Evaluation of Facial Aging in Different Age and Gender Groups With Computed Tomography-Based Calvarium and Face Measurements.

BACKGROUND: The human face is a complex area formed by the combination of many different components and varies among individuals according to gender, age, and ethnicity. OBJECTIVE: The aim of this study was to evaluate age-related changes in the facial and calvarial bones in a large sample of both genders. METHODS: The retrospective study included nontraumatic brain computed tomography scans of 280 Turkish adults. Participants were divided into 7-decade groups with the age ranging from 20 to 89 years. Measurements of the face and calvaria were recorded, and calvarial volume was calculated. The relationship of these parameters with age and gender was examined. RESULTS: Statistically significant differences were observed in all the facial and calvarial measurements, except the transverse diameter of the head, with increasing age in both genders. Regardless of age, no significant differences were found in facial and calvarial measurements between genders. In addition, there was a significant decrease in the calvarial volume in both genders after the seventh decade of life. CONCLUSION: The structure of the face and calvarium continues to change and differentiate throughout life. Taking these changes into account during surgical and facial rejuvenation procedures can help predict outcomes and avoid the use of incorrect techniques.

Mammalian face as an evolutionary novelty.

The anterior end of the mammalian face is characteristically composed of a semimotile nose, not the upper jaw as in other tetrapods. Thus, the therian nose is covered ventrolaterally by the "premaxilla," and the osteocranium possesses only a single nasal aperture because of the absence of medial bony elements. This stands in contrast to those in other tetrapods in whom the premaxilla covers the rostral terminus of the snout, providing a key to understanding the evolution of the mammalian face. Here, we show that the premaxilla in therian mammals (placentals and marsupials) is not entirely homologous to those in other amniotes; the therian premaxilla is a composite of the septomaxilla and the palatine remnant of the premaxilla of nontherian amniotes (including monotremes). By comparing topographical relationships of craniofacial primordia and nerve supplies in various tetrapod embryos, we found that the therian premaxilla is predominantly of the maxillary prominence origin and associated with mandibular arch. The rostral-most part of the upper jaw in nonmammalian tetrapods corresponds to the motile nose in therian mammals. During development, experimental inhibition of primordial growth demonstrated that the entire mammalian upper jaw mostly originates from the maxillary prominence, unlike other amniotes. Consistently, cell lineage tracing in transgenic mice revealed a mammalian-specific rostral growth of the maxillary prominence. We conclude that the mammalian-specific face, the muzzle, is an evolutionary novelty obtained by overriding ancestral developmental constraints to establish a novel topographical framework in craniofacial mesenchyme.

Bifurcation of the mandibular canal according to sex, age, and facial skeletal pattern: a morphological and morphometric study of cone beam computed tomography.

PURPOSE: To assess the presence of mandibular canal bifurcation (BMC) and classify these variations by correlating findings with sex, age and facial skeletal pattern, measurements were made, including height, width, and distance from bifurcation to anatomical cortical bones. METHODS: BMC was identified in cone beam CT exams of 301 patients and classified according to its origin, location, direction, configuration and ending. The height and width of the MC before and after the bifurcation; height and width of the BMC; and distance from BMC to alveolar (C1), buccal (C2), lingual (C3) and basal (C4) bone cortices were measured. All data were correlated with sex, age, and facial skeletal pattern (class I, II, III). The significance level was 5%. RESULTS: 67 BMC (22.26%) were identified in 55 patients (18.28%). Bifurcations were more prevalent in females (p = 0.57), aged 18-39 years (p = 0.40), class I (p = 0.77). Single bifurcations, located in the posterior region of the mandible, originating in the MC, with a superior direction and ending in the retromolar foramen were more prevalent (p > 0.05). Mean cortical measurements were higher in male individuals, with significant differences only at C1 (p = 0.03). The mean height and width of BMC were 2.24 (± 0.62) and 1.75 (± 0.45) mm. There was no association between BMC classification and the variables studied (p > 0.05). CONCLUSION: Approximately 1/5 of the population studied had BMC. There were no associations of BMC presence or characteristics with sex, age, and facial skeletal pattern. The distance from bifurcation to alveolar (superior) cortical bone is greater in male individuals.

