Variability of facial movements in relation to sexual dimorphism and age: three-dimensional geometric morphometric study.

The aim of this study was to introduce suitable imaging technique and analytical methods for a detailed description of the facial movements in relation to sexual dimorphism and age in adult individuals. Removing of size factor from the analysis, we hypothesised that there will be no significant intersexual difference in facial mobility. We assume facial movements to be more pronounced in the older age category due to increasing the facial surface. We have compared five facial movements - raising eyebrows, closing eyes, pursing of the lips, inflating of the cheeks and smile - in relation to neutral expression of the human face. The material sample comprised three-dimensional facial surface models of healthy adult individuals of the Czech nationality (63 females, 58 males). Methods of geometric morphometry and multivariate statistics were used. Local tissue motion due to facial movements was expressed using colour-coded maps. The movement showing significant intersexual difference was inflating of the cheeks. Ageing in both sexes has significantly influenced the facial mobility on average after 50 years of age. Changes related to senescence have occurred in eye closing, smile and inflating of the cheeks. An enlarged facial surface has been noted in the group of individuals belonging to the older age category, what is probably the result of increased manifestation of skin folds and wrinkles. This is related to the loss of skin elasticity and overall weakening of the underlying muscles, especially in the infraorbital and cheeks area.

Three-dimensional development of the upper dental arch in unilateral cleft lip and palate patients after early neonatal cheiloplasty.

OBJECTIVES: This prospective morphometric study evaluated the growth of the upper dental arch in UCLP patients after early neonatal cheiloplasty and compared the selected dimensions with published data on non-cleft controls and on later operation protocol patients. METHODS: The sample comprised 36 Czech children with nonsyndromic complete UCLP (cUCLP) and 20 Czech children with nonsyndromic incomplete UCLP (UCLP + b). 2-D and 3-D analyses of palatal casts were made at two time points: before neonatal cheiloplasty at the mean age of 3 days (±1 day), and 10 months after surgery at the mean age of 10 months (±1 month). RESULTS: The upper dental arch of cUCLP and UCLP + b patients showed similar developmental changes, but the cleft type influenced growth significantly. The initial high shape variability in cUCLP patients diminished after 10 months, and approached the variability in UCLP + b patients. Both the width and length dimensions increased after surgery. Important growth concerned the anterior ends of both segments. The width and length dimensions illustrated similar growth trends with non-cleft controls and UCLP patients who underwent later cheiloplasty. CONCLUSION: Early neonatal cheiloplasty caused no reduction in the length or width dimensions during the first year of life. Our data suggest a reconstructed lip has a natural formative effect on the actively growing anterior parts of upper dental arch segments, which cause narrowing of the alveolar cleft.

Diachronic changes in size and shape of human proximal tibia in Central Europe during the latest 1200 years.

During the past twelve centuries, the stature of Central European inhabitants has increased significantly with corresponding changes in the size of lower limb bones. The aim of our study was to determine whether these changes have occurred strictly in relation to size or if the shape of skeletal structures has been altered simultaneously. Diachronic size and shape changes in the proximal part of tibia in a Central European population (Czech Republic) were studied using geometric morphometrics (principal components analysis, Hotelling's test, linear discriminant analysis). The study sample consisted of 183 three-dimensional (3D) models of adult tibiae dating to the early Middle Ages (N=65), early 20th century (N=60), and from a modern Czech population (N=57). A positive secular trend in size manifested only between the two modern Czech populations (the 20th century vs. the 21st century), a time range shorter than one century. By contrast, landmark-based shape analyses revealed significant differences in tibial morphology over the three periods covered in the study. In particular, progressive changes were observed in the position of tibial tuberosity (shifted medially), the inclination of the line connecting tuberosity with anterior edge of the tibial plateau (sloped down), the reshaping of the lower back condyle boundary (shifted posteriorly), and reshaping of the medial contour of the medial condyle (shifted anteriorly). Changes in the shape of the proximal tibial extremity across the chronologically distinct groups indicated the existence of discreet but convincing microevolutionary trends involving this anatomical structure.

Three-dimensional evaluation of facial morphology in pre-school cleft patients following neonatal cheiloplasty.

