Growth Pattern In Patients Research Articles

Prognostic Utility of Histological Growth Patterns of Colorectal Lung Oligometastasis.

BackgroundPatients with resectable colorectal lung oligometastasis (CLOM) demonstrate a heterogeneous oncological outcome. However, the parameters for predicting tumor aggressiveness have not yet been fully investigated in CLOM. This study was performed to determine the prognostic value of histological growth patterns in patients who underwent surgery for CLOM. MethodsThe study included 92 patients who were diagnosed with CLOM among the first resection cases. CLOMs grow according to three histological patterns: aerogenous, pushing, and desmoplastic patterns. The growth patterns were evaluated on archival hematoxylin and eosin–stained tissue sections. ResultsThe aerogenous pattern was found in 29.4% (n=27) of patients, the pushing pattern in 34.7% (n=32), the desmoplastic pattern in 6.5% (n=6), and a mix of two growth patterns in 29.4% (n=27). The size of the aerogenous pattern was significantly smaller than that of metastases with other patterns (p=.033). Kaplan-Meier analysis demonstrated that patients showing an aerogenous pattern appeared to have a poorer prognosis, which was calculated from the time of diagnosis of the CLOM (p=.044). The 5-year survival rate from the diagnosis of colorectal cancer tended to be lower in patients with an aerogenous pattern than in those who had a non-aerogenous pattern; however, the difference was marginally significant (p=.051). In the multivariate Cox analysis, the aerogenous pattern appeared as an independent predictor of poor overall survival (hazard ratio, 3.122; 95% confidence interval, 1.196 to 8.145; p=.020). ConclusionsThese results suggest that the growth patterns may play a part as a histology-based prognostic parameter for patients with CLOM.

Comparison of the adult three-dimensional craniofacial features of patients with unilateral craniofacial microsomia with and without early mandible distraction

This study was conducted to analyze the long-term facial growth of patients with craniofacial microsomia (CFM) after early mandible distraction osteogenesis (DO), and compared adult three-dimensional (3D) craniofacial features of patients with and without early mandibular DO for Pruzansky grade II deformities. The study included 20 patients: 9 with early mandible DO (the DO group) and 11 without previous treatment (the NDO group). Longitudinal radiographs were measured for growth changes after DO. The 3D craniofacial images were constructed to compare the craniofacial forms between the two groups. The patients with early DO presented 8 to 9mm forward and downward maxillary growth and 4.6mm limited forward and 17.3mm substantial downward mandibular growth. The ramus length ratio (affected/nonaffected) was 90.8% at DO completion and decreased to 69.5% at growth completion during 13 years of follow-up. Both groups showed obvious craniofacial asymmetry, as indicated by occlusal plane canting, chin deviation, transverse and vertical condyle positions, and mandibular contours. Although all the bilateral differences were higher in the NDO group than in the DO group, no statistical differences were found. Early mandible distraction could not alter the inherent facial growth pattern in patients with grade II CFM. Limited changes are derived for definitive facial correction with early DO.

Growth patterns of patients with Noonan syndrome: correlation with age and genotype.

Growth patterns of patients with Noonan syndrome (NS) were established before the involved genes were identified. The goal of this study was to compare growth parameters according to genotype in patients with NS. The study population included 420 patients (176 females and 244 males) harboring mutations in the PTPN11, SOS1, RAF1, or KRAS genes. NS-associated PTPN11 mutations (NS-PTPN11) and NS with multiple lentigines-associated PTPN11 mutations (NSML-PTPN11) were distinguished. Birth measures and height and body mass index (BMI) measures at 2, 5, 10 years, and adulthood were compared with the general population and between genotypes. Patients with NS were shorter at birth (mean birth length standard deviation score (SDS): -1.0 ± 1.4; P < 0.001) and throughout childhood than the healthy population, with height SDS being -2.1 ± 1.3 at 2 years, and -2.1 ± 1.2 at 5 and 10 years and adulthood (P < 0.001). At birth, patients with NS-PTPN11 were significantly shorter and thinner than patients with NSML-PTPN11, SOS1, or KRAS. Growth retardation was significantly less severe and less frequent at 2 years in patients with NSML-PTPN11 and SOS1 than in patients with NS-PTPN11 (P < 0.001 and P = 0.002 respectively). Patients with NS had lower BMI at 10 years (P < 0.001). No difference between genotypes was demonstrated. Determining the growth patterns of patients with NS according to genotype should better inform clinicians about the natural course of growth in NS so that they can optimize the follow-up and management of these patients.

