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This article examines the relation between commercial activity and knowledge-making, looking at hatmakers in order to open up a more general question about the overlap between the knowledge practices of 19th-century science and those of everyday commercial culture of the time. Phrenology also claims attention here, since it can be said to have occupied an intermediate position between science and commerce. From time to time during the first half of the century, phrenologists attended to hatmakers in the hope of gleaning knowledge from their commercial experience, but after about 1860, scientific craniometers took a very different view. Physical anthropologists like Paul Broca believed that the skull was the key source of data on which to build a scientific anthropology of race or ethnicity. Observers drew the attention of Broca and his colleagues to the existence of a commercial device called the conformateur des chapeliers, used by hatters to determine head shape. But Broca was far less inclined to welcome hatmakers into the domain of craniology than the phrenologists had been. Whereas phrenologists had found validation in common sense, any widely available understanding of racial types was considered by Broca to be a distraction from the work of science and a potential distortion of its data. Far from the welcoming curiosity shown by London-based phrenologists, the anthropological enterprise led by Broca defined itself as scientific in part by the strictness with which it considered and dismissed such approximate and informal ways of knowing. [ABSTRACT FROM AUTHOR]

To analyze cranial growth and size of anterior fontanel during the first year of life, we undertook a cohort study with a sample of 33 infants assessed at birth and reexamined at 1, 2, 3, 4, 5, 6, 9, and 12 months. Examination included assessment of head circumference, anterior fontanel size, anteroposterior distance, biauricular distance, and cephalic index. All infants were neurologically normal. Mean size of the anterior fontanel at birth was 1.77 cm² and, in disagreement with literature data, fontanel size increased up to 2 months of age; fontanel was closed at 1 year for 27.3% of infants. Significant differences in cranial anthropometry were not found in relation to method of delivery (vaginal or cesarean section), gender and gestational age. Our results indicate the need to reevaluate anthropometric examination data and to establish patterns of normality, particularly for miscegenated populations that have not been widely investigated. [ABSTRACT FROM AUTHOR]

Objective: To evaluate the long-term effectiveness of helmet therapy in the correction of deformational plagiocephaly and to assess the early occlusal abnormalities seen in these patients. Design: A prospective study with blinded measurements. Patients: Twenty-eight patients with deformational plagiocephaly who were treated with molding helmet therapy with at least 5 years of follow-up. Interventions: The average length of molding helmet treatment was 6.2 months. At the time of this follow-up evaluation, the mean interval since completing the molding helmet therapy was 5.6 years. Main Outcome Measures: Anthropometric measurements of cranial asymmetry included cranial vault asymmetry (CVA), orbitotragial depth asymmetry (OTDA), and cranial base asymmetry (CBA). A dental examination was also performed. Results: At the completion of therapy, the most improvement was seen in the measurement of CBA, followed by CVA and OTDA. However, in evaluating the long-term stability of molding treatment, OTDA tended to continue improving after the initial treatment, while CBA and CVA appeared to regress, although none of the changes reached statistically significant levels. In dental measurements, all the dental midline and chin deviations were toward the unaffected side with respect to occipital deformation. Conclusion: This study demonstrated that helmet remodeling with the dynamic orthotic cranioplasty band is effective in the correction of cranial asymmetry, with some nonstatistically significant changes in long-term cranial vault symmetry. Dental observations indicated the possibility of occlusal abnormalities that may affect dental, especially orthodontic, diagnosis and teatment planning. [ABSTRACT FROM AUTHOR]

The article offers information about vertex birth molding among newborns. Vertex molding refers to the mechanical changes in fetal head shape, which results from external compression on the cranium and bony adjustments within the cranium. Several factors which influence the individual fetal cranial response include fetal head position and size, gestation age, maternal pelvic shape and dimensions and the quality of uterine contraction. The authors assess that vertex molding sometimes persists beyond the early newborn period, which lead to permanent deformation of head shape. Details about the diagnosis and management of extensive vertex birth molding are presented, as well as seven infants documented with extensive degrees of vertex molding.