PURPOSE: To evaluate the facial morphology of pre-school patients with various types of orofacial cleft after neonatal cheiloplasty in pre-school aged children; and to compare facial variability and mean shape with age-corresponding healthy controls. MATERIALS AND METHODS: The sample included 40 patients with unilateral cleft lip (CL), 22 patients with unilateral cleft lip and palate (UCLP), and 10 patients with bilateral cleft lip and palate (BCLP). Patients were divided into two age categories, with a mean age of 3 years and 4.5 years, respectively. The group of healthy age-matched controls contained 60 individuals. Three-dimensional virtual facial models were evaluated using geometric morphometry and multivariate statistics methods. RESULTS: Statistically significant differences were found between each of the cleft groups and the controls. Color-coded maps showed facial shape deviations, which were located mainly in the nasal area and philtrum in all groups examined, and also in the buccal region and the chin in patients with UCLP or BCLP. These differences became more apparent, but not significantly so, in the older age category. CONCLUSION: Facial deviations typical of patients with clefts were observed in all of the patient groups examined. Although the analysis showed statistically significant differences in overall facial shape between patients and controls among all groups tested, the facial morphology in patients who have undergone only neonatal cheiloplasty (CL) is influenced to a small extent and may be considered satisfactory. More severe cleft types (UCLP, BCLP) together with palatoplasty, are reflected in more marked impairments in facial shape.

Three-dimensional analysis of palatal shape in patients treated with SARME using traditional and geometric morphometrics.

OBJECTIVES: To demonstrate the advantages of dense surface models in the evaluation of surgical-assisted rapid maxillary expansion's effect (SARME) on palatal morphology. Furthermore, we compared the palatal surface before (T1) and after (T2) therapy with controls. SETTING AND SAMPLE POPULATION: Surgical-assisted rapid maxillary expansion's effect group of 15 adult patients (Le Fort I and midpalatal sagittal osteotomy, hyrax screw) and 50 adult individuals. Patients were treated in General Faculty Hospital, Prague. MATERIALS AND METHODS: Eighty plaster casts were digitized using a three-dimensional laser scanner and evaluated using traditional and geometric morphometrics. RESULTS: An unpaired Student's t-test on the controls and the SARME T1 group revealed significant differences in all width measurements. Between the controls and the SARME T2 group, significant differences were only related to the interdental angle between the first molars and particularly to the palatal height. The most remarkable differences between the pre- and post-treatment palatal morphology were a widening of the dental arch and buccal shift of the lateral teeth associated with apparent flattening of the alveolar crest. CONCLUSIONS: Dense surface model provided descriptive visualization of the treatment effect and was helpful in the evaluation of palatal shape variability including detection of the most difficult patients. Correction of the dental arch width discrepancy by SARME was successfully achieved. After therapy, palatal shape variability of most of the patients was comparable to the variability of the control group.

Development of facial sexual dimorphism in children aged between 12 and 15 years: a three-dimensional longitudinal study.

OBJECTIVES: To evaluate sexual dimorphism of facial form and shape and to describe differences between the average female and male face from 12 to 15 years. SETTING AND SAMPLE POPULATION: Overall 120 facial scans from healthy Caucasian children (17 boys, 13 girls) were longitudinally evaluated over a 4-year period between the ages of 12 and 15 years. MATERIALS AND METHODS: Facial surface scans were obtained using a three-dimensional optical scanner Vectra-3D. Variation in facial shape and form was evaluated using geometric morphometric and statistical methods (DCA, PCA and permutation test). Average faces were superimposed, and the changes were evaluated using colour-coded maps. RESULTS: There were no significant sex differences (p > 0.05) in shape in any age category and no differences in form in the 12- and 13-year-olds, as the female faces were within the area of male variability. From the age of 14, a slight separation occurred, which was statistically confirmed. The differences were mainly associated with size. Generally boys had more prominent eyebrow ridges, more deeply set eyes, a flatter cheek area, and a more prominent nose and chin area. CONCLUSION: The development of facial sexual dimorphism during pubertal growth is connected with ontogenetic allometry.

