Morphological changes of human mandibular bone during fetal periods

Fetal facial bone growth: Post-mortem CT analysis

OBJECTIVE

To describe and model the normal growth of fetal facial bones and angles.

MATERIAL AND METHODS

A total of 118 fetal CT scans obtained at 19 to 41 weeks gestation after in utero fetal death or late miscarriage were analyzed. CT scan was followed by autopsy and pathological examination and only fetuses free from brain disease or abnormal craniofacial development were included. The measurements were taken using software for frontal, sagittal and 3D reconstruction from native axial sections. The optimal plane for bone analysis was chosen and the measurements made by multiplanar reconstruction.

RESULTS

There was a statistically significant increase (P<0.001) in all measurements regardless of gestational age (GA) except those of the mandibulo-fronto-maxillary angle (P=0.412), the naso-mandibulo-maxillary angle (P=0.828) and mandibular width (P=0.86). There was no significant difference according to fetal sex. Based on these results, the corresponding growth curves were created. The anteroposterior mandibular diameter (APD) was very strongly correlated with GA (R=0.926, P<0.001). The following equation: GA=(8.187×APD)+4.257 can be used to estimate GA with a confidence interval (CI) of±2.42. The same applies to maxillary width (MW) (R=0.922; P<0.001). The equation GA=(11.059×MW)+7.571 can be used to estimate GA with a CI of 2.17.

CONCLUSION

The growth of the mandible, maxilla, zygomatic bone and orbits was measured and the corresponding growth curves were established. Several measurements were strongly correlated with gestational age.

Morphometric Development of the Mandible in Fetal Cadavers

PURPOSE

The aim of this study is to present reliable data by measuring the morphometric properties of the mandible in the fetal period.

METHODS

A study was performed on mandibles of 35 fetuses (18 male fetuses and 17 female fetuses), aged between 21 and 40 weeks of gestation. Fetuses were examined in 3 groups according to their developmental stages: 2nd trimester, 3rd trimester, and full-term. Morphometric measurements were performed for both the right and left sides of each mandible. The measurements of the mental foramen were performed using a digital caliper, and other measurements were performed using the ImageJ program. The data obtained were analyzed using the SPSS 20 for Windows program.

RESULTS

There was no significant gender difference for all parameters. When the parameters were compared by the trimesters, no significant difference was determined in the 2nd trimester - 3rd trimester, 3rd trimester-full-term, and second trimester - full-term comparisons of the angle of the mandible, and there was a significant difference in all other parameters (P < 0.05). According to the trimesters, all parameters, except the angle of the mandible, increased naturally with the development of the mandible. It was observed that the angle of the mandible decreased from the 2nd trimester to the 3rd trimester and increased from the 3rd trimester to the full term. When the right and left measurements were compared, no significant difference was found for all parameters in both general and trimester groups.

CONCLUSION

The present study includes fetal mandibular parameters that have not been reported elsewhere. It is thought that the obtained data will contribute to the determination of anomalies, pathologies, and variations.

