Developmental changes in craniofacial morphology in subjects with Duchenne muscular dystrophy.

Lateral cephalometric radiographs of 35 Japanese male patients suffering from Duchenne muscular dystrophy (DMD) were taken longitudinally from 10 to 20 years of age. Eighteen landmarks were placed and 15 angles and four linear distances calculated. Profile diagrams (profilograms) were produced to analyse changes in craniofacial morphological growth in the DMD subjects. The measurements were then compared with Japanese standards. In young patients with DMD, compared with the controls, the following were observed: a large gonial angle; clockwise rotation of the mandible; short sagittal length of the cranial base and protrusion of the upper incisors. In adult patients, the maxillary alveolus and the upper incisors were protruded, compared with the controls. Overbite in DMD subjects also showed a tendency to decrease. In the controls, mandibular growth direction tended to be straight down and forward, while in patients with DMD, the growth direction was down until approximately 16 years of age and, after that, a forward vector of growth was apparent. As a result, the tendency towards a clockwise rotation of the mandible in the adults was less than in the young patients. These findings showed that DMD significantly affects craniofacial morphology.