A three-dimensional analysis of the effect of atopy on face shape

Three-Dimensional Stereophotogrammetry Facial Morphologic Signatures of Temporomandibular Disorders

AIM

To utilize stereophotogrammetry to investigate changes in three-dimensional (3D) facial morphology in both TMD-free individuals and TMD patients, both before and after treatment, and to classify subjects as either TMD-free or TMD patients.

METHODS

40 participants (TMD and TMD-free, mean age of 38.9 ± 15.3 years) were recruited from the Oral Medicine Clinic at the Faculty of Dentistry, University of Otago. Participants were given a questionnaire, and 3D images of their faces at maximum mouth opening and in occlusion were recorded using the 3dMDtrio craniofacial scanner. Participants were followed up after 3 months and 6 months. The 3D images captured were analysed using the 3dMD Vultus software.

RESULTS

Significant changes were observed between baseline and 3-month follow-up measurements in TRAR-GoR(C), GoR-GN(C) and LS-PG(O) (p < 0.05). At the 6-month follow-up, additional significant differences were found in G-PG(R), TRAL-SN(C), TRAR-GoR(C), GoR-GN(C), LS-PG(O), and maximum mouth opening (MMO) (p < 0.05). TRAR-GoR(C), LS-PG(O), TRAL-GoL(C), MMO, and TRAR-SN(C) exhibited significant correlations. LS-PG(R) was the most reliable predictor. Discriminant analysis revealed an 85% sensitivity and 90% specificity in classifying individuals with and without TMD.

CONCLUSION

Significant 3D morphological changes were detected in TMD patients' post-treatment, with notable mouth opening and masseter muscle volume reduction.

Study on anti-inflammatory effect of peptides-conjugated alumina nanoparticle on allergic rhinitis mice model

Allergic rhinitis (AR) is a common atopic problem in which immune response to the environmental factors leads to clinical symptoms. Helicobacter pylori neutrophil-activating protein (HP-NAP) as a peptide attenuates Th2 response and stimulates Th1 activation and mucus adhesion promoting protein (MapA) as a cell-surface protein binds to mucus. This study evaluated the effect of HP-NAP and MapA conjugated with alumina nanoparticle on AR. HP-NAP and HP-NAP with MapA were conjugated to alumina nanoparticle and two separate nanoparticles were produced. The AR mice were treated with these and HP-NAP in peptide form. The AR symptoms, gene expression of mucus, levels of IL-33 and IL-4, and total and ovalbumin (OVA)-specific IgE levels were evaluated. Nasal rubbing, sneezing, gene expression of mucus, and IL-33 and IL-4 levels, and OVA-specific and total IgE were decreased in three treated groups compared to AR, and there was a significant decrease in the symptoms in AR-H-M-A group (P < 0.05) when compared to the other treated groups. HP-NAP has a controlling effect on AR, and in nanoparticle-conjugated form it can strongly attach to the airway's mucus via MapA. Therefore, cooperation of HP-NAP-alumina with MapA can produce an effective and applicable treatment for AR.

The role of craniofacial maldevelopment in the modern OSA epidemic: a scoping review

OBJECTIVES

There is increasing recognition that environmental factors affect human craniofacial development and our risk for disease. A scoping review of the literature was performed looking at environmental influences on craniofacial development to better understand this relationship and investigate what further study is needed to determine how this relationship may impact obstructive sleep apnea.

METHODS

A comprehensive literature search was performed using the Ovid Medline database from inception to May 2020 with relevance to craniofacial development in 5 clinically oriented variables: diet, secular change, breastfeeding/nonnutritive sucking habits, nasal obstruction/mouth breathing, and masticatory muscle function. The Oxford Centre for Evidence-Based Medicine Levels of Evidence was used to assess studies based on study design.

RESULTS

We initially identified 18,196 articles, of which 260 studies were fully reviewed and 97 articles excluded. The remaining 163 articles were categorized as follows: secular change (n = 16), diet (n = 33), breastfeeding/nonnutritive sucking habits (n = 28), nasal obstruction/mouth breathing (n = 57), and masticatory muscle function (n = 35). Ninety-three percent of included studies reported a significant association between craniofacial morphology and environmental factors. The majority of studies were characterized as low-level-of-evidence studies, with 90% of studies being a level-of-evidence of 4 or 5.

CONCLUSIONS

The studies in this review suggest that environmental factors are associated with changes in craniofacial development. However, most studies were heterogeneous and low-level studies, making strong conclusions about these relationships difficult. Future rigorous studies are needed to further our understanding of environmental influences on craniofacial development and obstructive sleep apnea risk.

CITATION

Yu JL, Tangutur A, Thuler E, Evans M, Dedhia RC. The role of craniofacial maldevelopment in the modern OSA epidemic: a scoping review. J Clin Sleep Med. 2022;18(4):1187-1202.

