A Treatise on the Continuum of Growth in the Aging Craniofacial Skeleton. (Volumes I and II) (Adult).

Abstract

From the records of the Bolton-Brush Studies, which comprise extensive longitudinal growth data collected in the 1930's and 1940's, some 113 of the original 6000 participants were recalled for new data collection. One hundred sixty three cases spanning ages 17-83 years (524 lateral cephalograms) were then utilized. The purpose was to determine the nature and extent of any adult craniofacial alterations which occurred. Cephalometric examinations revealed continuing growth of the craniofacial complex throughout all age levels, similar to typical adolescent alterations but of lesser magnitude and rates. Both size and shape changes were noted. Certain facial regions altered differentially with a considerable extent of enlargement. Lesser but consistent changes were noted for many other areas. In young adulthood, directions of growth were specific to an individual's growth pattern and sex. In later adulthood, vertical dimensional changes appeared to be a common alteration. Some soft tissue alterations were dramatic, more so than among most skeletal alterations. These involved primarily elongation of the nose and relative flattening of the lips. Definite differences in the nature and extent of some changes were found between males and females. Typically, females grew less, and their growth was more vertical. Forward rotation of the m and ible in the male and a converse direction in females were common. Sexual dimorphic features were especially prominent in the orbital region. Data suggest that females undergo a generalized growth deceleration in their teens but with re-acceleration in the twenties. Orthodontically treated cases and individuals with multiple tooth loss demonstrated continuous adult changes, but the nature and amount were different. These involved midfacial and m and ibular size and position. Recall studies are continuing as there are many implications for medicine and dentistry involved in a craniofacial complex that undergoes known and predictable adult changes.