Objective: Various causal mechanisms of familial nonsyndromic craniosynostosis have been presented. One hypothesis suggests that overproduction of bone at the suture is the primary origin of craniosynostosis, which affects brain and cranial growth secondarily through altered intracranial pressure (Primary Suture Fusion Model). Other hypotheses suggest that decreased cranial base growth or abnormal brain growth are the primary cause of craniosynostosis (Cranial Base, Brain Parenchyma Models, respectively). This study was designed to investigate which model best describes neurocranial changes associated with craniosynostosis in a rabbit model through multivariate path analysis. Design: Serial magnetic resonance imaging scans and intracranial pressure measurements were obtained at 10, 25, and 42 days of age from 18 rabbits: six controls, six with delayed-onset synostosis, and six with early-onset synostosis. Five variables were collected from each rabbit: calvarial thickness at the affected suture, cranial base length, brain volume, cerebrospinal fluid volume, and intracranial pressure. This data set was used to test causal pathway relationships generated by the proposed models. Goodness of fit was measured by experimental group for each model. Results: Primary Suture Fusion Model best explained the variables in both delayed-onset and early-onset synostotic rabbits (Goodness of fit = 93%, 97%, respectively). Cranial Base Model (Goodness of fit = 94%) best explained the data in control rabbits. Conclusion: Results suggest that the primary site of craniosynostosis in craniosynostotic rabbits is most likely the synostosed suture. Other cranial vault anomalies are most likely secondary compensatory changes. Results of the present study may provide insight regarding the causal pathway of craniosynostosis. [ABSTRACT FROM AUTHOR]

Objective: To identify the long-term effects of palate repair on craniofacial growth in patients with unilateral cleft lip and palate (UCLP). Design: Retrospective cross-sectional study. Setting: Sri Lankan Cleft Lip and Palate Project. Subjects: Forty-eight adults with nonsyndromic unilateral cleft lip and palate, 29 men and 19 women, had lip repair only (LRO group). Fifty-eight adults with nonsyndromic unilateral cleft lip and palate, 35 men and 23 women, had lip and palate repairs by the age of 9 (LPR group). Main Outcome Measures: Clinical notes were used to record surgical treatment histories. Cephalometry was used to determine craniofacial morphology. Results: In the lip and palate repair group, the depth of the bony pharynx (Ba-PMP), the maxillary length at the alveolar level (PMP-A), the effective length of the maxilla (Ar-IZ, Ar-ANS, Ar-A), the maxillary protrusion (S-N-ANS, SNA), the anteroposterior jaw relation (ANS-N-Pog, ANB), and the overjet were smaller than in the tip repair only group. There were no significant differences in the maxillary length at the basal level (PMP-IZ, PMP-ANS) and the anterior and posterior maxillary heights (N-ANS and R-PMP, respectively) in the two groups. Conclusion: Palate repair inhibits the forward displacement of the basal maxilla and anteroposterior development of the maxillary dentoalveolus in patients with unilateral cleft lip and palate. Palate repair has no detrimental effects on the downward displacement of the basal maxilla or on palatal remodeling in patients with unilateral cleft lip and palate. [ABSTRACT FROM AUTHOR]

Objective: To assess the skeletal and dental craniofacial proportions of unilateral cleft lip and palate patients who were operated upon using the Malek technique, and compare them with a normal group to highlight the effect of surgical correction on craniofacial development during growth. Design: Retrospective. Methods: The cleft palate was closed using the Malek technique in a single operation at 3 months for 11 patients (complete closure of lip and palate) and in a two-stage operation for 10 patients (soft palate at 3 months, lip and hard palate at 6 months). Comparisons were made with a normal control group. Angular and linear measurements of anterior and posterior dimensions of the upper and lower compartments of the face were measured in the 7th and 12th years. Results and Conclusion: No significant differences were observed between the two groups of palate technique repair, although significant differences were observed between craniofacial dimensions of normal versus cleft lip and palate patients. At a skeletal level, the maxilla and mandible were retrusive relative to the cranial base in the cleft lip and palate group, in fact, there was a backward rotation of the palatal plane with repercussions on the maxillo-mandibular complex position. Furthermore, the maxilla was shorter than in normal patients, whereas the mandible was normally shaped. The upper incisors were retroclined and they locked the lower incisors in linguoversion. There was a posterior skeletal deficit of the respiratory compartment, compensated by more marked posterior maxillary alveolar growth. Facial growth in cleft lip and palate patients followed the same pattern, but was delayed compared with normal patients. [ABSTRACT FROM AUTHOR]

