Long-term Patterns of Age-Related Facial Bone Loss in Black Individuals

Abstract

IMPORTANCE Facial skeletal changes that occur with aging have critical importance to the aesthetics of the aging face and the field of facial rejuvenation. Patterns of bony change may differ based on race, but existing research is limited primarily to white or unspecified racial populations.OBJECTIVE To longitudinally document patterns of facial skeletal change among black individuals. DESIGN, SETTING, AND PARTICIPANTSThis retrospective case series study evaluated the medical records of patients treated at an urban tertiary medical center and with at least 2 facial computed tomographic (CT) images obtained at least 6 years apart between 1973 and 2017. All patients were self-identified black adults initially aged 40 to 55 years with no history of facial surgery who required repeated facial CT imaging that included the entire midface and cranium. All data analysis took place between August 1, 2018, and October 31, 2018.MAIN OUTCOMES AND MEASURES Facial CT scans were analyzed for 2-dimensional measurements to document changes in glabellar angle, bilateral maxillary angles, frontozygomatic junction width, orbital width, and piriform width.RESULTS A total of 20 patients were included in our analysis (6 men, 14 women). The patients' mean (SD) initial age was 46.8 (5.8) years, with a mean (SD) follow-up of 10.7 (2.9) years. There was a significant increase in mean (SD) piriform aperture width from 3.24 (0.37) cm to 3.31 (0.32) cm (P = .002) and mean (SD) female orbital width from 3.77 (0.25) cm to 3.84 (0.19) cm (P = .04). There was a significant decrease in mean (SD) frontozygomatic junction width from 5.46 (1.38) mm to 5.24 (1.42) mm (P < .001). No significant differences were found in glabellar angles, maxillary angles, or male orbital width between initial and final imaging time points. CONCLUSIONS AND RELEVANCEThis study is the first to our knowledge to document longitudinal bony changes of the face among a population of black individuals. Although significant facial skeletal changes can be observed over an average 10-year period, they are minor in comparison to previously published data among whites. This study suggests that there may be significant differences in facial bony aging between races which may have an impact on the aesthetics of aging and hold implications for facial rejuvenation.LEVEL OF EVIDENCE NA.

Determining the Age Range Based on Machine-Learning Methods From Facial Skeletal Angles (Glabella and Maxilla Angle and Length and Width of Piriformis) in CT Scan

“…No significant difference was observed between age groups in men except for one group, which was similar to David's results among age groups [23]. However, in females, in this study, a significant relationship was observed between all groups, which indicates the stages of development in all periods in the condition of the bone in the growth of the midface in females.…”

Insight into age-related changes of the human facial skeleton based on medieval European osteological collection

“…Our results suggest that pyriform aperture edges are being resorbed with age, which causes an increase in its horizontal and vertical parameters. It is consistent with the results of other authors, which showed signi cant changes of this kind 25,26,41,46,48,51,52 . In the examined medieval sample, the only signi cant result was the increase of the surface area in successive age groups.…”

Buccal Bone Thickness in Anterior and Posterior Teeth—A Systematic Review

“…Some articles were excluded after full-text review for the following reasons: Lack of data referring to BBT [ 65 , 66 , 67 , 68 ], measurement not by (CB)CT scan [ 69 ] patients matching the exclusion criteria [ 19 , 70 , 71 , 72 , 73 , 74 , 75 , 76 , 77 , 78 , 79 , 80 , 81 , 82 , 83 , 84 ], patients with implants [ 85 ], patients without teeth [ 86 ], data not displayed as mean and SD [ 56 ], site or kind of measurement not adequate [ 19 , 62 , 64 , 77 , 87 , 88 , 89 , 90 , 91 , 92 , 93 , 94 , 95 , 96 , 97 , 98 , 99 , 100 , 101 , 102 , 103 , 104 , 105 , 106 , 107 ,…”