Análise do crescimento das dimensões da mandíbula em diferentes idades fetais

OBJETIVO: verificar se há assimetria de crescimento entre as hemimandíbulas esquerda e direita, durante o 2º e início do 3º trimestre de gestação. MÉTODOS: foram utilizadas 68 hemimandíbulas (34 mandíbulas) de fetos conservados em solução de formalina a 10%, sendo 20 femininos e 14 masculinos, e realizadas as seguintes mensurações: Côndilo-Processo Coronoide (Co-PC), Gônio-Processo Coronoide (Go-PC), Gônio-Gnátio (Go-Gn), Côndilo-Gnátio (Co-Gn), Altura da Sínfise (AS) e Ângulo da Mandíbula (AM). Os dados foram coletados, tabulados e analisados com auxílio do programa SPSS, versão 11.0, 2005, onde foi realizado o estudo One Way Anova para a comparação entre as médias dos valores das medidas anatômicas das hemimandíbulas direita e esquerda, sendo a idade dividida entre segundo trimestre (Período 1: 13-18 semanas e Período 2: 18-24 semanas), e início do terceiro trimestre (Período 3: 24-30 semanas) de gestação. RESULTADOS: houve discreta assimetria no ritmo de crescimento das medidas Go-Gn, Co-PC, Co-Gn, Go-PC e AS, comparando-se os lados direito e esquerdo, entre o 2º e início do 3º trimestre gestacional, apesar de não estatisticamente significativa (p > 0,05). Constatou-se, também, que houve redução da medida AM, com discreta assimetria, no mesmo período pré-natal, sendo estatisticamente significativa (p < 0,05). CONCLUSÃO: não foram observadas diferenças estatísticas significativas quanto ao crescimento das hemimandíbulas direita e esquerda no período estudado. Por outro lado, houve redução da medida do ângulo da mandíbula no mesmo período, apresentando significância estatística.

[Genes, forces and forms: mechanical aspects of prenatal craniofacial development]

Current knowledge of molecular signaling during craniofacial development is advancing rapidly. We know that cells can respond to mechanical stimuli by biochemical signaling. Thus, the link between mechanical stimuli and gene expression has become a new and important area of the morphological sciences. This field of research seems to be a revival of the old approach of developmental mechanics, which goes back to the embryologists His [36], Carey [13, 14], and Blechschmidt [5]. These researchers argued that forces play a fundamental role in tissue differentiation and morphogenesis. They understood morphogenesis as a closed system with living cells as the active part and biological, chemical, and physical laws as the rules. This review reports on linking mechanical aspects of developmental biology with the contemporary knowledge of tissue differentiation. We focus on the formation of cartilage (in relation to pressure), bone (in relation to shearing forces), and muscles (in relation to dilation forces). The cascade of molecules may be triggered by forces, which arise during physical cell and tissue interaction. Detailed morphological knowledge is mandatory to elucidate the exact location and timing of the regions where forces are exerted. Because this finding also holds true for the exact timing and location of signals, more 3D images of the developmental processes are required. Further research is also required to create methods for measuring forces within a tissue. The molecules whose presence and indispensability we are investigating appear to be mediators rather than creators of form.

Genes, forces, and forms: mechanical aspects of prenatal craniofacial development

Current knowledge of molecular signaling during craniofacial development is advancing rapidly. We know that cells can respond to mechanical stimuli by biochemical signaling. Thus, the link between mechanical stimuli and gene expression has become a new and important area of the morphological sciences. This field of research seems to be a revival of the old approach of developmental mechanics, which goes back to the embryologists His (1874), Carey (1920), and Blechschmidt (1948). These researchers argued that forces play a fundamental role in tissue differentiation and morphogenesis. They understood morphogenesis as a closed system with living cells as the active part and biological, chemical, and physical laws as the rules. This review reports on linking mechanical aspects of developmental biology with the contemporary knowledge of tissue differentiation. We focus on the formation of cartilage (in relation to pressure), bone (in relation to shearing forces), and muscles (in relation to dilation forces). The cascade of molecules may be triggered by forces, which arise during physical cell and tissue interaction. Detailed morphological knowledge is mandatory to elucidate the exact location and timing of the regions where forces are exerted. Because this finding also holds true for the exact timing and location of signals, more 3D images of the developmental processes are required. Further research is also required to create methods for measuring forces within a tissue. The molecules whose presence and indispensability we are investigating appear to be mediators rather than creators of form.

