Table Of ContentCranio-facial Growth in Man
PROCEEDINGS OF A CONFERENCE ON GENETICS, BONE BIOLOGY,
AND ANALYSIS OF GROWTH DATA
HELD MAY 1-3, 1967, ANN ARBOR, MICHIGAN
Edited by
ROBERT E. MOYERS
and
WILTON M. KROGMAN
Cosponsored by the Center for Human Growth and Development,
University of Michigan; and the National Institute of Dental
Research and the Institute for Child Health and Human Develop-
ment, National Institutes of Health, Bethesda, Maryland (Research
Grant No. DE HD-02516)
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First edition 1971
Library of Congress Catalog Card No. 76-118872
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08 016331 9
Conference Participants
ACKERMAN, JAMES GRAINGER, ROBERT
Orthodontist Faculty of Dentistry
Westfield, New Jersey University of Toronto
Present Address: Toronto, Canada
Dept. of Orthodontics Present Address:
School of Dental Medicine Research Director
University of Pennsylvania Assoc. of Canadian Medical Colleges
Philadelphia Ottawa, Ontario
ANDERSON, CARL
GREEN, EARL L.
Department of Orthopedic Surgery
The Jackson Laboratory
University of California
Bar Harbor, Maine
Santa Rosa, California
BAER, MELVYN HARRIS, JAMES
School of Dentistry Department of Orthodontics
University of Detroit School of Dentistry
Detroit, Michigan University of Michigan
Present Address: Ann Arbor, Michigan
School of Dentistry, University of Michigan
Ann Arbor, Michigan HISAOKA, K. KENNETH
Oral-facial Growth and Development
BJORK, ARNE
National Institute of Dental Research
Department of Orthodontics
National Institutes of Health
Royal Dental College
Bethesda, Maryland
Copenhagen, Denmark
DULLEMEIJER, P. HOROWITZ, SIDNEY
Zoological Laboratories Institute of Reconstructive Plastic Surgery
University of Leiden School of Medicine
Leiden, The Netherlands New York University Medical Center
New York, New York
ENLOW, DONALD Present Address:
Department of Anatomy Department of Orthodontics
University of Michigan Columbia University
Ann Arbor, Michigan New York, New York
EVANS, F. GAYNOR
Department of Anatomy HOWELLS, W. W.
University of Michigan Department of Anthropology
Ann Arbor, Michigan Peabody Museum
Harvard University
FALCONER, D. S. Cambridge, Massachusetts
Institute of Animal Genetics
Edinburgh, Scotland
HOYTE, DAVID A. N.
FELTS, WILLIAM Department of Anatomy
Department of Anatomy University of the West Indies
University of Minnesota Kingston, Jamaica
Minneapolis, Minnesota
Present Address: HUNT, EDWARD
Department of Anatomy Department of Anthropology
Oklahoma Medical Center Hunter College
Oklahoma City New York, New York
FROST, HAROLD
HUNTER, W. STUART
Department of Orthopedics
School of Dentistry
Henry Ford Hospital
University of Michigan
Detroit, Michigan
Ann Arbor, Michigan
GOSS, R. J. Present Address:
Division of Biological and Medical Sciences Department of Orthodontics
Brown University University of Western Ontario
Providence, Rhode Island London, Ontario
JOHNSON, LENT C. NEEL, JAMES V.
Armed Forces Institute of Pathology Department of Human Genetics
Washington, D.C. University of Michigan
Ann Arbor, Michigan
JOHNSTON, LYSLE
Departments of Anatomy and Orthodontics OSBORNE, RICHARD
Western Reserve University Department of Genetics
Cleveland, Ohio University of Wisconsin
Madison, Wisconsin
KEMPTHORNE, OSCAR
Department of Statistics RAO, C. R.
Iowa State University Indian Statistical Institute
Ames, Iowa Calcutta, India
KLEIN, DAVID SCHULL, WILLIAM J.
Department of Genetics Department of Human Genetics
University of Geneva University of Michigan
Geneva, Switzerland Ann Arbor, Michigan
KOSKI, KALEVI SOLOW, BENI
Department of Orthodontics Department of Orthodontics
School of Dentistry The Royal Dental College
University of Turku Copenhagen, Denmark
Turku, Finland
TANNER, JAMES M.
KRESHOVER, SEYMOUR Institute of Child Health
National Institute of Dental Research University of London
National Institutes of Health London, England
Bethesda, Maryland
WALKER, GEOFFREY
KROGMAN, WILTON M. Philadelphia Center for Research in Child Growth
Philadelphia Center for Research in Child Growth Philadelphia, Pennsylvania
Philadelphia, Pennsylvania Present Address:
School of Dentistry
LEDLEY, ROBERT S. University of Michigan
National Biomedical Research Foundation Ann Arbor, Michigan
Silver Springs, Maryland
WESTERVELT, FRANKLIN H.
