Total Cranial Base Length Research Articles

The Association between Cranial Base and Maxillomandibular Sagittal and Transverse Relationship: A CBCT Study

The cranial base has a crucial effect on the position of the maxilla and mandible. This study aims to investigate the relationship between the cranial base sagittal and transverse dimensions in different skeletal patterns. This is a retrospective study of pre-existing CBCT images of 132 subjects (60 males and 72 females) from Saudi Arabia with a mean age of 35 years old. The grouping of the subjects was based on the ANB angle of Steiner’s analysis. One-way ANOVA was used to compare the means of the sagittal and transverse dimensions between different skeletal patterns, followed by a post hoc test for individual comparisons. Logistic regression analysis was performed to test the relationship between gender, age, and cephalometric values between the three groups. The significance level was 0.05. One-way ANOVA revealed a statistically significant difference in posterior cranial base length (p < 0.05) and total cranial base length (p < 0.05) among different skeletal patterns. Tukey’s post hoc analysis showed that skeletal class II had a smaller posterior cranial base and total cranial base length when compared to the other groups. The class II skeletal pattern has a smaller posterior cranial base and total cranial base when compared to skeletal class I and class III skeletal patterns.

Craniofacial morphology in down syndrome: a systematic review and meta-analysis.

The aim of this study was to evaluate the craniofacial cephalometric characteristics of individuals with Down syndrome (DS), comparing them with healthy subjects. An electronic search was made in Pubmed, Embase, Lilacs, Scopus, Medline and Web of Science without imposing limitations on publication date or language. Studies were selecting following the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) statement. The PECO acronym was applied as follows: P (population), individuals with DS; E, (exposition) diagnosis of DS; C (comparison), individuals without DS; O (outcomes) craniofacial characteristics based on cephalometric measurements. Independent reviewers performed data extraction and assessed the methodological quality of the articles using the Newcastle–Ottawa Quality-Assessment-scale. Seven case–control studies were included in meta-analysis. Given the variability of the cephalometric measurements used, only those that had been reported in at least three or more works could be included. Anterior cranial base length (SN), posterior cranial base length (SBa), total cranial base length (BaN), effective length of the maxilla (CoA), sagittal relationship between subspinale and supramentale (ANB), anterior facial height (NMe), and posterior facial height (SGo) values were significantly lower in the DS population than among control subjects. No significant differences were found in sagittal position of subspinale relative to cranial base (SNA) and sagittal position of supramentale relative to cranial base (SNB). Summarizing, individuals with DS present a shorter and flatter cranial base than the general population, an upper jaw of reduced sagittal dimension, as well as a tendency toward prognatic profile, with the medium third of the face flattened and a reduced anterior and posterior facial heights.

Evaluation of craniofacial morphology in short-statured children: growth hormone deficiency versus idiopathic short stature.

BackgroundShort stature is defined as a height below the 3rd percentile or more than two standard deviations below the mean for a given age, sex, and population. There have been inconsistent results regarding craniofacial morphology in short-statured children. This study aimed to analyze the differences between short-statured children with growth hormone deficiency, idiopathic short-statured children, and normal children.MethodsThirty-one short-statured children with growth hormone deficiency, 32 idiopathic short-statured children, and 32 healthy children were enrolled in this study. The measurements of their craniofacial structures from lateral cephalograms were evaluated.ResultsThere were statistically significant differences among the three groups seven variables (anterior cranial base length, posterior cranial base length, total cranial base length, upper posterior facial height, posterior total facial height, mandibular ramus length, and overall mandibular length) in the linear measurement and five variables (saddle angle, gonial angle, mandibular plane angle, position of mandible, and maxilla versus mandible) in the angular measurement.ConclusionCompared to the control group, many linear and angular measurements of the craniofacial structures were significantly different in the two short-statured groups (p<0.05). Treatment plans by orthodontists should include these craniofacial structure characteristics.