Determination of dimensions and angles of mandible in the fetal period

The aim of the present study was to determine the dimensions of the mandible during the fetal period, the relationship between the growth rates of the angle of the mandible and the dimensions of the mandible. Furthermore the angle of union of the two halves of the body of the mandible on the horizontal mandibular plane, which was not described elsewhere, is explored in this study. One hundred and sixty-one human fetuses (83 males and 78 females) without any cranio-facial or mandibular asymmetry, external pathology or anomaly and aged between 9 and 40 weeks of gestation were used in the study. Cases were stratified into four groups according to their developmental ages, that is, first trimester, second trimester, third trimester, and term fetuses. Cranio-facial parameters in addition to bi-condylar, bi-gonial, bi-mental tubercular, condyle-gonion, gonion-mental tubercle, condyle-mental tubercle, gonion-pogonion distances were measured. The degree of the angle of the mandible, angle of union of the two halves of the body of the mandible and sagittal length of the base of the mandible were calculated. The means of the parameters with respect to gestational weeks and groups were computed. While there were no sex differences in any of the parameters (P>0.05) there were very significant relationships between gestational age and parameters (P<0.001). The mean degree of the angle of the mandible during the fetal period was 122+/-8 degrees . The mean alpha angle of the base of the mandible was 65+/-8 degrees . None of these angles varied significantly throughout the fetal period. Height of the ramus of the mandible increased more than the length of the body of the mandible and bi-gonial distance in the first and second trimesters while in the third trimester and term period they increased at the same rate. Comparisons of groups for the ratio of the transverse to the sagittal lengths of the mandible revealed significant differences between first and second trimesters with term group (P<0.05). Accordingly, bi-gonial distance of the mandible increased more during the third trimester and term time than the first and second trimesters, compared with the sagittal length of the mandible. The morphometric features and architectural changes observed in the mandible do not totally occur during the fetal period but continue later in childhood and adulthood.

Bone remodeling during prenatal morphogenesis of the human mental foramen

From a morphogenetic point of view, the mental foramen of the mandible is a highly suitable model to study the interactions of different tissues such as nerves, vessels, mesenchymal cells, cartilage, and bone. In previous work, we provided a three-dimensional description of the mental foramen at different developmental stages, and now we complement those studies with a three-dimensional visualization of different bone remodeling activities around the mental foramen. Histological serial sections of human embryos and fetuses, ranging in size from 25 to 117 mm crown-rump-length (CRL), were used to characterize the bone remodeling activity (apposition, inactivity, and resorption). We quantified and reconstructed this activity in three dimensions, and included information on the spatial relationship of the nerves, vessels, and dental primordia. In general, the mandible showed strong apposition at its outer surfaces. The brim of the mental foramen, however, displayed changing remodeling activity at different stages. In the depth of the bony gutter, which provides space for the nerve and the blood vessels, we found bone resorption beneath the inferior alveolar vein. Bone was also resorbed in proximity to the dental primordia. In future studies, we will relate gene expression data to these morphological findings in order to identify molecular mechanisms that regulate this complex system.

Prenatal development of the muscles in the floor of the mouth in human embryos and fetuses from 6.9 to 76 mm CRL

The development of the muscles in the floor of the mouth is described in 10 human embryos and fetuses ranging from 6.9 to 76 mm CRL by means of computer-aided graphical 3D-reconstructions. All primordia of the muscles in the floor of the mouth could be identified from the 15.6 mm CRL stage on. The proportions and insertion lines of the early muscles were found to be different from adult anatomy. Each muscle first inserted in the medial surface of Meckels cartilage, but during the developmental period between 19 and 68 mm CRL the insertion lines were gradually transposed to the bony ridges of the mandible which progrediently embraced Meckels cartilage. The fibers of the mylohyoid muscles left the anterior region near the symphysis mentalis free during all stages of this study. The digastric muscle revealed only one belly with a constriction of its continuous fibers where it passed the hyoid bone primordium. There was no attachment of digastric muscle fibers to the hyoid; only geniohyoid and mylohyoid fibers. Geniohyoid and genioglossus muscles basically correspond to their definite arrangement, but they underwent proportional changes. Individual specimens embodied irregularities such as accessory geniohyoid and hyoid portions and muscle fibers separate from the mylohyoide muscle.