Craniofacial suture stenosis: morphologic effects

Craniofacial anomalies, such as Apert's and Crouzon's syndromes, are presumed to be related to premature growth arrest of cranial base growth sites. However, premature growth arrest at cranial vault sutures in animals appears to play a causative role in the development of cranial deformities characteristic of single-suture, or simple, craniosynostosis in humans. To study the possible causative role of cranial vault and other (interface) suture stenoses on the development of craniofacial deformity, a vault suture and an interface suture between the cranial vault and facial skeleton were simultaneously immobilized. Thirty-one New Zealand White rabbits at 9 days of age underwent implantation of dental amalgam growth markers adjacent to cranial vault and facial sutures. In the experimental group (n = 15), methylcyanoacrylate adhesive was applied over the coronal (vault) and frontonasal (interface suture between vault and facial skeleton) sutures to immobilize them. The remaining 16 animals served as sham-treated controls. All animals underwent serial radiographic cephalometry to document growth effects in the cranial vault, cranial base, and facial skeleton. Application of adhesive resulted in statistically significant (p less than 0.05) reduction in growth at the coronal and frontonasal sutures. This was accompanied by an overall significant reduction in neurocranial vault length during the first 30 days of development.(ABSTRACT TRUNCATED AT 250 WORDS)     

Roentgencephalometric measurements in trisomy 8 mosaicism: report of three cases

Roentgencephalometric anomalies in three cases of Warkany syndrome (trisomy 8 mosaicism) are described. These include asymmetry of the mandible with a wide gonial angle and a high and narrow symphysis; SNA (anteroposterior position of maxilla) and SNB (anteroposterior position of mandible) values indicate a backward position of the mandible. Other findings point to a disturbance in the vertical growth of the facial skeleton. These measurements may explain at least part of the facial phenotype and may aid in diagnosis, especially in those cases with an uncertain clinical diagnosis and "normal" karyotype in peripheral blood lymphocytes.     

Allometric relations of teeth and jaws in man

Static adult intraspecific allometry of jaws and teeth was investigated in a sample of 100 Negro crania. The relations between tooth area, postcanine surface, incisor surface, and four viscerocranial measures were examined separately for males and females. Our results indicate a marked lack of morphological integration between P-sets within the orofacial subregion and a similar lack of correspondence between jaw size and tooth size. Allometric analyses indicate that mandibular length scales negatively allometric to maxilloalveolar length and to bigonial width, that canine base area scales positively to upper and lower jaw length, and that all the other teeth scale negatively to jaw length. The postcanine surface area was found to be negatively allometric to the canine base area, which in turn scaled isometrically to incisor surface. Hence, any lengthening of the mandible will tend to be associated with a relative shortening of the maxilla, with relatively larger canines and a relative reduction of the cheek teeth.     

Facial Morphogenesis of the Earliest Europeans

The modern human face differs from that of our early ancestors in that the facial profile is relatively retracted (orthognathic). This change in facial profile is associated with a characteristic spatial distribution of bone deposition and resorption: growth remodeling. For humans, surface resorption commonly dominates on anteriorly-facing areas of the subnasal region of the maxilla and mandible during development. We mapped the distribution of facial growth remodeling activities on the 900–800 ky maxilla ATD6-69 assigned to H. antecessor, and on the 1.5 My cranium KNM-WT 15000, part of an associated skeleton assigned to African H. erectus. We show that, as in H. sapiens, H. antecessor shows bone resorption over most of the subnasal region. This pattern contrasts with that seen in KNM-WT 15000 where evidence of bone deposition, not resorption, was identified. KNM-WT 15000 is similar to Australopithecus and the extant African apes in this localized area of bone deposition. These new data point to diversity of patterns of facial growth in fossil Homo. The similarities in facial growth in H. antecessor and H. sapiens suggest that one key developmental change responsible for the characteristic facial morphology of modern humans can be traced back at least to H. antecessor.     

