Three-dimensional analysis of modeled facial aging and sexual dimorphism from juvenile to elderly age.

A detailed understanding of craniofacial ontogenetic development is important in a variety of scientific disciplines dealing with facial reconstruction, forensic identification, ageing prediction, and monitoring of pathological growth, including the effect of therapy. The main goals of this study were (1) the construction of the facial aging model using local polynomial regression fitting separately for both sexes, (2) evaluation of the aging effect not only on facial form as a whole but also on dimensions important for clinical practice, and (3) monitoring of the development of shape facial sexual dimorphism. Our study was based on the form and shape analysis of three-dimensional facial surface models of 456 individuals aged 14-83 years. The facial models were obtained using a structured light-based optical scanner and divided (for some analyses) into four age categories (juveniles, young adults, middle adults, and elderly adults). The methodology was based on geometric and classic morphometrics including multivariate statistics. Aging in both sexes shared common traits such as more pronounced facial roundness reducing facial convexity, sagging soft tissue, smaller visible areas of the eyes, greater nose, and thinner lips. In contrast to female faces, male faces increase in size until almost 30 years of age. After the age of 70, male facial size not only stagnates, like in females, but actually decreases slightly. Sexual dimorphic traits tended to diminish in the frontal and orbitonasal areas and increase in the gonial area.

Palatal growth changes in newborns with unilateral and bilateral cleft lip and palate from birth until 12 months after early neonatal cheiloplasty using morphometric assessment.

OBJECTIVES: To compare palatal growth changes in infants with complete unilateral (UCLP) or bilateral (BCLP) cleft lip and palate during the first year of life. MATERIALS AND METHODS: Upper dental arches of 68 neonates with UCLP and BCLP were evaluated using 2D and 3D morphometry based on dental casts obtained in two age categories (T0 before early neonatal cheiloplasty-UCLP 4 ± 3 days, BCLP 6 ± 5 days; T1 before palatoplasty-UCLP 10 ± 2 months, BCLP 12 ± 3 months). RESULTS: Intensive palatal growth was manifested in both directions of the palate. Palatal growth in the anterior direction was not restricted, despite the intercanine (CC´) and anterior (LL´) widths being significantly narrowed in the BCLP group (CC´ p = 0.019, LL´ p = 0.009). The posterior dental arches were significantly enlarged (UCLP p ≤ 0.001; BCLP p ≤ 0.001). The negative effect of cleft severity on palatal length was not confirmed (p = 0.802). Variability of the palate was immense mainly in BCLP infants (T0); however, it decreased in both cleft types, confirming the formative effect of palatal growth leading to alveolar cleft closure (UCLP p ≤ 0.001; BCLP p = 0.006 on the right, 0.005 on the left). CONCLUSIONS: Both analyzed cleft groups (UCLP, BCLP) grew favorably during the first year of life, and the palatal growth was not limited in any direction. CLINICAL RELEVANCE: Geometric morphometry allowed a comprehensive analysis of the palate, which can contribute to the improvement of surgical methods.

Three-dimensional mixed longitudinal study of facial growth changes and variability of facial form in preschool children using stereophotogrammetry.

OBJECTIVES: Since the normal, non-pathological facial growth in preschool children is not sufficiently reported, the aim was to follow growth changes of facial surface, sex differences and facial variability in preschool children using 3D stereophotogrammetry. SETTINGS AND SAMPLE POPULATION: Mixed longitudinal sample of healthy Caucasian preschool children without head and facial trauma or craniofacial anomalies from 3.4 to 6.7 years of age consisted of 25 girls and 17 boys. MATERIALS AND METHODS: 136 3D facial models from optical scanner Vectra 3D were evaluated by geometric morphometrics (CPC-DCA, PCA, per-vertex t test). RESULTS: In both sexes, the lower face was widened and elongated, and the prominences of the superciliary arches, lower orbital region, nose, lips and chin increased. Facial surface increments were more even in girls with a maximum between the fourth and fifth year of age, while in boys, there was the most intensive growth between fifth and sixth year of age. Sexual dimorphism was very stable during investigated period, only less statistically significant at the age of 3 years. Boys had more prominent lateral lower part of forehead, nose and lips than girls in every age category. CONCLUSIONS: The longitudinal growth of the face between third and sixth year of age was similar in both sexes, facial sex differences were found in terms of intensity, size and timing. Variability of facial form showed that boys' faces were larger on average and facial shape did not differ. The knowledge of facial growth is essential for diagnostics and clinical practice.

