Lip-nasal aesthetics following Le Fort I osteotomy

Forty-one patients undergoing Le Fort I osteotomy for superior and/or anterior repositioning of the maxilla were prospectively studied for changes in soft-tissue morphology of the nasomaxillary region. Nasal parameters studied were changes in interalar rim width and nasal tip projection. It was observed that alar rim width increases with anterior and/or superior repositioning of the maxilla, but increases in nasal tip projection occur only when there is an anterior vector of maxillary movement. These nasal changes could not be quantitatively correlated to magnitude of maxillary movement. Lip changes studied were the horizontal displacement at the vermilion border and subnasale versus that of the incisal edge and point A, respectively, when the maxilla is sagittally advanced and the vertical shortening of the lip versus that of the incisal edge when the maxilla is shortened. Using linear regression analysis, horizontal displacement of the upper lip at the vermilion border was 0.82 +/- 0.13 mm for every 1 mm of maxillary advancement at the incisal edge (p less than 0.001) and 0.51 +/- 0.13 at the subnasale for every 1 mm of maxillary advancement at point A (p less than 0.001). Eighty percent of patients undergoing maxillary intrusive procedures had lip shortening ranging from 20 to 50 percent of the vertical maxillary reduction. Surprisingly, no statistically significant correlation could be demonstrated for lip shortening versus extent of vertical maxillary reduction. Previous literature in disagreement with these findings is discussed. Guidelines for treatment planning utilizing these data are suggested.     

Age-related variability in occlusal wear planes

Investigation of two populations of 136 individuals shows several patterns of occlusal wear plane change which are positively correlated with age. For individuals up to the age of 18, there is a characteristic pattern in which the occlusal wear planes of the mandibular teeth are lingually sloped and those of the maxillary dentition buccally sloped, with the exception of the maxillary premolars, which are also lingually sloped. The long axes of the mandibular teeth give them a lingual orientation relative to the maxillary teeth, and the long axes of the maxillary molars, by contrast, are buccally oriented. In the 18-30 age range for all sexes, the mandibular M1 becomes buccally sloped on its occlusal surface while the occlusal wear plane on the maxillary M1 becomes lingually sloped. Later age changes indicate a trend for the mandibular premolars to become buccally sloped, while the wear planes of the maxillary premolars remain lingually sloped. There is a corresponding tendency for the maxillary and mandibular second molars to undergo changes in the initial orientation of the occlusal wear planes.     

Velopharyngeal function following maxillary advancement.

In a series of 40 patients who had maxillary advancements, none developed velopharyngeal incompetence. Unlike the cleft palate patient who is more at risk, there are distinct anatomical characteristics in craniofacial dysostosis which favor maintenance of the integrity of the velopharyngeal mechanism. Hyponasality was eliminated in 5 patients with Crouzon's disease. On cephalometric study, it was observed that after maxillary advancement the nasopharyngeal volume was expanded and the angle formed by the hard and soft palates was increased. On phonating cephalograms, the velopharyngeal contact became more physiological after maxillary advancement in the craniofacial dysostosis patient. The only postoperative articulatory changes after maxillary advancement were in the production of the /s/ sound, which is particularly sensitive to changes in dentoalveolar relationships.     

Maxillary sinus atelectasis in a wild born gibbon (Hylobates moloch)

In a mixed sex sample of ten adult gibbon (Hylobates moloch) skulls, one cranium of a male with maxillary sinus atelectasis of the left side was identified. While external inspection revealed a slight drop of the left orbital floor, serial coronal computer tomography (CT) scans show characteristic changes of the left maxillary sinus and its surrounding structures. In addition to the sunken orbital floor, radiological features of the specimen include an inward bowing of the medial sinus wall, sinus opacification, and a reduction in maxillary sinus size to a slit-like cavity, which suggest a diagnosis of silent sinus syndrome. This report is the first, to our knowledge, of maxillary sinus atelectasis in a non-human primate. This finding is valuable for the understanding of the pathogenesis and etiology of maxillary sinus atelectasis. At the same time, however, paleoanthropologists and primatologists may refer to this information when dealing with the interpretation of maxillary sinus pneumatization of partially broken archaeological and fossil skulls.     

