Craniofacial Morphology in Children with Growth Hormone Deficiency and Turner Syndrome

Abstract

The review aims to collect and demonstrate recent knowledge about craniofacial morphology in growth hormone (GH)-deficient children and children with Turner syndrome. The review describes also the effects of growth hormone treatment on craniofacial morphology of children with growth hormone deficiency and Turner syndrome. Regardless of the disorder it accompanies, short stature is associated with similar craniofacial features characteristic of all short-statured children. Characteristic craniofacial features involve lesser dimensions of the cranial base and mandibular length, proportionately smaller posterior than anterior facial height, retrognathic face, and posterior rotation of the mandible. We also analyze orthodontic treatment in children affected by disorders associated with GH deficiency or provided with growth hormone treatment in the aspect of craniofacial growth. Recent publications show also the connection between growth hormone receptor polymorphism and craniofacial growth. Specialists and orthodontists treating short-statured children must be aware of the results of studies on craniofacial morphology and educate themselves on the topic of craniofacial growth in children with short stature. Moreover, knowledge of the influence of GH therapy on growth of craniofacial structures is necessary to decide the proper timing and planning of orthodontic treatment.

The Role of GH/IGF Axis in Dento-Alveolar Complex from Development to Aging and Therapeutics: A Narrative Review

“…Craniofacial morphology and dental maturity in children with reduced somatic growth of different etiology have been recently reviewed [ 80 , 81 ]. Based on the published craniofacial and dental characteristics of children with isolated GH deficiency, with idiopathic short stature, small for gestational age and/or with intrauterine growth retardation, and of short-statured children of genetic origin (Silver-Russell syndrome, Turner syndrome, familial dwarfism), the authors concluded that children with short stature of different origins develop similar craniofacial characteristics, including smaller lengths of the cranial base and the mandible, and proportionately smaller posterior than anterior facial height, retrognathic face, and posterior rotation of the mandible.…”

Muscle insulin-like growth factor-I modulates murine craniofacial bone growth

“…Since orthodontic treatment is a common need among diseases with craniofacial abnormalities (Barton and Crowder, 2010;Hwang and Cha, 2004;Wójcik and Beń-Skowronek, 2020), the benefits of muscle IGF-I in the mandibular region were further studied. In mIgf1 +/+ mice, the mandibular plane angle was smaller during the active growth in the equivalent adolescent phase when compared to WT animals (Fig.…”

“…Specifically, local IGF-I administration into the muscle had the capacity to alter bone growth. This posits a major benefit in targeting specific bone growth either vertically or horizontally for correcting any disproportionate growth in the craniofacial bone that occurs in children with GHD, as children with GHD tend to have smaller mandible and facial proportions when compared to the calvarial region (Wójcik and Beń-Skowronek, 2020). Although the present study did not address if this effect could be extended to adult animals, the influence of IGF-I on an adult mandibular condylar growth plate may be akin to the present study given that secondary cartilage contains undifferentiated mesenchyme differing to the appendicular primary skeletal cartilage.…”

“…There is an interaction between mechanical loading and local IGF-I levels in load-mediated bone anabolism Introduction Craniofacial structures of children with GHD and severe IGFD appear abnormal due to delayed growth in isolated regions. In addition to the appearance of a childish face but with a large skull, they often require orthodontic treatment due to higher incidence of tooth crowding (Hwang and Cha, 2004;Wójcik and Beń-Skowronek, 2020). Indeed, disproportionate growth occurs in the jaw and cranial base structures of boys with short stature, with the addition of delayed tooth eruption (Kjellberg et al, 2000).…”

“…Indeed, disproportionate growth occurs in the jaw and cranial base structures of boys with short stature, with the addition of delayed tooth eruption (Kjellberg et al, 2000). Thus, GH replacement therapy combined with orthodontic treatment is a standard regimen for children with GHD ( Barton and Crowder, 2010;Hwang and Cha, 2004;Wójcik and Beń-Skowronek, 2020).…”