Korean J Orthod.  2024 Jul;54(4):210-228. 10.4041/kjod23.224.

A scoping review of cephalometric normative data in children

• Nguyen TK
• Cambala A
• Hrit M
• Zimmermann EA

• KMID: 2558291
• DOI: http://doi.org/10.4041/kjod23.224

Abstract

Objective
Understanding the orofacial characteristics and growth patterns in children is essential for both orthodontics and research on children with orofacial abnormalities. However, a concise resource of normative data on the size and relative position of these structures in different populations is not available. Our objective was to aggregate normative data to assess the growth of the orofacial skeletal structures in children with a well-balanced face and normal occlusion.
Methods
The MEDLINE, Embase, and Scopus databases were searched. Inclusion criteria included longitudinal and cross-sectional studies on cephalometric measurement of skeletal tissues and a study population ≤ 18 years with a well-balanced face and normal occlusion. Key study parameters were extracted, and knowledge was synthesized. A quality appraisal was performed using a 10-point scale.
Results
The final selection comprised of 12 longitudinal and 33 cross-sectional studies, the quality of which ranged from good to excellent. Our results showed that from childhood to adulthood, the length of the cranial base increased significantly while the cranial base angle remained constant; both the maxilla and mandible moved forward and downward. The profile becomes straighter with age.
Conclusions
Growth patterns in children with a well-balanced face and normal occlusion follow accepted theories of growth.

Keyword

Cephalometrics; Normative data; Pediatric dentistry

Figure

• 

  Figure 1 PRISMA flow diagram. Flow diagram of the final selection process. SD, standard deviation.

• 

  Figure 2 Cephalometric measurements. Cephalometry measures angles and distances on lateral radiographs of the head to quantify the size and relative position of the cranial base, maxilla, and mandible. The parameters for the cranial base and maxilla are illustrated in (A), while those of the mandible and maxillomandibular difference are shown in (B). Facial height and divergence measurements are shown in (C). ATFH, anterior total facial height; PTFH, posterior total facial height; AUFH, anterior upper facial height; ALFH, anterior lower facial height; PUFH, posterior upper facial height; PLFH, posterior lower facial height; SN, plane formed by connecting point Sella and Nasion; FH, Frankfort horizontal plane; PP, palatal plane; MP, mandibular plane. *Evaluation of PUFH is assessed through S-Ar’, in which, Ar’ is projection of Ar on S-Go plane (S-Ar is considered posterior cranial base).

Reference

References

1. Bishara SE, Peterson LC, Bishara EC. 1984; Changes in facial dimensions and relationships between the ages of 5 and 25 years. Am J Orthod. 85:238–52. https://doi.org/10.1016/0002-9416(84)90063-0. DOI: 10.1016/0002-9416(84)90063-0. PMID: 6584033.

2. Ursi WJ, Trotman CA, McNamara JA Jr, Behrents RG. 1993; Sexual dimorphism in normal craniofacial growth. Angle Orthod. 63:47–56. https://pubmed.ncbi.nlm.nih.gov/8507031/.

3. Bartzela TN, Carels C, Maltha JC. 2017; Update on 13 syndromes affecting craniofacial and dental structures. Front Physiol. 8:1038. https://doi.org/10.3389/fphys.2017.01038. DOI: 10.3389/fphys.2017.01038. PMID: 29311971. PMCID: PMC5735950. PMID: fcda40e1d608409ab8d81ce46f74765a.

4. Jacobson A, Jacobson RL. 2006. Radiographic cephalometry: from basics to 3-D imaging. Quintessence Pub Co.;Chicago: https://www.amazon.com/Radiographic-Cephalometry-Basics-3-d-Imaging/dp/0867154616. DOI: 10.1016/j.ajodo.2007.02.038.

5. Jodeh DS, Kuykendall LV, Ford JM, Ruso S, Decker SJ, Rottgers SA. 2019; Adding depth to cephalometric analysis: comparing two- and three-dimensional angular cephalometric measurements. J Craniofac Surg. 30:1568–71. https://doi.org/10.1097/SCS.0000000000005555. DOI: 10.1097/SCS.0000000000005555. PMID: 31299770.

6. Thordarson A, Johannsdottir B, Magnusson TE. 2006; Craniofacial changes in Icelandic children between 6 and 16 years of age- a longitudinal study. Eur J Orthod. 28:152–65. https://doi.org/10.1093/ejo/cji084. DOI: 10.1093/ejo/cji084. PMID: 16230326.

