OBJECTIVE: To evaluate the effects of bone-anchored maxillary protraction (BAMP) treatment and longterm stability in growing cleft lip and palate and isolated cleft palate (CLP/CP) patients with mild maxillary hypoplasia and to compare maxillary growth patterns of BAMP-treated patients to matched control CLP/CP patients.
METHODS: Ten patients with CLP/CP were treated with BAMP; they were compared to the maxillary growth pattern of 10 age-matched cleft control patients with no maxillary protraction treatment, who later received surgical Le Fort I maxillary advancement after the growth period. The assessment of maxillary growth and the occlusion started at mean 8 years of age and continued until mean 18 years of age.
RESULTS: The use of BAMP orthopedic traction changed the growth pattern of mild hypoplastic maxilla toward a more anterior direction and advanced the face even above the level of Le Fort lll with only a minor effect on dentoalveolar units. The correction of occlusion and facial convexity were stable in the long term.
CONCLUSIONS: The using BAMP may improve the position of the maxilla relative to the anterior cranial base for the correction of mild maxillary hypoplasia in adolescent patients with CLP/CP. The achieved results are rather stable in the long term.

OBJECTIVE: To investigate the influence of vertical facial type on esthetic perception of lower facial asymmetry as evaluated by orthodontists, dentists, and laypeople.
METHODS: Three adult females were selected with normal growth patterns (NGP), vertical growth patterns (VGP), and horizontal growth patterns (HGP). Frontal photographs were made symmetric and digitally altered, rotating the lower facial third clockwise, ranging from 0° to 6° in 1° increments. A web-based survey was designed with 24 images (eight images for each model) in random order. Each image was rated using a scale ranging from 0 (unattractive) to 10 (the most attractive) by 75 orthodontists, 73 dentists, and 78 laypeople. Kruskal-Wallis test was used to determine whether differences among groups were significant. Pairwise comparisons were made with Mann-Whitney U test. The significance level was set at P = .05.
RESULTS: In NGP, orthodontists and dentists could recognize slighter deviations (2°), while deviations in VGP and HGP under 3° were not recognized by all groups. Severe deviations (≥4°) were distinguished better in HGP by orthodontists and laypeople. In VGP and NGP, there was no significant difference over 4°.
CONCLUSIONS: Growth pattern has a significant influence on perception of lower facial asymmetry. Less severe asymmetry can be detected better in NGP. In severe degrees, increments of asymmetry can be perceived more in HGP by orthodontists and laypeople.

In recent years, a large number of studies have demonstrated that obstructive sleep apnea （OSA） can lead to the abnormal development of maxillofacial region in pediatric patients, which may result in a \'vicious circle\' aggravating OSA, therefore adversely affecting quality of life. Understanding the effect and mechanism of OSA on children\'s maxillofacial development is helpful to better prevent and treat OSA and maxillofacial dysplasia in children.
摘要: 近年来，大量的研究证实儿童阻塞性睡眠呼吸暂停（obstructive sleep apnea，OSA）会使儿童颌面部发育异常，而颌面部的异常发育可能导致OSA病情持续发展以及颌面部的持续异常发育，对孩子身心造成不利影响。了解OSA对儿童颌面发育的影响和机制，有助于更好地预防及治疗儿童OSA以及颌面发育不良问题。.

OBJECTIVE:  To determine the effect of tongue position on facial morphology of Pakistani adults and different growth patterns.
METHODS:  Cross-sectional study. Place and Duration of the Study: Department of Orthodontics, Karachi Medical and Dental College, Karachi, Pakistan, from January to April 2021.
METHODS:  The study included individuals aged 17 to 30 years with no history of prior orthodontic treatment, absence of wound, burn, or scar tissue in the neck region, comfortable breathing through the nose, absence of deglutition disorder, and a skeletal Class I or II relationship. The exclusion criteria were a cleft lip or palate, or a history of chronic mouth breathing, snoring, or tonsillectomy. According to their skeletal relationships, the subjects were split into three groups; Group I (low-angle), Group II (normal growth), and Group III (high-angle). Vertical growth pattern was assessed on radiograph by interpreting the values of NS / ML (nasion-sella / mandibular plane) angle, and angle formed between FH / ML (Frankfort horizontal plane / mandibular plane). A predesigned proforma was used to record all the measurements made on pre-treatment lateral cephalograms by the sole investigator. Data were analysed using SPSS 24.0.
RESULTS:  Data from the lateral cephalogram of 79 patients, consisting of 18 (22.8%) males and 61 (77.2%) females who met the inclusion criteria, were analysed. The sample included 15 low-angle, 45 normal vertical growth, and 19 high-angle cases. Fifty participants had Class I skeletal relationships, while 29 had Class II relationships. According to the ANOVA test, FH / ML and NS / ML measurements showed no statistically significant variations in tongue position and growth trends.
CONCLUSIONS: There was no statistically significant difference between tongue position and facial morphology of Class I or II subjects with different vertical growth patterns. However, there was a statistically sufficient evidence showing the tongue height was greater in Class I skeletal relationship patients as compared to Class II skeletal cases (p = 0.008).
BACKGROUND: Tongue position, Tongue space, Tongue length, Growth pattern.

