Craniofacial Complex Research Articles

Orbital dimensions of Maharashtrian population a direct measurement study using dry skulls

Orbital dimensions of Maharashtrian population a direct measurement study using dry skulls - IDJSR- Print ISSN No: - 2394-708X Online ISSN No:- 2278-3784 Article DOI No:- 10.18231/j.idjsr.2019.025, International Dental Journal of Student's Research-Int Dent J Stud Res

Towards an early 3D-diagnosis of craniofacial asymmetry by computing the accurate midplane: A PCA-based method

Background and objectiveCraniofacial asymmetry is a common growth disorder often caused by unilateral chewing. Although an early orthodontic treatment would avoid surgical procedures later in life, the uncertainty of defining the accurate sagittal midplane potentially leads to misdiagnosis and therefore inaccurate orthodontic treatment plans. This novel study aims to 3D-diagnose craniofacial complex malformations in children with unilateral crossbite (UXB) considering a midplane which compensates the asymmetric morphology. MethodsThe sagittal midplane of 20 children, fifteen of whom exhibited UXB, was computed by a PCA-based method which compensates the asymmetry mirroring the 3D models obtained from cone-beam computed tomography data. Once determined, one side of the data was mirrored using the computed midplane to visualize the malformations on the hard and soft tissues by 3D-computing the distances between both halves. Additionally, 31 skull's landmarks were manually placed in each model to study the principal variation modes and the significant differences in the group of subjects with and without UXB through PCA and Mann-Whitney U test analyses respectively. ResultsMorphological 3D-analysis showed pronounced deformities and aesthetic implications for patients with severe asymmetry (jaw deviation > 0.8 mm) in whole craniofacial system, while initial signs of asymmetry were found indistinctly in the mandible or maxilla. We detected significant (p < 0.05) malformations for example in mandibular ramus length (0.0086), maxillary palate width (0.0481) and condylar head width (0.0408). Craniofacial malformations increased the landmarks’ variability in the group of patients with UXB over the control group requiring 8 variation modes more to define 99% of the sample’ variability. ConclusionsOur findings demonstrated the viability of early diagnosis of craniofacial asymmetry through computing the accurate sagittal midplane which compensates the individual's asymmetrical morphology. Furthermore, this study provides important computational insights into the determination of craniofacial deformities which are caused by UXB, following some empirical findings of previous clinical studies. Hence, this computational approach can be useful for the development of new software in craniofacial surgery or for its use in biomedical research and clinical practice.

Disrupted Protein Expression and Altered Proteolytic Events in Hypophosphatemic Dentin Can Be Rescued by Dentin Matrix Protein 1.

Dentin, one of the four mineralized tissues of the craniofacial complex, forms sequentially from the deposition of an organic matrix to the nucleation of an inorganic phase within the matrix scaffold. Several promoters and inhibitors of mineralization support and regulate mineral nucleation. Clinical and experimental evidence suggest that dentin matrix protein 1 (DMP1) and phosphate-regulating neutral endopeptidase (PHEX) cooperate and are necessary for the formation of a cohesive dentin layer. The following study investigates the effect of PHEX loss-of-function on dentin matrix formation preceding mineralization. Using the Hyp mouse, an animal model for X-linked hypophosphatemia (XLH), we identified an irregular distribution of dentin extracellular matrix proteins. Likewise, dental pulp stem cells (DPSCs) from XLH patients exhibited altered proteolytic events with disrupted extracellular matrix deposition. Further differentiation assays demonstrated that XLH DPSCs exhibited impaired matrix mineralization. Overexpression of DMP1 in XLH DPSCs restored the irregular protein processing patterns to near-physiological levels. Our results support the hypothesis that hypophosphatemia resulting from PHEX loss-of-function affects the integrity of the organization of the dentin matrix and suggests that exogenous DMP1 can restore physiological processing of matrix proteins, in addition to its canonical role in mineralization.