7. Björk A, Skieller V. 1983; Normal and abnormal growth of the mandible. A synthesis of longitudinal cephalometric implant studies over a period of 25 years. Eur J Orthod. 5:1–46. https://doi.org/10.1093/ejo/5.1.1. DOI: 10.1093/ejo/5.1.1. PMID: 6572593.

8. Riolo ML. 1974. An Atlas of craniofacial growth: cephalometric standards from the University school growth study, the University of Michigan. Center for Human Growth and Development, University of Michigan;Ann Arbor: https://deepblue.lib.umich.edu/handle/2027.42/146700.

9. Thompson GW, Popovich F. 1977; A longitudinal evaluation of the Burlington growth centre data. J Dent Res. 56 Spec No:C71–8. https://doi.org/10.1177/002203457705600321011. DOI: 10.1177/002203457705600321011. PMID: 273032.

10. Sherman SL, Woods M, Nanda RS, Currier GF. 1988; The longitudinal effects of growth on the Wits appraisal. Am J Orthod Dentofacial Orthop. 93:429–36. Erratum in: Am J Orthod Dentofacial Orthop 1988;94:178. DOI: 10.1016/0889-5406(88)90103-5. PMID: 3163222.

11. Enlow DH, Hans MG. 2008. Essentials of facial growth. Needham Press;Ann Arbor: https://search.worldcat.org/ko/title/essentials-of-facial-growth/oclc/430525503. DOI: 10.1097/00008505-199600540-00041.

12. Burr DB, Allen MR. 2014. Basic and applied bone biology. Academic Press;Cambridge: https://www.sciencedirect.com/book/9780124160156/basic-and-applied-bone-biology. DOI: 10.1016/c2011-0-05817-9.

13. Afrand M, Ling CP, Khosrotehrani S, Flores-Mir C, Lagravère-Vich MO. 2014; Anterior cranial-base time-related changes: a systematic review. Am J Orthod Dentofacial Orthop. 146:21–32.e6. https://doi.org/10.1016/j.ajodo.2014.03.019. DOI: 10.1016/j.ajodo.2014.03.019. PMID: 24974995.

14. Currie K, Sawchuk D, Saltaji H, Oh H, Flores-Mir C, Lagravere M. 2017; Posterior cranial base natural growth and development: a systematic review. Angle Orthod. 87:897–910. https://doi.org/10.2319/032717-218.1. DOI: 10.2319/032717-218.1. PMID: 28737426. PMCID: PMC8317569.

15. Proffit WR, Fields HW, Larson B, Sarver DM. 2018. Contemporary orthodontics. Mosby;St. Louis: https://www.amazon.com/Contemporary-Orthodontics-William-Proffit-DDS/dp/0323543871. DOI: 10.1053/j.sodo.2018.10.005.

16. Costello BJ, Rivera RD, Shand J, Mooney M. 2012; Growth and development considerations for craniomaxillofacial surgery. Oral Maxillofac Surg Clin North Am. 24:377–96. https://doi.org/10.1016/j.coms.2012.05.007. DOI: 10.1016/j.coms.2012.05.007. PMID: 22857717.

17. Liu YP, Behrents RG, Buschang PH. 2010; Mandibular growth, remodeling, and maturation during infancy and early childhood. Angle Orthod. 80:97–105. https://doi.org/10.2319/020309-67.1. DOI: 10.2319/020309-67.1. PMID: 19852647. PMCID: PMC8978730.

18. Broadbent BH, Golden WH. 1975. Bolton standards of dentofacial developmental growth. Mosby;St. Louis: https://search.worldcat.org/ko/title/Bolton-standards-of-dentofacial-developmental-growth/oclc/1207326.

19. Arksey H, O'Malley L. 2005; Scoping studies: towards a methodological framework. Int J Soc Res Methodol. 8:19–32. https://doi.org/10.1080/1364557032000119616. DOI: 10.1080/1364557032000119616.

20. Levac D, Colquhoun H, O'Brien KK. 2010; Scoping studies: advancing the methodology. Implement Sci. 5:69. https://doi.org/10.1186/1748-5908-5-69. DOI: 10.1186/1748-5908-5-69. PMID: 20854677. PMCID: PMC2954944. PMID: 3a6c8738730e4fe793eb151f2e924635.

21. Tricco AC, Lillie E, Zarin W, O'Brien KK, Colquhoun H, Levac D, et al. 2018; PRISMA extension for Scoping Reviews (PRISMA-ScR): checklist and explanation. Ann Intern Med. 169:467–73. https://doi.org/10.7326/M18-0850. DOI: 10.7326/M18-0850. PMID: 30178033.

