Endocrine Abstracts

Growth is a complex process, influenced to a large extent by GH. Children with GH deficiency (GHD) have typical somatic features, including short stature and a reduction of the craniofacial structures. Dental age (DA) is normally delayed in relation to chronological age (CA). The effect of GH replacement on craniofacial growth is still poorly understood. We studied the craniofacial development and dental maturation in 17 patients (4F, 13M) with GHD of different etiologies. The length of rhGH treatment lasted from 0–15.2 yr. The median CA was 16.2±3.9 yr (±S.D.). BA varied from 5–18 yr and DA, from 7.7–17 yr. Mean stature Z-escore was −1.8±1.8 (mean±S.D.). Craniofacial morphology was analysed by standardized lateral cephalometric radiographs with 21 measurements. DA was calculated by panoramic radiographs and BA was estimated by left hand-wrist radiographs. This study was approved by the local Ethics Committee. Statistics were performed using the principal component analysis, simple linear regression and Pearson correlation coefficient. P values <0.05 were considered significant. The most affected measures were the posterior cranial base, position of the temporomandibular articulation, facial height and mandibular length, that had correlation with BA and lenght of GH treatment (P<0.05). BA was delayed in comparison with CA and DA. There were no significant differences between CA and DA. We observed a positive correlation between BA and DA (r=0.8), CA and BA (r=0.8), and CA and DA (r=0.7). In conclusion, we showed that our group of GHD patients presents with a short face (mainly in the lower third) and a retropositioned mandible, conferring a more convex face profile to them. A longitudinal study will provide a greater knowledge of the effect of rhGH treatment on the craniofacial structures, looking for earlier orthodontic follow-up and better results in these children.