Evidence of vasculature and chondrocyte to osteoblast transdifferentiation in craniofacial synovial joints: Implications for osteoarthritis diagnosis and therapy.

Temporomandibular joint osteoarthritis (TMJ OA) leads to permanent cartilage destruction, jaw dysfunction, and compromises the quality of life. However, the pathological mechanisms governing TMJ OA are poorly understood. Unlike appendicular articular cartilage, the TMJ has two distinct functions as the synovial joint of the craniofacial complex and also as the site for endochondral jaw bone growth. The established dogma of endochondral bone ossification is that hypertrophic chondrocytes undergo apoptosis, while invading vasculature with osteoprogenitors replace cartilage with bone. However, contemporary murine genetic studies support the direct differentiation of chondrocytes into osteoblasts and osteocytes in the TMJ. Here we sought to characterize putative vasculature and cartilage to bone transdifferentiation using healthy and diseased TMJ tissues from miniature pigs and humans. During endochondral ossification, the presence of fully formed vasculature expressing CD31+ endothelial cells and α-SMA+ vascular smooth muscle cells were detected within all cellular zones in growing miniature pigs. Arterial, endothelial, venous, angiogenic, and mural cell markers were significantly upregulated in miniature pig TMJ tissues relative to donor matched knee meniscus fibrocartilage tissue. Upon surgically creating TMJ OA in miniature pigs, we discovered increased vasculature and putative chondrocyte to osteoblast transformation dually marked by COL2 and BSP or RUNX2 within the vascular bundles. Pathological human TMJ tissues also exhibited increased vasculature, while isolated diseased human TMJ cells exhibited marked increased in vasculature markers relative to control 293T cells. Our studyprovides evidence to suggest that the TMJ in higher order species are in fact vascularized. There have been no reports of cartilage to bone transdifferentiation or vasculature in human-relevant TMJ OA large animal models or in human TMJ tissues and cells. Therefore, these findings may potentially alter the clinical management of TMJ OA by defining new drugs that target angiogenesis or block the cartilage to bone transformation.

Comparison of cephalometric measurements of living subjects and ancient skulls in Anatolia

Aim: This study aims to provide insights into the evolutionary adaptation of human, via comparing the craniofacial characteristics of living subjects and ancient skulls from Anatolia. Material and Methods: Cone-beam computed tomography (CBCT) generated 2D cephalometric projections of 32 ancient skulls and well matched lateral cephalometric images of 32 patients were evaluated. Sixteen widely used cephalometric measurements were performed. Intra-class correlation coefficients were used to examine intra-observer reliability. Mann–Whitney tests and chi-square tests were used to compare cephalometric measurements of the groups.Results: The linear measurements of living subjects were smaller than the linear measurements of ancient skulls (p0.05). Significant differences were found between the groups in the cranial base lengths, maxillary and mandibular dimensions (p0.05). The maxilla and mandible were found more prognathic in ancient men and women (p0.001).Conclusion: Environmental factors and genetic changes lead to a reduction in the sagittal and vertical dimensions of the human craniofacial complex. Dental practitioners should consider these evolutionary changes during the treatment planning process.

Alternativa de tratamiento oportuno de mordida cruzada posterior unilateral en dentición primaria y mixta temprana. Serie de casos.

