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Short stature of prenatal origin: craniofacial growth and dental maturation
R Van Erum1, M Mulier, C Carels
1Department of Orthodontics, Catholic University of Leuven, Belgium.
Insights
Children born small for gestational age (SGA) with growth failure exhibit distinct craniofacial differences, including a retrognathic face. Dental maturation, however, remains unaffected by their general growth retardation.
Area of Science:
- Pediatric Endocrinology
- Craniofacial Biology
- Orthodontics
Background:
- Children born small for gestational age (SGA) with catch-up growth failure are increasingly treated with high-dose growth hormone (GH).
- Understanding the impact of GH on craniofacial development in these children is crucial.
Purpose of the Study:
- To evaluate craniofacial growth and dental maturation in short SGA individuals.
- To assess potential effects of high-dose GH treatment on facial structures.
Main Methods:
- Analysis of 77 cephalograms and orthopantomograms from 48 subjects (ages 2-32 years).
- Craniofacial growth assessed using standard deviation scores (SDS) for linear and angular measurements.
- Dental maturation evaluated using a dental delay score (dental age minus chronological age).
Main Results:
- Short SGA individuals showed a smaller anterior cranial base, retropositioned mandible, and smaller maxilla.
- Increased mandibular plane angle and cranial base angle were observed, leading to a retrognathic face with increased lower anterior face height.
- Dental age was not delayed, indicating independence from general growth and bone age.
Conclusions:
- General growth retardation in SGA individuals affects craniofacial complex differently.
- Dental maturation appears independent of general growth and bone age in this cohort.
- Further research is needed to understand the long-term effects of GH treatment on craniofacial development.
Abstract:
Recently, children born small for gestational age (SGA) with a catch-up growth failure, have been selected for high dose growth hormone (GH) treatment. In order to gain greater insight concerning dentofacial growth and maturation of these patients, and to evaluate the possible effects of high does GH administration on facial structures, craniofacial growth and dental maturation were evaluated in short SGA persons. Seventy-seven cephalograms and orthopantomograms were available from 48 subjects, aged between 2 and 32 years. Craniofacial growth was assessed by calculating age- and gender-specific standard deviation scores (SDS) for eight linear and five angular measurements. Tooth formation was evaluated by means of a dental delay score (i.e. dental age minus chronological age). The SDS for craniofacial growth measurements for the lateral aspect showed a short anterior cranial base (-1.8 SDS), a small retropositioned mandible (< or = -1.7 SDS) and a small maxilla (-1.5 SDS); a high mandibular plane angle (+1.9 SDS) and a wide cranial base angle (+1 SDS). These findings result in a small retrognathic face with a relatively increased lower anterior face height (+1.7 SDS). In contrast to skeletal maturation, dental age was not delayed. The general growth retardation is, apparently, reflected to a differential extent within the craniofacial complex, while dental maturation appears to be a distinct process tightly linked to chronological age, and independent of general growth and bone age.