Author:

Keywords:

Age Determination by Skeleton, Age Factors, Body Height, Cephalometry, Child, Child, Preschool, Cohort Studies, Evaluation Studies, Female, Follow-Up Studies, Growth Disorders, Growth Substances, Humans, Infant, Newborn, Infant, Small for Gestational Age, Injections, Subcutaneous, Male, Mandible, Maxilla, Maxillofacial Development, Nose, Retrognathism, Skull Base, Vertical Dimension, Science & Technology, Life Sciences & Biomedicine, Dentistry, Oral Surgery & Medicine, intra-uterine growth retardation, cephalometry, longitudinal study, INTRAUTERINE GROWTH, BINDING-PROTEINS, TURNERS SYNDROME, FINAL HEIGHT, HUMAN FETUS, CATCH-UP, RETARDATION, TERM, RESPONSES, BIRTH, Evaluation Studies as Topic, Retrognathia, 1105 Dentistry, Dentistry, 3203 Dentistry

Abstract:

The effects of growth hormone (GH) therapy in children have yet to be completely catalogued. In the present study, the effect of high-dose GH treatment on craniofacial growth was evaluated once yearly in 21 pre-pubertal, non-GH-deficient children born small for gestational age. These children were randomly allocated to be either untreated or treated with GH at a daily subcutaneous dose of 0.2 or 0.3 IU/kg for 2 yrs. The group consisted of 12 girls and 9 boys with a mean age of 5.1 yr (range, 2 to 8 yr), bone age of 3.4 yr, and height SDS of -3.6. At the start of the study, all children showed an overall delay of craniofacial growth. This cohort of short children born small for gestational age showed a small SNB angle and a large ANB angle; all other angular measurements were within normal range. GH treatment accelerated growth in several craniofacial components, especially the posterior total facial height, the cranial base length, and the overall mandibular length. The increase of the mandibular length increased the SNB angle; no other angular measurements were affected. Age at start of treatment differently influenced the increase in posterior and total cranial base length, the increase in mandibular corpus length, and the position of the mandible in relation to the cranial base. Although GH treatment for 2 yrs led to a craniofacial growth acceleration, the position of the mandible in relation to the cranial base and the craniofacial size in lateral aspect were not normalized in the majority of the GH-treated children. No signs of disproportional growth were evidenced after 2 yrs of high-dose GH treatment. In conclusion, short pre-pubertal SGA children display an overall delay of linear craniofacial growth and a retrognathic mandible. High-dose GH treatment over 2 yrs leads to craniofacial catch-up growth, which is pronounced in regions where interstitial cartilage is involved and results in a less convex face in profile.