Introducción Las mordidas cruzadas posteriores unilaterales (MCPU) constituyen uno de los tipos de maloclusiones más frecuentes encontrados tanto en dentición primaria como en dentición mixta temprana. Debido a su origen multifactorial su tratamiento se encuentra enfocado no solo en la corrección de la maloclusión, sino en obtener una estabilidad oclusal y funcional a largo plazo que disminuya las alteraciones en el crecimiento y desarrollo del sistema estomatognático en edades tempranas. El objetivo de esta serie de casos es presentar dos alternativas de tratamiento oportuno para esta maloclusión.&#x0D; Descripción de los casos El primer caso es un paciente de 8 años de edad con MCPU izquierda quien recibe tratamiento de expansión palatina controlada con un tornillo tipo Hyrax con férula acrílica, en el cual se obtienen resultados favorables en corto tiempo y con estabilidad a largo plazo. El segundo caso es una paciente de 4 años de edad con MCPU derecha a la cual se le realizan Pistas Directas Planas logrando un cambio postural mandibular deseado. &#x0D; Discusión En las alternativas de tratamiento presentadas, varios autores han reportado una serie de beneficios obtenidos a partir del tipo de intervención que no solo logran la corrección de la maloclusión, sino que a su vez alcanzan la mejoría de estructuras que componen el complejo craneofacial, dentro de los cuales se destaca la estabilidad a largo plazo deseada. Estos beneficios se obtienen a través de la alternativa de tratamiento seleccionada, según el diagnóstico y las características clínicas presentadas en cada paciente y justifica la decisión de realizar una intervención temprana especialmente en este tipo de maloclusión.&#x0D; Conclusión El tratamiento temprano de la mordida cruzada posterior unilateral debe ser seleccionado según el tipo de dentición y necesidad del paciente, lo que favorece el adecuado crecimiento y desarrollo del sistema estomatognático.&#x0D; Palabras Claves &#x0D; Mordida cruzada posterior unilateral, maloclusión, tratamiento oportuno, pistas directas planas, expansión palatina.&#x0D;

Alterações funcionais e estruturais do complexo craniofacial na síndrome branquio-óculo-facial: relato de caso

Introdução: A Síndrome Branquio-Óculo-Facial é uma doença autossômica rara com expressão variável, dependente das mutações genéticas, cujo fenótipo caracteriza-se por alterações oculares, auriculares e craniofaciais. Objetivo: Descrever características clínicas, alterações funcionais e estruturais do complexo craniofacial de sujeito com síndrome branquio-óculo-facial. Método: Paciente de 13 anos e 3 meses, respiradora oral com perda auditiva condutiva de grau moderadamente severo em ambas as orelhas, diagnosticada com síndrome branquio-óculo-facial, apresentou: fissura labiopalatina transforame bilateral completa corrigida por labioplastia e palatoplastia primárias, assimetria facial, fístula em região anterior de palato duro, atresia maxilar transversa, dentinogênese imperfeita, trespasse horizontal negativo, oclusão Classe I de Angle e mordida aberta anterior e lateral bilateralmente, desvio severo da linha média superior para a esquerda, incisivo lateral superior permanente semi-erupcionado por vestibular do canino superior decíduo do lado esquerdo, retenção prolongada do segundo molar inferior decíduo direito, apinhamento dentário inferior, hipotonia e posicionamento inadequado de língua, ausência de vedamento labial em repouso, deglutição adaptada, alteração na mobilidade de lábios, bochechas e palato mole com escape de ar nasal na fala, caracterizando disfunção velofaríngea. Sujeitos com fissura lábiopalatina podem apresentar grande variedade de alterações na produção dos fones. Paciente apresenta crescimento deficiente da maxila que, como relatado na literatura, pode alterar o desenvolvimento do terço médio da face com repercussão na oclusão dentária, fala e formato do nariz. Conclusão: As alterações clínicas funcionais e estruturais relatadas são na maioria do complexo craniofacial, demonstrando a importância da otorrinolaringologia, fonoaudiologia e odontologia na terapêutica interdisciplinar dos pacientes com a síndrome.

Diagnostic Accuracy of 3d Scan and Plain Radiograph in Diagnosis of Midface Fractures