Surface facial modelling and allometry in relation to sexual dimorphism.

Sexual dimorphism is responsible for a substantial part of human facial variability, the study of which is essential for many scientific fields ranging from evolution to special biomedical topics. Our aim was to analyse the relationship between size variability and shape facial variability of sexual traits in the young adult Central European population and to construct average surface models of adult males and females. The method of geometric morphometrics allowed not only the identification of dimorphic traits, but also the evaluation of static allometry and the visualisation of sexual facial differences. Facial variability in the studied sample was characterised by a strong relationship between facial size and shape of sexual dimorphic traits. Large size of face was associated with facial elongation and vice versa. Regarding shape sexual dimorphic traits, a wide, vaulted and high forehead in combination with a narrow and gracile lower face were typical for females. Variability in shape dimorphic traits was smaller in females compared to males. For female classification, shape sexual dimorphic traits are more important, while for males the stronger association is with face size. Males generally had a closer inter-orbital distance and a deeper position of the eyes in relation to the facial plane, a larger and wider straight nose and nostrils, and more massive lower face. Using pseudo-colour maps to provide a detailed schematic representation of the geometrical differences between the sexes, we attempted to clarify the reasons underlying the development of such differences.

Extension of orofacial cleft size and gestational bleeding in early pregnancy.

OBJECTIVE: The oronasal cavity in humans develops during embryonic day 30-60. There are three critical periods when this process can be affected, resulting in a specific type of orofacial cleft: cleft lip (CL), cleft palate (CP), or most serious, total cleft lip+palate (CLP). We assessed whether gestational bleeding during early pregnancy might act to produce a non-specific worsening of embryo status resulting in extension of the basic cleft type (CL or CP) into more serious CLP. STUDY DESIGN: In a group of the child patients with orofacial clefts, the cleft spectrum was correlated with first trimester gestational bleeding reported by the mother. Data were also related to the gender of patients, hereditary factors and additional malformations. RESULTS: Among 2524 mothers who gave birth to babies with an orofacial cleft in the Czech Republic during 1983-2009, 253 (10.0%) had gestational bleeding. Among the children with an orofacial cleft, 497 (19.7%) had an orofacial cleft among relatives and 297 (11.8%) exhibited an additional congenital malformation. In comparison with mothers without bleeding, there was significant increase of children with CLP (p < 0.01) at the expense of children with CP, whose number significantly decreased (p < 0.01) in the bleeding mothers. In the group of children with clefts among relatives we did not find any significant change associated with bleeding. The maternal bleeding was more frequent in children with additional malformations, but this difference was not significant (p = 0.112). CONCLUSION: We hypothesize that size/extent and therefore seriousness of orofacial cleft might increase as a consequence of hypoxia resulting from gestational bleeding.

Adolescent patient with bilateral crossbite treated with surgically assisted rapid maxillary expansion: a case report evaluated by the 3d laser scanner, and using FESA method.

Our purpose in this case report is to present an orthodontic treatment obtained and the results achieved in 17-year-old white female patient with Angle Class II malocclusion and bilateral posterior crossbite. Patient was treated with bonded acrylic Hyrax appliance and surgically assisted rapid maxillary expansion (SARME). The multiloop system 0.16 TMA (ß titanium) arch wire was used in the alignment phase and on purpose to prohibit bite opening and optimize threedimensional movement control. After treatment bonded lingual retainers were placed in between maxillary central incisors and in mandible canine-to-canine. A functional removable Klammt appliance was used for retention. The 3D Laser Scanner Roland LPX-250 was used in order to obtain digital dental casts. Evaluation of the treatment results was measured on these models and using finite element scaling analysis (FESA). An Angle Class I relationship was obtained after 2½ years of treatment, function and facial aesthetics were improved. The shape of the palate changed significant in the width direction, not significantly in length and high direction. The greatest expansion of palate was found in the region between the palatal cusps of the first molars 26.6%, followed by first 21.9% and second premolars 16.5%. SARME in adult patients with bilateral cross bite and maxillary deficiency lead to satisfactory results. The 3D laser scanned models and their measurements, using advanced software's are successfully used for precise studies.