Restricted growth at the frontonasal suture: alterations in craniofacial growth in rabbits

Apposition of bone at the sutural margin is generally thought to be a compensatory adjustment to growing soft-tissue organs such as the brain or eyes within the skull. The frontonasal suture which is located at the interface between the cranial and facial skeletons is a site of extremely active growth in the young rabbit. Recently, we showed that premature closure of a cranial suture, the coronal suture, can alter the growth not only at the adjacent frontonasal suture but also of the basicranium and midface. This study examines the effects of restricted growth at the frontonasal suture on both growth at adjacent cranial sutures and linear growth of the basicranium and midface. Thirty newborn New Zealand White rabbits were subdivided into experimental and sham-treated groups of equal size and distribution for sex and birth weight. At 9 days of age, the frontonasal suture of each experimental animal was immobilized by bilateral application of methyl-cyanoacrylate adhesive across the frontonasal suture. Growth and morphometric changes were monitored by radiocephalometric methods through 120 days of age by bilateral implantation of radiopague markers on each side of frontonasal, coronal, and anterior lambdoid sutures. Results indicate that restricted growth at the frontonasal suture results not only in a significant shortening of the midface but also in significant decreases in growth at the coronal and internasal sutures. Growth at the interfrontal and sagittal sutures is increased. Furthermore, growth at the anterior portion of the nasal bones is significantly increased, thereby offsetting a portion of the decreased nasal bone length resulting from frontonasal restriction.     

Arterial vascularization of the mandible and maxilla of neotropical primates

The objective of the present investigation was to conduct a comparative macroscopic study of the arterial vascularization of the mandible and maxilla of neotropical primates of the genera Cebus, Alouatta, Callithrix, and Leontopithecus. After vinyl was injected into the arterial system of the head of each specimen, the pieces were macerated and corroded. The level of the bifurcation of the common carotid artery into the internal and external carotids varied between the first and third cervical vertebrae. The external carotid artery accounts for most of the vascularization of the facial structures. The actual vessels responsible for the supply of this region are the sublingual, facial, angular, lingual, submandibular, submental, inferior and superior labial, maxillary, inferior alveolar, infraorbital, superior posterior alveolar, palatine major, and sphenopalatine arteries. We conclude that although the arterial vascular pattern was similar in all the genera studied, and resembles the human pattern, there are notable variations in the vasculature of the mandible and maxilla among these four neotropical genera.     

Craniofacial growth in subjects with unilateral complete cleft lip and palate, and unilateral incomplete cleft lip, from 2 to 22 months of age

This paper reports a longitudinal quantitative cephalometric analysis of the craniofacial growth in subjects with unilateral complete cleft lip and palate (UCCLP), and unilateral incomplete cleft lip (UICL), from 2 to 22 months of age. The purpose of the study was to determine the amount and direction of growth in UCCLP compared to UICL (control group) from 2 months of age (just prior to lip repair) to 22 months of age, 20 months later. The sample comprised of 49 subjects with UCCLP (37 males and 11 females) and 45 with UICL (29 males and 16 females). The cephalometric analysis of the craniofacial morphology included lateral, frontal, and axial projections. The data were presented as mean plots of the craniofacial region including the calvaria, cranial base, orbits, nasal bone, maxilla, mandible, cervical column, pharynx, and soft-tissue profile. A valid common coordinate system (registration according to the n-s line in the lateral projection, latero-orbitale line in the frontal projection, and meatus acusticus externus line in the axial projection for the landmark positions at examination 1 and 2) was ascertained. The growth at a specific anatomical location in a patient was defined as the displacement vector from the coordinate of the corresponding landmark in the X-ray at examination 1 to its coordinate at examination 2, corrected for X-ray magnification. The growth of an anatomical region in a patient was assessed by investigating the growth pattern formed by a collection of individual growth vectors in that region. The amount of growth in the UCCLP and UICL group was very similar. The general craniofacial growth pattern, in terms of the direction of growth, was also fairly similar in the UCCLP group and the control group. However, the maxilla and mandible showed a more vertical growth pattern than that observed in the control group. This study confirms that UCCLP is a localized deviation, and not a craniofacial anomaly, due to the fact that a normal growth potential has been observed in all craniofacial regions, except where the growth had been directly influenced by surgical intervention. Furthermore, the vertical growth pattern of the maxilla and mandible supports the hypothesis of a special facial type in cleft lip and palate individuals, and the facial type as a liability factor increasing the probability of cleft lip and palate.     

Insulin-like growth factor-I stimulates acromegaly-like specific mandibular enlargement in rats.

To help us investigate the time course of mandibular enlargement in acromegaly or acrogiantism to determine the most suitable period for occlusal treatment in this disease, our aim was to develop a rat model of acromegaly (acrogiantism). In this study, prominent mandibular enlargement was induced by continuous subcutaneous infusion of human recombinant insulin-like growth factor-I (IGF-I) (640 microg/day) in 10-week-old male rats for 4 weeks (n = 6); the control sham-operated group was injected with saline alone (n = 6). Circulating human IGF-I was clearly detectable in the IGF-I group during the four-week administration period, while endogenous rat IGF-I levels decreased. Total IGF-I (human + rat) increased significantly during administration, returning to control levels afterwards. The length of every bone examined (mandible, maxilla, and femur) showed a significant increase compared to control rats, especially the mandible. Although the mandible did not continue to grow after discontinuation of IGF-I administration, it did not return to control size, unlike the maxilla and femur, and disharmonious jaw size (between maxilla and mandible) persisted even after circulating IGF-I levels normalized. These findings in our rat model suggest that mandibular occlusal treatment should only be considered for acromegalic (acrogiantic) patients after serum IGF-I levels have normalized and bone growth has ceased.     