OBJECTIVE: To determine the diagnostic accuracy of plain radiographs and 3D scan in diagnosis of mid face fractures by taking surgery findings as a gold standard. STUDY DESIGN : Cross Sectional Study SETTING: study was carried out at Department of Oral &amp; Maxillofacial Surgery, Nishtar Institute of Dentistry, Multan. DURATION : Study was completed in 6 months from May, 2017 to November 2017in Nishtar . Methodology: 181 Patients were included from Department of Oral &amp; Maxillofacial Surgery, Nishtar Institute of Dentistry, Multan after taking informed consent and permission from ethical committee and research department. Demographic information of patients (name, age, gender, duration of Fracture had taken. Patients from both gender with age range of 18-35 years having Maxillofacial trauma &lt; 10 days were included in this study and patients in which CT scan was contraindicated and those taken any surgical treatment for facial trauma were excluded in this study. Radiographic examination for the cranio-facial complex had performed for all patients followed by routinely and according to the needs of each individual case. RESULTS: From 181 patients, the minimum age was 18 years and maximum age was 35 years. According to plain radiographs, fracture was detected in 88.4% patients. By using 3D scan, fracture was detected in 96.7% patients. Sensitivity of 3D scan for detection of fracture was calculated as 98.13%, specificity was 14.28%, positive predicted value was 89.71%, negative predicted value was 50% and diagnostic accuracy was 88.39%. CONCLUSION: Among 181 patients, fracture was detected in 88.4% patients by using plain radiographs. By using 3D scan, fracture was detected in 96.7% patients. Sensitivity of 3D scan for detection of fracture was calculated as 98.13%, specificity was 14.28%, positive predicted value was 89.71%, and diagnostic accuracy was 88.39%. Keywords: 3D scan, plain radiographs, mid face fractures DOI : 10.7176/JMPB/60-01 Publication date :October 31 st 2019

Imaging of the temporomandibular joint - contemporary clinical and radiological implications

The temporomandibular joint (TMJ) represents a biomechanically and morphologically complex structure, tightly connected with the development and growth of mandible and craniofacial complex. The aim of this article is to comprehensively present contemporary diagnostic modalities and clinical implications for imaging of the TMJ. Contemporary imaging modalities, if used properly and according to adequate clinical implications and criteria, are able to depict different pathological processes and play a crucial role in establishing the right diagnosis and monitoring therapeutic effect. The key to right diagnosis, however, still lies in good knowledge of the TMJ developmental and functional anatomy, as well as the TMJ dysfunction related to the jaws, surrounding muscles, teeth, and cranial base.

S14-09 SESSION 14: FACIOCRANIOSYNOSTOSIS – PART III MITIGATION OF SHP2 ACTIVATION PREVENTS FGFR2 SIGNALING INDUCED CRANIOSYNOSTOSIS

Introduction: Activating-dominant mutations in the fibroblast growth factor receptor IIIc splice variant gene (Fgfr2c) cause premature cranial suture fusion (craniosynostosis), which can restrict growth of the craniofacial complex. Fgfr2c signaling is mediated via the docking protein Frs2a, which interacts with both Shp2, a tyrosine phosphatase, and Grb2, an adapter protein, to induce ERK-MAPK activation. The role of both Shp2 and Grb2 in craniosynostosis and craniofacial growth remains unknown; however, it is known that gain-of-function Fgfr2c mutant mice demonstrate hyperactivation of the ERK-MAPK signaling cascade and osteoblast activity. The objective of the current study is to determine the role Shp2 and Grb2 may play in Fgfr2-induced craniosynostosis and craniofacial growth. Methods: Gain-of-function Fgfr2c mice were crossed with mice deficient in two Shp2- or four Grb2-specific tyrosine phosphorylation sites within Frs2a. Skull morphology and sutures were analyzed grossly, histologically, and by micro-Computed Tomography. Coronal sutures were analyzed for ERK protein activation and whole calvaria were cultured and analyzed for alkaline phosphatase activity. Fluorescence-lifetime imaging microscopy – Fluorescence Resonance Energy Transfer (FLIM-FRET) was performed to study the interactions between FRS2a, Shp2, and Grb2 within WT or gain-of-function Fgfr2c mutant HEK293T cells. Analysis of Variance was used to compare three or more groups. An observed P value ≤ 0.05 was considered statistically significant. Results: Reduction of Shp2 activation prevents coronal suture fusion and restores normal craniofacial growth (P < 0.05), ERK-MAPK signaling (P < 0.05), and osteoblast activity (P < 0.05) in a mouse model of Fgfr2c-induced craniosynostosis via an Frs2a-dependent mechanism. Complete uncoupling of Grb2 from Frs2a resulted in only partial rescue of normal suture formation and growth. FLIM-FRET analysis revealed a complex interplay between FRS2a, Shp2, and Grb2 in the setting of dysregulated Fgfr2c signaling. Conclusion: This study provides mechanistic insight into craniofacial development and identifies Shp2 as a key regulator of craniofacial growth and development and highlights the therapeutic potential of Shp2 modulation for the treatment of Fgfr2c-related disorders.