Objectives: The aims of the study were: (1) to develop a technique to quantify plagiocephaly that is safe, accurate, objective, easy to use, well tolerated, and inexpensive; and (2) to compare this method with tracings from a flexicurve ruler. Design: A case-control study of 31 case infants recruited from outpatient plagiocephaly clinics and 29 control infants recruited from other pediatric outpatient clinics. Participants: Infants in the study had been diagnosed with nonsynostotic plagiocephaly or brachycephaly and were between 2 and 12 months old. Interventions: infants' head shapes were measured using (a) digital photographs of a head circumference band and (b) a flexicurve ruler. Flexicurve tracings were scanned, and both the digital photos and the scanned flexicurve tracings were analyzed using a custom-written computer program. Main Outcome Measures: The oblique cranial length ratio was used to quantify cranial asymmetry, and the cephalic index was used to quantify the degree of brachycephaly. Results: The infants tolerated the photo technique better than the flexicurve. Also, mothers preferred the photo technique. There was less within-subject variance for the photos than for the flexicurve measurements. The results suggested that an oblique cranial length ratio of ⩾106% can define plagiocephaly and that a cephalic index of ⩾93% can define brachycephaly. Conclusions: The photographic technique was better accepted and more repeatable than the flexicurve measuring system. We propose that "normal" head shape is indicated in infants with both an oblique cranial length ratio of less than 106% and a cephalic index of less than 93%. [ABSTRACT FROM AUTHOR]

Craniosynostosis is a congenital disorder of premature ossification of cranial sutures, occurring in one of approximately every 2500 live human births. This work addressed a hypothesis that a cranial suture can be tissue-engineered from autologous cells. Dermal fibroblasts were isolated subcutaneously from growing rabbits, culture-expanded, and seeded in a gelatin scaffold. We fabricated a composite tissue construct by sandwiching the fibroblast-seeded gelatin scaffold between two collagen sponges loaded with recombinant human BMP2. Surgically created, full-thickness parietal defects were filled with the composite tissue construct in the same rabbits from which dermal fibroblasts had been obtained. After four-week in vivo implantation, there was de novo formation of tissue-engineered cranial suture, microscopically reminiscent of the adjacent natural cranial suture. The tissue-engineered cranial suture showed radiolucency on radiographic images, in contrast to radio-opacity of microscopically ossified calvarial defects filled with fibroblast-free, BMP2-loaded constructs. This approach may be refined for tissue engineering of cranial sutures for craniosynostosis patients. [ABSTRACT FROM AUTHOR]

Objective: This histomorphometric study compared the open and prematurely fused side of the coronal suture in subjects with unilateral coronal synostosis (UCS). Methods: Sutures and parasutural bone were obtained from seven subjects with nonsyndromic UCS during operative correction at 3 to 24 months of age. Histological and cellular analyses were performed for the affected and open sutures. Specimens were examined by light and polarizing microscopy. Sutural patterns, osseous morphology, calvarial thickness, tartrate-resistant acid phosphatase (TRAP)-positive cells, and marrow spaces were evaluated histomorphologically, qualitatively, and semi-quantitatively. Histomorphometry was performed to determine total projected area of marrow space as a percentage of unit area, total number of TRAP-positive cells per specimen, and perisutural cranial thickness. Results: Polarizing microscopy showed that affected sutures were composed of more lamellar bone than the normal sutures. By light microscopy, the clinically fused sutures were 1.7-fold thicker (p < .02), had twofold larger marrow spaces (p < .0006), and contained sixfold more TRAP-positive osteoclasts in marrow spaces near the suture (p < .04) than the normal sutures. Quantitative analysis of the normal sutures revealed that calvarial thickness was greater with age and that there was an inverse correlation between medullary area and age. For the affected sutures, there was also an age-related increase in calvarial thickness. There were also trends for age-related declines in numbers of osteoclasts in both open and affected sides. Conclusions: These results question the hypothesis that defective osteoclastic activity is pivotal in the pathogenesis of UCS and support the hypothesis that this condition results from abnormally active bony remodeling. [ABSTRACT FROM AUTHOR]