Variation of Cranial Base Morphology among Different Sagittal Skeletal Malocclusion – A Cephalometric Study in Nepalese Population

Introduction: Variation of cranial base morphology among different sagittal skeletal malocclusion has been evaluated previously by many studies. However, the findings of these studies conducted in different population differ due to racial/ ethnic differences. Objective: To obtain measurement data for various cranial base parameters and evaluate the variation in cranial base morphology among different sagittal skeletal malocclusion in Nepalese population. Materials and Methods: Manual tracing and measurement of 4 different cranial base parameters [linear- Anterior Cranial Base Length (ACBL), Posterior Cranial Base Length (PCBL) and Total Cranial Base Length (TCBL); angular - Cranial Base Angle (CBA)] were done on 90 pretreatment lateral cephalogram of healthy adult orthodontic patients. Study samples were matched for age and were equally distributed among three different sagittal skeletal malocclusion group using ANB angle. [skeletal Class I: 30, skeletal Class II: 30 and skeletal Class III: 30]. Analysis Of Variances [ANOVA] followed by Least Significant Difference (LSD) post hoc test was used to determine difference in cranial base measurements among three sagittal skeletal group. Results: While comparing the cranial base parameters among different sagittal skeletal class, mean value for all the parameters reduced systematically from skeletal Class II, via skeletal Class I, to skeletal Class III group. However, a statistically significant difference was found only for TCBL between skeletal Class II and skeletal Class III (p &lt; 0.01). Conclusions: A significant difference in TCBL among different sagittal skeletal malocclusion was observed in Nepalese adults.

Relationship between cranial base and jaw base in different skeletal patterns

PurposeTo determine the relationship between the cranial base and both jaw bases in different skeletal patterns. Materials and methodsLateral cephalometric radiographs of 180 adult patients of all three malocclusion groups were evaluated and analyzed. A group of linear and angular measurements were measured and compared among all study groups to assess the existence of any relationship between the cranial base and both jaw base discrepancies. ResultsSignificant differences were found in the cranial base angle (NSBa) and both jaw base lengths among all three malocclusion groups, while no significant differences were found in the cranial base lengths. As for angular measurements, an inverse correlation was found between the cranial base angle and both SNA and SNB angles in both Class II and Class III malocclusion groups. Concerning linear measurements, a significant correlation was found between the total cranial base length and the total facial height among all malocclusion groups. ConclusionThe cranial base angle affects the anteroposterior orientation of both maxilla and mandible with a minimal contribution to the appearance of different vertical skeletal patterns. Meanwhile, the cranial base length affects minimally the anteroposterior orientation of both the maxilla and the mandible. However, a significant link was found between it and the total facial height, thus contributing to the appearance of different vertical skeletal patterns.

Craniofacial and airway growth in 9–11 years old normal dental occlusion in Iranian adolescents: A longitudinal cephalometric study

Introduction: The present study was aimed to assess the amount and direction of growth in cranial base, jaws, and soft tissue of airway structures by cephalometric analysis in 9–11-years-old Iranian girls and boys. Materials and Methods: Thirty-four Iranian children with normal occlusion and class I molar relationships were recruited, and 2 lateral cephalograms were obtained from 9 and 11-year-old children Cephalometric variables included variables defining cranial base length and angle, maxillomandibular length and height, dental relationship, head and cervical position, soft palate and tongue, vallecula and hyoid position, and pharyngeal dimension. Normal distribution was confirmed by Kolmogorov–Smirnov analysis (P>0.05). Paired t-test was used for assessing growth changes. P value was set at 0.05. Results: Anterior, posterior, and total cranial base length were increased significantly. The increase in total and upper anterior, total and lower posterior facial heights, ramus height, and palatal inclination were statistically significant. Maxillomandibular length increased significantly with insignificant change in their position. Dental relationship and head and cervical posture were stable. Oropharyngeal and nasopharyngeal anteroposterior dimension did not change. However, hypopharynx sagittal length increased significantly. Nasopharyngeal vertical dimension increased and hyoid moved anteriorly and inferiorly. Conclusion: The results of the present study showed that cranial base and jaws grow anteriorly and inferiorly while maintaining dental occlusion and head posture. Most of the airway structures grow simultaneously with craniofacial components.

