Tuomo Heikkinen

Three-dimensional longitudinal assessment of facial symmetry in adolescents.

Recent advances in laser scanning technology provide the opportunity to examine faces in three dimensions. The aim of this prospective clinical study was to explore facial symmetry in healthy growing individuals and determine whether asymmetric changes occur during adolescent growth. Non-invasive laser surface scanning was performed to capture facial images of 60 Caucasian Finnish adolescents (30 males and 30 females, mean 11.5 years). Facial symmetry was analysed on images obtained at the initial scanning (T₁), 2.5 (T₂), and 4.5 (T₃) years thereafter. The final sample consisted of 39 adolescents (19 males and 20 females, mean 16 years). Three-dimensional images were processed and analysed using an in-house developed subroutine for commercial software. A mirror image was generated and superimposed on the original image to create a symmetric face and establish the midsagittal plane. The surface matching of the original face and the mirror face (amount of symmetry) was measured for the whole face, upper, middle, and lower thirds at tolerance level 0.5 mm and presented with colour maps. Three angular and 14 linear measurements were made based on 21 soft tissue landmarks, which have proven to be reliable. The results of the Friedman test showed that facial symmetry parameters did not significantly differ over time (P > 0.05). Mann-Whitney U-test did not reveal statistically significant differences between genders at any time point (P > 0.05). Facial growth of healthy individuals during adolescence is symmetric, although further investigation on larger randomized sample is suggested.

Maternal smoking and tooth formation in the foetus. II. Tooth crown size in the permanent dentition

Altogether 2159 pregnancies among black and white Americans in the Collaborative Perinatal Study and dental casts from their children at the age of 6-12 years were studied to determine the effect of maternal smoking on permanent tooth crown dimensions. A trend of reduction, similar to that observed in the deciduous second molars, was found in the permanent first molars and also in the mesio-distal dimension of permanent incisors in relation to sex and race of the children and smoking habits of the mother. In terms of peak in their mitotic growth, the results can be interpreted to indicate a sensitive period of intra uterine development from the 24th to 28th gestational weeks. Comparisons of postnatal body size and differential correlation patterns in affected tooth dimensions with early postnatal body and head size between smokers and non-smokers, suggests that maternal smoking during pregnancy may have an effect on basic growth of the head and body and/or the developmental process that impacts tooth development at some specific sensitive period also during the postnatal formation of these tooth crowns.

Permanent tooth crown dimensions in prematurely born children

AIM The aim was to examine the effect of preterm birth on permanent tooth crown dimensions. MATERIALS AND METHODS The data consisted of 328 prematurely born white and black children and 1804 control children who participated in the cross-sectional study of the Collaborative Perinatal Project (USA) in the early 1960s and 1970s. The dental examinations were carried out in a standardized fashion at ages varying from 6 to 12 years in 95% of cases. Tooth crown size measurements were performed on the dental casts with an electronic measuring device and readout by two experienced observers according to precise definitions generally quoted in the anthropological and genetic literature. The preterm and control groups were divided by sex and race. RESULTS The results show both increased and decreased tooth crown dimensions in the prematurely born children. Significantly increased dimensions were found in the means of the intercuspal distances of the first permanent molars in the white boys and in the mesiodistal dimensions (MD) of the lower lateral incisors and the upper left first molar in the black girls. By contrast, there were decreased intercuspal distances, MD and labiolingual (LL) tooth crown dimensions in the white girls and black boys. The statistical method used was the Mann-Whitneys U-test (Willcoxon Rank-Sums test). CONCLUSIONS The findings partly support previous reports of decreased tooth crown dimensions in preterm infants, but the increased dimensions found in the preterm white boys and black girls differ from earlier reports. Our results indicate the importance of environmental factors including neonatal factors in determining permanent tooth crown dimensions. Growth patterns, the buffering capacity and the timing of sensitive moments in tooth crown volume gain may vary between the sexes and ethnic groups and the possible effect of the accelerated growth period in preterm infants (catch-up growth) may influence the determination of permanent tooth crown dimensions.

Tooth eruption symmetry in functional lateralities.

Dental casts and oral photographs from a cross-sectional sample of 2092 young North Americans with detailed information on functional lateralities (eyedness, handedness and footedness) were examined to compare the proportions of symmetrical and asymmetrical eruption of the antimeric (left-right, contralateral pair) permanent teeth using a four-grade eruption scale. The proportion of symmetrically erupting antimeric teeth was higher for some teeth in those with non-right-sidedness of the feet and eyes, but not significantly so in the case of handedness. Left-footedness was significantly (95% confidence interval) associated with an increased proportion of symmetrical pairs of the maxillary first molar and mandibular lateral incisor, and non-right-eyedness with an increased proportion of symmetrical eruption and left/right non-balanced proportions of asymmetrical eruption in maxillary central incisors. True right-sidedness (hand, foot and eye) was significantly (P< or =0.05) associated with advanced eruption of the left mandibular first molar. It is suggested that while the timing of antimeric tooth emergence and clinical eruption is primarily programmed before crown mineralization, starting approximately at the 30th gestational week in the case of first permanent molars, symmetrical/asymmetrical tooth emergence and eruption may provide information a posteriori on prenatal and early postnatal growth and development.