Assessment of Parametrial Response by Growth Pattern in Patients With FIGO Stage IIB and IIIB Cervical Cancer: Analysis of Patients From a Prospective Multicentric Trial (EMBRACE)

Assessment of Parametrial Response by Growth Pattern in Patients With FIGO Stage IIB and IIIB Cervical Cancer: Analysis of Patients From a Prospective Multicentric Trial (EMBRACE)

Prognostic value of combined visualization of MR diffusion and perfusion maps in glioblastoma.

We analyzed whether the combined visualization of decreased apparent diffusion coefficient (ADC) values and increased cerebral blood volume (CBV) in perfusion imaging can identify prognosis-related growth patterns in patients with newly diagnosed glioblastoma. Sixty-five consecutive patients were examined with diffusion and dynamic susceptibility-weighted contrast-enhanced perfusion weighted MRI. ADC and CBV maps were co-registered on the T1-w image and a region of interest (ROI) was manually delineated encompassing the enhancing lesion. Within this ROI pixels with ADC values <the 30th percentile (ADCmin), pixels with CBV values >the 70th percentile (CBVmax) and the intersection of pixels with ADCmin and CBVmax were automatically calculated and visualized. Initially, all tumors with a mean intersection greater than the upper quartile of the normally distributed mean intersection of all patients were subsumed to the first growth pattern termed big intersection (BI). Subsequently, the remaining tumors' growth patterns were categorized depending on the qualitative representation of ADCmin, CBVmax and their intersection. Log-rank test exposed a significantly longer overall survival of BI (n = 16) compared to non-BI group (n = 49) (p = 0.0057). Thirty-one, four and 14 patients of the non-BI group were classified as predominant ADC-, CBV- and mixed growth group, respectively. In a multivariate Cox regression model, the BI-, CBV- and mixed groups had significantly lower adjusted hazard ratios (p-value, α(Bonferroni) < 0.006) when compared to the reference group ADC: 0.29 (0.0027), 0.11 (0.038) and 0.33 (0.0059). Our study provides evidence that the combination of diffusion and perfusion imaging allows visualization of different glioblastoma growth patterns that are associated with prognosis. A possible biological hypothesis for this finding could be the interpretation of the ADCmin fraction as the invasion-front of tumor cells while the CBVmax fraction might represent the vascular rich tumor border that is "trailing behind" the invasion-front in the ADC group.

Assessment of Parametrial Response by Growth Pattern in Patients With International Federation of Gynecology and Obstetrics Stage IIB and IIIB Cervical Cancer: Analysis of Patients From a Prospective, Multicenter Trial (EMBRACE)

To assess disease response along the parametrial space according to tumor morphology in patients with International Federation of Gynecology and Obstetrics (FIGO) stage IIB and IIIB cervical cancer at the time of image-guided adaptive brachytherapy. Patients with FIGO stage IIB and IIIB cervical cancer registered as of November 2013 in the EMBRACE study were evaluated. Tumors were stratified according to morphologic subtype on magnetic resonance imaging (expansive and infiltrative), and the characteristics of those subtypes were analyzed. Parametrial involvement at diagnosis and at brachytherapy was evaluated, and the response to chemo-radiotherapy was classified as good, moderate, or poor. The response grade was compared between the 2 groups and analyzed with regard to tumor volumes, and dosimetric parameters. A total of 452 patients were evaluated, of whom 186 had expansive growth type and 266 had infiltrative morphology. Patients with infiltrative tumors had more extensive disease, as indicated by a higher rate of FIGO stage IIIB disease, as well as radiologic evidence of extension into the distal parametrial space and to the pelvic side wall on magnetic resonance imaging. Cervical necrosis was more common in the infiltrative group. Good response was more common in the expansive group (34% vs 24%; P=.02), and poor response was more common in the infiltrative group (11% and 19%; P=.02). Mean gross tumor volume at diagnosis was equal in both groups (51.7 cm(3)). The high-risk clinical target volume was larger in infiltrative tumors (37.9 cm(3) vs 33.3 cm(3), P=.005). The mean high-risk clinical target volume D90 was slightly higher in expansive tumors (92.7 Gy and 89.4 Gy, P<.001). Infiltrative tumors are more advanced at presentation and respond less favorably to chemo-radiotherapy when compared with expansive tumors that are more or less equivalent in size. The use of image-guided adaptive brachytherapy allows achieving reasonably high doses in both groups.

