Biological arches and changes to the curvilinear form of the aging maxilla

The facial skeleton can be conceptualized as a series of arches aligned along a vertical axis, with regional differences in shape. Previous work suggested that the maxilla undergoes differential growth with time. Because these arch forms resemble geometric forms, it may be possible to measure changes to their shape with the aging process. A contour analysis of the aging maxilla was undertaken. Computed tomographic data were assembled retrospectively. Only men were studied, and they were divided into two groups: Young (aged 18 to 24 years; n = 6) and old (aged 40 to 66 years; n = 6). The computed tomography data were reconstructed into three-dimensional images and underwent standardization for comparison purposes. An axial view of the maxilla along the Frankfort horizontal was used for analysis. To quantify changes between curves, measurements were made of the vertical distance from eight equidistant points along each curve perimeter to a standardized baseline. Average arch forms for young and old men were then generated for comparison purposes. Each of the eight points along the older maxillary arch form existed further from the baseline than the younger arch form. This difference reached statistical significance at three of the eight points measured along the two curves. The greatest difference occurred at point 8 (p = .0006), which was at the medial maxilla near the nasomaxillary junction. The results of the study suggest that the actual contour of the maxilla undergoes changes as a result of the aging process. Mathematically defined idealized skeletal contours could help guide reconstructive surgery and aesthetic augmentation of the facial skeleton in the future. In addition, certain soft tissues of the face and torso seem to share a common shape (an alpha contour). This shape may also exhibit idealized forms open to quantitative analysis. The skeletal arch form and alpha contour most likely exhibit sexual dimorphism and will require further investigation. The ubiquity of the arch form in nature and possible implications for growth and development of the human facial skeleton are also discussed.