Individual appraisal of facial soft and hard tissues with the mesh diagram

The lateral cephalometric mesh diagram analysis presents advantages not readily available in conventional cephalometric methods. The face is oriented on the patient's natural head position, which provides comparability between cephalometric findings and the clinical facial examination. The patient's profile is not directly compared with the population norm but with an "individualized norm" derived from the application of the population norm to a grid scaled on the patient's facial shape namely, the upper face height [N-ANS] and facial depth [N-S]. Each landmark is assessed by its proportionate location in the mesh diagram grids. Thus, facial form is evaluated in one single display easily interpretable without computation of linear and angular measurements. These principles are illustrated for diagnosis of malocclusions and treatment with a combination of orthodontics and orthognathic surgery. The discrepancies between hard and soft tissues are readily ascertained and measured through the mesh display, and allow the formulation of conclusions on treatment and outcome. The mesh diagram is a flexible cephalometric analysis that should be incorporated in the routine dentofacial diagnosis and treatment planning

Effect of compromised nasal breathing on craniofacial development

The impact of nasal respiration impairment on craniofacial growth and development has been evaluated intensively in human and animal studies. The aims of this paper are to critically review: 1- the causes and diagnostic methods of nasal obstruction, specifically septal deviation, turbinate dysfunction, lymphoid tissue hypertrophy, and soft tissue alteration. 2- the growth pattern of the adenoids in relation to age and their size change in response to environmental factors. 3- the role of mouth breathing in the development of characteristic malocclusions and associated patterns of facial growth ["adenoid fades"], with a focus on available and needed research. 4- the ongoing debate about removal of lymphoid tissues to avoid facial dysmorphology, and the corollary issue of optimal timing of adenoidectomy and/or tonsillectomy that would prevent the development of such dysmorphology. The importance of a multidisciplinary approach in diagnosing, referring and treating patients with airway impairment will be emphasized