title: Three-dimensional Bolton-Brush Growth Study landmark data: ontogeny and sexual dimorphism of the Bolton standards cohort.
abstract: OBJECTIVE
  The treatment of craniofacial reconstructive surgery patients may benefit from comparison to average referent three-dimensional landmark data. These data may be useful for diagnosis, treatment planning, prosthetic design, or outcomes assessment. With regard to subadult patients, we hypothesize that the pattern of ontogenetic shape change of same sex, same ethnicity, referent populations will show gross uniformity. We present a preliminary shape analysis of 50 three-dimensional landmarks derived from 317 Bolton-Brush Growth Study biorthogonal image pairs. We determine which landmarks can be collected from scanned radiographs reliably by four operators for the precisely locatable points, ontogenetic trends in landmark configuration shape change, and patterns of sexual dimorphism.
  
  
  METHODS
  Participants were Bolton standards individuals (16 male and 16 female) who contributed biplane cephalograms seven or more times with annual or greater spacing between ages 3 and 18 years.
  
  
  METHODS
  After removing outliers, we searched for ontogenetic heterogeneity, including sexual dimorphism and within sex-specific Procrustes coordinate shape spaces.
  
  
  RESULTS
  A cut-off of 4.3-mm interoperator error left 32 landmarks in our analysis. Three different approaches (principal component analysis, age-trend analysis, and principal components of age residuals) all found no patterns of individual variation around sex-specific average trends of shape change. Male shape change peaks at age 15, a correlate of the growth spurt.
  
  
  CONCLUSIONS
  Simultaneous frontal and lateral anatomic landmark identification improves three-dimensional localization reliability. Three-dimensional craniodental shape change from ages 8 to 18 within the Bolton standards presents little heterogeneity. Considerations of ethnicity aside, these may be initial grounds for use of these data as a normative referent.
authors.affiliation: Department of Neurological Surgery, School of Medicine, Case Western Reserve University, Cleveland, Ohio 44106-4905, USA. dxd35@po.cwru.edu
authors.forename: D
authors.initials: D
authors.lastname: Dean
authors.forename: M G
authors.initials: MG
authors.lastname: Hans
authors.forename: F L
authors.initials: FL
authors.lastname: Bookstein
authors.forename: K
authors.initials: K
authors.lastname: Subramanyan
mesh_terms: D000293:Adolescent; D000367:Age Factors; D002508:Cephalometry / Q000592:standards*; D002648:Child; D002675:Child, Preschool; D003627:Data Interpretation, Statistical; D005147:Facial Bones / Q000033:anatomy & histology* / Q000000981:diagnostic imaging / Q000254:growth & development; D005260:Female; D006801:Humans; D008297:Male; D008445:Maxillofacial Development; D015999:Multivariate Analysis; D011856:Radiographic Image Enhancement; D011857:Radiographic Image Interpretation, Computer-Assisted; D012015:Reference Standards; D012044:Regression Analysis; D015203:Reproducibility of Results; D012727:Sex Characteristics