Do patients with different craniofacial patterns have differences in upper airway volume? A systematic review with network meta-analysis.

BACKGROUND: Craniofacial skeletal discrepancies have been associated with upper airway dimensions. OBJECTIVE: To identify differences in upper airway volume across different sagittal and vertical skeletal patterns. SEARCH METHODS: Unrestricted literature searches in eight databases/registers for human studies until May 2023. SELECTION CRITERIA: Cross-sectional studies measuring upper airway volumes using three-dimensional imaging in healthy patients of different sagittal (Class I, Class II, and Class III) or vertical (normodivergent, hypodivergent, and hyperdivergent) craniofacial morphology. DATA COLLECTION AND ANALYSIS: Duplicate independent study selection, data extraction, and risk of bias assessment. Random-effects frequentist network meta-analysis was performed followed by subgroup-analyses and assessment of the quality of clinical recommendations (confidence in effect estimates) with the CINeMA (Confidence in Network Meta-Analysis) approach. RESULTS: Seventy publications pertaining to 66 unique studies were included with 56 studies (5734 patients) contributing to meta-analyses. Statistically significant differences were found for total  pharyngeal airway volume, with Class II having decreased airway volume (-2256.06 mm3; 95% Confidence Interval [CI] -3201.61 to -1310.51 mm3) and Class III increased airway volume (1098.93 mm3; 95% CI 25.41 to 2172.45 mm3) compared to Class I. Significant airway volume reductions for Class II were localized mostly at the oropharynx, followed by the palatopharynx, and the glossopharynx. Significant airway volume increases for Class III were localized mostly at the oropharynx, followed by the intraoral cavity, and hypopharynx. Statistically significant differences according to vertical skeletal configuration were seen only for the oropharynx, where hyperdivergent patients had reduced volumes compared to normodivergent patients (-1716.77 mm3; 95% CI -3296.42 to -137.12 mm3). Airway differences for Class II and Class III configurations (compared to Class I) were more pronounced in adults than in children and the confidence for all estimates was very low according to CINeMA. CONCLUSIONS: Considerable differences in upper airway volume were found between sagittal and vertical skeletal configurations. However, results should be interpreted with caution due to the high risk of bias, owing to the retrospective study design, inconsistencies in anatomic compartment boundaries used, samples of mixed children-adult patients, and incomplete reporting. CLINICAL TRIAL REGISTRATION: PROSPERO (CRD42022366928).

INDIVIDUAL ANATOMICAL VARIABILITY OF THE ANTEROPOSTERIOR LATERAL DIMENSIONS OF THE FACIAL SKULL IN MATURE ADULTS.

Despite the significance of anatomical variability in various specialties, there is currently limited research dedicated to this topic. Most studies focus on the brain, with only a small number examining the human skull, primarily in relation to anatomical variability in childhood. AIM: Therefore, the aim of our work is to determine the individual anatomical variability of the lateral dimensions of the facial section of the adult human skull. MATERIALS AND METHODS: The study included 115 skulls of mature individuals, comprising 35 dry bone specimens from the anatomy museum collection and 80 results from human head CT scans without bone tissue pathologies. To detail the craniometric characteristics of the lateral surface of the facial section of the skull, polygons (polygons) were constructed with dividing of the facial section of the skull is into the orbital-frontal, nasal, and maxillary. The facial profilegram of the skull was formed as a set of predetermined dimensions between facial profile points, presenting a continuous line passing through points gl-n-rhi-ns-pr-id-pg, reflecting the shape, dimensions, and position of the cranial profile of mature adults regardless of sex or cranial type. RESULTS: It was established that the longitudinal anteroposterior dimensions of the facial skull exhibit a certain range of variability in mature individuals depending on gender. For instance, the distance between the points gl-po (glabella-porion) reaches its maximum values in individuals with a brachycranial skull shape, ranging from 107 mm to 130 mm in men and from 104 mm to 128 mm in women. In individuals with a mesocranial skull shape, this parameter gradually decreases to 109-126 mm in men and 107-124 mm in women. A similar decrease is observed in those with a dolichocranial skull shape, where the range is 109-121 mm in men and 109-120 mm in women. The distance between n-po (nasion-porion) in brachycranial and mesocranial individuals remains within 96-123 mm and 102-123 mm, regardless of gender, indicating that this parameter is relatively stable. However, in dolichocranial individuals, this distance decreases to 104-115 mm. CONCLUSIONS: Individual anatomical variability of the anteroposterior lateral dimensions of the facial skeleton in mature individuals has been determined. A more in-depth analysis of the existing range of individual variability in the profile configuration of the facial skull was conducted using sagittal polygons. It was found that the polygons gl-po-n, n-po-rhi, and rhi-po-ns relate to the structure of the bony profile of the orbital-temporal and nasal regions of the facial skull, reflecting the upper, combined orbital-nasal section of the head.