Relationship of pathologic factors to efficacy of sorafenib treatment in patients with metastatic clear cell renal cell carcinoma.

To evaluate the predictive value of growth patterns in patients undergoing sorafenib treatment for metastatic clear cell renal cell carcinomas (CCRCCs). Forty-eight patients were analyzed, each of whom underwent nephrectomy and received sorafenib treatment for metastatic CCRCC. Progression-free survival (PFS) was predicted using pathologic parameters, including pathologic stage, Fuhrman nuclear grade (FNG), the presence of a sarcomatoid component, lymphovascular invasion, tumor necrosis, and growth pattern. Three (6%) patients showed partial response, 20 (42%) patients showed stable disease, and 25 (52%) patients showed progressive disease. Univariate analyses demonstrated that FNG, the presence of a sarcomatoid component, tumor necrosis, and growth pattern were significantly associated with PFS. In the multivariate analysis, growth pattern was the only parameter that was significantly and independently predictive of PFS. As a novel histologic prognostic parameter, growth pattern may be useful for predicting response to sorafenib treatment.

Assessing reliability of mandibular planes in determining gonial angle on lateral cephalogram and panoramic radiograph

Introduction: Gonial angle is used widely in orthodontic tracing and is a significant indicator to diagnose the growth pattern in patients. Lateral cephalograms and panoramic radiographs both effectively determine the gonial angle. A definite variation exists when the gonial angle is determined using three different mandibular planes as described by Tweed, Steiner, and Down, respectively. The aim of this study was to evaluate, which gonial angle (obtained from Tweed's, Steiner's or Down's mandibular plane) on lateral cephalogram has the value closest to that obtained on a panoramic radiograph. Materials and Methods: A total of 300 patients between 12 and 29 years of age were selected. Panoramic and lateral cephalometric radiographs were obtained. On panoramic radiograph, gonial angle was determined by tangent of inferior border of mandible and most distal aspect of ascending ramus and condyle and compared with the value of each gonial angle obtained using three mandibular planes as described by Tweed, Steiner and Downs on lateral cephalogram. Levene's and Independent samples t -test were done for comparison. Results: Difference between gonial angles determined by Tweeds mandibular plane on lateral cephalogram and panoramic radiograph was statistically insignificant ( P > 0.05). Conclusion: Of the three commonly used mandibular planes in measuring gonial angles, the value obtained with Tweeds mandibular plane seems to be more reliable.

Multivariate longitudinal shape analysis of human lateral ventricles during the first twenty-four months of life.

BackgroundLittle is known about the temporospatial shape characteristics of human lateral ventricles (LVs) during the first two years of life. This study aimed to delineate the morphological growth characteristics of LVs during early infancy using longitudinally acquired MR images in normal healthy infants.Methods24 healthy infants were MR imaged starting from 2 weeks old every 3 months during the first and every 6 months during the second year. Bilateral LVs were segmented and longitudinal morphological and shape analysis were conducted using longitudinal mixed effect models.ResultsA significant bilateral ventricular volume increase (p<0.0001) is observed in year one (Left: 126±51% and Right: 145±62%), followed by a significant reduction (p<0.02) during the second year of life (Left: −24±27% and Right: −20±18%) despite the continuing increase of intracranial volume. Morphological analysis reveals that the ventricular growth is spatially non-uniform, and that the most significant growth occurs during the first 6 months. The first 3 months of life exhibit a significant (p<0.01) bilateral lengthening of the anterior lateral ventricle and a significant increase of radius (p<0.01) and area (p<0.01) at the posterior portion of the ventricle. Shape analysis shows that the horns exhibit a faster growth rate than the mid-body. Finally, bilateral significant age effects (p<0.01) are observed for the growth of LVs whereas gender effects are more subtle and significant effects (p<0.01) only present at the left anterior and posterior horns. More importantly, both the age and gender effects are growth directionally dependent.ConclusionsWe have demonstrated the temporospatial shape growth characteristics of human LVs during the first two years of life using a unique longitudinal MR data set. A temporally and spatially non-uniform growth pattern was reported. These normative results could provide invaluable information to discern abnormal growth patterns in patients with neurodevelopmental disorders.