Three-dimensional geometric morphometric analysis of cranio-facial sexual dimorphism in a Central European sample of known sex.

This article presents an approach for estimating the sexual dimorphism of adult crania using three-dimensional geometric morphometric methods. The study sample consisted of 139 crania of known sex (73 males and 66 females) belonging to persons who lived during the first half of the 20th century in Bohemia. The three-dimensional co-ordinates of 82 ecto-cranial landmarks and 39 semi-landmarks covering the midsagittal curve of the cranial vault were digitised using a MicroScribe G2X contact digitiser. The purposes of the investigation were to define the regions of the cranium where sexual dimorphism is most pronounced and to investigate the effectiveness of this method for determining sex from the shape of the cranium. The results demonstrate that it is better to analyse apportionable parts of the cranium rather than the cranium as a whole. Significant sexual differences (significance was determined using multivariate analysis of variance) were noted in the shape of the midsagittal curve of the vault, upper face, the region of the nose, orbits, and palate. No differences were recorded either in the shape of the cranium as a whole or in the regions of the base and the neurocranium. The greatest accuracy in determining sex was found in the region of the upper face (100% of study subjects correctly classified) and the midsagittal curve of the vault (99% of study subjects correctly classified).

Variability of the Upper Palaeolithic skulls from Predmostí near Prerov (Czech Republic): craniometric comparison with recent human standards.

One of the largest skeletal series of the Upper Palaeolithic period from Predmostí was destroyed during the Second World War, but the study of this material continues up to the present. The discovery of Matiegka's original photographic documentation on glass plates [Velemínská et al., 2004. The use of recently re-discovered glass plate photo-documentation of those human fossil finds from Predmostí u Prerova destroyed during World War II. J. Nat. Mus. Nat. Hist. Ser. 173, 129-132] gives an opportunity to perform a new and detailed craniometric analysis of five adult skulls in their lateral projection. The craniometric data were analysed using specialised Craniometrics software, and the analysis included morphological and dimensional comparisons with current Central European norms. The aim of the study was not only to monitor the skull shape as a whole, but predominantly, to evaluate the size and shape of various parts of the splanchnocranium. The Upper Palaeolithic skulls are significantly longer, and male skulls are also higher than the current norms. The crania of anatomically modern humans are characterised by two general structural features: mid-lower facial retraction and neurocranial globularity. The height of the face of the Palaeolithic skulls corresponds to that of the current Central European population. The face has a markedly longer mandibular body (3-4 SD), while female mandibular rami are shorter. The skulls are further characterised by a smaller gonial angle, the increased steepness of the mandibular ramus, and the greater angle of the chin. These changes in the size and shape associated with anterior rotation of the face produce a strong protrusion of both jaws, but the sagittal inter-maxillary relationships remain unchanged. The observed facial morphology is similar to the Czech Upper Palaeolithic skulls from Dolní Vestonice. This study confirms the main diachronic changes between skulls of Upper Palaeolithic and present-day human populations.

Development prediction of sagittal itermaxillary relations in patients with complete unilateral cleft lip and palate during puberty.

The main objective was to find a predictive model for the development of the jaw in patients with the most frequent facial cleft malformation, i.e. complete unilateral cleft lip and palate (UCLPc) by means of multivariate methods. This prediction is urgently needed from the clinical aspect. It will make it possible to provide early detection for patients at risk of adverse development. The study is based on a long-term X-ray cephalometric follow-up of 73 boys with UCLPc during puberty. Prediction was performed by methods of multiple regression and regression partitioning trees. The best equation predicts the intermaxillary relations at 15 years of age with high reliability (determination coefficient R2 = 0.822). The model was successfully verified statistically. In clinical practice, we suggest the use of a simple method of regression partitioning trees where the measurement of only 1 to 4 dimensions in a ten-year-old patient would suffice to achieve a reliable reading of the ANB angle at 15 years of age from a tree diagram.

Analysis of facial skeleton shape in patients with complete unilateral cleft lip and palate: geometric morphometry.