22. Ouzzani M, Hammady H, Fedorowicz Z, Elmagarmid A. 2016; Rayyan-a web and mobile app for systematic reviews. Syst Rev. 5:210. https://doi.org/10.1186/s13643-016-0384-4. DOI: 10.1186/s13643-016-0384-4. PMID: 27919275. PMCID: PMC5139140.

23. National Heart, Lung, and Blood Institute (NHLBI). 2021. Study quality assessment tools [Internet]. NHLBI;Bethesda: Available from: https://www.nhlbi.nih.gov/health-topics/study-quality-assessment-tools. cited 2022 Feb 17.

24. Pan XG, Liu HH, Cao HJ. 1996; McNamara cephalometric analysis for Shanghai adolescents and adults. Shanghai Kou Qiang Yi Xue. 5:195–7. Chinese. https://pubmed.ncbi.nlm.nih.gov/15159982/.

25. Sobreira CR, Vilani GNL, de Siqueira VCV. 2011; Comparative study of facial proportions between Afro Brazilian and White Brazilian children from 8 to 10 years of age. Dental Press J Orthod. 16:85–93. https://doi.org/10.1590/S2176-94512011000200011. DOI: 10.1590/S2176-94512011000200011. PMID: 8d434e3ccd7e421eb7b3fb99ca073a9c.

26. AlShayea EI, Almoammar K, Alsultan M, Albarakati SF. 2022; Skeleto-dental features among a sample of Saudi female children compared to British standards: a cephalometric study. Niger J Clin Pract. 25:454–65. https://doi.org/10.4103/njcp.njcp_1819_21. DOI: 10.4103/njcp.njcp_1819_21. PMID: 35439904.

27. Chuang SY. 2000; Craniofacial growth changes of Mongolian children with normal occlusion from 8 to 12 years. Kaohsiung J Med Sci. 16:400–13. https://pubmed.ncbi.nlm.nih.gov/11221544/.

28. Jiménez I, Villegas L, Salazar-Uribe JC, Álvarez LG. 2020; Facial growth changes in a Colombian Mestizo population: an 18-year follow-up longitudinal study using linear mixed models. Am J Orthod Dentofacial Orthop. 157:365–76. https://doi.org/10.1016/j.ajodo.2019.04.032. DOI: 10.1016/j.ajodo.2019.04.032. PMID: 32115115.

29. Chang HP, Kinoshita Z, Kawamoto T. 1993; A study of the growth changes in facial configuration. Eur J Orthod. 15:493–501. https://doi.org/10.1093/ejo/15.6.493. DOI: 10.1093/ejo/15.6.493. PMID: 8112415.

30. Baccetti T, Franchi L, Grabowski R, Klink-Heckmann U, McNamara JA. Stahl de Castrillon F. 2013; Lateral cephalometric standards of Germans with normal occlusion from 6 to 17 years of age. J Orofac Orthop. 74:236–56. https://doi.org/10.1007/s00056-013-0140-5. DOI: 10.1007/s00056-013-0140-5. PMID: 23649277.

31. Moldez MA, Sato K, Sugawara J, Mitani H. 2006; Linear and angular Filipino cephalometric norms according to age and sex. Angle Orthod. 76:800–5. https://pubmed.ncbi.nlm.nih.gov/17029513/.

32. Humerfelt A. 1970; A roentgenographic cephalometric investigation of Norwegian children with normal occlusion. Scand J Dent Res. 78:117–43. https://doi.org/10.1111/j.1600-0722.1970.tb02062.x. DOI: 10.1111/j.1600-0722.1970.tb02062.x. PMID: 5273687.

33. Obloj B, Fudalej P, Dudkiewicz Z. 2008; Cephalometric standards for Polish 10-year-olds with normal occlusion. Angle Orthod. 78:262–9. https://doi.org/10.2319/011207-14.1. DOI: 10.2319/011207-14.1. PMID: 18251596.

34. Bishara SE, Abdalla EM, Hoppens BJ. 1990; Cephalometric comparisons of dentofacial parameters between Egyptian and North American adolescents. Am J Orthod Dentofacial Orthop. 97:413–21. https://doi.org/10.1016/0889-5406(90)70113-Q. DOI: 10.1016/0889-5406(90)70113-Q. PMID: 2333855.