Relationships between growth at the sutures of the rabbit calvarium

The present study was designed to elucidate the relationships between growth increments at the cranial vault sutures in rabbits. Thirteen male New Zealand white rabbits were followed regularly from age 31 to 142 days using a roentgen stereophotogrammetric system. Spherical tantalum markers were implanted into the nasal, frontal, and parietal bones, and implant stability was checked at each stereo examination. Problems with instability were encountered only in the nasal bones. Registered growth rates conformed to our previous investigations. High correlations were observed between the following areas; the coronal suture to the frontonasal suture, the first principal component of the neurocranial suture group to the frontonasal suture, and the principal component of the craniofacial suture group to the coronal suture. Remaining relationships demonstrated dispersion to various extents. The findings indicate that there seems to exist a basic mutual dependence between neural and facial skeletal growth, as well as complex covariations between the various sutures of the rabbit calvarium.     

Directed Bmp4 expression in neural crest cells generates a genetic model for the rare human bony syngnathia birth defect

Congenital bony syngnathia, a rare but severe human birth defect, is characterized by bony fusion of the mandible to the maxilla. However, the genetic mechanisms underlying this birth defect are poorly understood, largely due to limitation of available animal models. Here we present evidence that transgenic expression of Bmp4 in neural crest cells causes a series of craniofacial malformations in mice, including a bony fusion between the maxilla and hypoplastic mandible, resembling the bony syngnathia syndrome in humans. In addition, the anterior portion of the palatal shelves emerged from the mandibular arch instead of the maxilla in the mutants. Gene expression assays showed an altered expression of several facial patterning genes, including Hand2, Dlx2, Msx1, Barx1, Foxc2 and Fgf8, in the maxillary and mandibular processes of the mutants, indicating mis-patterned cranial neural crest (CNC) derived cells in the facial region. However, despite of formation of cleft palate and ectopic cartilage, forced expression of a constitutively active form of BMP receptor-Ia (caBmprIa) in CNC lineage did not produce the syngnathia phenotype, suggesting a non-cell autonomous effect of the augmented BMP4 signaling. Our studies demonstrate that aberrant BMP4-mediated signaling in CNC cells leads to mis-patterned facial skeleton and congenital bony syngnathia, and suggest an implication of mutations in BMP signaling pathway in human bony syngnathia.     

Shape of the craniofacial complex in 45,X females: cephalometric study

The shape of the craniofacial complex was analysed cephalometrically in sixty-four adult 45,X females (Turner syndrome) using lateral skull radiographs, and the subjects were compared with first-degree female relatives and control females. The results showed that 45,X females have marked changes in relatively few craniofacial areas compared to the controls. Most of the changes are located in the cranial base, so that the face is retrognathic. The mandible is short, whereas the maxilla is of normal length. The results support the view that the morphology of the cranial base is markedly affected in 45,X females, whereas most other craniofacial changes could be considered secondary to the cranial base abnormality. It is suggested that retarded cartilage growth may be a factor leading to the present findings.     

Differential growth of facial primordia in chick embryos: responses of facial mesenchyme to basic fibroblast growth factor (bFGF) and serum in micromass culture

Differential growth of the three major facial primordia, the frontonasal mass, maxilla and mandible, results in a characteristic face shape. Abnormal growth of any of the primordia can lead to facial defects. In order to dissect out the factors that control growth, we developed a functional assay for cell proliferation using micromass culture and defined medium. Cell number was determined over a 4 day period and BrdU incorporation was used to determine the percentage of cells in S-phase. In defined medium, cell number progressively decreases and proliferation is very reduced in cultures of cells from all three primordia. When foetal calf serum was added, frontonasal mass cell number triples, mandible doubles and maxilla increases by half. The number of cells in S-phase increased in every case but the final cell number reflects a balance between proliferation and cell loss from the culture. The addition of basic fibroblast growth factor (bFGF) to defined medium leads to an increase in cell number in the frontonasal mass, while the cell number of mandibular and maxillary cultures is relatively unaffected. The percentage of cells in S-phase is highest in frontonasal mass cultures. Serum and bFGF both increase chondrogenesis in frontonasal mass cultures when compared to defined medium. In contrast in mandibular cultures, serum does not change the amount of cartilage and with bFGF chondrogenesis is reduced. The coordination of the changes in proliferation and differentiation in frontonasal mass cultures suggest that either these two processes are independently stimulated to the same extent or a single subpopulation of cells is stimulated to divide and differentiate into chondrocytes.(ABSTRACT TRUNCATED AT 250 WORDS)     