Evolvability of the vertebrate craniofacial skeleton.

The skull is a vertebrate novelty. Morphological adaptations of the skull are associated with major evolutionary transitions, including the shift to a predatory lifestyle and the ability to masticate while breathing. These adaptations include the chondrocranium, dermatocranium, articulated jaws, primary and secondary palates, internal choanae, the middle ear, and temporomandibular joint. The incredible adaptive diversity of the vertebrate skull indicates an underlying bauplan that promotes evolvability. Comparative studies in craniofacial development suggest that the craniofacial bauplan includes three secondary organizers, two that are bilaterally placed at the Hinge of the developing jaw, and one situated in the midline of the developing face (the FEZ). These organizers regulate tissue interactions between the cranial neural crest, the neuroepithelium, and facial and pharyngeal epithelia that regulate the development and evolvability of the craniofacial skeleton.

Evolution and development of the cartilaginous skull: From a lancelet towards a human face.

Chrondrocranium, the cartilaginous skull, is one of the major innovations that underlie evolution of the vertebrate head. Control of the induction and shaping of the cartilage is a key for the formation of the facial bones and largely defines facial shape. The appearance of cartilage in the head enabled many new functions such as protection of central nervous system and sensory structures, support of the feeding apparatus and formation of muscle attachment points ensuring faster and coordinated jaw movements. Here we review the evolution of cartilage in the cranial region and discuss shaping of the chondrocranium in different groups of vertebrates.

Location of the infraorbital foramen with reference to soft tissue landmarks for regional nerve blocks during midface surgery.

PURPOSE: An infraorbital nerve (ION) block is widely used to accomplish regional anesthesia during surgical procedures involving the midface region. This study aimed to elucidate the exact location of the infraorbital foramen (IOF) in relation to clinically useful soft-tissue landmarks for achieving an effective ION block. METHODS: Forty-three hemifaces from 23 embalmed Korean cadavers were dissected. The lateral canthus, peak of Cupid's bow, medial limbus, and midline were used as reference points. The distances from the IOF to the midline and the lateral canthus were measured. RESULTS: The IOF was located approximately 25 mm below the lateral canthus and 27 mm lateral to the midline. In all cases, the IOF was situated within 9.0 mm of the crossing point of the oblique line connecting the lateral canthus to the peak of Cupid's bow and the vertical line through the medial limbus. CONCLUSION: Considering the spread of an anesthetic agent, injecting it into the crossing point of the oblique line through the lateral canthus to the peak of Cupid's bow and the vertical line through the medial limbus would successfully block the ION in most patients.

Whole-exome sequencing identified four loci influencing craniofacial morphology in northern Han Chinese.

