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At least 487 records · Page 27Linked to original sources
PubMed2005

Relationship between the pharyngeal airway space and craniofacial morphology, taking into account head posture.

This study assessed the relationship between craniofacial characteristics and the size of the pharyngeal airway space (PAS), taking into account head posture. Sixty dental students 25-30 years of age (30 men and 30 women) were examined by lateral cephalometry. The data were corrected with the use of appropriate regression equations for the PAS. The PAS significantly correlated with hyoid position, maxillary and mandibular size, maxillary and mandibular prognathism, and mandibular inclination. A large, anteriorly positioned mandible was associated with a large PAS-TP (the most proximal distance between the posterior pharyngeal wall and the tongue base). Uvula length and PNS-Ba (the distance between the most posterior point of the hard palate and the most inferior point of the anterior foramen magnum) correlated with PAS-UP (the most proximal distance between the posterior pharyngeal wall and uvula). Our results suggest that the anteroposterior dimension of the PAS is substantially affected by the size of the enclosure surrounding the PAS, including the maxilla, mandible and soft palate.

Adult↗
PubMed2004

Cephalometric assessment of the mandibular growth pattern in mouth-breathing children.

OBJECTIVE: At the present time, it is generally accepted that chronic mouth breathing influences craniofacial growth and development. The objective of this study was to determine the position of the jaw, its growth direction and morphology, and the facial proportions of children with two different etiological factors of mouth breathing, at different age groups. MATERIALS AND METHODS: Four groups of mouth breathing children were analyzed by cephalometry. Two groups, ages ranging from 3 to 6 and 7 to 10 years, with respiratory obstruction due to isolated adenoid hypertrophy (AH), and two groups, ages ranging from 3 to 6 and 7 to 10 years, due to adenotonsillar hypertrophy (ATH). RESULTS: No significant differences were observed between mouth breathing children caused either by AH or by ATH in any of the age groups. Only the linear Ar-Go measurement was significantly larger in children with ATH with 7 years or more. CONCLUSIONS: The results suggest that the influence of mouth breathing on mandibular growth is poorly related to the etiological factors analyzed. The single difference observed was the lower posterior facial height in children of 7 years of age or more, which was higher in those with ATH than in those with AH.

Adenoids↗
PubMed2006

Evaluation of potential predictors of outcome of laser-assisted uvulopalatoplasty for snoring.

OBJECTIVE: Laser-assisted uvulopalatoplasty (LAUP) is a common treatment for snoring, but up to 50% of patients obtain little or no sustained benefit. We investigated whether pre-operative measurements from lateral cephalometry, acoustic rhinometry, analysis of snoring sounds, and body mass index (BMI) could predict which snorers benefited from LAUP. STUDY DESIGN AND SETTING: Fifty-five snoring patients were assessed pre- and 6 months post-LAUP. Snoring severity was assessed by objective sound level recorded during polysomnography, and a Snoring Symptoms Inventory (SSI) questionnaire. RESULTS: The outcome of surgery was assessed by changes in objective sound measurements and in SSI, 6 months after LAUP. CONCLUSIONS: Relationships between the predictive measurements and outcome were at best only weak and none had sufficient predictive value to be useful in clinical practice.

Adult↗
PubMed2004

Mouth closing device (chinstrap) reduces mouth leak during nasal CPAP.

BACKGROUND AND PURPOSE: Mouth leak occasionally complicates continuous positive airway pressure (CPAP) therapy, which leads to discomfort. While a chinstrap prevents the mouth from opening during sleep, its efficacy in diminishing mouth leak has not been studied. PATIENTS AND METHODS: Fifteen patients with mouth leak complaining of mouth dryness and nasal obstruction underwent two consecutive overnight polysomnographies, one with a chinstrap, in random order. Cephalometry with and without a chinstrap was randomly performed on six patients. RESULTS: With the chinstrap, both mouth leak and the arousal index decreased significantly, from (mean+/-SD) 42.9+/-23.5 to 23.8+/-13.3% of total sleep time (TST), and from 33.4+/-18.6 to 23.6+/-9.3/sleep hour, respectively. However, snoring time showed a concomitant increase from 6.7+/-14.3 to 24.0+/-13.2% of TST. The arousal index was significantly higher during leak periods, and its changes correlated positively with changes in mouth leak. Cephalometric measures showed a significant decrease in anterior lower facial height. CONCLUSIONS: The chinstrap, by closing the mouth during CPAP, reduces mouth leak and therefore the arousal index in most patients. Nevertheless, the indices remained unacceptably high. The chinstrap may also increase snoring and, in rare cases, can worsen the respiratory disturbance index. Consideration of these potential effects is important before instituting regular home use of the chinstrap.

