Neural crest cells have embriologically important role for the development and growth in oral and maxillofacial region. If the early hereditary defect occurs or environmental factors affect these cells diminutive mesenchymal cells are disabled to make neural plate and decreased proliferation of mesenchymal cells result in hypoplastic development of neural crest. As a result, this brings about severe facial malformations such as various located facial clefts and/or loss or duplication of facial structure. These are two cases of accessory maxilla and zygomatic deformity with and without facial cleft.
Congenital Abnormalities ; Growth and Development ; Maxilla* ; Neural Crest ; Neural Plate

OBJECTIVEThis study aimed to explore the effects of different types of palatal lateral excisions on the growth and development of the maxilla and dental arch, and to investigate the underlying mechanisms.

METHODSA total of 112 3-week-old Sprague-Dawley (SD) male rats were randomly divided into a control and 3 experimental groups: the mucoperiosteal denudation group, the mucosal flap excision group, and the periosteum excision group. In the experimental groups, bilateral mucoperiosteal, mucosal flap and periosteum were excised respectively in the lateral one half of the palate. Four rats in each group were randomly chosen for sacrifice every two weeks. The maxilla was dissected following the excision. The widths of the maxilla and dental arch were measured and the histological phenomena were investigated at different phases. At the same time, 12 animals in each group were sequentially injected with calcein every two weeks. Three animals in each group, whose fluorescent labeling was used, were sacrificed for investigating bone formation at Week 8 following injection.

RESULTS(1) Each experimental group presented the constriction of the maxilla and dental arch. The upper first molars in the experimental groups inclined medially. The mucoperiosteal denudation group showed the largest degree of effect followed by the periosteum excision group. The indices of the mucosal flap excision group, which retained the structures of the periosteum layer, had the most approximate values to the control group; (2) Different histological changes among the experimental groups were detected. The fibers penetrated into the palatal bone as Sharpey's fibers in the mucoperiosteal denudation group. The pattern of bone deposition was the bundle type. Sharpey's fibers were not found in the mucosal flap and periosteum excision groups and the depositions of palatal bone were the lamellar type as those in the control group; (3) The rates of bone deposition in the experimental groups decreased compared with the control group. The rates in different phases were the most approximate values to those of the control group in the mucosal flap excision group, which has the same structure of periosteum as the control group.

CONCLUSIONThere were different effects on the growth and development of the maxilla and dental arch in different types of palatal lateral excisions. Periosteum is important for bone formation and deposition pattern. The prevention of Sharpey's fibers forming and attaching to the palatine can effectively avert the following malformation.

Animals ; Dental Arch ; growth & development ; Male ; Maxilla ; growth & development ; Palate ; surgery ; Rats ; Rats, Sprague-Dawley

Russell-Silver syndrome (RSS) is a congenital disease characterized by short stature due to growth hormone deficiency, physical asymmetry, inverted triangular face, micrognathia, prominent forehead, and hypodontia. This case report presents a prosthetic management of a 6-year-old patient with Russell-Silver syndrome treated with overdentures on the maxilla and the mandible using the remaining primary teeth. Subsequent and comprehensive dental management considering the growth and development of a young patient will be necessary.
Anodontia ; Child ; Denture, Overlay ; Forehead ; Growth and Development ; Growth Hormone ; Humans ; Mandible ; Maxilla ; Silver-Russell Syndrome* ; Tooth, Deciduous

The facial patterns were expressed by the interrelation of variable factors such as heredity, function and environment. Such variable factors have an effect on the growth and development of maxillofacial bones. The malocclusions with skeletal discrepancies are caused by abnormal forms, sizes and positions of cranial base, maxilla and mandible. For the proper diagnosis and treatment planning, the analysis of such structures is necessary. Lateral cephalograms of 54 adults with class III malocclusion patients (test group) and 61 adults with normal occlusion (control group) were analyzed. Anteroposterior relations and sizes of cranial base, maxilla, mandible were estimated to compare with those of normal ones. In test group, the anterior cranial base length was within normal range, but posterior cranial base, maxilla and mandibular body were longer than those in control group, significantly. Based on the cranial base, the location of maxilla in test group was normal, but the location of mandible was more anterior than that in control. Based on the maxilla, the location of mandible was more anterior in test group than that in control. Both mandibular body and ramus anteroposterior lengths in test group were larger than those in control. Both mandibular plane angle and upper gonial angle were within normal range, but lower gonial angle was significantly high in test group.
Adult ; Diagnosis ; Growth and Development ; Heredity ; Humans ; Malocclusion ; Mandible* ; Maxilla* ; Reference Values ; Skull Base*