Facial shape differences are one of the most significant phenotypes in humans. It is affected largely by skull shape. However, research into the genetic basis of the craniofacial morphology has rarely been reported. The present study aimed to identify genetic variants influencing craniofacial morphology in northern Han Chinese through whole-exome sequencing (WES). Phenotypic data of the volunteers' faces and skulls were obtained through three-dimensional CT scan of the skull. A total of 48 phenotypes (35 facial and 13 cranial phenotypes) were used for the bioinformatics analysis. Four genetic loci were identified affecting the craniofacial shapes. The four candidate genes are RGPD3, IGSF3, SLC28A3, and USP40. Four single-nucleotide polymorphism (SNP) site mutations in RGPD3, IGSF3, and USP40 were significantly associated with the skull shape (p < 1×10-6), and three SNP site mutations in RGPD3, IGSF3, and SLC28A3 were significantly associated with the facial shape (p < 1×10-6). The rs62152530 site mutation in the RGPD3 gene may be closely associated with the nasal length, ear length, and alar width. The rs647711 site mutation in the IGSF3 gene may be closely associated with the nasal length, mandibular width, and width between the mental foramina. The rs10868138 site mutation in the SLC28A3 gene may be associated with the nasal length, alar width, width between tragus, and width between the mental foramina. The rs1048603 and rs838543 site mutations in the USP40 gene may be closely associated with the pyriform aperture width. Our findings provide useful genetic information for the determination of face morphology.

Variation in facial bone growth remodeling in prehistoric populations from southern South America.

OBJECTIVES: To assess the intraspecific variation in bone remodeling patterns in modern humans, we studied two populations from southern South America that represent the extremes of morphological variation in this region. We particularly analyzed the ontogenetic changes in the patterns of bone growth remodeling and compared the patterns between samples. MATERIALS AND METHODS: We obtained high-resolution casts of the periosteal surface of the upper and middle face of subadults (n = 36) and adult (n = 36) individuals from a sample of hunter-gatherers from Patagonia and a sample of horticulturists from Northwest Argentina. The areas of bone formation and resorption were registered using an incident-light microscope. We then estimated the average bone remodeling map by sample and age, and performed principal component analysis and multivariate regressions to assess the extension and distribution of these areas across ontogeny and between samples. RESULTS: We found that the remodeling pattern of the glabella, supraorbital arch, frontal process of the maxilla, and a large part of the zygomatic bone is relatively constant in subadults and adults from both sample with a clear predominance of bone formation. In contrast, the middle face is characterized by the spatial alternation between formation and resorption areas, and greater variation with age and between samples. The main differences were found in areas related to chewing and muscle insertions. CONCLUSIONS: Our study provides the first evidence of interpopulation variation in bone growth remodeling and suggests that biomechanical factors can influence the observed patterns. It also underlines the need to account for ecological factors in within and between species comparisons.

Morphological integration affects the evolution of midline cranial base, lateral basicranium, and face across primates.

OBJECTIVES: The basicranium and face are two integrated bony structures displaying great morphological diversity across primates. Previous studies in hominids determined that the basicranium is composed of two independent modules: the midline basicranium, mostly influenced by brain size, and the lateral basicranium, predominantly associated with facial shape. To better assess how morphological integration impacts the evolution of primate cranial shape diversity, we test to determine whether the relationships found in hominids are retained across the order. MATERIALS AND METHODS: Three-dimensional landmarks (29) were placed on 143 computed tomography scans of six major clades of extant primate crania. We assessed the covariation between midline basicranium, lateral basicranium, face, and endocranial volume using phylogenetically informed partial least squares analyses and phylogenetic generalized least squares models. RESULTS: We found significant integration between lateral basicranium and face and between midline basicranium and face. We also described a significant correlation between midline basicranium and endocranial volume but not between lateral basicranium and endocranial volume. DISCUSSION: Our findings demonstrate a significant and pervasive integration in the craniofacial structures across primates, differing from previous results in hominids. The uniqueness of module organization in hominids may explain this distinction. We found that endocranial volume is significantly integrated to the midline basicranium but not to the lateral basicranium. This finding underlines the significant effect of brain size on the shape of the midline structures of the cranial base in primates. With the covariations linking the studied features defined here, we suggest that future studies should focus on determining the causal links between them.

The panoramic dental radiograph for emergency physicians.