Dental development and craniofacial morphology in school-age children.

The growth of the craniofacial complex is important for establishing a balanced relationship among the teeth, jaws, and other facial structures. However, there is still a lack of information about craniofacial parameters that are affected by the rate of dental development. The aim of this study was to investigate the association between dental development and craniofacial morphology in school-age children. This study was embedded in the Generation R Study, Rotterdam, The Netherlands. In 3,896 children aged 8 to 11years, dental development was assessed from panoramic radiographs and craniofacial morphology was assessed by combining cephalometric parameters into 9 uncorrelated principal components, each representing a distinct skeletal or dental craniofacial pattern. The statistical analysis was performed using linear and nonlinear regression model. Dental development was positively associated with the bimaxillary growth (β=0.04; 95% CI 0.01 to 0.08). Children with above-average dental development had a tendency toward Class II jaw relationship (β=-0.08; 95% CI -0.13 to -0.04). Regarding dental parameters, the proclination increased for incisors and lips with advanced dental development (β=0.15 [95% CI 0.10 to 0.19] and β=0.13 [95% CI 0.09 to 0.17], respectively), but the incisor proclination remained more pronounced in children that had above-average dental development. The findings of this large population-based study show that dental development is associated with specific dental and skeletal cephalometric characteristics in school-age children. Further longitudinal studies are necessary to confirm the observed effects over time.

THE VARIABILITY OF LINEAR PARAMETERS OF THE FACIAL PART OF THE SCULL DEPENDING ON THE ITS TYPE

Earlier studies of the linear characteristics of the parameters of the skull demonstrate the lack of a unified point of view on this issue. The current level of development of practical medicine requires morphometric accuracy in determining the shapes, spatial location and dimensional characteristics of the craniofacial complex parameters. The search for the most informative features using new technical and statistical methods is one of the current trends in modern craniology. The purpose of the study is to identify the variability of the morphometric linear parameters of the facial section of the skull, taking into account the craniological type. The article presents the morphometric characteristics of the linear parameters of the facial section of the skull of persons of mature age of both sexes. The work was carried out taking into account the craniological type. The presence of sexual dimorphism with prevalence of indicators on male preparations was found for the length and width parameters of the facial section of the skull only on mesocranic type skulls, for the parameters of the upper and middle depths of the facial section of the skull - only on mesocranic and dolichocranic type skulls. A sign of stability of indicators was established for indicators of the dents-alveolar part of the upper and lower jaw, the height of the lower jaw, the upper and middle depths of the facial section of the skull on preparations of the brachycranic type and the upper height of the facial section of the skull on preparations of the mesocranic type. Thus, the presence of sexual dimorphism with prevailing indicators on male preparations, depending on the type of skull, is proved.

Effects of nicotine exposure on murine mandibular development.

