Geometric morphometric analysis of growth patterns among facial types

Ryan P. Knigge; Kieran P. McNulty; Heesoo Oh; Anna M. Hardin; Emily V. Leary; Dana L. Duren; Manish Valiathan; Richard J. Sherwood

doi:10.1016/j.ajodo.2020.04.038

Geometric morphometric analysis of growth patterns among facial types

Ryan P. Knigge, Kieran P. McNulty, Heesoo Oh, Anna M. Hardin, Emily V. Leary, Dana L. Duren, Manish Valiathan, Richard J. Sherwood

Research output: Contribution to journal › Article › peer-review

21 Scopus citations

Abstract

INTRODUCTION: Extreme patterns of vertical facial divergence are of great importance to clinicians because of their association with dental malocclusion and functional problems of the orofacial complex. Understanding the growth patterns associated with vertical facial divergence is critical for clinicians to provide optimal treatment. This study evaluates and compares growth patterns from childhood to adulthood among 3 classifications of vertical facial divergence using longitudinal, lateral cephalograms from the Craniofacial Growth Consortium Study.

METHODS: Participants (183 females, 188 males) were classified into 1 of 3 facial types on the basis of their adult mandibular plane angle (MPA): hyperdivergent (MPA >39°; n = 40), normodivergent (28° ≤ MPA ≤ 39°; n = 216), and hypodivergent (MPA <28°; n = 115). Each individual had 5 cephalograms between ages 6 and 20 years. A set of 36 cephalometric landmarks were digitized on each cephalogram. Landmark configurations were superimposed to align 5 homologous landmarks of the anterior cranial base and scaled to unit centroid size. Growth trajectories were calculated using multivariate regression for each facial type and sex combination.

RESULTS: Divergent growth trajectories were identified among facial types, finding more similarities in normodivergent and hypodivergent growth patterns than either share with the hyperdivergent group. Through the use of geometric morphometric methods, new patterns of facial growth related to vertical facial divergence were identified. Hyperdivergent growth exhibits a downward rotation of the maxillomandibular complex relative to the anterior cranial base, in addition to the increased relative growth of the lower anterior face. Conversely, normodivergent and hypodivergent groups exhibit stable positioning of the maxilla relative to the anterior cranial base, with the forward rotation of the mandible. Furthermore, the hyperdivergent maxilla and mandible become relatively shorter and posteriorly positioned with age compared with the other groups.

CONCLUSIONS: This study demonstrates how hyperdivergent growth, particularly restricted growth and positioning of the maxilla, results in a higher potential risk for Class II malocclusion. Future work will investigate growth patterns within each classification of facial divergence.

Original language	English (US)
Pages (from-to)	430-441
Number of pages	12
Journal	American Journal of Orthodontics and Dentofacial Orthopedics
Volume	160
Issue number	3
DOIs	https://doi.org/10.1016/j.ajodo.2020.04.038
State	Published - Sep 2021

Bibliographical note

Funding Information:
The research program of the Craniofacial Growth Consortium is indebted to the numerous investigators, researchers, and staff who contributed their time and effort to the studies now combined into the Craniofacial Growth Consortium Study. Support for these studies was provided by numerous agencies, foundations, and institutions. A special thanks to the American Association of Orthodontists Foundation Craniofacial Growth Legacy Collection. The current study was supported by the National Institute of Dental and Craniofacial Research of the National Institutes of Health under Award Numbers R01DE024732, R01DE024732-06W1, and F32DE029104. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.

Funding Information:
The research program of the Craniofacial Growth Consortium is indebted to the numerous investigators, researchers, and staff who contributed their time and effort to the studies now combined into the Craniofacial Growth Consortium Study. Support for these studies was provided by numerous agencies, foundations, and institutions. A special thanks to the American Association of Orthodontists Foundation Craniofacial Growth Legacy Collection. The current study was supported by the National Institute of Dental and Craniofacial Research of the National Institutes of Health under Award Numbers R01DE024732, R01DE024732-06W1, and F32DE029104. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.

Publisher Copyright:
© 2021 American Association of Orthodontists

Keywords

Adolescent
Adult
Cephalometry
Child
Face/anatomy & histology
Female
Humans
Male
Malocclusion, Angle Class II
Mandible/diagnostic imaging
Maxilla/diagnostic imaging
Young Adult