The Effects of Maxillary Protraction with or without Rapid Maxillary Expansion and Age Factors in Treating Class III Malocclusion: A Meta-Analysis

We conducted a comprehensive meta-analysis of 12 studies to examine whether maxillary protraction face mask associated with rapid maxillary expansion (FM/RME) could be an effective treatment for Class III malocclusion and to evaluate the effect of timing on treatment response. Patients with a maxillary deficiency who were treated with FM with or without RME were compared with those who had an untreated Class III malocclusion. In both treatment groups, forward displacement of the maxilla and skeletal changes were found to be statistically significant. In addition, posterior rotation of the mandible and increased facial height were more evident in the FM group compared with the control group. However, no significant differences were observed between the early treatment groups and late treatment groups. The results indicated that both FM/RME and FM therapy produced favorable skeletal changes for correcting anterior crossbite, and the curative time was not affected by the presence of deciduous teeth, early mixed dentition or late mixed dentition in the patient.     

Unicausal theories of human canine evolution: are they sufficient?

Most theories of human canine evolution are unicausal and only purport to explain size and related shape changes in human canines. The present work tests whether one of the morphological changes, dulling of the distal edge of the maxillary canine, can be entirely explained as a byproduct of changes in the overall shape of the canine. The data show that the distal edge of maxillary canines of A. afarensis became far duller than would be predicted from changes in crown shape. The greater than expected dullness of the distal edge can be explained by evolutionary changes in the genetic field for cheek tooth morphology. This suggests that human canine evolution is complex and cannot be accounted for by unicausal theories.     

Maxillary sinusitis as an indicator of respiratory health in past populations

Chronic infectious respiratory disease in a past human population is investigated through the quantification of maxillary sinusitis among Iroquoian horticulturists. Three hundred forty-eight right and left maxillae of a Southern Ontario Iroquoian skeletal sample, Uxbridge Ossuary, ca. AD 1440, were examined for evidence of chronic infection (minimum number of individuals = 207: 114 adults, 22 adolescents, 38 juveniles and 33 infants). Modern clinical criteria were applied to differentiate lesions of respiratory and dental origin. Osseous lesions of the maxillary sinuses were observed in 50% of the individuals examined. These lesions are morphologically consistent with nonspecific lesions observed in other past populations that have been attributed to the presence of pathogens. The prevalence of maxillary sinusitis increases with age. Osseous changes suggestive of maxillary sinusitis of respiratory origin are at a maximum prevalence in juveniles and adolescents. In adults, infection of dental origin becomes a confounding factor in the identification of sinusitis of respiratory origin. Fifteenth century Iroquoians were experiencing high airborne pathogen levels and poor indoor air quality. The prevalence of maxillary sinusitis and the exploration of the origin of tissue injury may contribute to our reconstruction of the quality of life and the respiratory health status of past human populations.     

Analysis of Drosophila proboscipedia mutant alleles.

Proboscipedia (PB) is a HOX protein required for adult maxillary palp and proboscis formation. To identify domains of PB important for function, 21 pb point mutant alleles were sequenced. Twelve pb alleles had DNA sequence changes that encode an altered PB protein product. The DNA sequence changes of these 12 alleles fell into 2 categories: missense alleles that effect the PB homeodomain (HD), and nonsense or frameshift alleles that result in C-terminal truncations of the PB protein. The phenotypic analysis of the pb homeobox missense alleles suggests that the PB HD is required for maxillary palp and proboscis development and pb - Sex combs reduced (Scr) genetic interaction. The phenotypic analysis of the pb nonsense or frameshift alleles suggests that the C-terminus is an important region required for maxillary palp and proboscis development and pb-Scr genetic interaction. PB and SCR do not interact directly with one another in a co-immunoprecipitation assay and in a yeast two-hybrid analysis, which suggests the pb-Scr genetic interaction is not mediated by a direct interaction between PB and SCR.     

Palatal growth in baboons (Papio cynocephalus anubis)

In this study the structure and development of the palate as observed in a cross-sectional collection of olive baboons (Papio cynocephalus anubis) skulls are described and analyzed using craniometric techniques. Considered are structural functional relationships among different parts of the palate, and between the palate and other parts of the craniofacial skeleton. Several inferences are drawn and speculated upon. These inferences are as follows: odontogenesis affects premaxillary growth the most during late fetal and early postnatal development; maxillary length is significantly affected by development and eruption of the maxillary dentition, whereas maxillary breadth is less affected by dental development. Growth of the palatine bones and nasopharyngeal airway is correlated with dentomasticatory changes; the developmental and functional significance of these correlations is unclear. Further inferences are that growth rates for each palatal component differ for each sex even though lengths of the components relative to total palatal dimensions show no sexual dimorphism. Also, it is determined that maxillary length remains constant, premaxillary length reduces and palatine length increases relative to total palatal length with growth.     

