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.

Keywords: Turner syndrome; children; craniofacial abnormalities; dentistry craniofacial morphology; growth hormone; growth hormone deficiency; orthodontics; short stature.

Figure 1

Association between longitudinal cranial bone growth, remodeling, and rHGH therapy. The therapy of rHGH impacts the growth of the skull in a dual mechanism: by longitudinal growth of bones under GH influence and by remodeling of bones under IGF1 action.

Figure 2

Short stature characteristics.