McELHANEY, JAMES H. Computing Center
Department of Theoretical and Applied Mechanics University of Michigan
West Virginia University Ann Arbor, Michigan
Morgantown, West Virginia
Present Address: WOODSIDE, DONALD
Highway Safety Research Institute Faculty of Dentistry
University of Michigan University of Toronto
Ann Arbor, Michigan Toronto, Ontario
MOORREES, COENRAAD F. A. YAEGER, JAMES
Forsyth Dental Center Department of Histology
Boston, Massachusetts School of Dentistry
University of Illinois
MOSS, MELVIN L. Chicago, Illinois
Dean of Dental School Present Address:
College of Physicians and Surgeons School of Dentistry
Columbia University University of Connecticut Health Center
New York, New York Hartford, Connecticut
MOYERS, ROBERT E.
Center for Human Growth and Development
University of Michigan
Ann Arbor, Michigan
Foreword
THE sense of excitement that has characterized dental research in recent years is nowhere
more apparent than in the area of growth and development. It is at this cutting edge of the
biomedical sciences where much significant new knowledge will be generated, contributing
to the ultimate prevention of many of the disorders that afflict man.
In carrying out its mission to improve the oral health of the people of the United States,
the National Institute of Dental Research has provided substantial support to research and
the training of research manpower in the area of normal and abnormal growth, development,
and function of the oral-facial complex. In addition to the contributions of the clinical
researcher, the skills of over 20 basic disciplines—ranging from genetics to physiology—
have been tapped.
Fundamental, however, to the spurring of progress in any field is a periodic evaluation of
the strengths and weaknesses in its base of knowledge. The conference on Cranio-facial
Growth illustrates one important approach to state-of-the-art reviews. The procedures of
this conference also will serve as a useful guide, not only to prospective and active investiga-
tors in the field, but to graduate students in their selection of a meaningful research topic.
Similarly, they will provide helpful insights to the NIDR in terms of future program plan-
ning. It is our hope that the perspectives afforded herein will lead to further substantive
accomplishments in a vital field of human biology.
SEYMOUR J. KRESHOVER, D.D.S., M.D., Ph.D.
Director, National Institute of Dental Research
vii
Preface
THE idea for a conference on cranio-facial growth originated in discussions of the Dental
Study Section, National Institutes of Health. The conference had its inception in awareness
of two kinds: the present state of knowledge in the area of cranio-facial growth, and of the
need yet to develop a broad spectrum of concept and data from all possibly related disci-
plines if further advances were to be made. Therefore, we began to plan a conference with
the premise that, though much progress had been made and primary direction had been
established, there was much we did not know. Accordingly, we decided to bring together
workers competent in the field of cranio-facial growth (both human and comparative) and
specialists in annectant fields who might be able to hasten our advances along directions
already discerned. In substance, we asked ourselves a series of questions: Where have we
been in cranio-facial growth? How far have we gotten? What are we achieving today?
Where are we going? What are the gaps seen and foreseeable ? What do we need to fill those
gaps? Who can help us? And how can they help? Will emerging concepts, methods and
data facilitate the application of basic knowledge?
Two kinds of scientists were invited to the conference: those already working in cranio-
facial growth, and those in related fields whose ideas, techniques, or strategies of research
might be grafted usefully onto that which was already functioning. It was decided to empha-
size three primary areas of cranio-facial research: bone biology, genetics, and the analysis of
growth data. In the sections and chapters which follow, we lay before you the results of the
conference held in Ann Arbor, Michigan, on May 1-3, 1967. The conference was jointly
sponsored by the National Institute of Dental Research, Dr. Seymour Kreshover, Director;
and the University of Michigan, which designated the conference one of the official sesqui-
centennial conferences in honor of the 150th anniversary of the University's founding.
This book consists of several kinds of papers arranged in six parts to emphasize the main
themes of the conference. Review papers, surveying an important and large area, were pre-
pared and distributed for reading by the participants before the conference began. Research
papers on specific topics were presented at the conference by experts in particular fields or
research methods. Seminars held during the conference were contrived exchanges of ideas
and interactions among several selected leaders on important problems of cranio-facial
growth. Their spontaneous discussions were recorded and edited for presentation herein.
Pathfinder papers were written during the conference and presented at its closing to synthe-
size our efforts and suggest new horizons and directions. The book is arranged for ease in
understanding and reading and is not a sequential presentation of the conference itself.
The reader will find herein answers to some of our original questions, but many more new
questions, for this is a report of progress—progress attained and progress projected into the
near future. The theme is today's knowledge and research methods integrated to provide
greater insight and applicability tomorrow.
