Non-invasive longitudinal assessment of facial growth in children and adolescents with hypohidrotic ectodermal dysplasia.

Facial growth patterns in 12 subjects (six boys and six girls) with hypohidrotic ectodermal dysplasia (HED) were analyzed and compared with facial growth patterns obtained in healthy reference peers. All subjects with HED were aged 7 yr (mean age +/- standard deviation: 7.08 +/- 0.41 yr) at the first examination and 14 yr (mean age +/- standard deviation: 14.56 +/- 0.34 yr) at the last examination. In each subject, the three-dimensional coordinates of facial landmarks were collected non-invasively at eight subsequent years. The volumes of forehead, nose, maxilla and mandible, upper lips, and lower lips were estimated. For each facial volume, differential values between different time points were calculated individually, separately for the 'childhood' (7-10 yr) and the 'adolescence' (11-14 yr) growth period in both HED and reference subjects. Children and adolescents with HED had a slightly reduced global facial growth in comparison with normal reference peers. The peak mandibular and maxillary development was delayed by approximately 2 yr towards later adolescence. The present non-invasive system seems to be useful for studying longitudinal changes of facial growth in healthy and syndromic subjects.

Three-dimensional facial morphometry of attractive adolescent boys and girls.

OBJECTIVES: To identify reference standards and possible esthetic features of facial size and form of Italian adolescent boys and girls. METHODS AND SUBJECTS: A three-dimensional electromagnetic digitizer was used to collect the coordinates of 50 facial landmarks (forehead, eyes, nose, cheeks, mouth, jaw, ears) in 231 healthy, reference adolescents (10-17 years old) and in 93 "attractive" adolescents selected by a commercial casting; soft tissue facial angles, distances and volumes were computed. RESULTS: Attractive adolescents had wider and shorter faces than reference subjects of the same age and sex, with relatively larger upper and middle facial thirds, and a reduced mandible relative to the maxilla. Lips were larger and more prominent, and the nasolabial angle was reduced, but in older boys the effect was reversed. The prominence of the soft-tissue profile, and of the maxilla relative to the mandible, were larger in attractive boys, but smaller in attractive girls than in their reference peers. Attractive adolescents had a relatively less prominent chin relative to the lower lip, with increased values of the mentolabial angle. In the horizontal plane, attractive "young" adolescents had a more obtuse mandibular convexity angle, while the opposite pattern was observed in the "old" adolescent subjects, with a relatively more prominent chin. Attractive adolescents had smaller noses than reference subjects of the same age and sex. CONCLUSION: Esthetic reference values have been identified which could be used to determine optimal timing and goals in orthodontic treatment.

Craniofacial growth in ectodermal dysplasia. An 8 year longitudinal evaluation of Italian subjects.

OBJECTIVE: To identify the main directions of growth of facial structures in subjects with hypohidrotic ectodermal dysplasia (HED). MATERIALS AND METHODS: The 3D noninvasive facial measurements were collected in 12 subjects (6 boys, 6 girls) with HED during four assessments (at 8, 11, 12, and 15 years) using an electromagnetic digitizer. The modifications of linear distances in the upper, middle, and lower third of the face were analyzed and compared with cross-sectional data obtained in normal healthy coetaneous. For each distance, differential values between the last and the initial data were calculated individually, separately for a first (8-11 years) and a second growth period (12-15 years). RESULTS: In the first time span, the growth of all facial measurements was reduced in HED subjects compared with control subjects. During this interval, most of the HED children underwent a functional and/or prosthetic treatment. During adolescence, the width and height of the lower and upper facial thirds showed a larger growth in HED subjects than in control subjects, while all facial depths and all distances in the middle facial third maintained a reduced growth. CONCLUSIONS: The deviation from normal facial growth of HED subjects tends to lessen with age. Functional and prosthetic appliances may have enhanced facial growth.

Age- and sex-related changes in the soft tissues of the orbital region.

The orbital region plays a predominant role in the evaluation of the craniofacial complex. In the current study information about normal sex-related dimensions of the orbital region, and growth, development and aging, were provided. The three-dimensional coordinates of several soft-tissue landmarks on the orbits and face were obtained by a non-invasive, computerized electromagnetic digitizer in 531 male and 357 female healthy subjects aged 4-73 years. From the landmarks, biocular and intercanthal widths, paired height and inclination of the orbit relative to both the true horizontal (head in natural head position) and Frankfurt plane, length and inclination of the eye fissure, the relevant ratios, soft-tissue orbital area, were calculated, and averaged for age and sex. Comparisons were performed by factorial analysis of variance. Biocular and intercanthal widths, length of the eye fissure, soft-tissue orbital area, and the inclination of the orbit relative to the true horizontal, were significantly larger in men than in women (p<0.01), with a significant effect of age (p<0.001), and significant agexsex interactions (p<0.001). Orbital height, and the height-to-width ratio increased as a function of age (p<0.001), but without gender-related differences. The inclination of the orbit relative to Frankfurt plane, and the inclination of the eye fissure did not differ between men and women, but modified as a function of age (p<0.001), with different sex-related patterns (sexxage interaction, p<0.001). On average, the paired measurements were symmetric, with similar values within each sex and age group. Overall, when compared to literature data, some differences were found due to both ethnicity, and different instruments. Nevertheless, during childhood, adolescence, and young adulthood, the age-related trends for linear dimensions were similar to those found in previous studies, while no previous data exist for older adults. During aging an increment in soft-tissue orbital area was found, with a progressive downward shift of landmark orbitale. Data collected in the present investigation could serve as a data base for the quantitative description of human orbital morphology during normal growth, development and aging. Forensic applications (evaluations of traumas, craniofacial alterations, teratogenic-induced conditions, facial reconstruction, aging of living and dead persons, personal identification) may also benefit from age- and sex-based data banks.