Maternal smoking and tooth formation in the foetus. III. Thin mandibular incisors and delayed motor development at 1 year of age

Dental casts from 2159 black and white Americans with detailed neurological data available from the Collaborative Perinatal Study were examined to investigate the relationship of maternal smoking during pregnancy and delayed motor development at 1 year of age to morphological traits in the dentition. Earlier results have indicated that maternal smoking during pregnancy may cause selected tooth size metric reductions in the deciduous dentition and at least in some of the permanent teeth with prenatal crown formation, these features being influenced by sex and race differences. The present results suggest that a thinning of the incisal parts of the permanent mandibular incisors is associated with heavy maternal smoking during pregnancy, and those white girls, in whom this dental variant is found, have probably experienced more severe central damage during the smoking sensitive gestational months, as is also seen in a delayed motor development at the age of 1 year.

Masculinization of the eruption pattern of permanent mandibular canines in opposite sex twin girls

The aim of this study is to explore the effect of prenatal androgenization on the clinical eruption of permanent teeth expressing dimorphism and bimaturism. The eruption curves of permanent teeth (except third molars), including those that make up the canine complex (permanent canines, lower first premolars), are compared among opposite sex twins (OS twins) relative to single-born boys and girls. The comparisons are made with regard to three phases of eruption (pierced mucosa, half- erupted, and completely erupted) from a cross-sectional sample of dental casts, using Kaplan-Meier survival and Cox regression analyzes. The casts were collected from 2159 school children from the US Collaborative Perinatal Project, including 39 pairs of OS-twins, of which 12 pairs (30.8%) were Euro-Americans and 27 pairs (69.2%) were of African-American ancestry. The eruption patterns of the incisors, upper first molars, and lower canines were found to be significantly masculinized (delayed) among OS twin girls. The differences in most other teeth were either not significant, or the number of observations of active eruption phases were too few, such as in the upper first molars and incisors, to yield strong evidence and meaningful results. The masculinization of the tooth eruption pattern in OS twin girls is intriguing because of the lower canine responses during puberty, as well as canine primordial formation during early fetal androgenization of their co-twin during the 8th to 14th gestational weeks. The present results offer a challenge for future research exploring tooth eruption mechanisms, and may also highlight some cases of delayed or ectopic canines, which are biased toward females.

Comparing Facial 3D Analysis With DNA Testing to Determine Zygosities of Twins.

The aim of this study was to compare facial 3D analysis to DNA testing in twin zygosity determinations. Facial 3D images of 106 pairs of young adult Lithuanian twins were taken with a stereophotogrammetric device (3dMD, Atlanta, Georgia) and zygosity was determined according to similarity of facial form. Statistical pattern recognition methodology was used for classification. The results showed that in 75% to 90% of the cases, zygosity determinations were similar to DNA-based results. There were 81 different classification scenarios, including 3 groups, 3 features, 3 different scaling methods, and 3 threshold levels. It appeared that coincidence with 0.5 mm tolerance is the most suitable feature for classification. Also, leaving out scaling improves results in most cases. Scaling was expected to equalize the magnitude of differences and therefore lead to better recognition performance. Still, better classification features and a more effective scaling method or classification in different facial areas could further improve the results. In most of the cases, male pair zygosity recognition was at a higher level compared with females. Erroneously classified twin pairs appear to be obvious outliers in the sample. In particular, faces of young dizygotic (DZ) twins may be so similar that it is very hard to define a feature that would help classify the pair as DZ. Correspondingly, monozygotic (MZ) twins may have faces with quite different shapes. Such anomalous twin pairs are interesting exceptions, but they form a considerable portion in both zygosity groups.

Analyzing infant head flatness and asymmetry using kernel density estimation of directional surface data from a craniofacial 3D model.

Infant skull deformation is analyzed using the distribution of head normal vector directions computed from a 3D image. Severity of flatness and asymmetry are quantified by functionals of the kernel estimate of the normal vector direction density. Using image data from 99 infants and clinical deformation ratings made by experts, our approach is compared with some recently suggested methods. The results show that the proposed method performs competitively. Copyright

Primary tooth size asymmetry in twins and singletons.

OBJECTIVES To explore asymmetry values of antimeric deciduous tooth crown dimensions in three types of twins: monozygotic (MZ), dizygotic same-sex (DZ) and opposite-sex (OS) vs. single-born controls. SETTING AND SAMPLE POPULATION Mesiodistal and labio-lingual crown dimensions of second deciduous molars and mesiodistal canine and first molar crown dimensions of 2159 children at 6-12 years of age were evaluated, originating from the US cross-sectional Collaborative Perinatal Study from the 1970s, including altogether MZ (n = 28), DZ same-sex (n = 33) and OS (n = 39) pairs. Single born (n = 1959) were used as controls. MATERIAL AND METHODS Dental casts were measured for comparison of variance relationships calculated from antimeric teeth, exhibiting fluctuating (FA), and directional (DA) asymmetry using anova. RESULTS Significant differences appeared in MZ and OS girls in DA of deciduous canines, which gain size in the first and second trimester, and deciduous second molars, which finally stop crown growth during the early post-natal period. Significantly, increased FA values appeared for lower deciduous canines and second molars, indicating greatest environmental stress in OS girls, MZ girls and DZ boys. Twin girls had more fluctuating and directional crown asymmetry than twin boys, but in some dimensions, the twins were more symmetric than controls. CONCLUSIONS Transmembrane hormonal influence between opposite-sex twins, and late gestational stress factors, caused by placental malfunction and/or monochorionicity, may be involved in asymmetric growth of antimers, during critical periods of crown size gain.