ROBERT E. MOYERS
WILTON M. KROGMAN
ix
Introduction to Conference
DR. ROBERT E. MOYERS '.
It is my pleasure to welcome you on behalf of The University of Michigan, which is
celebrating its 150th anniversary this year. This conference is one of a series of official
sesquicentennial conferences.
Dr. Krogman and I have been planning this conference for two or three years, having
been designated to do so by the Dental Study Section, National Institutes of Health. The
conference is structured a bit differently than most such meetings, since it is intended to be
a working, participating conference. Dr. Krogman will explain the modus operandi.
DR. WILTON M. KROGMAN I
I would like to add a little to what Bob has said as to the genesis of this conference. To
confer is, in a sense, to get together for the purpose of expressing a mutual need for clarifica-
tion and an opportunity for further exposition. When you confer with somebody, you come
to an attitude of both giving and receiving, the idea being that there will be a free and un-
complicated exchange of concepts, information, and goals. This suggests what Bob and I
had in mind when we nodded to one another a couple of years ago. We were both on the
Dental Study Section and, as we reviewed many of the applications, we realized that they
were particulate, that they were isolate and, even if several were put together, there were
lacunae in continuity. The idea of fragmentation caused us to turn to one another and say,
in effect, "Look, we must provide the opportunity for a free exchange of ideas, with a
certain amount of structuring, that will given an opportunity for the presentation and
discussion of information and problems at several levels."
In simplest terms, the rationale, the very spirit, of the present conference is this: that it
brings together qualified men who are specialists, yet who are completely aware of the first
need of careful planning, i.e. the apperception of the hypotheses to be tested; a knowledge,
therefore, of an ultimate goal, the solution of which is to be sought. Secondly, thoughtful
prosecution. This refers to the working out of the total program. There must be represented
related steps that mesh, that integrate, that come together, so that we have a logical sequence
and emergent interrelationships. There must be the cumulative development of ideas.
Thirdly, we need conservative interpretation; i.e. we shall have emergent conclusions, ideas,
goals, visions, that represent a careful appraisal and evaluation, so that the interpretation
will be consistent with the data made available. Conservatism, therefore, in interpretation
and, finally and ultimately, integrative analysis.
This explains to you the thought processes by which the conference was developed. It was
emergent; it was an evolutionary process. There are three major types of papers. The first
type may be termed essays, or reports, on specific areas. For example, we shall hear papers on
both the ontogeny and phylogeny of cranio-facial growth, that there may be emergent
patterns of development at several levels: first, a level with reference to our own kind;
second, a perspective that will enable us to see in those forms of life that are antecedent to
us, an emergent continuity. We shall observe the basic ground pattern that has been our
3
DR. ROBERT Ε. MOYERS
phylogenetic inheritance and that through the selective mechanisms of hominid evolution
have become peculiarly our own. Cranio-facial growth of Homo sapiens is, of course, the
ultimate understanding that we hope to achieve; we seek the understanding of our own kind
in terms of those forms of mammalian life that are peculiarly adaptable to the experimental
approach, so that we may understand the phenomena that go into the total picture of human
growth. We shall proceed from the ultimate structure of bone on to those much more gross
phenomena of measuring, e.g. a roentgenographic cephalometric x-ray film, wherein we
must be content to talk about ± half a millimeter or ± one degree of arc. We shall proceed
from the microscopic by logical steps to the macroscopic, so that ultimately we may put our
data together in such fashion that they relate to the problems of the clinician in the several
fields or specialties of dentistry.
We then go on to what may be termed a "seminar". A seminar is, or should be, a dis-
cussion between intellectual equals, grouped quite literally around a table; individuals who
are not only able, but who are willing to participate, sharing of their own knowledge,
pooling the knowledge already spread before them by the more formal seminarians who
constitute the panels that have been set up.
We wish to emphasize that this is merely a structural dichotomy; it should not be divisive
in practice or in its working-out. If a few names appear as being on a panel, this is for the
priming of the pump—the lead comments, so to speak, which we hope and trust will be both
provocative and evocative, i.e. an intellectual discourse between equals.
We are hoping that the final three papers will be more than a mere recapitulation: "You
have heard this, you have heard that": we hope for papers that not only call to our atten-
tion, in a fashion of putting together, the various strands of thought that have been woven
into a pattern which we hope will eventuate in this conference. We hope to go even further
and step, as it were, into the bounds of the future and say: "Arising from what we have dis-
cussed in the preceding sessions are the goals and visions that we now feel are on the
extended horizons, that we, all of us, will envision as a result of hearing and sharing with
our colleagues." We are not going to lay before you anything, I trust, that is ivory tower,
anything that is isolate, anything that is particulate, anything that is not capable of being
implemented into the mainstream of thought concerning cranio-facial biology and develop-
ment. If I speak with a bit of vigor about ivory towers, it is because I recall the following
quatrain :
It has been ordained by higher Powers
And is a law sidereal
That those who dwell in ivory towers
Have heads of the same material.