BACKGROUND: Cleft lip and palate deformity have unknown patterns of maxillofacial growth and development. The maxillofacial growth can be affected either by congenital or environmental factors such as infection and trauma. Surgical repair of cleft lip and palate may interfere the subsequent growth and development of maxillofacial region. The purpose of this study is to evaluate the characteristics of maxillofacial growth patterns in adult cleft lip and palate patients. MATERIALS AND METHODS: The material for this study consisted of 17 adult male patients with cleft lip and palate. Cephalometric tracing and measurements were done by one investigator. The relationship between 17 cleft lip and palate patients and Korean norms were evaluated statistically. RESULTS: There were statistically difference in Na, perpendicular to point A, SNA angle, effective maxillary length, maxillofacial differencial, Wit's appraisal and upper incisor to point A (p < 0.01). Pogonion to Na. perpendicular also statistically differed (p < 0.05). Other measurements didn't statistically differ. CONCLUSION: It was evident that in adult cleft lip and palate patients, maxilla was retruded and short. Careful cleft lip and palate repair and treatment are recommended for facilitating normal growth of maxilla.
Adult* ; Cleft Lip* ; Congenital Abnormalities ; Growth and Development ; Humans ; Incisor ; Male ; Maxilla ; Palate* ; Research Personnel

OBJECTIVEThis study aims to investigate the temporal pattern of expression of vascular endothelial growth factor (VEGF) and new bone formation during midpalatal suture expansion osteogenesis for rapid maxillary expansion.

METHODSA total of44 New Zealand white rabbits were randomly assigned to 11 groups, namely, five experimental groups, five control groups, and one control 0 group. A Haas appliance was used for the rapid expansion of the midpalatal suture; rapid expansion was set for 2 weeks and fixed for 4 weeks. The tissue of the maxillary midpalatal suture was harvested on the day of installing rapid expansion (control 0 group), on weeks 1 and 2 for rapid expansion, and on weeks 1, 2, and 4 for fixed (experimental group and control group, respectively). The immunohistochemical method was used to detect distribution and expression of VEGF, and new bone formation was observed with periodic acid-Schiff.

RESULTSHigher VEGF expressions are observed after midpalatal suture distraction osteogenesis. Positive staining for VEGF is mainly noted in the vascular endothelial cells, and the active osteoblasts are at the edge of a newborn trabecular bone. A weak VEGF expression is detected among cells in the control group. The VEGF expression of the experimental group is higher than that of the control group in rapid expansion weeks 1 and 2 and in fixed weeks 1 and 2. The expression of VEGF in the experimental group increases significantly and peaks at fixed week 1, and then gradually decreases. The amount of newly formed bone in the experimental groups is always higher than that in the control group; moreover, it increases significantly and peaks at fixed week 2, and then gradually decreases.

CONCLUSIONThe mechanical strain created by rapid maxillary expansion generates a sequence of VEGF cellular events that lead to increased vascularization and subsequent new bone formation.

Animals ; Maxilla ; Osteoblasts ; Osteogenesis ; Osteogenesis, Distraction ; Palatal Expansion Technique ; Rabbits ; Sutures ; Vascular Endothelial Growth Factor A

OBJECTIVETo explore the factor of age related to protraction response.

METHODSFour 12-week mongrel dogs in the same nest were randomly assigned into two groups: the control (n = 1) and the experimental groups (n = 3). Four pairs of titanium bone markers were fixed on either side of the bone sutures of all animals. Distraction device was fitted in the experimental group, A forward elastic force was exerted through the device for 1 month. Midface skeleton protraction was applied to experimental group at different age. Dog 2 was started at 12 weeks of age. Dog 3 was started at 16 weeks of age. Dog 4 was started at 20 weeks of age. The protraction force was 600g. All the animals were sacrificed at their age of 9 months. The results were evaluated clinically, radiographically, and cephalometrically.

RESULTSAll the animals in the experimental group showed progressively forward movement of the maxilla at the end of the experiment. In the same condition, the younger age appeared to have more effective in treatment than the older age. After 3 approximately 4 weeks stagnation, the maxilla gradually recovered normal growth.