PubMed: MeSH publication types

Journal Article

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10.1016/j.ajodo.2020.04.038

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@article{11d18c366a2a465b89fe774f228dbabb,

title = "Geometric morphometric analysis of growth patterns among facial types",

abstract = "INTRODUCTION: Extreme patterns of vertical facial divergence are of great importance to clinicians because of their association with dental malocclusion and functional problems of the orofacial complex. Understanding the growth patterns associated with vertical facial divergence is critical for clinicians to provide optimal treatment. This study evaluates and compares growth patterns from childhood to adulthood among 3 classifications of vertical facial divergence using longitudinal, lateral cephalograms from the Craniofacial Growth Consortium Study.METHODS: Participants (183 females, 188 males) were classified into 1 of 3 facial types on the basis of their adult mandibular plane angle (MPA): hyperdivergent (MPA >39°; n = 40), normodivergent (28° ≤ MPA ≤ 39°; n = 216), and hypodivergent (MPA <28°; n = 115). Each individual had 5 cephalograms between ages 6 and 20 years. A set of 36 cephalometric landmarks were digitized on each cephalogram. Landmark configurations were superimposed to align 5 homologous landmarks of the anterior cranial base and scaled to unit centroid size. Growth trajectories were calculated using multivariate regression for each facial type and sex combination.RESULTS: Divergent growth trajectories were identified among facial types, finding more similarities in normodivergent and hypodivergent growth patterns than either share with the hyperdivergent group. Through the use of geometric morphometric methods, new patterns of facial growth related to vertical facial divergence were identified. Hyperdivergent growth exhibits a downward rotation of the maxillomandibular complex relative to the anterior cranial base, in addition to the increased relative growth of the lower anterior face. Conversely, normodivergent and hypodivergent groups exhibit stable positioning of the maxilla relative to the anterior cranial base, with the forward rotation of the mandible. Furthermore, the hyperdivergent maxilla and mandible become relatively shorter and posteriorly positioned with age compared with the other groups.CONCLUSIONS: This study demonstrates how hyperdivergent growth, particularly restricted growth and positioning of the maxilla, results in a higher potential risk for Class II malocclusion. Future work will investigate growth patterns within each classification of facial divergence.",

keywords = "Adolescent, Adult, Cephalometry, Child, Face/anatomy & histology, Female, Humans, Male, Malocclusion, Angle Class II, Mandible/diagnostic imaging, Maxilla/diagnostic imaging, Young Adult",

author = "Knigge, {Ryan P.} and McNulty, {Kieran P.} and Heesoo Oh and Hardin, {Anna M.} and Leary, {Emily V.} and Duren, {Dana L.} and Manish Valiathan and Sherwood, {Richard J.}",

note = "Funding Information: The research program of the Craniofacial Growth Consortium is indebted to the numerous investigators, researchers, and staff who contributed their time and effort to the studies now combined into the Craniofacial Growth Consortium Study. Support for these studies was provided by numerous agencies, foundations, and institutions. A special thanks to the American Association of Orthodontists Foundation Craniofacial Growth Legacy Collection. The current study was supported by the National Institute of Dental and Craniofacial Research of the National Institutes of Health under Award Numbers R01DE024732, R01DE024732-06W1, and F32DE029104. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. Funding Information: The research program of the Craniofacial Growth Consortium is indebted to the numerous investigators, researchers, and staff who contributed their time and effort to the studies now combined into the Craniofacial Growth Consortium Study. Support for these studies was provided by numerous agencies, foundations, and institutions. A special thanks to the American Association of Orthodontists Foundation Craniofacial Growth Legacy Collection. The current study was supported by the National Institute of Dental and Craniofacial Research of the National Institutes of Health under Award Numbers R01DE024732, R01DE024732-06W1, and F32DE029104. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. Publisher Copyright: {\textcopyright} 2021 American Association of Orthodontists",

year = "2021",

month = sep,

doi = "10.1016/j.ajodo.2020.04.038",

language = "English (US)",

volume = "160",

pages = "430--441",

journal = "American Journal of Orthodontics and Dentofacial Orthopedics",

issn = "0889-5406",

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number = "3",

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T1 - Geometric morphometric analysis of growth patterns among facial types

AU - Knigge, Ryan P.

AU - McNulty, Kieran P.

AU - Oh, Heesoo

AU - Hardin, Anna M.

AU - Leary, Emily V.

AU - Duren, Dana L.

AU - Valiathan, Manish

AU - Sherwood, Richard J.

N1 - Funding Information: The research program of the Craniofacial Growth Consortium is indebted to the numerous investigators, researchers, and staff who contributed their time and effort to the studies now combined into the Craniofacial Growth Consortium Study. Support for these studies was provided by numerous agencies, foundations, and institutions. A special thanks to the American Association of Orthodontists Foundation Craniofacial Growth Legacy Collection. The current study was supported by the National Institute of Dental and Craniofacial Research of the National Institutes of Health under Award Numbers R01DE024732, R01DE024732-06W1, and F32DE029104. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. Funding Information: The research program of the Craniofacial Growth Consortium is indebted to the numerous investigators, researchers, and staff who contributed their time and effort to the studies now combined into the Craniofacial Growth Consortium Study. Support for these studies was provided by numerous agencies, foundations, and institutions. A special thanks to the American Association of Orthodontists Foundation Craniofacial Growth Legacy Collection. The current study was supported by the National Institute of Dental and Craniofacial Research of the National Institutes of Health under Award Numbers R01DE024732, R01DE024732-06W1, and F32DE029104. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. Publisher Copyright: © 2021 American Association of Orthodontists

