A Three-dimensional Analysis of Nasopharyngeal Airway Characteristics in Subjects with Cleidocranial Dysplasia: A CBCT Study (original) (raw)
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Relationship of oropharynx to craniofacial morphology in skeletal Class II patients
The Journal of Indian Orthodontic Society, 2016
IntRoductIon The oropharynx encompasses the portion of the upper aero-digestive tract which extends from the anterior tonsillar pillars inferiorly to the pharyngo-epiglottic folds and superiorly to the soft palate. The tongue base, which lies caudal to the circumvallate papillae, is included in the oropharynx. [1] This portion of the upper airway has attracted less attention than its nasal counterpart. [2] Various studies have shown that obstructions of the upper airway lead to change in neuromuscular patterns. It has been shown that if these obstructions are present during a long period of time with active growth, facial morphology maybe influenced. Posterior rotation of the mandible combined with an increase of base plane angle and increase in anterior lower facial height has been reported in such cases. [3] The classic clinical example of the possible relationship between upper airway obstruction and aberrant craniofacial growth is the development of "adenoid facies" in patients with mouth breathing habit. These patients usually present mouth-open posture, a small nose with button-like tip, nostrils that are small and poorly developed, a short upper lip, prominent upper incisors, a pouting lower lip, and an expressionless face. [4] Severe mandibular deficiency and mandibular retrognathism [5] have also been linked to reduced oropharyngeal dimensions. Decreased space between the cervical column and the
Oral health and dental management, 2014
Cleidocranial Dysplasia (CCD) is a rare inherited autosomal dominant congenital syndrome that occurs in approximately one out of every one million individuals worldwide; it primarily affects bones that undergo intra-membranous ossification, generally the skull and clavicles. Other bones may be affected such as the long bones, spine, pelvis, bones of hands and feet showing hypoplasia of distal phalanges. Indispensable is the role of the gene Runx2, necessary for the differentiation of odontoblasts and osteoblasts; it regulates the expression of many genes related to the development of dental hard tissues. The aim of this study was to appraise the connection between the Cleidocranial Dysplasia and the appearance of skeletal and dental anomalies not much deepen to this day. With particular emphasis, it wants to describe the multidisciplinary therapeutic approach. The patient showed multiple skeletal features of CCD. A distinctive feature was the failed or delayed exfoliation of deciduo...
Unilateral craniofacial microsomia. Part I. Mandibular analysis
American journal of orthodontics, 1983
Various attempts to describe the skeletal characteristics of unilateral craniofacial microsomia have been made with the use of cephalometric and panoramic roentgenograms. Previous studies have been only descriptive in nature. To date, a detailed (quantitative) cephalometric analysis of the mandibular deformity has not been reported. The purpose of this study was to describe the skeletal jaw deformity by means of cephalometric landmarks in the lateral view. The patient population consisted of sixteen boys and eight girls who ranged in age from 6 to 16 years. They were compared to the University of Michigan normal control population for the following measures: gonial angle, mandibular plane angle, overall oblique length of the mandible, ramal height, and body length. The affected side showed a larger gonial angle and mandibular plane angle. The oblique length of the mandible (Cd-Gn) was decreased on both sides, as were ramal height and body length. Paradoxically, body length appeared ...
Dental Anomalies Associated with Craniometaphyseal Dysplasia
Journal of Dental Research, 2014
Craniometaphyseal dysplasia (CMD) is a rare genetic disorder encompassing hyperostosis of craniofacial bones and metaphyseal widening of tubular bones. Dental abnormalities are features of CMD that have been little discussed in the literature. We performed dentofacial examination of patients with CMD and evaluated consequences of orthodontic movement in a mouse model carrying a CMD knock-in (KI) mutation (Phe377del) in the Ank gene. All patients have a history of delayed eruption of permanent teeth. Analysis of data obtained by cone-beam computed tomography showed significant bucco-lingual expansion of jawbones, more pronounced in mandibles than in maxillae. There was no measurable increase in bone density compared with that in unaffected individuals. Orthodontic cephalometric analysis showed that patients with CMD tend to have a short anterior cranial base, short upper facial height, and short maxillary length. Microcomputed tomography (micro-CT) analysis in homozygous Ank (KI/KI) mice, a model for CMD, showed that molars can be moved by orthodontic force without ankylosis, however, at a slower rate compared with those in wild-type Ank (+/+) mice (p < .05). Histological analysis of molars in Ank (KI/KI) mice revealed decreased numbers of TRAP(+) osteoclasts on the bone surface of pressure sides. Based on these findings, recommendations for the dental treatment of patients with CMD are provided.
