Reference Values for Craniofacial Structures in Children 4 to 6 Years Old: Review of the Literature

Abstract

This review article addresses the question as to what methods can be used to investigate cranial structure and growth development in children 4 to 6 years old, and what the relevant reference values are for this age group. We screened the literature for epidemiological, longitudinal and cross-sectional studies investigating healthy children 4 to 6 years old without abnormalities and orthodontic therapy. Radiographic cephalometry is a practical, valid tool for analyzing craniofacial structure and growth processes. But it has several disadvantages, including the use of ionizing radiation, measuring points that are difficult to locate, no means of radiographic enlargement without distorting reference values, and the data's two-dimensionality. Anthropometry is another procedure for creating reference values for the craniofacial structure in children. Its advantages over radiographic cephalometry include three-dimensional results and no radiation exposure. Moreover, it yields precise and valid results for a wide variety of potential applications. In addition to these procedures, there are other techniques with which cranial structure and growth development in children 4 to 6 years old can be investigated. Those reported in the literature in this connection include standardized photographs, the creation of computerized and magnetic resonance images, and investigations performed on dry skulls. In short, there is great demand nowadays for investigations aimed at developing reference values for Caucasian children 4 to 6 years old. Radiographic cephalometry and anthropometry are two very common methods. Anthropometry is expected to become increasingly important because it involves no exposure to radiation.

Midfacial growth patterns in males from newborn to 5 years old based on computed tomography

“…Conversely, numerous studies have aimed to create normative values for craniofacial measurements to be used in medical practice (Brief et al, ; Delye et al, ; Dowgiallo, ; Escaravage & Dutton ; Hahn, Chu, & Cheung, ; Honn & Goz, ; Likus, Bajor, Gruszczyńska, Baron, & Markowski, ; Pool, Didier, Bardo, Selden, & Kuang, ; Stepanenko, ; Waitzman et al, ; including numerous X‐ray cephalometric studies, e.g., Broadbent, Broadbend, & Golden, ; Riolo et al, 1974; see also Hunter et al, ; Palomo & Broadbent, ). But despite this effort, growth trends of different regions of the facial skeleton in infancy and early childhood are still relatively poorly known.…”

“…Studies based on autopsy material are rare and mostly dated (Fazekas & Kosa, ; Lang, ; Young, ), and some of them are poorly known to researchers worldwide (Dovgiallo, 1937; Sysak, ).The development of high resolution CT scanning appears to be a very promising solution for understanding craniofacial ontogeny of infants and small children, and for defining normative values for different cranial measurements. The need for such data is appreciated by many authors (Brief et al, ; Delye et al, ; Escaravage & Dutton ; Hahn et al, ; Honn & Goz, ; Licus et al, 2014; Marcus et al, ; Pool et al, ; Stepanenko, ) and emphasized by the fact that the earliest works using CT data are still highly influential in different fields (Waitzman, ). But up to now, clinical CT data have been insufficiently used for describing craniofacial growth trends in infancy and early childhood.…”

Reference values for three‐dimensional surface cephalometry in children aged 3–6 years

“…There are various reasons why few reference values exist for 3–6‐year‐olds (2). Examinations are more difficult to perform at this age because of lack of compliance (3).…”

The Reproducibility of Landmarks on Threedimensional Images of 4- to 6-year-old Children

“…Heutzutage besteht ein hoher Bedarf an Untersuchungen zur Erstellung von Referenzwerten vor allem für die Jüngeren [8,11].…”

“…There is currently a great need for studies to determine reference values, particularly for younger children [8,11].…”