Growth charts for patients with Hunter syndrome

Children with mucopolysaccharidosis II (MPS II), also known as Hunter syndrome, an X-linked disorder, suffer from a multisystem dysfunction caused by the accumulation of glycosaminoglycans. However, there has been no systemic report on the growth of patients with MPS II. The purpose of this study is to describe the growth patterns of patients with MPS II and to compare with the patterns of age-matched controls. Data (height, weight, age, etc.) was collected in a longitudinal study of Japanese male patients with MPS II (n=111). The mean birth length was 50.31±1.42cm, while the mean birth weight was 3.35±0.39kg. The mean final height and weight at 18years and older were 125.63±9.09cm and 37.18±8.72kg; corresponding to a difference of −46.40cm and −25.89kg lower, when compared with healthy Japanese male controls. The mean birth BMI was 10.84±3.29kg/m2, while the mean BMI at 18years was 29.41±6.15kg/m2. The growth pattern in patients with MPS II was characterized by overgrowth for the first several years, although growth velocity fell below that of the normal healthy controls after one year of age. No statistical difference in height was observed between patients with the attenuated and severe phenotypes in each age class.In conclusion, this report describes the natural history of growth in patients with MPS II, which can help in monitoring the progression of the disease as well as assessing therapeutic efficacy.

A Retrospective Analysis of the Growth Pattern in Patients with Salt-wasting 21-Hydroxylase Deficiency.

The objective of this study was to investigate the growth pattern of children with the salt-wasting form of congenital adrenal hyperplasia caused by 21-hydroxylase deficiency (21-OHD). We reviewed the medical records of 13 patients in whom salt-wasting 21-OHD was diagnosed during the first 2 mo of life at our hospital from 1980 through 2008. Six reached adult height. Growth patterns, bone age, biochemical data, and the hydrocortisone dose at each growth stage were analyzed retrospectively. The mean adult height was 155.1 ± 6.5 cm (mean ± SD) in females and 158.1 ± 7.1 cm in males. Although length at birth was normal or longer than the national mean in almost all patients, the mean height SD score of both boys and girls decreased to below 0 SD during infancy. Subsequently, both boys and girls transiently showed growth acceleration and reached their peak growth velocity at 3–10 yr of age. In conclusion, in addition to suppression of growth during infancy, there was inappropriate growth acceleration during childhood. Especially from 3 mo to 3 yr of age, decreasing the hydrocortisone dose in patients who exhibit slower growth may lead to satisfactory height outcomes. Also, strict adjustment of the hydrocortisone dose to avoid accelerated growth from childhood to adolescence might improve adult height outcomes of patients with 21-OHD.

Residents' journal review

Residents' journal review

Sagittal Maxillary Growth Pattern in Unilateral Cleft Lip and Palate Patients With Unrepaired Cleft Palate

The objective of the study was to examine the sagittal maxillary growth pattern during the mixed and permanent dentition in unilateral cleft lip and palate (UCLP) patients with unrepaired cleft palate. A total of 30 nonsyndromic UCLP patients with unrepaired cleft palate were included, 15 of whom were in mixed dentition and 15 in permanent dentition.Cephalograms were analyzed and compared in the patients with UCLP who have operatively undergone repair with both the lip and palate as well as normal subjects. The UCLP patients with unrepaired cleft palate in mixed dentition showed decreased anterior-posterior length of the maxilla. The UCLP patients with unrepaired cleft palate in permanent dentition demonstrated an almost normal maxillary growth. The operated-on patients both in mixed and permanent dentitions showed maxillary retrusion as well as decreased maxillary length. There appears that there may be the potential normal maxillary growth in UCLP patients, and early surgical repair of the cleft palate may affect sagittal maxillary growth pattern in patients with cleft.

Facial Nerve Schwannomas Presenting as Occluding External Auditory Canal Masses

Introduction: Facial nerve schwannomas are rare tumors of the lateral skull base. Treatment options for these tumors include observation, stereotactic radiation, and microsurgical removal. Erosion of the bony posterior canal from the descending segment of an entirely intratemporal tumor is an unusual growth pattern. With tumor in the external canal, a unique set of clinical challenges arises. We discuss the management strategies for facial schwannomas with this unusual growth pattern in patients of two disparate ages.