The study is based on a longitudinal cephalometric follow-up of X-ray films of patients with a complete unilateral cleft lip and palate during puberty. Carthesian x, y coordinates of the total of 22 landmarks on the lateral films of 25 patients with the same diagnosis and therapy were established, which served as outcome data for shape analysis. The changes in facial shape experienced by patients between their 10th and 15th year were evaluated by the thin-plate splines (TPS) method. We used the TPS method to find a function which transforms the shape of the face at the age of 10 as well as the square TPS grid into the facial shape at the age of 15 years with the deformed TPS grid. With the help of Geometric PCA for Bookstein's coordinates we found individuals with different shapes who develop abnormally during puberty and whose development is not well predictable. During puberty the face becomes relatively elongated. The most pronounced deformation is caused by the shift of the first permanent molar anteriorly, or a relative shortening of the frontal part of the dental arch. In the anterior direction the position of landmarks changed only in the area of nose; the alveolar process shows retrusion. The position of the mandible in relation to the maxilla change mainly in the inferior direction; the mandibular angle shifts posteriorly. The shape of skeletal profile was compared with a group of patients with the same diagnosis who underwent different therapy.

The skull of Wolfgang Amadeus Mozart predicates of his death.

W. A. Mozart died due to the consequences of chronic epidural hematoma after sustaining a dull injury to his head, probably at an early age. Exacerbation of the process was repeated over a period of many years and manifested itself as pyrexial disease, meningeal irritation with intense headaches. After the attack subsided, the illness manifested itself again. After the last attack of the likely infected nidus, Mozart died on December 5, 1791. Historic data about the composer's behavior indicate development of a temporal syndrome or temporal epilepsy with typical clinical manifestations.

Predicting the development of jaws in patients with complete unilateral cleft of the lip and palate.

The main objective of this study was to find a predictive multivariate model of jaw development in patients with the most frequent cleft malformation, i.e. complete unilateral cleft lip and palate (UCLP). The prediction is urgently needed from the clinical aspect. It will be possible to detect early adversely developing patients upon whom intensive care and adequate orthodontic treatment could be devoted in good time. The study is based on a long-term cephalometric follow-up of lateral X-rays of 48 boys with UCLP during puberty. Using multivariate methods we investigated the relationship of 75 craniofacial characteristics of size, shape and position during the time interval from 10 to 15 years of age. As the prediction of the development of the jaws in patients with clefts is very complicated, we have attempted to find a reliable predictive system. Sagittal intermaxillary relations can be predicted most accurately in the investigated group by means of the angular dimension Ss-N-Sm (A-N-B angle). We suggest using in clinical practice trinomial equations, the coefficient of determination of which varies round 0.80, and thus the position of the variables can be explained with sufficient accuracy (the coefficient of determination 0.64 is considered in orthodontics a value of predictive significance). The proposed predictive technique was successfully tested in a group of 12 patients with the same diagnosis and therapy.

The development of intracranial relations in patients with complete unilateral cleft lip and palate in relation to surgery method and gender aspect.

This study focuses on cranium development during puberty growth spurt in patients with complete unilateral cleft of the lip and palate (UCLPc) after use of various surgery methods. Next, this study focuses on cranium development differences between the genders in patients undergoing operations by the same method, as well as comparison of intracranial relations between impaired and healthy individuals. The work is based on longitudinal cephalometric measurement of X-ray films and it is interpreted by cluster analysis. It focuses mainly on mutual interrelations of linear dimensions (meaning longitudinal and vertical) with angular dimensions (characteristic of shape and position). Mutual relationships of linear characteristics were closer than its relationship with the angular characteristics and characteristics of shape and position were mutually closely related than with characteristics of the size. The development of the cranial shape in regards to the linear dimensions is influenced particularly by the depth of maxilla, the length of the ramus of the mandible, and the height of the upper face. The study confirms the least positive development of cranium in boys with a bone graft. Girls undergoing operations with the same technique have the advantage of earlier growth termination of most parts of the cranium, which makes it possible to maintain the results of the therapeutical compensation of the defect.

Facial growth and development during the pubertal period in patients with complete unilateral cleft of lip one palate.