暂无摘要。

Malocclusions are common craniofacial malformations which cause quality of life and health problems if left untreated. Unfortunately, the current treatment for severe skeletal malocclusion is invasive surgery. Developing improved therapeutic options requires a deeper understanding of the cellular mechanisms responsible for determining jaw bone length. We have recently shown that neural crest mesenchyme (NCM) can alter jaw length by controlling recruitment and function of mesoderm-derived osteoclasts. Transforming growth factor beta (TGF-β) signaling is critical to craniofacial development by directing bone resorption and formation, and heterozygous mutations in TGF-β type I receptor (TGFBR1) are associated with micrognathia in humans. To identify what role TGF-β signaling in NCM plays in controlling osteoclasts during mandibular development, mandibles of mouse embryos deficient in the gene encoding Tgfbr1 specifically in NCM were analyzed. Our lab and others have demonstrated that Tgfbr1fl/fl;Wnt1-Cre mice display significantly shorter mandibles with no condylar, coronoid, or angular processes. We hypothesize that TGF-β signaling in NCM can also direct later bone remodeling and further regulate late embryonic jaw bone length. Interestingly, analysis of mandibular bone through micro-computed tomography and Masson\'s trichrome revealed no significant difference in bone quality between the Tgfbr1fl/fl;Wnt1-Cre mice and controls, as measured by bone perimeter/bone area, trabecular rod-like diameter, number and separation, and gene expression of Collagen type 1 alpha 1 (Col1α1) and Matrix metalloproteinase 13 (Mmp13). Though there was not a difference in localization of bone resorption within the mandible indicated by TRAP staining, Tgfbr1fl/fl;Wnt1-Cre mice had approximately three-fold less osteoclast number and perimeter than controls. Gene expression of receptor activator of nuclear factor kappa-β (Rank) and Mmp9, markers of osteoclasts and their activity, also showed a three-fold decrease in Tgfbr1fl/fl;Wnt1-Cre mandibles. Evaluation of osteoblast-to-osteoclast signaling revealed no significant difference between Tgfbr1fl/fl;Wnt1-Cre mandibles and controls, leaving the specific mechanism unresolved. Finally, pharmacological inhibition of Tgfbr1 signaling during the initiation of bone mineralization and resorption significantly shortened jaw length in embryos. We conclude that TGF-β signaling in NCM decreases mesoderm-derived osteoclast number, that TGF-β signaling in NCM impacts jaw length late in development, and that this osteoblast-to-osteoclast communication may be occurring through an undescribed mechanism.

OBJECTIVE: To three-dimensionally assess differences in craniomaxillofacial skeletal development in patients with operated unilateral cleft lip and palate (UCLP) treated with/without presurgical nasoalveolar molding (PNAM) with a mean age of 5 years.
METHODS: Cone-beam CT radiographs of 30 patients with UCLP who had undergone PNAM and 34 patients with UCLP who did not receive PNAM were analyzed. The data were stored in DICOM file format and were imported into the Dolphin Imaging program for 3D image reconstruction and landmark identification. 33 landmarks, 17 linear and three angular variables representing craniofacial morphology were analyzed and compared by using the Mann-Whitney U tests.
RESULTS: The vast majority of linear variables and 3D coordinates of landmark points reflecting craniofacial skeletal symmetry were not significantly different between the two groups. In terms of craniofacial skeletal development, the PNAM group had a significantly smaller anterior nasal spine offset in the midsagittal plane and a greater maxillary length compared to the non-PNAM group.
CONCLUSIONS: Evaluations performed in early childhood showed that treatment with/without PNAM in the neonatal period was not a major factor influencing craniomaxillofacial hard tissue development in patients with UCLP; moreover, PNAM treatment showed significant correction of skeletal deviation at the base of the nose.
CONCLUSIONS: Follow-up in early childhood has shown that PNAM treatment administered during the neonatal stage does not impede maxillary development and has benefits in correcting nasal floor deviation. It is a viable option for improving nasal deformity in children with unilateral cleft lip and palate.

Primary cilia have versatile functions, such as receiving signals from the extracellular microenvironment, mediating signaling transduction, and transporting ciliary substances, in tissue and organ development and clinical disease pathogenesis. During early development (embryos within 10 weeks) in the oral and maxillofacial region, defects in the structure and function of primary cilia can result in severe craniofacial malformations. For example, mice with mutations in the cilia-related genes Kif3a and IFT88 exhibit midline expansion and cleft lip/palate, which occur due to abnormalities in the fusion of the single frontonasal prominence and maxillary prominences. In the subsequent development of the oral and maxillofacial region, we discussed the regulatory role of primary cilia in the development of the maxilla, mandible, Meckel cartilage, condylar cartilage, lip, tongue, and tooth, among others. Moreover, primary cilia are promising regulators in some oral and maxillofacial diseases, such as tumors and malocclusion. We also summarize the regulatory mechanisms of primary cilia in oral and maxillofacial development and related diseases, including their role in various signaling transduction pathways. For example, aplasia of submandibular glands in the Kif3a mutant mice is associated with a decrease in SHH signaling within the glands. This review summarizes the similarities and specificities of the role of primary cilia in tissue and organ development and disease progression in the oral and maxillofacial region, which is expected to contribute several ideas for the treatment of primary cilia-related diseases.

暂无摘要。

Craniomaxillofacial development involves a series of highly ordered temporal-spatial cellular differentiation processes in which a variety of cell signaling factors, such as fibroblast growth factors, play important regulatory roles. As a classic fibroblast growth factor, fibroblast growth factor 7 (FGF7) serves a wide range of regulatory functions. Previous studies have demonstrated that FGF7 regulates the proliferation and migration of epithelial cells, protects them, and promotes their repair. Furthermore, recent findings indicate that epithelial cells are not the only ones subjected to the broad and powerful regulatory capacity of FGF7. It has potential effects on skeletal system development as well. In addition, FGF7 plays an important role in the development of craniomaxillofacial organs, such as the palate, the eyes, and the teeth. Nonetheless, the role of FGF7 in oral craniomaxillofacial development needs to be further elucidated. In this paper, we summarized the published research on the role of FGF7 in oral craniomaxillofacial development to demonstrate the overall understanding of FGF7 and its potential functions in oral craniomaxillofacial development.