Nicotine is known to affect cell proliferation and differentiation, two processes vital to proper development of the mandible. The mandible, the lower jaw in mammals and fish, plays a crucial role in craniofacial development. Malformation of the jaw can precipitate a plethora of complications including disrupting development of the upper jaw, the palate, and or impeding airway function. The purpose of this study was to test the hypothesis that in utero nicotine exposure alters the development of the murine mandible in a dose dependent manner. To test this hypothesis, wild type C57BL6 mice were used to produce in utero nicotine exposed litters by adding nicotine to the drinking water of pregnant dams at concentrations of 0 μg/ml (control), 50 μg/ml (low), 100 μg/ml (medium), 200 μg/ml (high) throughout pregnancy to birth of litters mimicking clinically relevant nicotine exposures. Resultant pups revealed no significant differences in body weight however, cephalometric investigation revealed several dimensions affected by nicotine exposure including mandibular ramus height, mandibular body height, and molar length. Histological investigation of molars revealed an increase in proliferation and a decrease in apoptosis with nicotine exposure. These results demonstrate the direct effects of nicotine on the developing mandible outside the context of tobacco use, indicating that nicotine use including tobacco alternatives, cessation methods, and electronic nicotine delivering products may disrupt normal growth and development of the craniofacial complex.

Craniofacial malformations and their association with brain development: the importance of a multidisciplinary approach for treatment.

The craniofacial complex develops mainly in the first trimester of pregnancy, but its final shaping and the development of the teeth extend into the second and third trimesters. It is intimately connected with the development of the brain because of the crucial role the cranial neural crest cells play and the fact that many signals which control craniofacial development originate in the brain and vice versa. As a result, malformations of one organ may affect the development of the other. Similarly, there are developmental connections between the craniofacial complex and the teeth. Craniofacial anomalies are either isolated, resulting from abnormal development of the first two embryonic pharyngeal arches, or part of multiple malformation syndromes affecting many other organs. They may stem from gene mutations, chromosomal aberrations or from environmental causes induced by teratogens. The craniofacial morphologic changes are generally cosmetic, but they often interfere with important functions such as chewing, swallowing and respiration. In addition, they may cause hearing or visual impairment. In this review we discussed only a small number of craniofacial malformations and barely touched upon related anomalies of dentition. Following a brief description of the craniofacial development, we discussed oral clefts, craniofacial microsomia, teratogens that may interfere with craniofacial development resulting in different malformations, the genetically determined craniosynostoses syndromes and few other relatively common syndromes that, in addition to the craniofacial complex, also affect other organs. The understanding of these malformations is important in dentistry as dentists play an integral role in their diagnosis and multidisciplinary treatment.

Tuftelin's involvement in embryonic development.

Little is known about tuftelin expression in the developing embryo, previously it was thought to play a role in tooth enamel mineralization. In this study we show tuftelin's spatio-temporal expression in mineralizing and nonmineralizing tissues of the craniofacial complex in the developing mouse embryo. Embryos aged E10.5-E18.5 and newborns aged P3 were used in this study. Polymerase chain reaction (PCR), Real-time PCR, sequencing, and in-situ hybridization were used to detect and quantify messenger RNA (mRNA) expression in different developmental stages. We applied indirect immunohistochemistry and western-blot analyses to investigate protein expression.Two tuftelin mRNA transcripts and a single 64KDa protein were detected throughout embryonic development. Tuftelin was detected in tissues which develop from different embryonic origins; ectoderm, ectomesenchyme, and mesoderm.Tuftelin mRNA and protein were expressed already at E10.5, before the initiation of tooth formation and earlier than previously described. The expression pattern of tuftelin mRNA and protein exhibits dynamic spatio-temporal changes in various tissues.Tuftelin is expressed in neuronal tissues, thus fitting with its described correlation to nerve growth factor. A shift between cytoplasmatic and perinuclear/nuclear expression implies a possible role in regulation of transcription.Recent studies showed tuftelin is induced under hypoxic conditions in-vitro and in-vivo, through the hypoxia-inducible factor 1-α pathway. These results led to the hypothesis that tuftelin is involved in adaptation to hypoxic conditions. The fact that much of mammalian embryogenesis occurs at O 2 concentrations of 1-5%, raises the possibility that tuftelin expression throughout development is due to its role in the adaptivemechanisms in response to hypoxia.

Breaking Symmetry: A Quantitative Analysis of Facial Skeleton Disharmony in Children Born with Bilateral Cleft Lip and Palate.

