Reference values for craniofacial structures in children 4 to 6 years old: review of the literature

This review article addresses the question as to what methods can be used to investigate cranial structure and growth development in children 4 to 6 years old, and what the relevant reference values are for this age group. We screened the literature for epidemiological, longitudinal and cross-sectional studies investigating healthy children 4 to 6 years old without abnormalities and orthodontic therapy. Radiographic cephalometry is a practical, valid tool for analyzing craniofacial structure and growth processes. But it has several disadvantages, including the use of ionizing radiation, measuring points that are difficult to locate, no means of radiographic enlargement without distorting reference values, and the data's two-dimensionality. Anthropometry is another procedure for creating reference values for the craniofacial structure in children. Its advantages over radiographic cephalometry include three-dimensional results and no radiation exposure. Moreover, it yields precise and valid results for a wide variety of potential applications. In addition to these procedures, there are other techniques with which cranial structure and growth development in children 4 to 6 years old can be investigated. Those reported in the literature in this connection include standardized photographs, the creation of computerized and magnetic resonance images, and investigations performed on dry skulls. In short, there is great demand nowadays for investigations aimed at developing reference values for Caucasian children 4 to 6 years old. Radiographic cephalometry and anthropometry are two very common methods. Anthropometry is expected to become increasingly important because it involves no exposure to radiation.