Dental emergencies are common reasons for presenting to hospital emergency departments. Here, we discuss the panoramic radiograph (orthopantomogram (OPG, OPT) as a diagnostic tool for the assessment of mandibular trauma and odontogenic infections. In this article, we review the radiographic principles of image acquisition, and how to conduct a systematic interpretation of represented maxillofacial anatomy. The aim is to equip the emergency physician with the skills to use the OPG radiograph when available, and to rapidly assess the image to expedite patient management. Included is a discussion of a number of cases seen in the emergency setting and some common errors in diagnosis.

The Relationship Between Ocular Protrusion and Craniofacial Structures.

OBJECTIVE: This study aimed to evaluate the relationships between ocular protrusion and other craniofacial structures. METHODS: The lateral cephalograms of 124 nonsyndromic white adults were assessed. Two orbital and 13 craniofacial parameters were measured. Subgroups were constructed according to sex, anteroposterior position of maxilla, and mandibular plane angle values.Anatomical parameters and their relationships were statistically analyzed by analysis of variance and multivariate stepwise regression analysis. RESULTS: There were no significant differences in ocular protrusion distances between sexes, and between individuals with different maxillary anteroposterior position and mandibular plane angle values. Ocular protrusion distances, the distance between the eyeball apex and the lateral orbital margin (Eyeball apex-LOr: OP1) and inferior orbital margin (Eyeball apex-IOr: OP2), were found to be 20.6 ±â€Š2.8 and 16.5 ±â€Š3.1, respectively. However, regression analysis showed that the ocular protrusion distances had weak correlation with a few craniofacial structures. The OP1 had a low negative relationship with the maxillary anteroposterior position (N-Aperp) (r: -0.289) (P < 0.05). The OP2 had a low negative relationship with the palatal plane angle (FH/PP) (r: -0.291) (P < 0.01) but had a positive relationship with the cranial base angle (BSN) (r: 0.304) (P < 0.01) and posterior facial height (SGo) (r: 0.299) (P < 0.01). CONCLUSIONS: Ocular protrusion distances did not differ by sex, maxillary anteroposterior position, and amount of mandibular plane angle and showed weak correlation with a few craniofacial structures. Ocular protrusion amounts can be used for diagnosis and treatment plan in craniofacial syndromic or nonsyndromic anomalies.

Three-Dimensional Displacement of Partial Craniofacial Bones Following Rapid Maxillary Expansion in Young Patients with Angle Class III Malocclusions.

OBJECTIVE: The aim of this study was to analyze the displacement in 3D direction of some craniofacial bones with the rapid maxillary expansion in Angle class III malocclusion. METHOD: Thirteen Angle class III patients (mean age: 12.4 ±â€Š1.7 years; 7 males, 6 females) using rapid maxillary expansion as part of their orthodontic treatment were selected and computed tomography scans were taken before and after expansion. The 3D models were reconstructed using the Mimics software and the maxillary, zygomata, nasal bones were separated. With 3D models correction and registration, the displacements in the 3D directions of partial craniofacial bones were measured. Quantitative variables were analyzed by using SPSS19.0 and a t value less than 0.05 was considered statistically significant. RESULTS: Measurement results showed that rapid maxillary expansion produced significant displacement in both sides of the maxillary, zygomata, and nasal bones. In the width of the midline palatine suture, the anterior nasal spine point was expanded a mean 4.18 mm (range 2.42 mm-5.68 mm, Pleft = 0.007, Pright = 0.014) and the posterior nasal spine point was expanded a mean 2.14 mm (range 1.96 mm-2.43 mm, Pleft < 0.001, Pright = 0.002). In the width of the maxillary in coronal plane, the Spr point was expanded a mean 4.86 mm (range 3.34 mm-6.22 mm, Pleft = 0.004, Pright = 0.008) followed by the A point expanded a mean 4.47 mm (range 2.87 mm-5.97 mm, Pleft = 0.005, Pright = 0.010). The bilateral maxillary moved to both sides and the points of the front maxillary anterior nasal spine and A moved forwards and downwards. In the width of the zygomata, the Zm point was expanded 2.18 mm (range 1.87 mm-2.41 mm, Pleft = 0.001, Pright = 0.002) on average and moved backwards, the retral and upper points of the zygomata Za and Mz also moved backwards. The points Zm, Za, and O all moved upwards. The external lateral side of the nasal bone expanded to both sides, the Ipa point was expanded a mean 2.04 mm (range 1.11 mm-2.46 mm, Pleft = 0.008, Pright = 0.019) and the centre of the nasal bone moved backwards and downwards. CONCLUSION: With rapid maxillary expansion, the increasement of width in the maxillary affected the position of the zygomata and nasal bones in the 3D directions, caused changes in facial appearance.