Craniofacial growth variations in nasal-breathing, oral-breathing, and tracheotomized children

Childhood oral breathing can alter muscular balance and lead to facial deformities. No articles in the literature have reported on the alteration of facial growth patterns in patients who have received tracheotomies. The purpose of this study was to evaluate craniofacial developmental consequences originating from variations in breathing mechanisms in children who are nasal breathers or oral breathers, and those who have been tracheotomized. The sample was divided into 3 groups of 10 each. The nasal group had a mean age of 13.9 years, the oral group had a mean age of 12.7 years, and the tracheotomy group had a mean age of 12.8 years. The masseter and suprahyoid muscles were evaluated with electromyography. The following measurements were made: facial, maxillary, and mandibular widths; nasion-sella-gnathion angle; and facial index. The tracheotomized group was similar to the nasal group for greater activity of the masseter muscles than of the suprahyoid muscles during mastication, as well as in the measurements of facial, maxillary, and mandibular widths. The oral group showed reductions in each category. The tracheotomized group was similar to the oral group during maximum dental occlusion for significantly higher activity of the suprahyoid muscles compared with the masseter muscles, with reductions in vertical values. A childhood tracheotomy might affect facial development in a way comparable with that of oral breathers, including abnormal facial growth variations.

"Pediatric-type" gastrointestinal stromal tumors in adults: distinctive histology predicts genotype and clinical behavior.

Gastrointestinal stromal tumors (GISTs) rarely affect children, mainly girls. Pediatric GISTs typically arise in the stomach as multifocal tumors with a multinodular growth pattern, epithelioid morphology, lymph node metastases, an absence of KIT and PDGFRA gene mutations, and indolent behavior. Occasional GISTs in adults show similar features. Such tumors are not widely recognized. GISTs with a multinodular growth pattern in patients over the age of 18 years were retrieved from surgical and consultation files. Hematoxylin and eosin-stained slides were reviewed, immunohistochemistry was performed, and KIT (exons 9, 11, 13, and 17) and PDGFRA (exons 12, 14, and 18) genes were screened for mutations. Clinical follow-up was obtained. Sixteen cases were identified, affecting 13 women and 3 men (median age, 31.5 y; range, 19 to 56 y), all in the stomach. The mean tumor size was 5.4 cm (range, 1.8 to 11 cm); 4 were multifocal. All tumors showed a multinodular or plexiform architecture and epithelioid (N=3) or mixed epithelioid and spindle cell (N=13) morphology. Five tumors had vascular invasion; 6 had focal necrosis. Mitotic activity ranged from 3 to 156/50 high-power fields (8 tumors had ≤5/50 high-power fields). Using Armed Forces Institute of Pathology risk stratification, categories for primary tumors were: none (N=2), very low risk (N=3), low risk (N=3), moderate risk (N=3), and high risk (N=5). By immunohistochemistry, all tumors were positive for KIT, 82% DOG1, 72% CD34, 18% caldesmon, 9% S-100, 8% smooth muscle actin, and 0% desmin. All tumors were wild type for KIT and PDGFRA in the exons that were screened. At primary resection, 9 patients (56%) had lymph node metastases and 3 patients had liver metastases. Follow-up ranged from 16 months to 16 years (median, 5 y). Two tumors recurred locally in the stomach and 7 patients developed subsequent metastases to the lymph nodes (N=5), liver (N=3), and peritoneum/omentum (N=3). Primary tumors from 7 patients with metastases were Armed Forces Institute of Pathology low risk, very low risk, or no risk of recurrence. None of the metastatic tumors responded to treatment with imatinib mesylate. One patient died of disseminated liver and intra-abdominal metastases and the remaining patients were alive at last follow-up. Gastric GISTs in adults with a multinodular or plexiform growth pattern and epithelioid or mixed morphology are similar to pediatric GISTs. Unlike conventional adult GISTs, this distinctive subset predominantly affects women, often metastasizes to lymph nodes, and lacks mutations in KIT and PDGFRA. Current risk assessment criteria do not reliably predict behavior for this group. Although metastases are common and most tumors are imatinib resistant, they pursue a relatively indolent clinical course. Recognition of "pediatric-type" GISTs in adults is critical for prognosis, appropriate therapy, and follow-up.