35. Aleksić E, Lalić M, Milić J, Gajić M, Stanković Z, Jevremović D, et al. 2012; Cephalometric standards for 9 year-old Serbian children with neutroocclusion. Acta Stomatol Naissi. 28:1155–63. https://doi.org/10.5937/asn1265155A. DOI: 10.5937/asn1265155A. PMID: ea4cc614e91841649cd007e7604cbea8.

36. El-Batran M, Soliman N. El-Wakil Kh. 2008; The relationship between cranial base and maxillo-facial morphology in Egyptian children. Homo. 59:287–300. https://doi.org/10.1016/j.jchb.2008.06.004. DOI: 10.1016/j.jchb.2008.06.004. PMID: 18707682.

37. Zhao XG, Hans MG, Palomo JM, Lin JX. 2013; Comparison of Chinese and white Bolton standards at age 13. Angle Orthod. 83:809–16. https://doi.org/10.2319/110412-849.1. DOI: 10.2319/110412-849.1. PMID: 23368780. PMCID: PMC8744519.

38. Barter MA, Evans WG, Smit GL, Becker PJ. 1995; Cephalometric analysis of a Sotho-Tswana group. J Dent Assoc S Afr. 50:539–44. https://pubmed.ncbi.nlm.nih.gov/8613579/.

39. Thilander B, Persson M, Adolfsson U. 2005; Roentgen-cephalometric standards for a Swedish population. A longitudinal study between the ages of 5 and 31 years. Eur J Orthod. 27:370–89. https://doi.org/10.1093/ejo/cji033. DOI: 10.1093/ejo/cji033. PMID: 16043474.

40. Al-Taai N, Persson M, Ransjö M, Levring Jäghagen E, Fors R, Westerlund A. 2022; Craniofacial changes from 13 to 62 years of age. Eur J Orthod. 44:556–65. https://doi.org/10.1093/ejo/cjac011. DOI: 10.1093/ejo/cjac011. PMID: 35348638. PMCID: PMC9486882.

41. Ogaard B, Bishara SE. el-Batouti A. 1994; Longitudinal cephalometric standards for Norwegians between the ages of 6 and 18 years. Eur J Orthod. 16:501–9. https://doi.org/10.1093/ejo/16.6.501. DOI: 10.1093/ejo/16.6.501. PMID: 7720795.

42. Thilander B, Persson M, Skagius S. 1982; Roentgencephalometric standards for the facial skeleton and soft tissue profile of Swedish children and young adults. II. Comparisons with earlier Scandinavian normative data. Swed Dent J Suppl. 15:219–28. https://pubmed.ncbi.nlm.nih.gov/6963777/.

43. Jamison JE, Bishara SE, Peterson LC, DeKock WH, Kremenak CR. 1982; Longitudinal changes in the maxilla and the maxillary-mandibular relationship between 8 and 17 years of age. Am J Orthod. 82:217–30. https://doi.org/10.1016/0002-9416(82)90142-7. DOI: 10.1016/0002-9416(82)90142-7. PMID: 6961794.

44. Hamamci N, Başaran G, Kiralp S, Şahin S, Selek M, Arslan S. 2006; Longitudinal study of untreated skeletal Class I subject's growth and development with Mc Namara cephalometric analysis. Biotechnol Biotechnol Equip. 20:175–83. https://doi.org/10.1080/13102818.2006.10817398. DOI: 10.1080/13102818.2006.10817398.

45. Alió-Sanz J, Iglesias-Conde C, Pernía JL, Iglesias-Linares A, Mendoza-Mendoza A, Solano-Reina E. 2011; Retrospective study of maxilla growth in a Spanish population sample. Med Oral Patol Oral Cir Bucal. 16:e271–7. https://doi.org/10.4317/medoral.16.e271. DOI: 10.4317/medoral.16.e271. PMID: 21196851.

46. Taneja JR, Chopra SL, Gupta A. Anuradha. 1991; Steiner's norms for North Indian pre-school children. J Indian Soc Pedod Prev Dent. 8:36–7. https://pubmed.ncbi.nlm.nih.gov/2056345/.

47. Ajayi EO. 2005; Cephalometric norms of Nigerian children. Am J Orthod Dentofacial Orthop. 128:653–6. https://doi.org/10.1016/j.ajodo.2005.07.002. DOI: 10.1016/j.ajodo.2005.07.002. PMID: 16286214.

48. Huang WJ, Taylor RW, Dasanayake AP. 1998; Determining cephalometric norms for Caucasians and African Americans in Birmingham. Angle Orthod. 68:503–11. discussion 512https://pubmed.ncbi.nlm.nih.gov/9851347/.