Dental development and craniofacial morphology in school-age children.

INTRODUCTION: 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. METHODS: This study was embedded in the Generation R Study, Rotterdam, The Netherlands. In 3,896 children aged 8 to 11 years, 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. RESULTS: Dental development was positively associated with the bimaxillary growth (ß = 0.04; 95% CI 0.01 to 0.08). Children with above-average dental development had a tendency toward Class II jaw relationship (ß = -0.08; 95% CI -0.13 to -0.04). Regarding dental parameters, the proclination increased for incisors and lips with advanced dental development (ß = 0.15 [95% CI 0.10 to 0.19] and ß = 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. CONCLUSIONS: 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.

Lip position analysis of young women with different skeletal patterns during posed smiling using 3-dimensional stereophotogrammetry.

INTRODUCTION: The aim of this study was to explore the internal relationship between posed smile characteristics, lip position, and skeletal patterns in young women. METHODS: Fifty women between the ages of 20 and 30 years were enrolled and divided into 3 groups-vertical, average, and horizontal patterns- using the following parameters: FMA, GoGn-SN, and Jarabak ratio. Each subject was scanned in natural head position and with a posed smile. The interlabial gap, intercommissural width, and smile index were calculated. The frontal region was selected as the reference plane for superimpositions. The changes of the lip landmarks in the vertical, sagittal, and coronal directions were investigated. RESULTS: The smile indexes were listed in the following sequence: vertical < average < horizontal. Significant differences were found in the interlabial gap among the 3 groups. Compared with the average and horizontal groups, the upper lip landmarks of the vertical group showed differences and changed more only in the vertical direction. However, the lower lip landmark showed no differences in any direction. CONCLUSIONS: Different skeletal patterns have characteristic smile features. The vertical skeletal pattern affects upper lip movements because there is more space for upper-lip elevation. However, the vertical skeletal pattern has no effect on lower lip movement.

Stability of upper face sexual dimorphism in central European populations (Czech Republic) during the modern age.

One of the most fundamental issues in forensic anthropology is the determination of sex and population affinity based on various skeletal elements. Therefore, we compared the sexual dimorphism of the upper facial skeleton from a recent Czech population (twenty-first century) with that of a population from Early Modern Age Bohemia (sixteenth to eighteenth centuries). Methods of geometric morphometrics were applied. According to the results, sexual dimorphism in terms of size, shape, and form was statistically significant in both populations. The best results of sex estimation originated from analyses of form. Thus, both size and shape differences should be taken into account for determination of the sex. The accuracy of prediction achieved 91.1% for individuals in the recent population and 87.5% for individuals from the early modern population. Only minor differences were found between sexual dimorphism in the studied populations. We conclude that sexual dimorphism of the upper facial skeleton is stable during the relatively short time period.

Accuracy of linear measurements on CBCT images related to presurgical implant treatment planning: A systematic review.