Objective: To describe the expression patterns of the various transforming growth factor-β (Tgf-β) isoforms, known to be involved in suture development, in the perisutural tissues of rabbits with naturally occurring craniosynostosis and relate such differential expression to the pathogenesis of premature suture fusion. Method: Twenty-one coronal sutures were harvested from six wild-type control New Zealand White rabbits and five rabbits with familial coronal suture synostosis at 25 days of age for histomorphometric and immunohistochemical analyses. Tgf-β isoform immunoreactivity was assessed using indirect immunoperoxidase procedures with specific antibodies. Results: Synostosed sutures had significantly (p < .01) greater bone area and relatively more osteobiasts and osteocytes in the osteogenic fronts, compared with wild-type sutures. Tgf-β isoform immunoreactivity showed differential staining patterns between wild-type and synostosed perisutural tissues. In wild-type sutures, Tgf-βl and Tgf-β3 immunoreactivity was significantly (p < .001) greater than Tgf-β2 staining in all perisutural tissues. In synostosed sutures, the opposite pattern was observed, with Tgf-β2 immunoreactivity significantly (p < .001) greater than Tgf-βl and Tgf-β3 in the osteogenic fronts, dura mater, and periosteum. Conclusions: Findings from this study suggest that an overexpression of Tgf-β2, either in isolation or in association with an underexpression of Tgf-β1 and Tgf-β3, may be related to premature suture fusion (craniosynostosis) in this pathological rabbit model. These abnormal expression patterns may be involved in premature suture fusion either through increased cell proliferation, decreased apoptosis of the osteoblasts or both at the osteogenic fronts. [ABSTRACT FROM AUTHOR]

Objective: To analyze changes in the facial, maxillary, and mandibular skeleton in the vertical, sagittal, and transverse dimensions during an orthodontically relevant period of dentofacial development (i.e., between 7 and 15 years of age). Subjects and Method: This longitudinal study comprised posteroanterior (PA) and lateral cephalograms at 7, 9, 11, 13, and 15 years of 18 untreated Class I subjects with good occlusion. Transverse growth (width) was analyzed on the basis of PA cephalograms and sagittal (depth) and vertical (height) growth by means of lateral cephalograms. For each linear measurement, mean percentage increases were calculated relative to the size at 7 years of age. Results and Conclusions: Between 7 and 15 years of age, in the whole facial skeleton and the maxilla, percentage increases were most pronounced in the vertical dimension when compared with the sagittal and transverse dimensions. In the mandible, the largest percentage increases were found in both sexes for vertical growth of the ramus, followed by sagittal growth (body length) and then mandibular width. In the sagittal dimension, development was more pronounced in the mandible (at pogonion more than at B point) than in the maxilla (A point). With respect to vertical growth, percentage increases in posterior face height exceeded the increases in anterior face height. When facial shape changes were analyzed between 7 and 15 years of age in both sexes, the ratio facial height/facial width increased and the ratio facial depth/ facial height decreased, which points toward an age-related increasing influence of vertical development. [ABSTRACT FROM AUTHOR]

Objective: The aim of this article is to describe the orthodontic therapy for Parry-Romberg syndrome. The therapeutic goal is to minimize the wasting effects of progressive atrophy on facial development of a part of the face. Design: To correct problems affecting craniofacial development of these patients, occurring during puberty, an orthodontic appliance was employed, which helps maintain parallelism of the facial planes, in particular the mandibular plane. Setting: Orthodontic care was carried out in the Dental Clinic of the Catholic University of the Sacred Heart of Rome. Intervention: Two patients underwent orthodontic therapy for 6 years. Appliances were checked every month and modified periodically so as to adapt to facial bone growth. Results: At the end of craniofacial growth, the mandible was almost symmetric and the problem relating to atrophy remained confined to the initial area. Cephalometric analyses demonstrated that the occlusal plane and the mandibular plane maintained a straight orientation in relation to the bizygomatic plane. The ratio between the left and right side of the ramus and condyle, in the mandible, improved. Conclusions: The use of orthodontic therapy allows patients affected by hemifacial progressive atrophy to present a more harmonic face at the end of puberty when final reconstruction can be planned. These results provide for a limitation of surgical intervention to the sclerodermic area alone. [ABSTRACT FROM AUTHOR]

