gms | German Medical Science

Objective: Changes in midfacial skeletal angles and widths have been identified to contribute to the appearance of the aging face. However, information on the onset and gender differences of these changes, as well as a complete understanding of the theory behind this clockwise rotation, remain elusive.

Material and methods: 157 Caucasian individuals (10 males and 10 females of each: 20–29 yrs, 30–39 yrs, 40–49 yrs, 50–59 yrs, 60–69 yrs, 70–79 yrs, 80–89 yrs & 8 males and 9 females 90–98 years) were investigated. Multi-planar computed tomographic scans with standardized angle and distance measurements in all 3 anatomical axes (x, y, z) in alignment to the sella – nasion (horizontal) line were conducted.

Results: Both males and females displayed an increase in orbital floor angle (p<0.001; maximum at 60–69 years), decrease in maxillary angle (p=0.035; 40–49 years), increase in palate angle (p<0.001; 50–59 years), increase in vomer angle (p=0.022, 30–39 years) but a decrease in the pterygoid angle (p=0.002, 80–89 years). Orbital width decreased (p<0.001; 60–69 yrs), pyriform aperture width increased (p=0.015; 60–69 yrs) and midfacial height decreased with aging (p<0.001; 60–69 yrs).

Conclusion: Age-related changes of the midfacial skeleton occurred independent of gender, but at various time points in different locations. The observed changes seem to be driven by a bone resorption center located in the posterior maxilla, rather than by a rotational movement of the facial skeleton.