The study is based on a long-term cephalometric follow-up of lateral X-ray films of 48 boys with complete unilateral cleft lip and palate during puberty. The configuration of the face was negatively influenced by the reduced depth of the maxilla and limited vertical growth of the upper lip. As compared with the mandible, the maxilla grew less harmoniously in many respects; on the soft profile the depth of the nose increased most intensely. Retrusion of the maxilla led to a deterioration of sagittal intermaxillary relations in almost 92% of patients. In 32% of these patients the deterioration exceeded 3 of the ANB angle, and in 27% a transition from the 1st to the 3rd skeletal class was recorded. 25% of the subjects already belonged in class III at the age of ten years. In 94% of patients during puberty, flattening of the face occurred, which was frequently associated with a sunken upper lip (63%). Due to successful orthodontic treatment it was possible to restore maxillary overjet in 46% of the patients. In subjects who had a maxillary overjet of at least 2 mm at the age of 10 years, it did not change to negative values by the age of 15 years. Patients with more severe impairment of the jaws were treated more frequently by means of fixed appliances, but they did not differ substantially from the other patients in their further development (with the exception of a significant anteinclination of the palate).

Development of intracranial relations in patients aged 10 to 18 years with clefts of the lip and palate, using cluster analysis.

The investigation is based on a longitudinal cephalometric investigation of lateral teleroentgenographic pictures of male patients with a complete unilateral cleft of the lip and palate. Using cluster analysis the authors investigated the relationship of 75 craniofacial characteristics of size, shape and position during the time interval from 10 to 18 years of age. The main objective of the work was to characterize the development of intracranial relations during the pubertal spurt and compare the final condition in adulthood with a control group. The angle of the cranial base and its effect on the position of the mandibular joint did not change during the investigation period. The relationship between the rotation of the mandible and the inclination of the upper alveolar process with the protrusion of different parts of the skeletal profile also remained constant. Up to adulthood, the rotation of the mandible developed independently of the sagittal intermaxillary relations. The relationship between the sagittal intermaxillary relations and other parts of the face did, however, change. Before the onset of puberty it was influenced most by the reduced length of the maxilla. The inadequacy of maxillary growth was balanced during this period by a change in the shape and position of the mandible. Its adaptative capacities could not compensate later for this uneven development of the jaws potentiated by the pubertal growth spurt. Due to this the intermaxillary relations deteriorated at the end of development in the majority of patients. The association of the restricted vertical maxillary growth with its retroposition was manifested only in adulthood. Intracranial relations of the control group differed from those in the group with clefts. Sagittal intermaxillary and dental relations were not associated in healthy men. As individual probands were not linked by any restriction of growth or development, no close relationship developed between the shape characteristics of the lower jaw, which is the main compensatory adaptative mechanism.

Analysis of intracranial relations in patients with unilateral cleft lip and palate using cluster and factor analysis.

The present investigation was based on the cephalometric analysis of lateral teleroentgenographic pictures of 48 ten-year-old boys with complete unilateral clefts of the lip and palate. Using cluster and factor analysis, the author investigated the relationships among 75 craniofacial size, shape and position characteristics. Both multivariation methods proved useful in the search for associations between partial cranial structures. They supplemented each other well, and their combined use contributed to the definition of the following basic and specific principles of craniofacial relations and compensatory and adaptive mechanisms in patients with clefts. The maxilla consists of two mutually almost independent parts. The vertical parameters of the anterior upper face are interrelated with the slope of the palate plane; the dentoalveolar component of the upper jaw is formed independently. This fact can be aptly explained by the effect of orthodontic treatment, which contributes substantially to an improvement of the facial configuration. Rotation of the mandible has an impact on the vertical dimensions of the anterior lower, as well as the whole, face and is closely associated with the position of the mandibular body but not with the position of its branch nor with its length. The slope of the mandibular branch correlates with the mental angle, with the gonial angle and the slope of its dentoalveolar component, which is the result of adaptation to a shortening of the maxilla while preserving a positive overjet. Damage to the sagittal intermaxillary and interalveolar relations is primarily due to a reduction in the depth of the maxilla and is associated with the length of the mandibular body, while no relation with its rotation or length of the ramus was found. Solution of the given problem may help to find predictive models of facial development in patients with clefts.