Objective: To recognize several conditions that result in a trapezoid head shape and review and contrast their various physical findings. Methods: A detailed review of all patients seen in the Craniofacial Clinic at the Children's Hospital and Regional Medical Center in Seattle, Washington, over a 10-year period from 1991 to 2001, with the diagnosis of craniosynostosis and plagiocephaly was performed. During this period, 690 patients had a surgical correction of craniosynostosis, and 1537 patients had posterior plagiocephaly. Results and Conclusions: The shape of the head when viewed from the vertex position in an axial plane can be a significant diagnostic aid when evaluating a patient with plagiocephaly. Positional molding causes the vast majority of plagiocephaly. This deformational change results in a parallelogram-shaped head. A much more rare cause of plagiocephaly is lambdoid synostosis. With premature fusion of one of the lambdoid sutures, the head takes on a very characteristic trapezoid shape when viewed from the vertex. Unilateral coronal synostosis that occurs on the same side as either posterior positional molding or unilateral lambdoid synostosis will also result in the trapezoid head shape. Furthermore, on the rare occasion when anterior and posterior deformational plagiocephaly occurs on the same side, the trapezoid head shape may be the consequence. The choice of appropriate treatment modality requires systematic evaluation of the patient with a trapezoid-shaped head to determine the etiology of the deformation. [ABSTRACT FROM AUTHOR]

Objective: To assess the effectiveness of multiplanar mandibular distraction by evaluating the treatment effect and 1-year stability, measuring changes on the affected and nonaffected sides, and evaluating correction of the occlusal plane and oral commissure cant. Patients and Method: Eleven patients aged 5 to 9.4 years (mean 6.7 years ) who underwent unilateral multiplanar mandibular distraction were included, 10 with hemifacial microsomia and one temporomandibular joint ankylosis. Intermaxillary elastics were applied to intraoral dental devices during and after distraction until bony consolidation and occlusal interdigitation were achieved. Radiographs were taken and measured before distraction, after vertical distraction, after completion of distraction, and 1 year after treatment. Frontal facial photographs were obtained to analyze the changes in the position of the oral commissure. Results: The facial profile was improved by sagittal mandibular advancement. Although the facial height increased 6.6 mm during vertical distraction, with a net gain of 5.8 mm in follow-up, the mandibular plane angle was maintained. The affected mandibular length increased 8.3 mm after distraction and remained unchanged after 1 year. Ramus height increased 12.7 mm after distraction and relapsed 3.8 mm at follow-up (30%). The affected body length demonstrated postoperative growth of 3.1 mm. Correction of the chin deviation was 9.8 mm after distraction and relapsed 1.6 mm (16.3%) after 1 year. Canting of the occlusal plane and oral commissure was corrected and remained stable. Conclusion: Multiplanar mandibular distraction is an effective treatment for correcting facial asymmetry in young children. The 1-year follow-up revealed that the new sagittal jaw relation and mandibular body length were stable, and the achieved occlusal interdigitation was well maintained. However, the ramus height and chin deviation demonstrated some relapse. [ABSTRACT FROM AUTHOR]

The etiology of mandibular prognathism has been attributed to various genetic inheritance patterns and some environmental factors. The variation in inheritance patterns can be partly due to the use of different statistical approaches in the respective studies. The objective of this study was to investigate the role of genetic influences in the etiology of this trait. We performed segregation analysis on 37 families of patients currently being treated for mandibular prognathism. Mandibular prognathism was treated as a qualitative trait, with cephalometric radiographs, dental models, and photographs used to verify diagnosis. Segregation analysis of a prognathic mandible in the entire dataset supported a transmissible Mendelian major effect, with a dominant mode of inheritance determined to be the most parsimonious. [ABSTRACT FROM AUTHOR]

This study considers the craniofacial morphology of two Australian Aboriginal populations with different patterns of tooth wear. Evidence of regional variation in cranial and facial morphology is provided by significant differences in a number of variables. In addition, the intergroup differences in the correlations between attrition and facial variables provide evidence of different adaptive and compensatory changes occurring in each group in response to the different patterns of tooth wear. [ABSTRACT FROM AUTHOR]

In vivo strain gauge analysis demonstrated that tensile bone strain is transmitted along the cranial vault to the parasagittal region during isotonic temporalis contraction. This strain is sufficient to cause measurable separation of the sagittal suture, and thus could influence growth at the sutural margins. [ABSTRACT FROM AUTHOR]

The article presents research investigating potential racial and individual variation in certain facio-dental relationships. Researchers seek to analyze the variability in the anthropometric measurements used in growth and orthodontic studies and assess the reliability of these determinations. Results suggest that there is no dependable relationship between any facial point or tooth in the head or skull, while the orbito-canine relationship is not constant, and orbital plane is extremely variable.