Cranial base characteristics in anteroposterior malocclusions: A meta-analysis.

To investigate cranial base characteristics in malocclusions with sagittal discrepancies. An electronic search was performed in PubMed, Embase, Web of Science, and the Cochrane Library. A fixed- or random-effect model was applied to calculate weighted mean difference with 95% confidence intervals (CIs) according to statistical heterogeneity. Outcome measures were anterior, posterior, and total cranial base length and cranial base angle. Sensitivity analysis and publication bias were conducted. Twenty studies that together included 1121 Class I, 1051 Class II, and 730 Class III cases qualified for the final analysis. Class III malocclusion demonstrated significantly reduced anterior (95% CI: -1.74, -0.53; P < .001 vs Class I; 95% CI: -3.30, -2.09; P < .001 vs Class II) and total cranial base length (95% CI: -3.33, -1.36; P < .001 vs Class I; 95% CI: -7.38, -4.05; P < .001 vs Class II). Further, Class II patients showed significantly greater anterior and total cranial base length than did Class I patients (95% CI: 0.51, 1.87; P < .001 for SN; 95% CI: 2.20, 3.30; P < .001 for NBa). Cranial base angle was significantly smaller in Class III than in Class I (95% CI: -3.14, -0.93; P < .001 for NSBa; 95% CI: -2.73, -0.68; P = .001 for NSAr) and Class II malocclusions (95% CI: -5.73, -1.06; P = .004 for NSBa; 95% CI: -6.11, -1.92; P < .001 for NSAr) and greater in Class II than in Class I malocclusions (95% CI: 1.38, 2.38; P < .001 for NSBa). This meta-analysis showed that anterior and total cranial base length and cranial base angle were significantly smaller in Class III malocclusion than in Class I and Class II malocclusions, and that they were greater in Class II subjects compared to controls.

Craniofacial morphology of patients with isolated cleft palate in the mixed dentition after palatoplasty

To evaluate the craniofacial morphology of patients with isolated cleft palate in the mixed dentition after palatoplasty. Twenty patients (7 to 11 years old) with isolated cleft palate in the mixed dentition were selected. The control group comprised 35 age-matched non-cleft children without orthodontic treatment. Cephalometric analysis was carried out to evaluate craniofacial morphology. The mean values of total cranial base length, maxillary depth, mandibular effective length in cleft patients were 86.48 mm, 44.79 mm and 65.45 mm, respectively. Those in control group were 91.27 mm, 48.84 mm and 70.49 mm, respectively (P < 0.001). Underdeveloped maxilla and class III skeletal profile were presented in patients with isolated cleft palate.

Associations between the Eustachian tube and craniofacial skeleton

Objective: growth and development of the anatomic region where the Eustachian tube (ET) is located are associated with the parameters related to other parts of the craniofacial skeleton (CFS). It has been suggested that ET dysfunction is as an important factor in pathogenesis of otitis media in childhood which is associated with its postnatal growth and development process. The purpose of this study was to evaluate associations of length of the ET with various craniofacial parameters. Methods: on lateral cephalometric radiographs of 50 Japanese adult (25 male and 25 female), the dimension of the region where the ET is located (‘length of the ET’) and 22 (15 linear and seven angular) craniofacial parameters were measured by using a digitiser and computer. Correlation and regression analyses were performed between this dimension and other craniofacial parameters. Results: it was found that the dimension of the region in which the ET is located (‘length of the ET’) was associated with many craniofacial parameters belonging to different subunits of the CFS. However, the stepwise regression analysis showed that total cranial base length, posterior upper face height and maxillary depth had determinative effects on this dimension. Conclusion: development of the ET was associated with development of the cranial base and nasomaxillary complex. Therefore, it could be hypothesised that any cessation or aberration in these parts of the CFS cause corresponding imbalances in the ET, which may predispose to otitis media.