Introduction: The purpose of this study was to morphometrically investigate the growth pattern of the adenoids in growing subjects with hyperdivergent and hypodivergent vertical craniofacial features. Methods: In this retrospective study, we used a longitudinal sample of lateral cephalometric radiographs of 28 hyperdivergent and 30 hypodivergent subjects from 4 to 13 years of age. The radiographs were obtained from the American Association of Orthodontists Foundation Craniofacial Growth Legacy Collection. Measurements were made using digital tracings of the lateral cephalograms and point distribution models. Mixed-model analyses were used for statistical analysis. Results: The mean distance between the sphenoid bone and the posterior nasal spine increased up to 5.3 mm over a 9-year span (95% CI, 4.1-6.5 mm; P \0.001). Furthermore, the mean distance between the sphenoid bone and the posterior nasal spine differed significantly (P 5 0.029) between facial types; it was consistently greater (1.8 mm; 95% CI, 0.2-3.3 mm) in the hyperdivergent group. The nasopharyngeal airway area showed a trend to increase with age up to 12-fold (P \0.001). A significant interaction (P 5 0.004) was found between age and facial type. Assessment of the adenoid shapes showed greater convexities in the hyperdivergent group, which were observable from an earlier age and for a longer duration. Conclusions: Clear differences in the morphometric growth pattern of the adenoids were found between facial types. Evaluation of adenoid shapes showed more prominent convexities that lasted longer in the long facial types than in the short facial types. (Am J Orthod Dentofacial Orthop 2016;150:451-8)
Maxillary sinuses and midface in patients with cleidocranial dysostosis
Annals of Anatomy - Anatomischer Anzeiger, 2017
The cleidocranial dysplasia is general skeletal disorder with an autosomal dominant inheritance. It is manifested by many craniofacial abnormalities, of which the maxillary hypoplasia is the most evident. The aim of the study was to use CBCT to evaluate the volume of the maxillary sinuses and the dimensions of maxillae in patients with CCD and compare them with healthy individuals. Files of four children with cleidocranial dysplasia were investigated.Volume of every maxillary sinus as well as two dimensional measurements of distances between particular points of interest located on surface of maxilla were calculated from reconstructed CBCT examination. Data were compared with a control group. Statistical analysis was performed. Linear and volumetric data obtained using CBCT was collected and compared with a control group.All affected children had both maxillary sinus volume and maxillary dimensions smaller than control values. The maxillary sinuses were underdeveloped up to half of normal values. The largest differences were recorded in vertical linear dimensions of the maxillae. Horizontal dimensions were also lower. There are morphological modifications of bone tissue which accompany CCD. It seems that these changes occur on the midfacial region and to a greater extent concern the maxillary sinus volume.
Development of the dentition in cleidocranial dysplasia
Journal of Oral Pathology and Medicine, 1990
Jensen BL, Kreiborg S: Development of the dentition in cieidocranial dysplasia, J Oral Pathol Med 1990; 19: 89-93, The purpose of the present investigation was to describe the formation, maturation and eruption of the dentition, including supernumerary teeth in a sample of patients with cieidocranial dysplasia. The dentition was evaluated from orthopantomograms, intraoral radiographs, cephalometric films, surgically removed teeth and intraoral photographs in 19 patients (9 men, 10 women), aged 3,5 to 34 years. Formation of primary teeth was normal, whereas all patients but one had supernumerary permanent teeth. Frequency of supernumerary teeth ranged from 22% in the maxillary incisor region to 5% in the molar regions. Supernumerary teeth were formed lingually and occlusally to the normal teeth. Maturation of the primary dentition was normal, while permanent teeth were delayed from 1 to 4 yr. Supernumerary teeth were delayed about 4 years in relation to normal permanent teeth. Eruption of primary teeth was normal, whereas all patients had severe eruption problems of permanent teeth. It was hypothesized that the dental lamina for both primary and permanent dentition is normal, but does not resolve completely and therefore may form supernumerary teeth. Abnormalities of tooth morphology is related to inadequate space and arrested eruption. Delayed or arrested eruption is probably caused by diminished resorption of bone and of primary teeth and to the presence of multiple supernumerary teeth.
CRANIO®, 2016
The aim of the present study was to evaluate if cranial dysfunctions felt by osteopaths could correlate with sagittal dysmorphologies diagnosed by orthodontists, using cephalometric traces in the sagittal plane. Metholology: One hundred and six children between 6 and 12 years old (42 boys and 64 girls) were tested by an osteopath to determine if the cranial movement felt was considered to be eased in flexion or extension. To test reproducibility intra-operator, 27 randomly selected subjects were tested twice, at a onemonth interval by the same osteopath before the start of their orthodontic treatment. These tests were then correlated with a cephalometric analysis of the sagittal plane to determine what type of dysmorphology existed, if any, as well as the angle of the spheno-occipital synchondrosis (SOS). Results: Practitioners systematically found more cranial movement in extension for all the bones in patients in skeletal class II than in the others. Similarly, they systematically found more cranial movement in flexion in patients in skeletal class III than in the other skeletal classes. However, there was no significant difference found in SOS angulation between skeletal classes I, II, and III. Discussion: This study tends to confirm the correlation, described previously by orthodontists, between the mobility of the bones of the cranial vault and dysmorphic dentofacial characteristics in the sagittal plane. Anomalies during development could lead to the typical cranial characteristics of flexion or extension. As such, these situations could be related to skeletal classes III and II respectively.