Morphologic analysis of dentofacial structure in patients with acromegaly.

The purpose of this study was to investigate the morphologic changes of the oral and maxillofacial skeletal structure in patients with acromegaly and the correlation between growth hormone, age at onset, and duration. Fifty-four acromegalic patients (28 men and 26 women) were compared with 45 normal adults (23 men and 22 women) using casts and cephalometric analysis. The incisor relationship was classified into four types: edge-to-edge bite, crossbite, maxillary incisor protrusion, and normal bite. Many cases of edge-to-edge bite and crossbite were observed in acromegalic patients. The most characteristic craniofacial skeletal differences in patients with acromegaly were protruded glabella and increased anterior face height. Enlargement of the ascending ramus and prominence of the mandible, chin, and mouth were the most noticeable profile characteristics of acromegalic patients. Male patients tended to demonstrate downward mandibular advancement and crossbite, while females showed extension of the ascending ramus, downward displacement of mandible, bimaxillary alveolar protrusion, and edge-to-edge bite.