Brief Report: Facial Asymmetry and Autistic-Like Traits in the General Population

Atypical facial morphology, particularly increased facial asymmetry, has been identified in some individuals with Autism Spectrum Conditions (ASC). Many cognitive, behavioural and biological features associated with ASC also occur on a continuum in the general population. The aim of the present study was to examine subthreshold levels of autistic traits and facial morphology in non-autistic individuals. Facial asymmetry was measured using three-dimensional facial photogrammetry, and the Autism-spectrum Quotient was used to measure autistic-like traits in a community-ascertained sample of young adults (n = 289). After accounting for covariates, there were no significant associations observed between autistic-like traits and facial asymmetry, suggesting that any potential facial morphology differences linked to ASC may be limited to the clinical condition.

Exploring the midline soft tissue surface changes from 12 to 15 years of age in three distinct country population cohorts

INTRODUCTION

Several studies have highlighted differences in the facial features in a White European population. Genetics appear to have a major influence on normal facial variation, and environmental factors are likely to have minor influences on face shape directly or through epigenetic mechanisms.

AIM

The aim of this longitudinal cohort study is to determine the rate of change in midline facial landmarks in three distinct homogenous population groups (Finnish, Latvian, and Welsh) from 12.8 to 15.3 years of age. This age range covers the pubertal growth period for the majority of boys and girls.

METHODS

A cohort of children aged 12 were monitored for facial growth in three countries [Finland (n = 60), Latvia (n = 107), and Wales (n = 96)]. Three-dimensional facial surface images were acquired (using either laser or photogrammetric methods) at regular intervals (6-12 months) for 4 years. Ethical approval was granted in each country. Nine midline landmarks were identified and the relative spatial positions of these surface landmarks were measured relative to the mid-endocanthion (men) over a 4-year period.

RESULTS

This study reports the children who attended 95 per cent of all scanning sessions (Finland 48 out of 60; Latvia 104 out of 107; Wales 50 out of 96). Considerable facial variation is seen for all countries and sexes. There are clear patterns of growth that show different magnitudes at different age groups for the different country groups, sexes, and facial parameters. The greatest single yearly growth rate (5.4 mm) was seen for Welsh males for men-pogonion distance at 13.6 years of age. Males exhibit greater rates of growth compared to females. These variations in magnitude and timings are likely to be influenced by genetic ancestry as a result of population migration.

CONCLUSION

The midline points are a simple and valid method to assess the relative spatial positions of facial surface landmarks. This study confirms previous reports on the subtle differences in facial shapes and sizes of male and female children in different populations and also highlights the magnitudes and timings of growth for various midline landmark distances to the men point.

Alterações bucais associadas à presença de atopia em crianças: um estudo transversal

Resumo Introdução É por meio da interação entre ambiente, indivíduo, sua predisposição à atopia e exposição a alérgenos que surgem as doenças alérgicas. Em crianças atópicas, foi observada uma alta prevalência de padrão respirador bucal, assim como resposta positiva a testes alérgicos. Essas alterações respiratórias possuem uma associação com deformidades orofaciais, especialmente as maloclusões. Objetivo Identificar a frequência de crianças e adolescentes portadores de alergias e buscar uma provável associação entre atopia e maloclusão, traumatismos dentoalveolares e hábitos bucais viciosos. Material e método Foram avaliados prontuários de crianças e adolescentes atendidos em duas instituições particulares de ensino da cidade do Rio de Janeiro no período compreendido entre agosto de 2017 e julho de 2018. Foram coletados dados do prontuário relacionados ao histórico médico, odontológico e de alergias. Os dados foram analisados descritivamente e por meio do teste qui-quadrado (p<0,05). Resultado Um total de 136 prontuários foi considerado elegível para avaliação. Durante a anamnese, 49 responsáveis (36%) relataram histórico de alergias em suas crianças e adolescentes. A prevalência de hábitos bucais viciosos foi verificada em 87 pacientes (64%), sendo presente em 65,3% de crianças e adolescentes que apresentavam atopia (p<0,05). Conclusão A prevalência de alergias relatada nesta população foi de 34,6%, e foi observada ainda uma alta prevalência de hábitos bucais viciosos e traumatismos dentoalveolares nesses pacientes. Foram constatadas associações significativas entre presença de atopias e histórico de traumatismos dentários, maloclusão e hábitos viciosos, demonstrando haver correlação entre atopia e alguns aspectos de saúde oral.

Spatially Dense 3D Facial Heritability and Modules of Co-heritability in a Father-Offspring Design

Introduction: The human face is a complex trait displaying a strong genetic component as illustrated by various studies on facial heritability. Most of these start from sparse descriptions of facial shape using a limited set of landmarks. Subsequently, facial features are preselected as univariate measurements or principal components and the heritability is estimated for each of these features separately. However, none of these studies investigated multivariate facial features, nor the co-heritability between different facial features. Here we report a spatially dense multivariate analysis of facial heritability and co-heritability starting from data from fathers and their children available within ALSPAC. Additionally, we provide an elaborate overview of related craniofacial heritability studies.