A comparative study of facial growth in Homo and Macaca

Sections were prepared throughout all areas of the various facial bones in young, growing Rhesus monkeys. The detailed distribution of resorptive and depository surfaces and the distribution of endosteal and periosteal bone tissue types were determined. From this information, the sequence of remodeling changes associated with the growth of the facial skeleton was then interpreted. This study is a sequal to previous reports in which growth and remodeling processes in the human face were described using similar procedures. In the present report, growth changes in the monkey and human facial skeleton are compared and contrasted. The general plan of facial growth is similar in both species, but major differences exist in the area of the muzzle. The maxillary arch in the monkey is entirely depository in nature, and it grows in a forward and downward direction as the maxillary tuberosity simultaneously grows backward. In the human, the forward part of the maxillary arch is resorptive in character. This contrasting growth factor results in a downward but not forward movement of this area. The result is decreased prognathism. Other differences in growth pattern exist in the forehead, malar, chin, and orbit. The developmental and phylogenetic basis for the upright human face is discussed and evaluated.     

Comparison of the response to histamine challenge of the nose and the maxillary sinus: effect of loratadine.

To study the response of the maxillary sinus to histamine provocation, we performed a double-blind, randomized, crossover trial during which nonallergic subjects without symptoms of rhinitis (n = 25) received either 10 mg loratadine or placebo once daily for a week and then underwent nasal challenge with histamine (3, 10, and 30 mg/ml) followed, 24 h later, by a maxillary sinus challenge while still receiving the medication. Nasal challenge with histamine led to significant increases in vascular permeability, reflex nasal secretions, sneezing, and other nasal symptoms. Sinus challenge resulted in significant increases in vascular permeability within the sinus cavity (P < 0.01) and some nasal symptoms but no significant change in reflex nasal secretions. The response of the sinus mucosa to histamine was lower in magnitude than that of the nose. Treatment with loratadine resulted in a significant inhibition of the histamine-induced changes in both nasal and sinus cavities. Our data suggest the lack of a sinonasal reflex response to histamine provocation of the maxillary sinus of nonallergic individuals.     

Effects of prostaglandin E2 on alveolar bone resorption during orthodontic tooth movement

Twenty Sprague-Dawley rats weighing 280-300 g were divided into two groups of ten animals each. They were treated by daily submucosal injections of 50 micrograms prostaglandin E2 (PGE2) per kilogram body weight into the region below the apex of the left first maxillary molar (experimental), or vehicle into the region below the apex of the right first molar (control), for a period of 5 days. The animals of the first group were sacrificed immediately following the treatment period, while those of the second group were sacrificed 5 days after the treatment period. Twenty-two hours prior to sacrifice, a piece of latex orthodontic elastic was secured to the adjacent area between the first and second maxillary molars of both sides of each rat by using two mosquito hemostats. The periodontal ligament (PDL) mesial to the mesiobuccal root of the first maxillary molar was assayed for changes in PDL cell factors. The results showed that immediately following the 5-day treatment period the left PDL had a significant decrease in the total number of fibroblasts and a significant increase in the total number of both osteoclasts and nuclei per osteoclast, while no significant changes in the osteoblasts when compared with those of the right control PDL. The left PDL of animals which were sacrificed 5 days after the treatment period revealed a significant decrease in the number of total fibroblasts and only a slight decrease in both numbers of total osteoclasts and total nuclei per osteoclast, but again no significant changes in osteoblasts when compared with those of the right control PDL.(ABSTRACT TRUNCATED AT 250 WORDS)     

Maxillary volume growth in childhood

Nasomaxillary abnormalities in form, position, and development in children are often prominent features of craniosynostosis, and in particular, craniofacial dysostosis. While attempting to quantitatively assess the volumetric maxillary deficiency in these patients, it became apparent that there was no "normal" reference range for maxillary volumes throughout childhood that could be used for comparison. The aim of this study was to generate a model for measuring maxillary volume and subsequent changes throughout childhood. The technique of segmentation was applied to magnetic resonance images obtained in 55 healthy children (30 boys, 25 girls), aged 1 month to 184 months (15.33 years). Maxillary volumes were plotted against age for boys and girls to create a model for normal maxillary growth during the first 15 years of life. Maxillary volumes were larger in boys at all ages. However, the pattern of maxillary growth in boys and girls was similar and could be divided into three periods, each lasting approximately 5 years. During the first 5 years of life, there is a steady increase in maxillary volume, at the end of which the maxilla has reached 53 percent of the volume recorded at 15 years. There is an accelerated rate of growth between 5 and 11 years, which corresponds to the development and eruption of the permanent dentition. Thereafter, until the age of 15 years, the rate of growth of the maxilla plateaus. Maxillary volume in the first 12 months of life is, on average, 29 cm3 in boys and 25 cm3 in girls. By 15 years of age, it has increased to an average of 73.0 cm3 in boys and 59.4 cm3 in girls (an increase by a factor of 2.5 in boys and 2.4 in girls). The difference between the two sexes is statistically significant for the entire series (boys: mean maxillary volume = 56.55 cm3, SD = 24.61; girls: mean maxillary volume = 40.68, SD = 17.69, p = 0.009, one-way analysis of variance).     