CONCLUSIONThe younger age lead more effective protraction than the older age. Persistent elastic distraction at the medium position of midface brought stable effects and no influence on facial growth.

Age Factors ; Animals ; Dogs ; Dysostoses ; surgery ; Maxilla ; growth & development ; Orthodontic Extrusion ; methods ; Osteogenesis, Distraction ; methods ; Time

This study is to evaluate the growth and development of the maxilla advanced by transoral distraction osteogenesis of cleft lip and palate children. Subjects are two patients diagnosed as maxillary hypoplasia with cleft lip and palate, and followed up over 5 years after distraction. At the age of 11.4 years (mean), the distraction had been rendered and periodically taken lateral cephalograms were analysed to trace the growth of the maxilla. This cephalometric study showed continuous growth and development of the distracted maxilla to be stable through long term follow-up.
Child ; Cleft Lip ; Follow-Up Studies ; Growth and Development ; Humans ; Maxilla ; Osteogenesis, Distraction ; Palate

In orthodontic field, it is very important to understand the normal growth, Such an understanding can be derived from observation of normal growth in various samples from childhood to adulthood, and this builds a foundation from which growth abnormality or variation can be defined. Thus, a broad data collection of normal children, as well as basic study reviewing such data become necessary. The relationship between the mean values of cephalometric measurements in Growth and Development was studied among the group(boys and Girls) of Korean children from the ages 6-years to 16-years. 220 boys 170 girls were chosen as subjects : cephalometric X-ray were taken for 3 years and hard tissue analysis on McNamara and Riketts Analysis which was divided into measurements of 5 parts(Cranial base, Cranial base and Maxilla & Mandible, Maxilla and Mandible, Mandible. Dental measurements). The relationship of craniofacial growth was studied. The following conclusions were obtained: 1. There was statistically significant differences in anterior cranial base between the two sexes of 14 and 15-year groups. 2. In comparison of growth amounts among different age group, statistically singnificant difference in Posterior facial height exhisted among 10~11, 12~13 and 14~15year-old interval groups. This pattern increased with aging. 3. Na perpendicular to A showed earlier growth peak in females(11-12years) than males (12-13years). When horizontal measurements of point A and Pogonion are compared, mandibular growth appeared to be greater. 4. Maximum growth peak of cranial base and mandible was earlier in females (11-12 years) than males(13-14years). 5. Upper central incisor flared out with aging, and there were increases in lower incisor to A-Pg, and lower incisor inclination. There was significant difference between the two sexes in 10-years-old group.
Aging ; Child* ; Data Collection ; Female ; Growth and Development ; Humans ; Incisor ; Male ; Mandible ; Maxilla ; Skull Base

The objective of this study was to understand the major changes of craniofacial dimensions and spatial growth pattern during the late embryonic and fetal period of human features. This study was performed with the selective materials of normal fetuses received from the Registry of Congenital Malformation of Seoul National University Hospital. The specimens consisted of nineteen embryos and sixty-six fetuses. The photomicrographs from mid-segittal sections of embryos were used for angular measurement, and the lateral cephalograms taken with soft X-ray were also measured in liners and angular aspects. All of the anatomical landmarks for the tracing of the photomicrographs and cephalograms were referred to the previous reports on literature. The sequential changes of prenatal craniofacial dimensions and agles were analyzed statistically and discussed on the focus about the developmental growth directions of human oro-facial structure arised from heterogeneous origins. The results are as follows, 1) Cranial base angle was almost formed at about 6 weeks old embryos with the average angle of 127.4 +/- 6.33degrees (n=3) and it was almost constant onwards. 2) The linear increase rates of anterior cranial base length and anterior facial height exceeded those of the posterior cranial base length and posterior facial height, and the maxilla grows more rapidly on the horizontal dimension than the vertical dimension during the fetal period. 3) The angular relationship between the anterior cranial base and palatal plane decreasedslightly during the fetal period, disclosing 11degrees at 12th week gestation and 5degrees at 41th weeks gestation. 4) Gonial angle was maintained almost constantly at about 130degrees during the fetal period from 12 weeks to 41 weeks of gestation.
Embryonic Structures* ; Fetus* ; Growth and Development* ; Humans ; Maxilla ; Pregnancy ; Seoul ; Skull Base ; Vertical Dimension