Methods: In total, 3D facial images of 762 father-offspring pairs were retained after quality control. An anthropometric mask was applied to these images to establish spatially dense quasi-landmark configurations. Partial least squares regression was performed and the (co-)heritability for all quasi-landmarks (∼7160) was computed as twice the regression coefficient. Subsequently, these were used as input to a hierarchical facial segmentation, resulting in the definition of facial modules that are internally integrated through the biological mechanisms of inheritance. Finally, multivariate heritability estimates were obtained for each of the resulting modules.

Results: Nearly all modular estimates reached statistical significance under 1,000,000 permutations and after multiple testing correction (p ≤ 1.3889 × 10^-3), displaying low to high heritability scores. Particular facial areas showing the greatest heritability were similar for both sons and daughters. However, higher estimates were obtained in the former. These areas included the global face, upper facial part (encompassing the nasion, zygomas and forehead) and nose, with values reaching 82% in boys and 72% in girls. The lower parts of the face only showed low to moderate levels of heritability.

Conclusion: In this work, we refrain from reducing facial variation to a series of individual measurements and analyze the heritability and co-heritability from spatially dense landmark configurations at multiple levels of organization. Finally, a multivariate estimation of heritability for global-to-local facial segments is reported. Knowledge of the genetic determination of facial shape is useful in the identification of genetic variants that underlie normal-range facial variation.

Facial Genetics: A Brief Overview

Historically, craniofacial genetic research has understandably focused on identifying the causes of craniofacial anomalies and it has only been within the last 10 years, that there has been a drive to detail the biological basis of normal-range facial variation. This initiative has been facilitated by the availability of low-cost hi-resolution three-dimensional systems which have the ability to capture the facial details of thousands of individuals quickly and accurately. Simultaneous advances in genotyping technology have enabled the exploration of genetic influences on facial phenotypes, both in the present day and across human history. There are several important reasons for exploring the genetics of normal-range variation in facial morphology.     - Disentangling the environmental factors and relative parental biological contributions to heritable traits can help to answer the age-old question "why we look the way that we do?"     - Understanding the etiology of craniofacial anomalies; e.g., unaffected family members of individuals with non-syndromic cleft lip/palate (nsCL/P) have been shown to differ in terms of normal-range facial variation to the general population suggesting an etiological link between facial morphology and nsCL/P.     - Many factors such as ancestry, sex, eye/hair color as well as distinctive facial features (such as, shape of the chin, cheeks, eyes, forehead, lips, and nose) can be identified or estimated using an individual's genetic data, with potential applications in healthcare and forensics.     - Improved understanding of historical selection and adaptation relating to facial phenotypes, for example, skin pigmentation and geographical latitude.     - Highlighting what is known about shared facial traits, medical conditions and genes.

The influence of snoring, mouth breathing and apnoea on facial morphology in late childhood: a three-dimensional study

OBJECTIVE

To explore the relationship between the prevalence of sleep disordered breathing (SDB) and face shape morphology in a large cohort of 15-year-old children.

DESIGN

Observational longitudinal cohort study

SETTING

Avon Longitudinal Study of Parents and Children (ALSPAC), South West of England.

PARTICIPANTS

Three-dimensional surface laser scans were taken for 4784 white British children from the ALSPAC during a follow-up clinic. A total of 1724 children with sleep disordered breathing (SDB) and 1862 healthy children were identified via parents' report of sleep disordered symptoms for their children. We excluded from the original cohort all children identified as having congenital abnormalities, diagnoses associated with poor growth and children with adenoidectomy and/or tonsillectomy.

MAIN OUTCOME MEASURES

Parents in the ALSPAC reported sleep disordered symptoms (snoring, mouth breathing and apnoea) for their children at 6, 18, 30, 42, 57, 69 and 81 months. Average facial shells were created for children with and without SDB in order to explore surface differences.

RESULTS

Differences in facial measurements were found between the children with and without SDB throughout early childhood. The mean differences included an increase in face height in SDB children of 0.3 mm (95% CI -0.52 to -0.05); a decrease in mandibular prominence of 0.9° (95% CI -1.30 to -0.42) in SDB children; and a decrease in nose prominence and width of 0.12 mm (95% CI 0.00 to 0.24) and 0.72 mm (95% CI -0.10 to -0.25), respectively, in SDB children. The odds of children exhibiting symptoms of SDB increased significantly with respect to increased face height and mandible angle, but reduced with increased nose width and prominence.

CONCLUSIONS

The combination of a long face, reduced nose prominence and width, and a retrognathic mandible may be diagnostic facial features of SBD that may warrant a referral to specialists for the evaluation of other clinical symptoms of SDB.