The scaling of tongue projection in the veiled chameleon,Chamaeleo calyptratus

Within a year of hatching, chameleons can grow by up to two orders of magnitude in body mass. Rapid growth of the feeding mechanism means that bones, muscles, and movements change as chameleons grow while needing to maintain function. A previous morphological study showed that the musculoskeletal components of the feeding apparatus grow with negative allometry relative to snout–vent length (SVL) in chameleons. Here, we investigate the scaling of prey capture kinematics and muscle physiological cross-sectional area in the veiled chameleon, Chamaeleo calyptratus. The chameleons used in this study varied in size from approximately 3 to 18 cm SVL (1–200 g). Feeding sequences of 12 chameleons of different sizes were filmed and the timing of movements and the displacements and velocities of the jaws, tongue, and the hyolingual apparatus were quantified. Our results show that most muscle cross-sectional areas as well as tongue and hyoid mass scaled with isometry relative to mandible length, yet with negative allometry relative to SVL. Durations of movement also scaled with negative allometry relative to SVL and mandible length. Distances and angles generally scaled as predicted under geometric similarity (slopes of 1 and 0, respectively), while velocities generally scaled with slopes greater than 0 relative to SVL and mandible length. These data indicate that the velocity of jaw and tongue movements is generally greater in adults compared to juveniles. The discrepancy between the scaling of cross-sectional areas versus movements suggests changes in the energy storage and release mechanisms implicated in tongue projection.     

A cephalometric study in Rubinstein-Taybi syndrome

A roentgencephalometric study to compare the facial morphology of 18 individuals affected with Rubinstein-Taybi syndrome and 25 of their parents was performed. The main findings in the affected individuals were shortening of facial height and depth, cranial base length, a marked decrease in size of the mandible, and a steep cranial base. A change with age was found for some dimensions. The pattern variability indices were high, indicating an abnormal craniofacial profile. The correlations between most patients were high, although this was less expressed for the younger patients. The parents had a normal pattern profile and pattern profile variability indices. The correlation between parents and their affected children was low. This study suggests that pattern profile analysis of cephalometric measurements may be a useful diagnostic tool in Rubinstein-Taybi syndrome. However, comparable studies of large groups of patients, especially of a younger age, are needed for further ascertainment of normal values in individuals with Rubinstein-Taybi syndrome at different stages of facial development.     

Analysis and treatment of hemifacial microsomia

Our experience over the past 25 years leads us to conclude that hemifacial microsomia is a progressive skeletal and soft-tissue deformity with the earliest skeletal manifestations in the mandible. We find that not only does the mandibular asymmetry become worse with time, but as the contralateral side grows, the deformed mandible also increases ipsilateral secondary deformation of the maxilla, nose, and orbit. We also find that there is virtually no "catch up" growth on the affected side of the face and that these patients always become more deformed with age. The psychological problems also increase with time and progression of the facial deformity. Based on our experience with correction of end-stage deformities, we now treat these patients at the earliest possible age, as determined by the patient's skeletal classification. We treat the mandible first in the hope that this repositioning in a more physiologic position will unlock the growth potential of the adjacent structures, minimize secondary deformity, and improve function and appearance to the greater benefit of the skeletal and psychological growth of the patient.     

Ontogenetic shape changes in Pomacentridae (Teleostei,Perciformes) and their relationships with feeding strategies: a geometric morphometric approach

The present study explores the shape changes of cranial structures directly involved in food capturing during growth after reef settlement in two species of Pomacentridae (Dascyllus aruanus and Pomacentrus pavo). Landmark‐based geometric morphometrics were used to study allometric patterns and related shape changes in four skeletal units: neurocranium, suspensorium and opercle, mandible and premaxilla. At settlement, the larvae of both species have a relatively similar morphology, especially with respect to the mandible. Their shapes suggest a feeding mode defined as ram/suction‐feeding. Ontogenetic shape changes show a shift to a suction feeding mode of prey capture. The main transformations involved are an increase in height of the suspensorium and the opercle, an elevation of the supraoccipital crest, a relative shortening of the mandible, and a lengthening of the ascending process of the premaxilla. Shape changes of the mandible in the two studied species also reflect an increase of biting capacities. The high disparity between adult shape results from differences in the rate and in the length of ontogenetic trajectories, from divergence of the ontogenetic trajectories (neurocranium, mandible, and premaxilla) and parallel shifts of the trajectories in the size‐shape space (suspensorium and opercle). In an evolutionary context, allometric heterochronies during ontogeny of different skeletal unit of the head may be considered as a basis for the explanation of the diversity of damselfishes. © 2008 The Linnean Society of London, Biological Journal of the Linnean Society, 2008, 95 , 92–105.     

