Facial bone aging: An update and literature review

Area of Science:

• Gerontology
• Craniofacial Anatomy
• Medical Imaging

Background:

• Facial bone aging involves complex skeletal remodeling, resorption, and architectural alterations.
• Craniofacial skeletal changes, including bone loss in the orbital rims, maxilla, and mandible, occur throughout adulthood.

Purpose of the Study:

• To review current evidence on facial bone aging, focusing on morphometric changes and imaging findings.
• To examine clinical implications of craniofacial skeletal changes between 2020 and 2023.

Main Methods:

• Systematic literature search of major databases (MEDLINE, PubMed, Ovid, Cochrane Library).
• Inclusion of studies on adult human craniofacial skeletal changes using validated imaging or morphometric techniques.
• Exclusion of case reports with ≤5 patients, non-craniofacial studies, soft-tissue analyses, and studies lacking primary data.

Main Results:

• Orbital enlargement averaged 15-20% by the 7th decade; maxillary height decreased 8-15%; mandibular angles increased 3-7°.
• Specific resorption patterns noted in the periorbital region, pyriform aperture, and alveolar processes.
• Greater orbital changes in women and more pronounced mandibular remodeling in men, influenced by ethnic, hormonal, and mechanotransduction factors.

Conclusions:

• Facial bone aging is integral to craniofacial aging, affecting aesthetic, reconstructive, and dental fields.
• Advanced imaging and morphometric analysis allow precise characterization of skeletal changes.
• These advancements support evidence-based treatment planning and patient counseling for age-related facial alterations.