OBJECTIVE: The aim of this systematic review was to identify, review, analyze, and summarize available evidence on the accuracy of linear measurements when using maxillofacial cone beam computed tomography (CBCT) specifically in the field of implant dentistry. MATERIAL AND METHODS: The search was undertaken in April 2017 in the National Library of Medicine database (Medline) through its online site (PubMed), followed by searches in the Cochrane, EMBASE, ScienceDirect, and ProQuest Dissertation and Thesis databases. The main inclusion criterion for studies was that linear CBCT measurements were performed for quantitative assessment (e.g., height, width) of the alveolar bone at edentulous sites or measuring distances from anatomical structures related to implant dentistry. The studies should compare these values to clinical data (humans) or ex vivo and/or experimental (animal) findings from a "gold standard." RESULTS: The initial search yielded 2,516 titles. In total, 22 studies were included in the final analysis. Of those, two were clinical and 20 ex vivo investigations. The major findings of the review indicate that CBCT provides cross-sectional images that demonstrate high accuracy and reliability for bony linear measurements on cross-sectional images related to implant treatment. A wide range of error has been reported when performing linear measurements on CBCT images, with both over- and underestimation of dimensions in comparison with a gold standard. A voxel size of 0.3 to 0.4 mm is adequate to provide CBCT images of acceptable diagnostic quality for implant treatment planning. CONCLUSIONS: CBCT can be considered as an appropriate diagnostic tool for 3D preoperative planning. Nevertheless, a 2 mm safety margin to adjacent anatomic structures should be considered when using CBCT. In clinical practice, the measurement accuracy and reliability of linear measurements on CBCT images are most likely reduced through factors such as patient motion, metallic artefacts, device-specific exposure parameters, the software used, and manual vs. automated procedures.

A Three-Dimensional Anthropometric Evaluation of Facial Morphology.

OBJECTIVES: The aims of this study were to evaluate sexual dimorphism for facial features within Italian and Egyptian populations and to compare the facial morphology by sex between these 2 populations. MATERIALS AND METHODS: Three-dimensional (3D) facial images were acquired by using the portable 3dMDface System, which captured 259 subjects from 2 population groups of Italian (n = 139) and Egyptian (n = 120). Each population was categorized into male and female groups for evaluation. All subjects in the groups were aged between 18 and 30 years and had no apparent facial anomalies. A total of 23 anthropometric landmarks were identified on the 3D faces of each subject. The independent t test was used to analyze each data set obtained within each subgroup. RESULTS: Egyptian women tend to have distinct facial features when compared with Italian women; they had less prominent eyes, more nasal width, more height of upper and lower faces and more height of upper and lower vermilion lengths. Egyptian and Italian males demonstrated very close facial features. However, Egyptian males had more nasal width, length of alare, and mandibular height. CONCLUSIONS: Sexual dimorphism for facial features was presented in both the Italian and Egyptian populations. In addition, there were significant differences in facial morphology between these 2 populations, especially in females.

Morphometric Measurements of Bony Nasolacrimal Canal in Children.

OBJECTIVE: Morphology and dimensions of the bony nasolacrimal canal duct (BNLD) as a key factor in the development of primary acquired nasolacrimal duct obstruction. We aimed to obtain detailed morphometric analysis of BNLD in children without nasolacrimal duct pathology by using computed tomography and provide standard measurements by means of age which could be utilized in planning management or in invasive interventions. METHODS: Picture Archiving Communication Systems database of our hospital's radiology department was searched for this retrospective study. Subjects were under 18 years of age who had undergone a paranasal, maxillofacial, or temporal bone high-resolution computed tomography scan in last 2 years with various indications. Those with fractures including facial bones and/or nasolacrimal canal or history of nasolacrimal duct pathology were excluded from the study. We measured the diameter, angle, and surface area of BNLD. RESULTS: A total number of 136 subjects (86 boys, 50 girls) were included in the study. The average age was 7.3 ±â€Š5.1 years. We documented statistically significantly positive correlation between all measured diameters and ages (P < 0.001), whereas there was a negative association between mean angle and age (P < 0.001). Mean angle is defined as the angle between BNLD and nasal floor. The surface area of BNLD was found to be significantly increasing depending on age (P < 0.001). However, we could not find any significant association between gender and measured parameters (P > 0.050). CONCLUSION: Our study demonstrated that development of BNLD continues during childhood, regardless of gender.