Adult↗
PubMed1982

Fetal lung maturity: the adjunctive use of ultrasound.

Ultrasonic cephalometry (BPD) was retrospectively studied in 268 patients at risk for the development of hyaline membrane disease (HMD). Thirty-seven patients were diagnosed as having diabetes and were excluded. Of the remaining 231 patients, 123 (53%) were found to have a biparietal diameter of (BPD) greater than or equal to 9.2 cm. There were 92 patients delivered within 5 days of scanning and none developed HMD. A BPD of 9.2 cm corresponded to an L/S ratio of 2.8 (r = 0.45, p less than 0.05). The above results indicate that it is safe to deliver a nondiabetic patient in whom a fetal BPD of 9.2 cm has been obtained.

Amniotic Fluid↗
PubMed1975

Biparietal diameter of the skull and fetal weight in the second trimester: an allometric relationship.

Ultrasonic cephalometry was performed prior to therapeutic abortion in 323 women during the second trimester of pregnancy. In 101 instances satisfactory paired measurements of intrauterine biparietal diameter and extrauterine fetal weight were obtained and these formed the basis for mathematical analysis. In midpregnancy increase in size of the fetal head and increase in body weight seem to proceed at different rates but the ratio of the rates appears to be constant--an allometric relationship of relative growth. The data were used to calculate a standard curve and a graphic method is proposed for estimating gestational age when reliable menstrual history is not available in the second trimester.

Abortion, Therapeutic↗
PubMed1983

Three-dimensional x-ray stereometry from paired coplanar images: a progress report.

More than fifty years ago, Broadbent reported the development of a three-dimensional cephalometric method which complexed information from pairs of x-ray images oriented in two planes at right angles to each other. Empirical problems have prevented the routine clinical use of this "biplanar" method, notwithstanding its obvious conceptual brilliance. The present article reports on recent work toward the development of an alternative method of three-dimensional cephalometry in which the two images of each x-ray pair are positioned in the same plane rather than being at right angles to each other. It is believed that this "coplanar" method avoids many of the technical problems that have limited the use of the Broadbent method.

Cephalometry↗
PubMed2000

Identification of matrix metalloproteinases and their tissue inhibitors type 1 and 2 in human masseter muscle.

Changes in masticatory muscle structure and function are either developmental, as seen in anomalies of facial form, or adaptive, as seen during procedures such as orthognathic surgery and functional-appliance orthodontic therapy. Remodelling of muscle extracellular matrix is pivotal in these processes. This turnover is mediated via members of the family of enzymes known as matrix metalloproteinases (MMP) and inhibited by the tissue inhibitors of metalloproteinases (TIMP). The aim here was to investigate the in vivo pattern of expression and distribution of MMPs and TIMPs in masseter muscle of humans with both normal and abnormal facial forms. Masseter muscle biopsies were taken from 10 patients, four with long-face syndrome and six normal controls as confirmed by cephalometry. Immunohistochemical techniques were used to show the pattern and distribution of MMPs and TIMP proteins in the muscle. Zymography of tissue extracts was used to determine the presence of MMP activity. Reverse transcriptase-polymerase chain reaction (RT-PCR) was used to detect the presence of MMP and TIMP-2 mRNA. MMP-1 was expressed around the individual muscle fibres, especially in those fibre surfaces in contact with the interstices of the connective tissue and around blood vessels. MMP-9 staining was less intense and was expressed in the interstices of the connective tissue and around blood vessels. Zymography of protein extracts confirmed that MMP-9 activity was present. MMP-2 and MMP-3 were not expressed in the samples, although MMP-2 mRNA could be detected by RT-PCR and its activity could be detected by zymography. Intense TIMP-1 staining was present around each muscle fibre, in the interstices of the connective tissue and surrounding blood vessels; TIMP-2 mRNA could be detected in all samples. These staining patterns were seen in all biopsies examined and were irrespective of the facial form of the donor. These findings provide evidence that the mechanisms required for matrix remodelling are present in the human masseter muscle.

Adult↗
PubMed2002

Comparison between anatomy and resistance of upper airway in normal subjects, snorers and OSAS patients.

