Arrested eruption of the permanent lower second molar.
The incidence of retention/impaction of the permanent lower second molar (M2inf) lies between 0.6/1000 and 3/1000. Therefore, the purpose of the present study was to investigate the craniofacial morphology, the frequency of dental anomalies and the inclination of the affected M2inf and the adjacent first molar in patients with arrested eruption of M2inf. The overall goal was to elucidate the aetiology of arrested tooth eruption and to present the characteristics of these patients in order to improve diagnosis and treatment planning. Radiographic material (profile radiographs and orthopantomograms) from 19 patients (nine females and 10 males; 13-19 years of age at the time of referral) were analysed. The ages of the patients when profile radiographs were taken for cephalometric analysis varied from 8 to 16 years. The study shows that this group of patients, compared with a reference group, had an increased sagittal jaw relationship (Class II). Specifically, the mandibular prognathism was less, the mandibular gonial angle smaller, the mandibular alveolar prognathism enlarged and the maxillary incisor inclination less than in the reference group. Furthermore, this group of patients had a more frequent occurrence of morphological tooth anomalies, such as root deflections, invaginations, and taurodontism. However, none of the patients with arrested eruption of M2inf had agenesis of the lower third molar. The study did not reveal an association between the degree of inclination of the M2inf and that of the first molar in the same region. The results of this investigation show that conditions such as the craniofacial morphology and deviations in the dentition are associated with arrested eruption of M2inf. Therefore, it is important to evaluate these conditions in future diagnosis and treatment planning of patients with arrested eruption of M2inf. (+info)
The robust australopithecine face: a morphogenetic perspective.
The robust australopithecines were a side branch of human evolution. They share a number of unique craniodental features that suggest their monophyletic origin. However, virtually all of these traits appear to reflect a singular pattern of nasomaxillary modeling derived from their unusual dental proportions. Therefore, recent cladistic analyses have not resolved the phylogenetic history of these early hominids. Efforts to increase cladistic resolution by defining traits at greater levels of anatomical detail have instead introduced substantial phyletic error. (+info)
Evaluation of CSF leaks: high-resolution CT compared with contrast-enhanced CT and radionuclide cisternography.
BACKGROUND AND PURPOSE: Radiologic evaluation of CSF leaks is a diagnostic challenge that often involves multiple imaging studies with the associated expense and patient discomfort. We evaluated the use of screening noncontrast high-resolution CT in identifying the presence and site of CSF rhinorrhea and otorrhea and compared it with contrast-enhanced CT cisternography and radionuclide cisternography. METHODS: We retrospectively reviewed the imaging studies and medical records of all patients who were evaluated for CSF leak during a 7-year period. Forty-two patients with rhinorrhea and/or otorrhea underwent high-resolution CT of the face or temporal bone and then had CT cisternography and radionuclide cisternography via lumbar puncture. The results of the three studies were compared and correlated with the surgical findings in 21 patients. RESULTS: High-resolution CT showed bone defects in 30 of 42 patients (71%) with CSF leak. High-resolution, radionuclide cisternography and CT cisternography did not show bone defects or CSF leak for 12 patients (29%) who had clinical evidence of CSF leak. Among the 30 patients with bone defects, 20 (66%) had positive results of their radionuclide cisternography and/or CT cisternography. For the 21 patients who underwent surgical exploration and repair, intraoperative findings correlated with the defects revealed by high-resolution CT in all cases. High-resolution CT identified significantly more patients with CSF leak than did radionuclide cisternography and CT cisternography, with a moderate degree of agreement. CONCLUSION: Noncontrast high-resolution CT showed a defect in 70% of the patients with CSF leak. No radionuclide cisternography or CT cisternography study produced positive results without previous visualization of a defect on high-resolution CT. CT cisternography and radionuclide cisternography may be reserved for patients in whom initial high-resolution CT does not identify a bone defect or for patients with multiple fractures or postoperative defects. (+info)
Comparison of cervicovertebral dimensions in Australian Aborigines and Caucasians.
