Craniofacial Growth Prediction in Different Facial Types

摘要 循证儿科实践需要透彻地理解在缺乏 干预。儿童和青少年颅面畸形的合理治疗计划需求 这既是对患者当前面部发育状况的准确评估，也是对未来发育的预测。然而， 目前得出这些信息的方法是不充分的。目前，还没有参考图表或实用图表 对这些参数进行个性化评估的工具，不仅要考虑性别和时间顺序 年龄，但面部类型，颈椎成熟度，以及既往的头面部测量。 我们将在1,104人的13,000多张头颅侧位片上识别地标，每个地标都在 在青春期中期前后至少观察两次，目的是建立一个预测年龄的模型 青春期颅面生长的开始、峰值速度和停止，以及 给定的个人。我们总共将评估来自5,803名0-24岁个人的30,000多张头颅侧位片 为了构建多个头面部特征的生长曲线，需要数年的时间。 这些数据来自由美国正畸医生协会组成的九项生长研究 基金会遗产收藏。通过对这些数据的分析，提出的研究将1)估计 多个头面部特征的青春期发育和成年大小的群体和个体水平的时间，2) 根据性别和年龄，提供颅面长度、角度和比率的诊断参考图，3)发展 预测颅面部剩余生长/变化和青春期生长突增时间的预测工具 特点，4)通过易于使用的免费网络将这些有价值的资源提供给临床医生和研究人员- 基于应用，以及5)应用几何形态测量技术来扩展当前的临床视野 对颅面生长进行量化。 这项拟议的研究明确地解决了NIDCR的目标，即将临床和人口健康结合起来 改进诊断和优化结果的方法。在这个项目完成时，临床实践 将通过提供简单易用的基于Web的工具来诊断当前状态来改进 头面部测量和基于当前测量的预测未来生长，性别，年龄，面部类型， 颈椎成熟度和过去的测量。此外，科学知识将得到提高 通过传播有关人口水平的颅面长度参考值的信息， 角度、比率，以及使用几何形态计量学分析对颅面整体生长的评价。 拟议研究的总体影响将是临床管理的转变 参考文献，儿童颅面外科患者向更循证的治疗计划迈进 以及基于北美最大的头影测量数据的预测。

Abstract Evidence-based pediatric practice requires a thorough understanding of growth in the absence of intervention. Proper treatment planning for craniofacial abnormalities in children and adolescents demands both an accurate assessment of a patient's current facial growth status and a prediction of future growth. Yet, current methods to derive this information are inadequate. Presently, there are no reference charts or practical tools for individualized assessment of these parameters that take into account not only sex and chronological age, but also facial type, cervical vertebral maturity, and past craniofacial measurements. We will identify landmarks on over 13,000 lateral cephalographs from 1,104 individuals, each with at least two observations before and after mid-puberty, for the purpose of building a model to predict the ages of onset, peak velocity, and cessation of pubertal craniofacial growth, and the amount of growth remaining for a given individual. Altogether, we will assess over 30,000 lateral cephalographs from 5,803 individuals, age 0-24 years for the purpose of constructing growth charts for multiple craniofacial traits. These data come from nine growth studies comprising the American Association of Orthodontists Foundation Legacy Collection. Through the analysis of these data, the proposed research will 1) estimate population- and individual-level timing of pubertal growth and adult size for multiple craniofacial traits, 2) provide diagnostic reference charts for craniofacial lengths, angles, and ratios given sex and age, 3) develop prognostic tools to predict remaining growth/change and the timing of the pubertal growth spurt for craniofacial traits, 4) make these valuable resources available to clinicians and researchers via an easy-to-use free web- based application, and 5) apply geometric morphometric techniques to extend current clinical views of quantifying craniofacial growth. The proposed research clearly addresses NIDCR's goal of integrating “clinical, and population health approaches to improve diagnostics and optimize outcomes.” At the completion of this project, clinical practice will be improved through the availability of easy-to-use web-based tools for diagnosing current status based on craniofacial measurements and predicting future growth based on current measurements, sex, age, facial type, cervical vertebral maturation, and past measurements. Additionally, scientific knowledge will be improved through the dissemination of information regarding population-level reference values for craniofacial lengths, angles, and ratios, and an evaluation of integrated craniofacial growth using geometric morphometric analysis. The overall impact of the proposed research will be a shift in the clinical management of pediatric craniofacial patients toward more evidence-based treatment planning, utilizing references and predictions based on data from the largest North American cephalometric collections.