Pain is associated with an endophytic cancer growth pattern in patients with oral squamous cell carcinoma before treatment

The origins and mechanisms of pain arising from oral cancer are important. Oral cancer pain impairs a patient's quality of life. This study was undertaken to elucidate significant risk factors associated with spontaneous pain in patients with untreated oral squamous cell carcinoma (OSCC) before treatment. A total of 113 patients (82 men, 31 women; median age, 64 years) with untreated OSCC were examined. Correlations between spontaneous pain in the primary site and sex, age, primary site, TN stage, clinical stage, and clinical growth type of cancer (exophytic or endophytic), as well as the degree of histological differentiation and the histological mode of invasion were evaluated. At the initial examination, 42 (37%) of patients had spontaneous pain. In univariate statistical analyses, reported pain correlated significantly with patient age and the clinical growth type of the cancer, as well as with the degree of histological differentiation and the histological mode of invasion. Multiple logistic regression analysis showed significant correlations between reported spontaneous pain and the clinical growth type of the cancer (P = 0.0003; odds ratio, 9.5; 95% confidence interval, 2.8-32.3), as well as reported spontaneous pain and the histological mode of invasion (P = 0.0026; odds ratio, 4.7; 95% confidence interval, 1.7-12.7). Clinical and histological endophytic growth patterns of OSCC might be significant risk factors for the presence of spontaneous pain before treatment.

Update on Diagnostic Practice: Tumors of the Nervous System

Changes in the practice of diagnosing brain tumors are formally reflected in the evolution of the World Health Organization classification. Beyond this classification, the practice of diagnostic pathology is also changing with the availability of new tests and the introduction of new treatment options. Glioblastomas, oligodendrogliomas, glioneuronal tumors, and primitive pediatric tumors are discussed in an exemplary way to illustrate these changes. Review of relevant publications through Medline database searches. The example of glioblastomas shows how new predictive markers may help identify subgroups of tumors that respond to certain therapy regimens. The development of new treatment strategies also leads to different questions in the assessment of brain tumors, as seen in the example of pseudoprogression or the changes in tumor growth pattern in patients taking bevacizumab. Oligodendrogliomas illustrate how the identification of 1p/19q loss as a cytogenetic aberration aids our understanding of these tumors and changes diagnostic practice but also introduces new challenges in classification. Glioneuronal tumors are an evolving group of lesions. Besides a growing list of usually low-grade entities with well-defined morphologic features, these also include more poorly defined cases in which a component of infiltrating glioma is often associated with focal neuronal elements. The latter is biologically interesting but of uncertain clinical significance. Oligodendrogliomas and glioneuronal tumors both illustrate the importance of effective communication between the pathologist and the treating oncologist in the discussion of these patients. Finally, the discussion of primitive pediatric tumors stresses the clinical importance of the distinction between different entities, like atypical teratoid rhabdoid tumor, "central" (supratentorial) primitive neuroectodermal tumor, "peripheral" primitive neuroectodermal tumor, and medulloblastoma. In medulloblastomas, the recognition of different variants is emerging as a prognostic factor that may in the future also predict therapy responsiveness.

Craniofacial Growth Patterns in Patients with Congenitally Missing Permanent Teeth*

Aim of this study was to investigate any correlations between the congenital absence of certain permanent teeth and individual craniofacial growth patterns. The lateral cephalograms of n = 101 patients (65 female und 36 male) with various congenitally missing teeth were analyzed according to Hasund [11] prior to orthodontic treatment. Cephalometric data to determine the craniofacial growth pattern comprised GntgoAr, NSBa, ML-NSL, NL-NSL, MLNL angles and the index between upper and lower facial heights. Correlations between the type of missing teeth and growth pattern were examined. Group distribution was A = all patients with missing teeth (n = 101), P = missing second premolars (n = 49), S = missing upper lateral incisors (n = 30), X = various missing teeth (n = 22). We included a control group for each of these groups using data from Riolo et al.'s [22] growth study. Group A revealed an even distribution with n = 32 patients (31.7%) having a vertical growth pattern, n = 37 patients (36.6%) a neutral growth pattern, and n = 32 patients (31.7%) a horizontal growth pattern. The majority of patients (n = 20, 40.8%) in group P exhibited a horizontal growth pattern, whereas there were no significant correlations between the kind of congenitally missing teeth and growth patterns in groups S and X. Comparison of the mean values of groups P, S and X, revealed no significant differences. When comparing the control group to groups A, P and S, we noted significantly or highly significantly smaller gonial and basal plane angles. No significant differences were apparent concerning group X. This examination demonstrates no statistically-relevant correlation between craniofacial growth pattern and the congenital absence of certain permanent teeth, although horizontal growth is more frequent (but not significant) in patients with congenitally missing second premolars.

Growth pattern in patients with mulibrey nanism

Growth pattern in patients with mulibrey nanism