Morphological observations in normal primary palate and cleft lip embryos in the Kyoto collection

Normal developmental events during human primary palate formation and alterations associated with cleft lip remain poorly defined. The purpose of this study was to analyze serially sectioned human embryos to identify morphological changes during normal palatal closure and alterations associated with failure of palatal formation. Normal and cleft embryos from the histological collection at the Congenital Anomaly Research Center at the University of Kyoto were studied and photographed for detailed evaluation. Seven serially sectioned cleft lip embryos of stages shortly after primary palate formation (Streeter-O'Rahilly stages 19, 20, and 22) with unilateral or bilateral clefts with varying degrees of clefting were studied. In the normal Kyoto embryos, initial nasal fin (epithelial seam) formation was observed between the medial nasal process and the lateral nasal and maxillary processes at stage 17. During stages 18 and 19, the nasal fin epithelium was replaced by an enlarging mesenchymal bridge, as the maxillary processes united with the medial nasal processes to form the primary palate. The most prominent features observed in the cleft embryos were a reduced thickness of mesenchymal bridging between the medial nasal and maxillary processes, with an excessive amount of epithelium at the junctions between these processes. With ingrowth of the maxillary processes, greater cell dispersion and apparent extracellular matrix accumulation were observed in the medial nasal region. During closure of the primary palate, terminal branches of the maxillary nerve crossed the mesenchymal bridge to the medial nasal region. The partial clefts had reduced maxillary ingrowth and smaller union areas with the medial nasal process. Detailed studies of experimental animal models are required to identify regional growth required for contact between the facial prominences, to clarify the mechanisms of mesenchymal ingrowth and epithelial displacement during palatal formation, and to identify local and/or general factors causing alterations that lead to primary palatal clefting.     

The British dental arch

Thirty-two dimensions of the maxillary and mandibular dental arches were measured on 320 adult skulls derived from Anglo-saxon to modern times. Multivariate analysis showed varying patterns of contrast between the samples, depending upon which arch dimensions were considered. The results suggest that dental arch changes occur independently of jaw changes.     

Clinal variation of maxillary sinus volume in Japanese macaques (Macaca fuscata)

Macaques (genus Macaca) are unique among cercopithecids in that they possess a maxillary sinus, and among anthropoids in that they demonstrate a relatively weak relationship between the size of this sinus and the cranium. To test the hypothesis that extrinsic factors may contribute to maxillary sinus size variation, a sample of 46 Japanese macaque (M. fuscata) crania from known localities were subjected to computed tomography (CT) imaging, and sinus volume and nasal cavity area were analyzed relative to latitude and temperature variables. The results suggest that the environmental factors are significant determinants of nasal cavity size in Japanese macaques, but that the relationships between the environment and maxillary sinus volume (MSV) are probably a passive consequence of changes in the size of the nasal cavity. The sinus shrinks as the nasal cavity expands, due to an increased need to condition inspired air in colder climates. This in turn suggests that the sinus itself does not contribute significantly to upper respiratory function.     

Ultrastructure of the maxillary organ of Scutigera coleoptrata (Chilopoda, Notostigmophora): description of a multifunctional head organ

The maxillary organ of Scutigera coleoptrata was investigated using light microscopy, electron microscopy, and maceration techniques. Additionally, we compared the maxillary organ of S. coleoptrata with those of two other notostigmophoran centipedes, Parascutigera festiva and Allothereua maculata, using SEM. The maxillary organ is located inside the posterior coxal lobes of the first maxillae and extends posteriorly as sac-like pouches. The narrow epidermis of the maxillae is differentiated to form the epithelium of the maxillary organ. Two types of epithelia are distinguishable: a simple cuboidal epithelium of different height and differentiation (types I, II, IV) and a pseudostratified columnar epithelium (type III). These epithelia are covered by a highly specialized cuticle. The pseudostratified epithelium is the most prominent feature of the maxillary organ. It is covered with hundreds of setae, protruding deep into the maxillary organ. Two different types of setae can be distinguished, filiform and fusiform. The maxillary organ communicates with the oral cavity, the maxillary organ gland, the maxillary nephridium, and with a large number of epidermal glands that secrete into the maxillary organ. Epithelium III allows the extension of the maxillary organ when its pouches are filled with secretion. The maxillary organ is a complex multifunctional organ. The organ probably stores excretion from the maxillary nephridia and secretory fluid from the maxillary organ gland and other epidermal glands. The fluid is primarily required as preening fluid. The ammonia of the excretory fluid is thought to evaporate via the setae and the wide opening of the maxillary organ. It is likely that parts of the fluid can be reabsorbed by the animal via the oral cavity.     