49. Kapila S. 1989; Selected cephalometric angular norms in Kikuyu children. Angle Orthod. 59:139–44. https://pubmed.ncbi.nlm.nih.gov/2729667/.

50. de Freitas LM, Pinzan A, Janson G, Freitas KM, de Freitas MR, Henriques JF. 2007; Facial height comparison in young white and black Brazilian subjects with normal occlusion. Am J Orthod Dentofacial Orthop. 131:706.e1–6. https://doi.org/10.1016/j.ajodo.2006.10.013. DOI: 10.1016/j.ajodo.2006.10.013. PMID: 17561045.

51. Bishara SE, Fernandez AG. 1985; Cephalometric comparisons of the dentofacial relationships of two adolescent populations from Iowa and northern Mexico. Am J Orthod. 88:314–22. https://doi.org/10.1016/0002-9416(85)90131-9. DOI: 10.1016/0002-9416(85)90131-9. PMID: 3863489.

52. Janson G, Quaglio CL, Pinzan A, Franco EJ, de Freitas MR. 2011; Craniofacial characteristics of Caucasian and Afro-Caucasian Brazilian subjects with normal occlusion. J Appl Oral Sci. 19:118–24. https://doi.org/10.1590/s1678-77572011000200007. DOI: 10.1590/S1678-77572011000200007. PMID: 21552712. PMCID: PMC4243749. PMID: a5c0e5a1dae84136ba5276fc8b036d74.

53. Hassan AH. 2005; Cephalometric norms for the Saudi children living in the western region of Saudi Arabia: a research report. Head Face Med. 1:5. https://doi.org/10.1186/1746-160X-1-5. DOI: 10.1186/1746-160X-1-5. PMID: 16270926. PMCID: PMC1277013. PMID: d84da46b74b3456c9b57ba39efb3ba84.

54. Gleis R, Brezniak N, Lieberman M. 1990; Israeli cephalometric standards compared to Downs and Steiner analyses. Angle Orthod. 60:35–40. discussion 41https://pubmed.ncbi.nlm.nih.gov/2316902/.

55. Kilic N, Catal G, Oktay H. 2010; McNamara norms for Turkish adolescents with balanced faces and normal occlusion. Aust Orthod J. 26:33–7. https://doi.org/10.2478/aoj-2010-0006. DOI: 10.2478/aoj-2010-0006. PMID: e7a81e29a5fa462797b562a1cff0e879.

56. Singh I, Kumar KK, Raj P, Babu RH, Pithani N, Thekiya AH. 2019; Cephalometric evaluation of natural head position in Lingayat population of Karnataka. J Pharm Bioallied Sci. 11(Suppl 1):S59–66. https://doi.org/10.4103/jpbs.JPBS_194_18. DOI: 10.4103/JPBS.JPBS_194_18. PMID: 30923432. PMCID: PMC6398306. PMID: c98d0daa04db492794db83036021047c.

57. Storniolo-Souza JM, Seminario MP, Pinzan-Vercelino CRM, Pinzan A, Janson G. 2021; McNamara analysis cephalometric parameters in White-Brazilians, Japanese and Japanese-Brazilians with normal occlusion. Dental Press J Orthod. 26:e2119133. https://doi.org/10.1590/2177-6709.26.1.e2119133.oar. DOI: 10.1590/2177-6709.26.1.e2119133.oar. PMID: 33759961. PMCID: PMC8018756. PMID: a0014f5ef1154f14b1ffa19049c75a8a.

58. Vieira FP, Pinzan A, Janson G, Fernandes TM, Sathler RC, Henriques RP. 2014; Facial height in Japanese-Brazilian descendants with normal occlusion. Dental Press J Orthod. 19:54–66. https://doi.org/10.1590/2176-9451.19.5.054-066.oar. DOI: 10.1590/2176-9451.19.5.054-066.oar. PMID: 25715717. PMCID: PMC4296657. PMID: 37e6cb528e274f73a5f492261ef2f5c4.

59. Folaranmi N, Isiekwe M. 2013; Anterior face height values in a Nigerian population. Ann Med Health Sci Res. 3:583–7. https://doi.org/10.4103/2141-9248.122121. DOI: 10.4103/2141-9248.122121. PMID: 24380013. PMCID: PMC3868128.

60. Singh Rathore A, Dhar V, Arora R, Diwanji A. 2012; Cephalometric norms for Mewari children using Steiner's analysis. Int J Clin Pediatr Dent. 5:173–7. https://doi.org/10.5005/jp-journals-10005-1161. DOI: 10.5005/jp-journals-10005-1161. PMID: 25206163. PMCID: PMC4155890.