Root system analysis of seedlings of seven tree species from a tropical dry forest in Mexico

Summary Root attributes of tree seedlings of seven species from the tropical deciduous forest along the Pacific Coast of Mexico are described using morphometirc root system analysis. Mean relative growth rate, root/shoot ratios, specific root length, root density, mean number of roots tips and root length/leaf area ratio were determined in seedlings grown for 35 days inside growth chambers. All the species had low relative growth rates, low root/shoot ratios and low root densities (<0.5 cm/cm³). The species associated with disturbed habitats, in contrast to the species characteristic of undisturbed areas, presented small seeds, a dichotomous root branching pattern and large specific root length. No relationship was found between seed size and mean relative growth rate among the species studied.     

A comparison of the craniofacial morphology in 2-month-old unoperated infants with unilateral complete cleft lip and palate, and unilateral incomplete cleft lip.

This paper reports a cephalometric analysis of the craniofacial morphology in infants with unoperated unilateral complete cleft lip and palate (UCCLP) and unoperated unilateral incomplete cleft lip (UICL). The purpose of the study was to determine the nature and extent of the craniofacial deviations in UCCLP as compared to the morphology in UICL, which has previously been shown to be close to normal. The samples comprised 82 infants with UCCLP (58 males and 24 females) and 75 with UICL (48 males and 27 females). The mean age was about 2 months in both groups. The cephalometric analysis of craniofacial morphology included the lateral, frontal, and axial projections. The data were presented as mean plots of the craniofacial region including the calvaria, cranial base, orbits, nasal bone, maxilla, mandible, cervical column, pharynx, and soft-tissue profile. The most pronounced deviations in the UCCLP group were observed in the maxillary complex and the mandible. The most striking findings were: markedly increased width of the maxilla, a short mandible, and bimaxillary retrognathia except for the premaxillary area, which was relatively protruding and asymmetric. The study did not support the hypothesis previously suggested in the literature that cleft lip and palate is a craniofacial anomaly as size and shape of the calvaria and cranial base were found to be normal. The etiology of cleft lip and palate is still incompletely understood. Based on the present study, we suggest that facial type may be a liability factor that could represent a developmental threshold increasing the probability of cleft lip and palate.     

The effect of unilateral partial facial paralysis on nasofrontal sutural growth: an experimental study in the rabbit.

In a previous study in the rabbit, it was demonstrated that paralysis of the midfacial musculature results in decreased anteroposterior growth of the snout. At the end of growth, these animals showed macroscopically striking similarities to animals with unilateral fusion of the nasofrontal suture. In this study, whether nasofrontal sutural growth is unilaterally restricted in animals with unilateral partial facial paralysis was investigated. A left-sided partial facial paralysis was induced in sixteen 12-day-old New Zealand White rabbits. At the ages of 5, 9, 12, and 17 weeks, four animals were randomly assigned to be killed for analysis of nasofrontal sutural growth. In each animal, the left experimental side was compared with the right control side. By means of histomorphometric measurements, it was shown that diminished sutural growth activity was present on the left paralyzed side in periods of rapid growth. On the other hand, no significant alterations in sutural width were found. These findings seem to explain some of the macroscopic growth alterations (i.e., diminished anterior maxillary length) observed in rabbits with unilateral partial facial paralysis.     

A simple and inexpensive system for monitoring jaw movements in ambulatory humans

A simple and inexpensive method for recording vertical movements of the human mandible relative to the maxilla is presented. Measurements are made from accelerometers and a Hall-effect device temporarily glued to the upper and lower anterior teeth. The accelerometer signals are integrated once to give velocity and a second time to give position. Movements of the mandible relative to the maxilla are obtained by integrating the difference between the two accelerometer signals. The (relative) velocity and position records derived in this way are linear, but subject to drift when the jaw is stationary. Steady mandibular position is obtained from the Hall-effect system, but this signal must be corrected for its inherent non-linearity. This device can record rapid movements of the mandible even when the head is unrestrained, and interferes minimally with normal jaw movements.