Three-dimensional development of the palate in bilateral orofacial cleft newborns 1 year after early neonatal cheiloplasty: Classic and geometric morphometric evaluation.

OBJECTIVES: The aim of this study was to assess palatal growth in newborns with complete bilateral cleft lip and palate (cBCLP) and bilateral cleft lip and palate with tissue bridges (BCLP + B) 1 year after early neonatal cheiloplasty (ENC). MATERIAL AND METHODS: The methodology was based on classic and morphometric analysis of dental models of newborns with cBCLP or BCLP + B. These analyses included metric analysis, coherent point drift-dense correspondence analysis, superprojection methods, and multivariate statistics. Dental casts were observed in two age categories, which were compared with each other. The first cast was obtained from each patient before ENC (T0, 5 ± 5 days) and the second one prior to palatoplasty (T1, 12 ± 6 months). RESULTS: Fifty-two dental models obtained from 26 newborns with cBCLP and BCLP + B were evaluated. The results showed that over the 12-month period, alveolar clefts were narrowed in both cleft types due to anterior growth combined with the formative effect of suturing. This was confirmed by decreases in the dimensions of the right (T0 9.93 ± 2.80 mm, T1 6.64 ± 2.43 mm; p ≤ 0.003) and left (T0 10.71 ± 4.13 mm, T1 6.69 ± 4.29 mm; p ≤ 0.003) alveolar clefts in cBCLP patients. Similar reductions in alveolar cleft widths occurred on the left side (T0 11.69 ± 4.75 mm, T1 4.34 ± 2.97 mm; p ≤ 0.001) of BCLP + B patients, while on the right side, which was connected by a combined tissue bridge, there was non-significant narrowing of the alveolar cleft (T0 1.61 ± 1.34 mm, T1 1.04 ± 0.70 mm; p = 0.120). The ENC did not restrict posterior palatal growth, meaning that intertuberosity width was extended in cBCLP (T0 32.80 ± 3.15 mm, T1 35.86 ± 2.80 mm; p ≤ 0.001) and in BCLP + B neonates (T0 34.01 ± 2.15 mm, T1 36.21 ± 2.14 mm; p ≤ 0.004). Width and length measurements in the observed groups showed growth tendencies equivalent to those in noncleft or LOP patients. Palatal variability was greater in neonatal cBCLP, but was reduced during the monitored period, approximating that for BCLP + B. Regions with the most notable palatal growth were located primarily at the premaxilla and at the anterior and partially posterior ends of the maxillary segments. CONCLUSION: Early neonatal cheiloplasty had no negative effect on palatal growth in any direction. There was no reduction in the length or width of the palate during the first year of life, nor was there narrowing of the dentoalveolar arch. The formative effect of the operated lip on the anterior part of the palate was confirmed. This, in combination with the favorable growth, lead to closure of the alveolar cleft.

Simulation of facial growth based on longitudinal data: Age progression and age regression between 7 and 17 years of age using 3D surface data.

Modelling of the development of facial morphology during childhood and adolescence is highly useful in forensic and biomedical practice. However, most studies in this area fail to capture the essence of the face as a three-dimensional structure. The main aims of our present study were (1) to construct ageing trajectories for the female and male face between 7 and 17 years of age and (2) to propose a three-dimensional age progression (age -regression) system focused on real growth-related facial changes. Our approach was based on an assessment of a total of 522 three-dimensional (3D) facial scans of Czech children (39 boys, 48 girls) that were longitudinally studied between the ages of 7 to 12 and 12 to 17 years. Facial surface scans were obtained using a Vectra-3D scanner and evaluated using geometric morphometric methods (CPD-DCA, PCA, Hotelling's T2 tests). We observed very similar growth rates between 7 and 10 years in both sexes, followed by an increase in growth velocity in both sexes, with maxima between 11 and 12 years in girls and 11 to 13 years in boys, which are connected with the different timing of the onset of puberty. Based on these partly different ageing trajectories for girls and boys, we simulated the effects of age progression (age regression) on facial scans. In girls, the mean error was 1.81 mm at 12 years and 1.7 mm at 17 years. In boys, the prediction system was slightly less successful: 2.0 mm at 12 years and 1.94 mm at 17 years. The areas with the greatest deviations between predicted and real facial morphology were not important for facial recognition. Changes of body mass index percentiles in children throughout the observation period had no significant influence on the accuracy of the age progression models for both sexes.