The headaches associated with muscle-contraction (tension) migraine, increased intracranial pressure and occipital neuralgia have a reasonably typical clinical profile. The optimal out-patient diagnostic evaluation of the child with headaches includes a thorough history and physical examination, and a skull x-ray. Radioactive brain scan, cervical spine x-rays, lumbar puncture, and psychiatric consultation are reserved for selected patients. Recommendations for therapy, based on the type of headache includes alleviation of family and environmental stresses, prophylactic anticonvulsant medication and rarely Methysergide. [ABSTRACT FROM AUTHOR]

A 1-year-old boy with extreme microcephaly and a complex brain malformation is reported. Magnetic resonance imaging revealed an abnormal gyral pattern with features of the agyria-pachygyria spectrum, partial agenesis of the corpus callosum, severely hypoplastic posterior cerebellar vermis, and an abnormal foliation pattern of the cerebellar hemispheres associated with a flat and wide isthmus and pons. Although this phenntype shares some features with malformations classified as microcephaly with a simplified gyral pattern, microlissencephaly, or lissencephaly with cerebellar hypoplasia, none of the several subgroups of these categories are identical to the cerebral dysgenesis found in this patient. (J Child Neurol 2005;20:170-172). [ABSTRACT FROM AUTHOR]

The palpebral fissure length was measured in 60 normal Chinese term infants in the first 48 hours of life. The measurement of the palpebral fissure length was performed with a vernier caliper by placing it across the greatest horizontal axis of the eye from the medial to the lateral canthus. The head circumference was measured by placing a tape anteriorly just above the eyebrows and posteriorly at the maximum point of the occiput. There was no difference according to sex or between the measurements in the right and the left eye. The palpebral fissure length was 1.94 ± 0.17 cm (mean ± standard deviation (SD)) and the head circumference was 34.0 ± 1.3 cm (mean ± SD). These data suggest that Chinese neonates have a shorter palpebral fissure length than do black American neonates and a longer palpebral fissure length than do white American and Turkish neonates. [ABSTRACT FROM AUTHOR]

Cerebrocostomandibular syndrome (CCM) is characterized by micrognathia, cleft palate, rib defects, and frequently, mental deficiency. Death from respiratory complications occurs in 40 percent of cases before they reach 1 year of age. We describe a case of CCM with the previously unreported findings of large for gestational age at birth, radiologic evidence of bilaterally displaced radial heads, and development of brachycephaly. [ABSTRACT FROM AUTHOR]

Reports on developments related to the American Cleft Palate-Craniofacial Association, as of January 2004. Call for papers for the annual meeting on March 15-16, 2004 in Chicago, Illinois; Cleft palate weekend seminar with Samuel Berkowitz on February 13-15, 2004 in Florida; Treatment of cleft lip and palate workshop on July 15-16, 2004 in London, England.

Examines infants who had an anterior fontanel bone. Neurologic status and head circumference; Occurrence of the bone noted in the techniques of craniometry; Importance of the correct diagnosis of anterior fontanel bone.

This article discusses the results of a research study conducted to examine the mandibular fossa size in a sample of slave skeletons excavated on Barbados. The researchers note that the sample is representative of the gene pool ancestral to African Americans. They conclude that a decrease in the size of the temporomandibular joint (TMJ) in African Americans can be attributed to environmental rather than genetic factors.

The article reports on the results of research which was conducted in an effort to investigate the relationship between tooth size and skull size. Researchers studied 100 Caucasian British men and used standard anthropological methods to measure their head sizes and the size of their teeth. They found that there was a greater correlation between tooth and skull size in brachycephalic individuals compared with other skull categories.

The article examines the incidence and age distribution of dental caries in Hungary from the seventh to the thirteenth centuries. A study was done in the Anthropological Institute of the Jozsef Attila University, Szeged, Hungary on 257 skulls from the Avar Period and on 266 skulls from the Arpad Period.