I suggest that there are none of us who have cranial vaults of ivorine texture! We are
realists; we have worked in the field, and we realize the problems of relating our basic
findings to the clinician. This is essential in bridging the gap between theory and practice,
between statement and implementation, between concept and the working out of that con-
cept in the cultural values of our world, with special reference to the healing arts of medi-
cine and dentistry. We feel very sincerely that a fundamental integrative knowledge of
cranio-facial development will be to the advantage of both dentistry and medicine, and we
dedicate ourselves to that as our basic conference motivation.
DR. MOYERS :
As Bill has said, this conference had its genesis in several sessions of the Dental Study
4
INTRODUCTION TO CONFERENCE
Section. The Dental Study Section has sponsored several conferences which have been
singularly successful, e.g. the conference on salivary gland physiology. The hope was that,
by having a conference on cranio-facial growth, we, in a similar fashion, might recharge and
redirect the energies in the several laboratories around the world working in the field to new
lines of effort.
There are two kinds of people here: those who are already working in the cranio-facial
area, and those who are not. In each category there are three subtypes: (1) bone biologists,
(2) geneticists, and (3) those expert in the analysis and treatment of growth data. So we have
group A, those already trying to solve the problems of the face (bone biologists, geneticists,
and analysts) ; and group Β (the biologists, geneticists, and analysts) who do not know much
about the face yet, or at least haven't yet had any academic interest in the face. The basic
idea of the conference is to mix groups A and B.
Since the idea for the conference started in the Dental Study Section, it is appropriate
that a person from the National Institute of Dental Research make the first presentation,
though the conference is jointly sponsored by the Institute of Dental Research and the
Institute for Child Health and Human Development. Now Dr. Kenneth Hisaoka, who is in
charge of growth and development programs at the National Institute for Dental Research,
will present his report on "The role of growth research at the National Institute of Dental
Research".
5
Role of Growth Research at the
National Institute of Dental Research
K. KENNETH HISAOKA*
IT IS indeed a pleasure to have the honor of addressing this distinguished group on the
interest of the National Institute of Dental Research in cranio-facial growth. As a back-
ground for my report, I would like to refer briefly to the reorganization of the Extramural
Programs of the NIDR, since I believe that it will have a definite impact on research in
cranio-facial growth. Originally, the extramural programs of the NIDR were administered
in two broad sections: namely, research grants and training grants. Under the leadership of
Dr. Seymour Kreshover, Director, NIDR, these two components were dissolved and five
major program areas were formed. Each program area was designed to encompass both
research and research manpower support in a specified research category. I have been given
the responsibility for administering research grants, training grants, and fellowships in the
program area entitled "Oral-facial growth and development".
The new organizational structure of the extramural programs of the NIDR allows the
scientist administrators of each program area to give greater visibility to a circumscribed
area of research and permits them to relate to a specific segment of the research community.
It allows the scientist administrators of each program to analyze and review past support in
a prescribed research area and to ascertain the state of the art from time to time. The pro-
gram approach is useful from the standpoint of planning, developing, and catalyzing
research, and it permits the program leaders to focus their attention on specific research
areas. However, I would hasten to point out that the areas of research which are highlighted
by NIDR are not selected in an arbitrary fashion. Scientific peers from the academic commun-
ity are consulted from time to time so that proper guidance is made available to each program
area. In this connection the NIDR anticipates that the deliberations during this conference
will serve to advise NIDR of exciting new areas of research which should be encouraged.
The Oral-facial Growth and Development program encompasses a rather broad area. It
covers normal and abnormal growth and development of the cranio-facial region and of
other related growth components. More specifically, this program includes research in
normal or abnormal development relating to the cause, prevention, correction, and rehabili-
tative aspects of oral-facial malformations such as cleft palate or malocclusion. In addition,
studies in physiology, including neurophysiology, relating to the oral-facial area, will be
supported by this program.
The expenditures for research support will indicate the relative size of this program at the
present time. In fiscal year 1967, approximately $3,000,000 will be expended in support of
70 research projects, including eight program projects, by the Oral-facial Growth and
Development program. Included in this sum is approximately $1,000,000 in support of 35
projects relevant to cranio-facial growth.
*Chief, Oral-facial Growth and Development Program, National Institute of Dental Research, Bethesda, Md.
7
