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Three-Dimensional Normal Facial Growth from Birth to the Age of 7 Years

Krimmel, Michael M.D., D.M.D., Ph.D.; Breidt, Martin Ph.D.; Bacher, Margit D.D.S.; Müller-Hagedorn, Silvia M.D., D.D.S.; Dietz, Klaus Ph.D.; Bülthoff, Heinrich Ph.D.; Reinert, Siegmar M.D., D.M.D., Ph.D.; Kluba, Susanne M.D., D.M.D.

Plastic and Reconstructive Surgery: October 2015 - Volume 136 - Issue 4 - p 490e–501e
doi: 10.1097/PRS.0000000000001612
Pediatric/Craniofacial: Original Articles

Background: With the advent of computer-assisted three-dimensional surface imaging and rapid data processing, oral and maxillofacial surgeons and orthodontists are enabled to analyze facial growth three dimensionally. Normative data, however, are still rare and inconsistent. The aim of the present study was to establish a valid reference system and to give normative data for facial growth.

Methods: Three-dimensional facial surface images were obtained from 344 healthy Caucasian children (aged 0 to 7 years). The images were put in correspondence by means of six landmarks close to the skull base (exocanthion, endocanthion, otobasion inferius). Growth curves for 21 landmarks were estimated in the three dimensions.

Results: Facial regions close to the skull base (orbit and ear) showed a biphasic growth pattern, with accelerated growth during the first year of life that subsided to a decreased and linear velocity thereafter. Landmarks on the nose, lips, and chin demonstrated either a curvilinear or a linear growth pattern.

Conclusions: The rapid increase of the orbit and ear region in infancy is a secondary phenomenon to the rapid growth of the neurocranium during the first year of life. Thereafter, maxillary and mandibular growth prevails. The present study gives three-dimensional normative data for an expanded growth span between birth and childhood.

Supplemental Digital Content is available in the text.

Tübingen, Germany

From the Departments of Oral and Maxillofacial Surgery, Orthodontics, and Medical Biometry, University Hospital Tübingen; and the Max Planck Institute for Biological Cybernetics.

Received for publication October 24, 2014; accepted April 24, 2015.

Disclosure: Part of Dr. Bülthoff´s research was supported by the Brain Korea 21 PLUS Program through the National Research Foundation of Korea funded by the Ministry of Education. All other authors declare that they have no financial disclosures.

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Michael Krimmel, M.D., D.M.D., Ph.D., Klinik und Poliklinik für Mund-, Kiefer- und Gesichtschirurgie, Osianderstrasse 2-8, D-72076 Tübingen, Germany,

©2015American Society of Plastic Surgeons