Postnatal Craniofacial Skeleton Development Following a Pushback Operation of Patients with Cleft Palate

A longitudinal growth study of the craniofacial skeleton in 52 (19 males, 33 females) Danish individuals with cleft palates was performed. Thirty (13 males, 17 females) had clefts of the soft palate only or clefts extending into the posterior third of the hard palate. Twenty-two (6 males, 16 females) had more extensive clefts including up to two-thirds of the hard palate. The cleft was closed with a pushback operation at 22 months of age. Orthodontic treatment was included in the early mixed dentition. Lateral cephalometries were obtained at 5, 8, 12, 16, and 21 years of age. Twenty-four variables were digitized and analyzed. The results indicated that patients with more extensive clefts demonstrated significantly smaller anterior cranial base length (N-S), total cranial base length (N-Ba), maxillary dentoalveolar base length (A-PMP), mandibular length (Cd-Pgn), upper anterior and posterior facial heights (N-ANS and P-PMP), and total facial height (N-Gn). Patients with the more extensive clefts reached maximum growth spurt later than patients with less extensive clefts in all dimensions except the A-PMP and the lower and total facial heights.

Postnatal Craniofacial Skeleton Development following a Pushback Operation of Patients with Cleft Palate

A longitudinal growth study of the craniofacial skeleton in 52 (19 males, 33 females) Danish individuals with cleft palates was performed. Thirty (13 males, 17 females) had clefts of the soft palate only or clefts extending into the posterior third of the hard palate. Twenty-two (6 males, 16 females) had more extensive clefts including up to two-thirds of the hard palate. The cleft was closed with a pushback operation at 22 months of age. Orthodontic treatment was included in the early mixed dentition. Lateral cephalometries were obtained at 5, 8, 12, 16, and 21 years of age. Twenty-four variables were digitized and analyzed. The results indicated that patients with more extensive clefts demonstrated significantly smaller anterior cranial base length (N-S), total cranial base length (N-Ba), maxillary dentoalveolar base length (A-PMP), mandibular length (Cd-Pgn), upper anterior and posterior facial heights (N-ANS and P-PMP), and total facial height (N-Gn). Patients with the more extensive clefts reached maximum growth spurt later than patients with less extensive clefts in all dimensions except the A-PMP and the lower and total facial heights.

The variability of some craniofacial dimensions.

The variability of eight linear and five angular dimensions measured on 124 lateral skull radiographs of 10-year-old boys was assessed by means of Bartlett's test for homogeneity of variances and Pitman's test for the comparison of correlated standard deviations. The linear dimensions which demonstrated the greatest variability within the four constituent Angle classes (N = 31) were mandibular body length, total cranial base length, total mandibular length and lower face height. The dimensions which demonstrated the least intra-group but greatest inter-group variability were maxillary length and Angle SNB. The Class II division 2 group exhibited the greatest variation in skeletal morphology; it is therefore postulated that its etiology is mainly dentoalveolar and soft tissue in origin.

Sagittal craniofacial growth in the fetal macaque monkey Macaca nemestrina

In the third trimester of fetal life in Macaca nemestrina, the craniofacial dimensions in the sagittal plane showed no statistically significant sexual differences. In the human fetus, facial dimensions and the anterior cranial base grow isometrically with proportional constancy relative to overall fetal length. In this study a linear regression in which the Y-intercept differed significantly from zero was used as an indicator of allometry. For the pooled male-female M. nemestrina sample, the regression coefficient for each variable was statistically significant for the linear function Y = a + b (CRL). The 99 per cent confidence intervals for the Y-intercepts of the variables measuring anterior and posterior upper facial height and pterygoid process length included zero, suggesting the proportional constancy relative to fetal size of isometric growth. The confidence intervals of the anterior, posterior, and total cranial base length did not include zero, suggesting allometric growth. The difference in the anterior cranial base growth pattern between human fetuses and those of M. nemestrina probably reflects the greater activity of midsphenoidal synchondrosis in M. nemestrina.