Bilateral cleft lip and palate (BCLP) occurs when craniofacial precursors fail to form or fuse properly during development. The aim of this retrospective, cross-sectional investigation was to quantify directional asymmetry (DA) of the facial skeleton of children born with Veau Class IV nonsyndromic BCLP. To accomplish this goal, coordinate values of anatomical landmarks were acquired from three-dimensional cone beam computed tomographic images of the craniofacial skeleton of middle- to late-aged children born with BCLP and age- and sex-matched controls and used to compare patterns of asymmetry variation. Multivariate analyses revealed different patterns of DA variation across samples and identified approximately 30% of DA measures as significantly different. Magnitudes of statistically significant linear distances differ in the craniofacial region, with most smaller DA differences located near the orbits and frontal bone, while larger differences were localized mostly to the midface, alveolar ridge, and nasal borders. Generally, areas of the craniofacial skeleton derived from the maxillary and nasal prominences demonstrated the highest magnitudes of DA. The methods and results presented will be useful to biomedical researchers when identifying the extent to which patients with BCLP diverge from typical developmental expectations. Quantifying DA and assessing local differences across the craniofacial complex can aid medical practitioners when developing treatments to improve BCLP surgical algorithms and outcomes. Anat Rec, 302:1726-1732, 2019. © 2019 American Association for Anatomy.

Posturography examination as a diagnostic tool in children - a review of the literature

Introduction. Posturograph tests are used to assess the vestibular reflex, which can be helpful for specialists who analyze body balance disorders. Despite many studies on the stability of body posture in pediatric patients, there is still a lack of reliable analysis.Aim. Performing a review of the literature to verify the relationship between balance and body posture as well as stomatognathic system as a part of motor system and the craniofacial complex using a posturograph.Material and Methods. A review of the literature has been carried out for the posturographic examination as a diagnostic tool. The following work is for reference only. A review of the Google Schoolar database and PubMed was made. Keywords used in the search are: (children) and (posturography, posture control, balance, temporomandibular joint). The authors took into account reports published in Polish and English. For the purposes of this review, strict criteria for the inclusion and exclusion of research work have been created.Results. The authors analyzed 335 research papers, of which 5 articles were qualified after the analysis. Studies show that there is a relationship between posturographic examination and postural disorders in children. However, the results are not conclusive and further research is necessary before these results can be considered as fully generalized.Summary. It is necessary to standardize the research using a posturograph. There is a need for further research due to the lack of standardized measurements showing norms for individual age groups.

Cone-Beam Computed Tomography of Osteogenesis Imperfecta Types III and IV: Three-Dimensional Evaluation of Craniofacial Features and Upper Airways.

ABSTRACTThis cross‐sectional study investigated the natural history of craniofacial deformities in osteogenesis imperfecta (OI) and determined the impact of three‐dimensional (3D) analysis on diagnosis and treatment planning in orthodontics and orthognathic surgery in comparison to conventional two‐dimensional (2D) cephalometric examination. 3D images of the craniofacial complex were acquired during 1 calendar year using cone‐beam computed tomography (CBCT) from a cohort of 41 individuals (aged 11 to 35 years; 28 females) with OI type III (n = 13) or IV (n = 28). 3D evaluation of the craniocervical junction and upper airways was conducted using InVivoTM. 2D lateral cephalogram was constructed, traced, and examined using the University of Western Ontario analysis (DolphinTM). Quantitative and qualitative parameters were compared between OI type III and type IV groups (unpaired t test) and the unaffected population (Z‐score). 3D evaluation revealed a high prevalence of craniocervical abnormalities, craniofacial asymmetries, and nasal septum deviation in both OI groups. Mean airway dimensions were comparable to the non‐affected population norms, except for 5 individuals who had insufficient airway dimensions. In 2D, the maxilla was retrognathic and hypoplastic, and the mandibular position was convergent with respect to the face, resulting in mandibular prognathism and face height reduction. The 2D trends were more pronounced in OI type III, whereas the 3D craniocervical and airway abnormalities were common in both types. This study illustrates the prevalence of craniofacial and airway anomalies in OI that occur along with facial deformities are not associated with postcranial phenotype and OI type, are apparent only in 3D evaluation, and are likely to influence treatment strategy. For OI patients, a team effort involving a dentist, orthodontist, neurologist, and ear‐nose‐throat (ENT) practitioner is recommended for successful management of craniofacial deformities. © 2018 The Authors JBMR Plus published by Wiley Periodicals, Inc. on behalf of American Society for Bone and Mineral Research.