Upper airway (UA) anatomical abnormalities are frequently observed in obstructive sleep apnea syndrome (OSAS). The correspondence between UA anatomical modifications and UA resistance (UAR) had not been studied. We aimed to determine if cephalometric characteristics could be related to segmental UAR. In twenty-five patients (21 males) (15 OSAS patients, 10 snorers) and 10 control subjects (8 males), segmental UAR were measured in supine position and cephalometry was performed. Inspiratory and expiratory UAR were calculated at peak flow. Length of the soft palate (LP), posterior airway space (PAS), distance from hyoid bone to mandibular plane and to posterior pharyngeal wall were different between the groups (P<0.01). Inspiratory and expiratory, total and segmental, UAR were higher in OSAS (P<0.001). Segmental UAR were correlated with PAS and distance from hyoid bone to mandibular plane and to pharyngeal posterior wall (P<0.05). In conclusion, OSAS patients had higher UAR depending on anatomical variables, especially the place of the hyoid bone.

Adult↗
PubMed2004

[Severe Class III malocclusion: long-term stability. Retrospective analysis of 12 cases].

PURPOSE: Long-term stability of severe class III is rarely evaluated in the literature. We present our findings with 12 patients who underwent surgery from June 1995 to December 1997 and analyze cephalometric superpositions. MATERIALS AND METHODS: Twelve operated patients were reviewed to analyze long-term results (follow-up 3 years 8 months). The sex ratio was well balanced. Mean age was 23 years. All patients were given pre- and postoperative orthodontic care and underwent bimaxillary surgery with Lefort 1 osteotomy and sagittal osteotomy of the rami. Delaire cephalometry on preoperative and early and late postoperative films was used to analyze outcome. Skeletal instability was defined as displacement greater than 4 mm. Recurrence was defined as secondary loss of the functional and esthetic result. RESULTS: Four patients (33%) developed skeletal instability. All patients achieved long-term stability. DISCUSSION: To detail the cause of skeletal instability, study of the principal factors of instability is presented together with a discussion of data in the literature.

Adolescent↗
PubMed1996

Linear and angular measurements of the mandible during maximal mouth opening.

PURPOSE: There are numerous reports of the translatory movement of the condyle in maximal mouth opening; however, the rotatory movement is less well understood. The purpose of this study was to investigate the rotatory condylar movement and the factors associated with it in normal subjects. PATIENTS AND METHODS: To study the role of facial morphology in maximal mouth opening, linear and angular measurements of the mandible in both the closed and maximal open positions were made by means of cephalometry. Dental students, 29 men and 31 women with no functional disorders of the masticatory system, were investigated. RESULTS: When the mouth was fully opened, the linear measurement of condylar movement was 20.5 +/- 4.0 mm in men and 18.1 +/- 2.5 mm in women, and the angular measurements of the rotation of the mandibular ramus were 39.1 +/- 5.9 degrees in men and 36.3 +/- 4.3 degrees in women. These differences were statistically significant (P < .01). CONCLUSIONS: During condylar movement and rotation of the mandible, mandibular length and the inclination of the mandibular ramus in the former, and the inclination of the mandibular ramus, the mandibular angle and the position of the condyle in the latter, were important factors.

Adult↗
PubMed1996

An extended Le Fort I osteotomy for correction of midface hypoplasia: a modified technique and results in 35 patients.

PURPOSE: This report analyzes the long-term results of a transoral high Le Fort I osteotomy (mean observation period, 37 months). PATIENTS AND METHODS: Thirty-five patients were treated with high Le Fort I osteotomies in which the zygomatic prominence was included in the osteotomy and advanced together with the maxilla. Twenty of the 35 patients were seen for long-term follow-up (mean, 37 months), which included clinical and radiographic examinations and anamnestic evaluation of the results. In nine patients it was possible to evaluate stability of the osteotomy by cephalometry. RESULTS: The treatment results clinically appeared stable, with good occlusion and, in most patients, improved function of the masticatory system. Patients reported satisfactory esthetic results. Radiologically the SNA angle was unaltered in six of seven non-CLP (cleft lip and palate) patients and was decreased in two of two CLP patients. There were few complications; one patient had the maxilla reoperated because of a lack of osseous healing and one patient had pulp necrosis of three maxillary teeth. CONCLUSION: The results achieved with the described method indicate that the use of minor modifications of routine surgical procedures in conventional orthognathic surgery can improve esthetic results in patients with extended midfacial hypoplasia.

