluctuating mandibular asymmetry over time in children with Crouzon or Apert syndrome. Mandibular asymmetry of children between 7.5 and 14 years of age with Crouzon syndrome (n = 35) and Apert syndrome (n = 24) were compared with controls (n = 327). From panoramic radiographs, mandibular directional and fluctuating asymmetry was determined for the three groups. Multilevel statistical techniques were used to describe mandibular asymmetry changes over time. Patients with Crouzon and Apert syndromes showed statistically significant more fluctuating asymmetry for mandibular measures than did controls. Between the Crouzon and Apert syndromes groups, no statistical differences were found in directional and fluctuating asymmetry. The control group showed statistically significantly more directional asymmetry than did patients with Crouzon or Apert syndrome. The controls showed no change over time for the directional asymmetry of condylar-ramal height; however, the directional asymmetry of the gonial angle increased. Patients with Crouzon syndrome showed side dominance for only condylar-ramal height; whereas, patients with Apert syndrome did not show dominance for any of the measurements. Apert and Crouzon syndromes showed developmental instability, in contrast to the controls. No statistically significant longitudinal differences were found for either the directional or the fluctuating asymmetry between Crouzon and Apert syndromes. Findings for fluctuating and directional asymmetry for both syndromes may indicate an inability to cope with genetic and environmental stress during development and treatment, compared with untreated nonsyndromic individuals

A longitudinal study of dental arch morphology in children with the syndrome of Crouzon or Apert

The aim of this study was to compare changes in dental arch morphology between patients with Crouzon syndrome or Apert syndrome and controls. Children between 4 and 14 yr of age with Crouzon syndrome (n = 40) or Apert syndrome (n = 28) were compared with non-syndromic controls (n = 457) in terms of arch widths, depths, and length dimensions. Multilevel statistical modeling techniques were used to evaluate changes over time. Dental arch dimensions were found to be smaller in patients with Crouzon syndrome or Apert syndrome compared with control subjects. Maxillary intercanine width for patients with Apert syndrome were increased, whilst other arch width variables showed no change. Patients with Crouzon syndrome showed increases in maxillary intercanine width, whilst intermolar width showed no change over time. Dental arch dimensions in syndromic patients were thus found to be consistently smaller than in control subjects between 4 and 14 yr of age, implying that patients with Crouzon syndrome and Apert syndrome had a diminished growth potential

Craniofacial stability in patients with crouzon or apert syndrome after le fort III distraction osteogenesis

Objective: Le Fort III osteotomy with distraction osteogenesis (DO) is used to improve the retruded midface in patients with Crouzon or Apert syndrome. This study aimed to evaluate sagittal and vertical preoperative and postoperative cephalometric changes of DO of the midface in patients with Crouzon or Apert syndrome. Design: Population-based case-control study. Patients and Methods: Records of patients with the syndrome of Crouzon (N=6) or Apert (N= 7) were compared, before and after Le Fort III DO, with a nonsyndromic untreated control group (N = 486). Main Outcome Measures: Sagittal and vertical cephalometric maxillary landmarks and measurements were used to predict and measure midface advanc