Modeling age-specific facial development in Williams-Beuren-, Noonan-, and 22q11.2 deletion syndromes in cohorts of Czech patients aged 3-18 years: A cross-sectional three-dimensional geometric morphometry analysis of their facial gestalt.

Three-dimensional (3D) virtual facial models facilitate genotype-phenotype correlations and diagnostics in clinical dysmorphology. Within cross-sectional analysis of both genders we evaluated facial features in representative cohorts of Czech patients with Williams-Beuren-(WBS; 12 cases), Noonan-(NS; 14), and 22q11.2 deletion syndromes (22q11.2DS; 20) and compared their age-related developmental trajectories to 21 age, sex and ethnically matched controls in 3-18 years of age. Using geometric morphometry statistically significant differences in facial morphology were found in all cases compared to controls. The dysmorphic features observed in WBS were specific and manifested in majority of cases. During ontogenesis, dysmorphic features associated with increased facial convexity become more pronounced whereas other typical features remained relatively stable. Dysmorphic features observed in NS cases were mostly apparent during childhood and gradually diminished with age. Facial development had a similar progress as in controls, while there has been increased growth of patients' nose and chin in adulthood. Facial characteristics observed in 22q11.2DS, except for hypoplastic alae nasi, did not correspond with the standard description of its facial phenotype because of marked facial heterogeneity of this clinical entity. Because of the sensitivity of 3D facial morphometry we were able to reach statistical significance even in smaller retrospective patient cohorts, which proves its clinical utility within the routine setting.

Three-dimensional assessment of facial asymmetry in preschool patients with orofacial clefts after neonatal cheiloplasty.

OBJECTIVES: To evaluate facial asymmetry changes in pre-school patients with orofacial clefts after neonatal cheiloplasty and to compare facial asymmetry with age-matched healthy controls. METHODS AND MATERIALS: The sample consisted of patients with unilateral cleft lip (UCL), unilateral cleft lip and palate (UCLP), and bilateral cleft lip and palate (BCLP). The patients were divided in two age groups with a mean age of 3 years (n = 51) and 4.5 years (n = 45), respectively, and 78 age-matched individuals as controls. Three-dimensional (3D) facial scans were analyzed using geometric morphometry and multivariate statistics. RESULTS: Geometric morphometry showed positive deviations from perfect symmetry on the right side of the forehead in the intervention groups and the controls. The UCL groups showed the greatest asymmetric nasolabial area on the cleft-side labia and the contralateral nasal tip. The UCLP group showed, moreover, asymmetry in buccal region due to typical maxillar hypoplasia, which was accentuated in the older group. The BCLP groups showed slightly similar but greater asymmetry than the control groups, except for the philtrum region. CONCLUSIONS: Asymmetry of each of the cleft groups significantly differed from the controls. Except for the buccal region in the UCLP and BCLP groups, asymmetry did not significantly increase with age.

Palatal growth in complete unilateral cleft lip and palate patients following neonatal cheiloplasty: Classic and geometric morphometric assessment.

BACKGROUND: A new method of early neonatal cheiloplasty has recently been employed on patients having complete unilateral cleft lip and palate (cUCLP). We aimed to investigate (1) their detailed palatal morphology before surgery and growth during the 10 months after neonatal cheiloplasty, (2) the growth of eight dimensions of the maxilla in these patients, (3) the development of these dimensions compared with published data on noncleft controls and on cUCLP patients operated using later operation protocol (LOP; 6 months of age). METHODS: Sixty-six virtual dental models of 33 longitudinally evaluated cUCLP patients were analysed using metric analysis, a dense correspondence model, and multivariate statistics. We compared the palatal surfaces before neonatal cheiloplasty (mean age, 4 days) and before palatoplasty (mean age, 10 months). RESULTS: The palatal form variability of 10-month-old children was considerably reduced during the observed period thanks to their undisturbed growth, that is, the palate underwent the same growth changes following neonatal cheiloplasty. A detailed colour-coded map identified the most marked growth at the anterior and posterior ends of both segments. The maxilla of cUCLP patients after neonatal cheiloplasty had a growth tendency similar to noncleft controls (unlike LOP). CONCLUSIONS: Both methodological approaches showed that early neonatal cheiloplasty in cUCLP patients did not prevent forward growth of the upper jaw segments and did not reduce either the length or width of the maxilla during the first 10 months of life.