Adaptive variability of the gustatory system receptor part of the carp Cyprinus carpio (Cyprinidae, Teleostei) after chronic anosmia

To confirm the existence in fish of the olfactogustatory interactions of adaptive significance, the study was performed of reactions of the receptor part of the carp gustatory system to the complete olfactory deafferentation with use of the method of scanning electron microscopy. Peculiarities of morphological changes of the taste receptor apparatus of the external and oral localization were revealed, and the dynamic of development of the taste receptor adaptive changes was traced for 1–9 months after production of anosmia. Receptors of the intraoral gustatory system had reactions of low statistical significance which were delayed in time by 5–6 months. The receptor apparatus of the external gustatory system receptors of the intraoral taste system showed pronounced hypertrophic changes that appeared since 2–3 months after the beginning of anosmia. The changes consisted in an increase of the area of the taste bud (TB) sensory field and of their number in the sensory zones of the maxillary and mandibular parts. The taste receptors located in the maxillary barbels and in the mandible gular zone had the most expressed reactions to the olfactory deafferentation. In the fish with anosmia, formation of the additional structures of the “external taste” was detected in the form of epidermal processes under the lower lip, which were covered with taste papillae. Thus, it has been shown that the fish olfactory and gustatory systems are functionally interrelated; under conditions of olfactory deprivation the external gustatory system is able to undergo compensatory morphofunctional changes aimed at vicariation of the lost distant chemical reception.     

Tooth wear and compensatory modification of the anterior dentoalveolar complex in humans

In populations living in environments where teeth wear severely, some compensatory modification of the dentoalveolar complex is thought to occur during life whereby functional occlusion is maintained as tooth substance is lost by wear. This study investigates one aspect of this modification process: Changes in the anterior dentoalveolar complex that are accompanied with wear were examined in a series of Japanese skeletal samples. In the prehistoric Japanese hunter-gatherer population heavy wear occurs over the entire dentition. The following changes were demonstrated to have occurred in the anterior segment of the dentition accompanied by wear on the anterior teeth: The anterior teeth tip lingually with wear up to a nearly upright position to fill in interproximal spaces that would have been generated by wear, and to maintain contact relations between adjacent teeth. At the same time, the anterior surface of the maxillary alveolar process also inclines lingually to a certain extent. The amount of lingual tipping is greater in the maxillary anterior teeth than in their mandibular antagonists. It is because of this discrepancy that, with age, the horizontal component of the overlap between maxillary and mandibular anterior teeth decreases, and their bite form changes from scissor bite to edge-to-edge bite. Lesser degrees of lingual tipping of the anterior teeth were also detected in the prehistoric agriculturists and historic Japanese populations. The variation in the degree of lingual tipping observed among the samples is explained by inter-population variation in severity and pattern of tooth wear. This and other evidence suggests that mechanisms that compensate for wear in the anterior dentition may be characteristic of all living human populations, independently of the degree of wear severity endured in their environments.     

The evolution of venom-delivery systems in snakes

The Colubroidea represents approximately 2300 of the 2700 species of living snakes and includes all venomous taxa. Although many morphological studies of colubroid snakes have been carried over the last hundred years, the phylogenetic relationships within this group are poorly known. In this study, components of the venom-delivery system (VDS) were examined within the context of two conflicting phylogenetic hypotheses proposed in 1988 by Cadle and in 1998 by Kraus & Braun. The results suggest that several major morphological changes occurred early in colubroid evolution: a Duvernoy's gland evolved, the posterior maxillary teeth became specialized relative to the anterior maxillary teeth, and the attachment of the pterygoideus muscle moved forward to a position associated with the posterior maxillary teeth. These innovations may have allowed the great radiation of colubroid snakes that led to the Colubroidea representing such a large percentage of living snakes. More recently, three separate lineages of colubroids have independently evolved highly specialized front-fanged VDSs with large and complex venom glands, venom gland compressor muscles, and tubular fangs.  © 2003 The Linnean Society of London, Zoological Journal of the Linnean Society, 2003, 137 , 337−354.