Cervicovertebral dimensions were compared in a group of 30 male and 30 female young adult Australian Aborigines from the Northern Territory, and a control sample consisting of 60 Caucasian dental students from Adelaide, matched for sex and age. Thirty-six variables, 22 cervical and 14 craniofacial, were derived from standardized lateral roentgenograms with the use of a computerized cephalometric system. Vertebral body height and length were significantly greater in Aboriginal males than females for C3 to C7, while dorsal arch height of C1 and C2 displayed the greatest dimensional variability in both sexes. The antero-posterior length of C1, dens height, and body heights of C3 and C4 were significantly shorter in Aborigines than Caucasians for both males and females. Total length of the column from C2 to C6 was approximately 12 per cent shorter in the Aborigines compared with Caucasians. The height of the posterior arch of C1 was significantly correlated with one or both posterior cranial base lengths in Aborigines and Caucasians. Associations were also noted between mandibular lengths and posterior arch heights of the upper two vertebrae. The results confirm and clarify several previous observations on the relative shortness of the cervical spine in Australian Aboriginals. They also indicate some associations between dimensions of the cervical vertebrae and craniofacial lengths, particularly those representing the posterior cranial base and the mandible. (+info)
Effect of low-dose testosterone treatment on craniofacial growth in boys with delayed puberty.
Craniofacial growth was investigated in boys treated with low-dose testosterone for delayed puberty (> 14 years old; testicular volume < 4 ml; n = 7) and compared with controls (12-14 years; n = 37). Cephalometric radiographs, statural height and pubertal stage were recorded at the start of the study and after 1 year. Craniofacial growth was assessed by nine linear measurements. At the beginning of the study, statural height, mandibular ramus length, upper anterior face height, and total cranial base length were significantly shorter in the delayed puberty boys than in the controls. After 1 year, the growth rate of the statural height, total mandibular length, ramus length, and upper and total anterior face height was significantly higher in the treated boys than in the untreated height-matched controls (n = 7). The craniofacial measurements were similar in the treated boys as compared with the controls. These results show that statural height and craniofacial dimensions are low in boys with delayed puberty. Low doses of testosterone accelerate statural and craniofacial growth, particularly in the delayed components, thus leading towards a normalization of facial dimensions. (+info)
Mandibular shape and skeletal divergency.
Pre-treatment lateral cephalograms of 41 skeletal Class I girls aged 11 to 15 were divided according to MP-SN angle: lower than 28 degrees (hypodivergent, 10 girls), between 31 and 34 degrees (normodivergent, 18 girls), or larger than 37 degrees (hyperdivergent, 13 girls). The mandibular outlines were traced and digitized, and differences in shape were quantified using the elliptic Fourier series. Size differences were measured from the areas enclosed by the mandibular outlines. Shape differences were assessed by calculating a morphological distance (MD) between the size-independent mean mathematical reconstructions of the mandibular outlines of the three divergency classes. Mandibular shape was different in the three classes: large variations were found in hyperdivergent girls versus normodivergent girls (MD = 4.61), while smaller differences were observed in hypodivergent girls (MD versus normodivergent 2.91). Mean size-independent mandibular shapes were superimposed on an axis passing through the centres of gravity of the condyle and of the chin. Normodivergent and hyperdivergent mandibles differed mostly at gonion, the coronoid process, sigmoid notch, alveolar process, posterior border of the ramus, and along the mandibular plane. A significant size effect was also found, with smaller mandibles in the hyperdivergent girls. (+info)
Linear and angular changes in dento-facial dimensions in the third decade.
The object of the study was to examine changes in dento-facial dimensions and relationships during the third decade of life, and consisted of a prospective cephalometric study. The data used consisted of 90 degree left lateral cephalometric radiographs of 21 males and 26 females at ages 18 years (T1) and 21 years (T2), and for 15 of the males and 22 of the females at 28 years (T3). Various dimensions representative of dento-facial morphology were measured and the changes in dimensions over time were calculated and tested for significance with the one sample t-test. In general, skeletal and dental relationships remained relatively stable. Face height and jaw length dimensions increased by small amounts. (+info)
Differential responses to parathyroid hormone-related protein (PTHrP) deficiency in the various craniofacial cartilages.
PTHrP null mutant mice exhibit skeletal abnormalities both in the craniofacial region and limbs. In the growth plate cartilage of the null mutant, a diminished number of proliferating chondrocytes and accelerated chondrocytic differentiation are observed. In order to examine the effect of PTHrP deficiency on the craniofacial morphology and highlight the differential feature of the composing cartilages, we examined the various cartilages in the craniofacial region of neonatal PTHrP deficient mice. The major part of the cartilaginous anterior cranial base appeared to be normal in the homozygous PTHrP deficient mice. However, acceleration of chondrocytic differentiation and endochondral bone formation was observed in the posterior part of the anterior cranial base and in the cranial base synchondroses. Ectopic bone formation was observed in the soft tissue-running mid-portion of the Meckel's cartilage, where the cartilage degenerates and converts to ligament in the course of normal development. The zonal structure of the mandibular condylar cartilage was scarcely affected, but the whole condyle was reduced in size. These results suggest the effect of PTHrP deficiency varies widely between the craniofacial cartilages, according to the differential features of each cartilage. (+info)