PY - 2021/9

Y1 - 2021/9

N2 - INTRODUCTION: Extreme patterns of vertical facial divergence are of great importance to clinicians because of their association with dental malocclusion and functional problems of the orofacial complex. Understanding the growth patterns associated with vertical facial divergence is critical for clinicians to provide optimal treatment. This study evaluates and compares growth patterns from childhood to adulthood among 3 classifications of vertical facial divergence using longitudinal, lateral cephalograms from the Craniofacial Growth Consortium Study.METHODS: Participants (183 females, 188 males) were classified into 1 of 3 facial types on the basis of their adult mandibular plane angle (MPA): hyperdivergent (MPA >39°; n = 40), normodivergent (28° ≤ MPA ≤ 39°; n = 216), and hypodivergent (MPA <28°; n = 115). Each individual had 5 cephalograms between ages 6 and 20 years. A set of 36 cephalometric landmarks were digitized on each cephalogram. Landmark configurations were superimposed to align 5 homologous landmarks of the anterior cranial base and scaled to unit centroid size. Growth trajectories were calculated using multivariate regression for each facial type and sex combination.RESULTS: Divergent growth trajectories were identified among facial types, finding more similarities in normodivergent and hypodivergent growth patterns than either share with the hyperdivergent group. Through the use of geometric morphometric methods, new patterns of facial growth related to vertical facial divergence were identified. Hyperdivergent growth exhibits a downward rotation of the maxillomandibular complex relative to the anterior cranial base, in addition to the increased relative growth of the lower anterior face. Conversely, normodivergent and hypodivergent groups exhibit stable positioning of the maxilla relative to the anterior cranial base, with the forward rotation of the mandible. Furthermore, the hyperdivergent maxilla and mandible become relatively shorter and posteriorly positioned with age compared with the other groups.CONCLUSIONS: This study demonstrates how hyperdivergent growth, particularly restricted growth and positioning of the maxilla, results in a higher potential risk for Class II malocclusion. Future work will investigate growth patterns within each classification of facial divergence.

AB - INTRODUCTION: Extreme patterns of vertical facial divergence are of great importance to clinicians because of their association with dental malocclusion and functional problems of the orofacial complex. Understanding the growth patterns associated with vertical facial divergence is critical for clinicians to provide optimal treatment. This study evaluates and compares growth patterns from childhood to adulthood among 3 classifications of vertical facial divergence using longitudinal, lateral cephalograms from the Craniofacial Growth Consortium Study.METHODS: Participants (183 females, 188 males) were classified into 1 of 3 facial types on the basis of their adult mandibular plane angle (MPA): hyperdivergent (MPA >39°; n = 40), normodivergent (28° ≤ MPA ≤ 39°; n = 216), and hypodivergent (MPA <28°; n = 115). Each individual had 5 cephalograms between ages 6 and 20 years. A set of 36 cephalometric landmarks were digitized on each cephalogram. Landmark configurations were superimposed to align 5 homologous landmarks of the anterior cranial base and scaled to unit centroid size. Growth trajectories were calculated using multivariate regression for each facial type and sex combination.RESULTS: Divergent growth trajectories were identified among facial types, finding more similarities in normodivergent and hypodivergent growth patterns than either share with the hyperdivergent group. Through the use of geometric morphometric methods, new patterns of facial growth related to vertical facial divergence were identified. Hyperdivergent growth exhibits a downward rotation of the maxillomandibular complex relative to the anterior cranial base, in addition to the increased relative growth of the lower anterior face. Conversely, normodivergent and hypodivergent groups exhibit stable positioning of the maxilla relative to the anterior cranial base, with the forward rotation of the mandible. Furthermore, the hyperdivergent maxilla and mandible become relatively shorter and posteriorly positioned with age compared with the other groups.CONCLUSIONS: This study demonstrates how hyperdivergent growth, particularly restricted growth and positioning of the maxilla, results in a higher potential risk for Class II malocclusion. Future work will investigate growth patterns within each classification of facial divergence.

KW - Adolescent

KW - Adult

KW - Cephalometry

KW - Child

KW - Face/anatomy & histology

KW - Female

KW - Humans

KW - Male

KW - Malocclusion, Angle Class II

KW - Mandible/diagnostic imaging

KW - Maxilla/diagnostic imaging

KW - Young Adult

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Geometric morphometric analysis of growth patterns among facial types

Abstract

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Keywords

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