A Systematic Review Of Cephalometric Normative Data In Children PDF Download

"Background: The head and neck consist of an intricate arrangement of bones, musculature, and airways playing a pivotal role in facial aesthetics, communication, chewing, swallowing, and breathing. Understanding the characteristics of craniofacial structures as well as their growth patterns in children is essential in orthodontic diagnosis and treatment planning. Rationale: Many separate studies report normative data on craniofacial structures in cross-sectional or longitudinal study designs. However, there is currently no systematic review compiling this information to evaluate consistency and the need for further normative data collection. Objectives: This study aims to aggregate normative data assessing the development of craniofacial skeletal structures in children with well-balanced face and normal occlusion; and identify different cephalometric characteristics between males and females and among races. Methods: With the help of a librarian from the McGill University library, Medline, Embase and Scopus were searched on 23 Dec 2020. Records were deduplicated in Endnote and resulted in 5,656 unique articles. Inclusion criteria were i) studies involving individuals with well-balanced face and normal occlusion, ii) subjects less than 18 years of age, iii) assessment of orofacial skeleton using a cephalometric analysis of hard tissues from 2D radiographs or 3D tomographs. In the first screening phase, 240 articles were selected based on review of titles and abstracts using Rayyan. In the second phase, 44 articles were selected after full text assessment, including 13 longitudinal studies and 31 cross-sectional studies, whose quality was appraised through a 10-point grading scale. Results: The review shows that, from childhood to adulthood, the length of cranial base increases significantly, while cranial base angle remains constant; the upper and lower jaws move forward and downward. Growth spurt occurs earlier in females; however, the great extent of growth lasts longer in males. Generally, males have longer linear parameters than females (except for similar Wits appraisal between sexes); however, difference of angular measurements between sexes is insignificant, with exception for greater mandibular plane angle in females from the age of 15 onwards. The profile becomes straighter with age as the growth of the mandible is greater than that of the maxilla. Regarding racial comparisons, when compared to whites, Asians present a shorter cranial base, more retrusive mandible, and more clockwise rotated mandible; black populations have a more protrusive maxilla. Whites tend to exhibit a straighter profile than Asians and blacks. Gaps in the literature are discussed. Conclusions: Here, we aggregate and synthesize knowledge from cephalometric investigations of children with a well-balanced face and normal occlusion. Our results indicate age-, sex- and race-dependent patterns in orofacial skeletal parameters. Therefore, normative data for age, sex, and race should be taken into account for diagnosis and treatment planning to better identify and serve different populations as well as for research on craniofacial morphology"--