Heritability of Craniofacial Characteristics in Twins - Cephalometric Study.

Introduction:The growth and development of the craniofacial complex are under the influence of genetic and environmental factors, which determine its morphological and functional characteristics. Twin studies provide significant insight into how many genetic and environmental factors determine dental and craniofacial characteristics.Aim:The aim of the study was to determine the genetic influence on craniofacial complex using a twin study model.Methods:The study sample comprised 52 pairs of twins who were referred to the Orthodontic Department, School of Dental medicine, University of Sarajevo. Informed consent was obtained by the parents of the children included in the study. Twenty pairs of twins were diagnosed as monozygotic while 32 pairs were diagnosed as dizygotic. Zygosity was diagnosed by physical characteristics similarity. Nineteen variables were measured: 10 dental variables, 9 cephalometric.Results:Based on the findings of this study, t-test showed significant genetic effect on the length of cranial base (p = 0.03), corpus of maxilla (p = 0.02) and mandibular length (p = 0.03), and also for B-angle (p = 0.04). Environmental factors are more involved in determining dental traits (e.g., the inclination of the incisors).Conclusion:There is a significant genetic effect on the linear cephalometric variables: the length of the cranial base, maxillary length and mandibular length.

ORAL HEALTH ABNORMALITIES IN CHILDREN BORN WITH MACROSOMIA ESTABLISHED DURING MIXED DENTITION PERIOD

Introduction: The prevalence of soft tissue and hard tooth tissuediseases in the oral cavity and the morphofunctional disorders of craniofacial complex, require attention ofspecialistsin various branches of medicine. Scientists began to pay attention to metabolic and other violations that have occurred in the fetal development and led to the occurrence of certain changes in the dental status of the child. The aim of this research is to study the features of the dental health condition in the children of Northeast of Ukraine, who were born with macrosomia during the period of mixed dentition. The study takes into account intrauterine body length growth acceleration, intrauterine obesity or well-balanced acceleration of both the body weight and length gain. Materials and methods:Thirty 6.5-11-year-old children with fetal macrosomia were examined (MainGroup). A Comparison Group was comprised of sixteen children, whose weight-height parameters at birth were normal (fetal normosomia). All children in the Main group were split into four subgroups in accordance with weight-height parameters at birth using the V. I. Grischenko and his co-authors' harmonious coefficient. The evaluation of the hygiene status of the oral cavity, the dental caries intensity evaluation, and the quantitative analysis of minor salivary gland secretion have been performed. The prevalence of dentoalveolar abnormalities was evaluated. Results: The highest values of caries intensity were recorded in macrosomic-at-birth children born with harmonious (well-balanced) intrauterine development, with intrauterine obesity and increased body length, or with intrauterine obesity and an average body length. Macrosomic children have reduced number of minor salivary glands per unit area in comparison with the normosomic-at-birth children. The saliva secretion of minor salivary glands in macrosomic children is reliably, by 16,5% on average, reduced. Children born with fetal macrosomia have long narrow faces and high palates more frequently than normosomic-at-birth children. Children born macrosomic have a significantly higher percentage (100% versus 73%)of dentoalveolar abnormalitiesin comparison with the normosomic-at-birth children. Conclusions: The processes causing fetal macrosomia have a great impact on the dental status of children in the period of mixed dentition.