61. Bishara S, Ogaard B, Jakobsen J. el-Batouti A. 1995; Dentofacial changes in Norwegian and Iowan populations between 6 and 18 years of age. Eur J Orthod. 17:241–9. https://doi.org/10.1093/ejo/17.3.241. DOI: 10.1093/ejo/17.3.241. PMID: 7621925.

62. Hamdan AM, Rock WP. 2001; Cephalometric norms in an Arabic population. J Orthod. 28:297–300. https://doi.org/10.1093/ortho/28.4.297. DOI: 10.1093/ortho/28.4.297. PMID: 11709595.

63. Alexander TL, Hitchcock HP. 1978; Cephalometric standards for American Negro children. Am J Orthod. 74:298–304. https://doi.org/10.1016/0002-9416(78)90205-1. DOI: 10.1016/0002-9416(78)90205-1. PMID: 281133.

64. Beugre JB, Sonan NK, Beugre-Kouassi AM, Djaha F. 2007; Comparative cephalometric study of three different ethnic groups of black Africa with normal occlusion. Odontostomatol Trop. 30:34–44. https://pubmed.ncbi.nlm.nih.gov/17654886/.

65. de Freitas LM, de Freitas KM, Pinzan A, Janson G, de Freitas MR. 2010; A comparison of skeletal, dentoalveolar and soft tissue characteristics in white and black Brazilian subjects. J Appl Oral Sci. 18:135–42. https://doi.org/10.1590/s1678-77572010000200007. DOI: 10.1590/S1678-77572010000200007. PMID: 20485924. PMCID: PMC5349749. PMID: 6d69ab1d46b541368594676be8c47d26.

66. Gu Y, Hagg U, Wu J, Yeung S. 2011; Differences in dentofacial characteristics between southern versus northern Chinese adolescents. Aust Orthod J. 27:155–61. https://doi.org/10.2478/aoj-2011-0020. DOI: 10.2478/aoj-2011-0020. PMID: 178de6b43bc24443a6d10c6a2d8e963e.

67. Barbosa LAG, Araujo E, Behrents RG, Buschang PH. 2017; Longitudinal cephalometric growth of untreated subjects with Class II Division 2 malocclusion. Am J Orthod Dentofacial Orthop. 151:914–20. https://doi.org/10.1016/j.ajodo.2016.10.026. DOI: 10.1016/j.ajodo.2016.10.026. PMID: 28457269.

68. Björk A. 1966; Sutural growth of the upper face studied by the implant method. Acta Odontol Scand. 24:109–27. https://doi.org/10.3109/00016356609026122. DOI: 10.3109/00016356609026122. PMID: 5225742.

69. Lowrey GH, Watson EH. 1973. Growth and development of children. Year Book Medical Publishers;Chicago: https://search.worldcat.org/ko/title/624826.

70. Hardin AM, Valiathan M, Oh H, Knigge RP, McNulty KP, Leary EV, et al. 2020; Clinical implications of age-related change of the mandibular plane angle. Orthod Craniofac Res. 23:50–8. https://doi.org/10.1111/ocr.12342. DOI: 10.1111/ocr.12342. PMID: 31465622. PMCID: PMC6980205.

71. Hardin AM, Knigge RP, Oh H, Duren DL, Valiathan M, McNulty KP, et al. 2018. Growth-related change in the mandibular plane angle with clinical implications [Internet]. University of Missouri Health Care;Columbia, MO: Available from: https://hdl.handle.net/10355/66591. cited 2023 May 1.

72. Nahhas RW, Valiathan M, Sherwood RJ. 2014; Variation in timing, duration, intensity, and direction of adolescent growth in the mandible, maxilla, and cranial base: the Fels longitudinal study. Anat Rec (Hoboken). 297:1195–207. https://doi.org/10.1002/ar.22918. DOI: 10.1002/ar.22918. PMID: 24737730. PMCID: PMC4103980.

73. Marchiori GE, Sodré LO, da Cunha TCR, Torres FC, Rosário HD, Paranhos LR. 2015; Pleasantness of facial profile and its correlation with soft tissue cephalometric parameters: perception of orthodontists and lay people. Eur J Dent. 9:352–5. https://doi.org/10.4103/1305-7456.163323. DOI: 10.4103/1305-7456.163323. PMID: 26430362. PMCID: PMC4569985.