Adolescent↗
PubMed1977

Cephalometric observations in premature craniosynostosis.

Forty patients with premature craniosynostosis of variable extent and severity were subjected to cephalometry. The majority of the children and adolescents involved had undergone bilateral cranial fenestration at age 6 months to 11 years. Lateral cephalometric radiographs were used for analysis. The measurements obtained were compared with normal values of comparable age groups. In two thirds of the patients examined facial skull growth was found to be impaired, the clinical appearance ranging from pronounced faciostenosis to abortive forms. In some cases the clinical appearance was normal. One of the conclusions derived from the cephalometric data is that inhibited growth primarily affects the anterior portions of the skull base, which are found to be shorter than normal. The defect appears to involve the spheno-ethmoidal, intersphenoidal and sphenofrontal synochondroses.

Cephalometry↗
PubMed1983

Masticatory muscle transposition in primates: effects on craniofacial growth.

The effects of early transposition of the masticatory muscles on the craniofacial growth and development of infant primates are documented with the aid of serial cephalometry, EMG's, and dry-skull preparations. The bilateral posterior transposition of the insertion of the masseter and temporalis muscles was followed by a significant superior and anterior rotation of the midfacial growth pattern as well as by marked skeletal morphological changes. The study documents the ability to change skeletal craniofacial growth patterns by altering muscle attachments.

Animals↗
PubMed1990

Increase in vertical dimension by interpositional bone grafts and subsequent craniofacial growth in adolescent monkeys.

The purpose of this study was to investigate the relationship between craniofacial growth and total maxillary osteotomy in adolescent Macaca fascicularis monkeys. The monkeys' facial height was increased with the help of interpositional bone grafts. Four monkeys underwent surgical procedures, and five served as controls. The changes in growth after surgery were then assessed with the help of conventional cephalometry and osseous implants. Lateral cephalometric radiographs of all monkeys were taken before and immediately after implant placement, immediately after surgery, and every 4 weeks thereafter for 1 year. Analysis of the cephalometric head films revealed that the increases in facial height assisted by interpositional grafts were not stable. Postsurgical observations showed a relapse in total facial height.

Animals↗
PubMed1990

Effect of surgical reduction of the tongue on oral stereognosis, oral motor ability, and the rest position of the tongue and mandible.

The oral ability to recognize forms and oral motor ability were studied by means of two specific tests in 27 subjects, 10 to 23 years of age, before and after tongue reduction because of macroglossia. Recordings were made before and 6 and 12 months after the operation. At the same time the natural position of the head and of the cervical column, the craniocervical relation, the position of the tongue and the hyoid bone, and the rest position of the mandible were studied with profile roentgen-cephalometry. The surgical reduction of the tongue had a minor influence on the subject's performance in the test of oral ability to recognize forms, where the number of false identifications increased somewhat. The oral motor ability and the positions of the head, the cervical column, and the hyoid bone were unaffected. After the operation, the tongue did not fill out the oral cavity as much as before and the freeway space decreased.

Adolescent↗
PubMed1995

Cephalometric and computed tomographic predictors of obstructive sleep apnea severity.

The interaction between craniofacial structure assessed by lateral cephalometry, and tongue, soft palate, and upper airway size determined from computed tomography (CT) scans was examined in 25 control subjects and 80 patients with obstructive sleep apnea (OSA). On the basis of the cephalometric analyses, the patients with OSA had retruded mandibles with larger ANB angle differences, elongated maxillary and mandibular incisors and mandibular molars, and high total upper and lower face heights The computed tomographic evaluations revealed that patients with OSA also had larger tongue, soft palate, and upper airway volumes. Men with OSA and skeletal Class I malocclusions had significantly larger soft palates than comparable controls. Both tongue and soft palate volumes were positively correlated with body mass index. A principal component analysis reduced the database, and one significant correlation was identified. Subjects with high total, upper and lower face heights, elongated maxillary and mandibular teeth, and proclined lower incisors were observed to have large tongue, soft palate, and upper airway volumes, to have a higher apnea index and to be obese. Linear regression analysis indicated that a high apnea index was seen in association with large tongue and soft palate volumes, a retrognathic mandible, an anteroposterior discrepancy between the maxilla and mandible, an open bite tendency between the incisors, and obesity.

Adult↗