Skip to main content
Top
Published in: Journal of Orofacial Orthopedics / Fortschritte der Kieferorthopädie 1/2015

01-01-2015 | Original article

Prenatal indices for mandibular retrognathia/micrognathia

Authors: Dr. J. Neuschulz, L. Wilhelm, H. Christ, B. Braumann

Published in: Journal of Orofacial Orthopedics / Fortschritte der Kieferorthopädie | Issue 1/2015

Login to get access

Abstract

Objective

Micro- and retrognathia of mandibular origin may lead to life-threatening respiratory problems in connection with glossoptosis immediately after birth. Prenatal screening for this malformation is therefore increasingly important. Today this is accomplished by predominantly subjective standards. Objective criteria have been proposed but have not become established. We therefore made an effort to develop indices that would identify major skeletal discrepancies or micrognathia in as straightforward a fashion as possible during routine prenatal sonography.

Materials and methods

Series of fetal jaw sonograms (Toshiba Aplio MX®) were obtained in 313 women with normal pregnancies from weeks 19–29 of gestation. Upper- and lower-jaw landmarks were interactively located on screen and evaluated for reproducibility. Linear parameters representative of maxillary and mandibular length (SpA’–SpP’ and Rami–SymMe) were measured and related to femur length and gestational age. Based on these data, indices for maxillary, and mandibular length were derived and analyzed.

Results

High correlations were identified for mandibular length both with gestational age (R = 0.845; R2 = 0.713) and with femur length (correlation coefficients (R) = 0.839; coefficients of determination (R2) = 0.704). For maxillary length, the respective correlation coefficients were 0.691 (R2 = 0.477) and 0.656 (R2 = 0.430). Estimates of mandibular and maxillary length based on gestational age and femur length were obtained by regression analysis. The mean bimaxillary length ratio was 0.628 ± 0.043.

Conclusion

Maxillary and mandibular growth can be objectively evaluated via indices. It is conceivable to develop this approach into a sensitive and reliable method of prenatal jaw screening for major skeletal anomalies and congenital malformations.
Literature
1.
go back to reference Bacher M, Sautermeister J, Urschitz MS et al (2011) An oral appliance with velar extension for treatment of obstructive sleep apnea in infants with Pierre Robin sequence. Cleft Palate Craniofac J 48:331–336PubMedCrossRef Bacher M, Sautermeister J, Urschitz MS et al (2011) An oral appliance with velar extension for treatment of obstructive sleep apnea in infants with Pierre Robin sequence. Cleft Palate Craniofac J 48:331–336PubMedCrossRef
2.
go back to reference Benson CB, Pober BR, Hirsh P et al (1988) Sonography of Nager acrofacial dysostosis syndrome in utero. J Ultrasound Med 7:163–167PubMed Benson CB, Pober BR, Hirsh P et al (1988) Sonography of Nager acrofacial dysostosis syndrome in utero. J Ultrasound Med 7:163–167PubMed
3.
go back to reference Beriaghi S, Myers SL, Jensen SA et al (2009) Cleft lip and palate: association with other congenital malformations. J Clin Pediatr Dent 33:207–210PubMed Beriaghi S, Myers SL, Jensen SA et al (2009) Cleft lip and palate: association with other congenital malformations. J Clin Pediatr Dent 33:207–210PubMed
4.
go back to reference Brand IR, Kaminopetros P, Cave M et al (1994) Specificity of antenatal ultrasound in the Yorkshire Region: a prospective study of 2261 ultrasound detected anomalies. Br J Obstet Gynaecol 101:392–397PubMedCrossRef Brand IR, Kaminopetros P, Cave M et al (1994) Specificity of antenatal ultrasound in the Yorkshire Region: a prospective study of 2261 ultrasound detected anomalies. Br J Obstet Gynaecol 101:392–397PubMedCrossRef
5.
go back to reference Bromley B, Benacerraf BR (1994) Fetal micrognathia: associated anomalies and outcome. J Ultrasound Med 13:529–533PubMed Bromley B, Benacerraf BR (1994) Fetal micrognathia: associated anomalies and outcome. J Ultrasound Med 13:529–533PubMed
6.
go back to reference Campbell S, Lee C, Moscoco G et al (2005) Ultrasound antenatal diagnosis of cleft palate by a new technique: the 3D “reverse face” view. Ultrasound Obstet Gynecol 25:12–18PubMedCrossRef Campbell S, Lee C, Moscoco G et al (2005) Ultrasound antenatal diagnosis of cleft palate by a new technique: the 3D “reverse face” view. Ultrasound Obstet Gynecol 25:12–18PubMedCrossRef
7.
go back to reference Captier G, Faure JM, Bäumler M et al (2011) Prenatal assessment of the antero-posterior jaw relationship in human fetuses: from anatomical to ultrasound cephalometric analysis. Cleft Palate Craniofac J 48:465–472PubMedCrossRef Captier G, Faure JM, Bäumler M et al (2011) Prenatal assessment of the antero-posterior jaw relationship in human fetuses: from anatomical to ultrasound cephalometric analysis. Cleft Palate Craniofac J 48:465–472PubMedCrossRef
8.
go back to reference Chitty LS, Campbell S, Altman DG (1993) Measurement of the fetal mandible—feasibility and construction of a centile chart. Prenat Diagn 13:749–756PubMedCrossRef Chitty LS, Campbell S, Altman DG (1993) Measurement of the fetal mandible—feasibility and construction of a centile chart. Prenat Diagn 13:749–756PubMedCrossRef
9.
10.
go back to reference Cohen MM (1999) Robin sequences and complexes: causal heterogeneity and pathogenetic/phenotypic variability. Am J Med Genet 84:311–315PubMedCrossRef Cohen MM (1999) Robin sequences and complexes: causal heterogeneity and pathogenetic/phenotypic variability. Am J Med Genet 84:311–315PubMedCrossRef
11.
go back to reference Crane JP, Beaver HA (1986) Midtrimester sonographic diagnosis of mandibulofacial dysostosis. Am J Med Genet 25:251–255PubMedCrossRef Crane JP, Beaver HA (1986) Midtrimester sonographic diagnosis of mandibulofacial dysostosis. Am J Med Genet 25:251–255PubMedCrossRef
12.
go back to reference Ewigman BG, Crane JP, Frogoletto FD et al (1993) Effect of prenatal ultrasound screening on perinatal outcome. RADIUS Study Group. N Engl J Med 329:821–827PubMedCrossRef Ewigman BG, Crane JP, Frogoletto FD et al (1993) Effect of prenatal ultrasound screening on perinatal outcome. RADIUS Study Group. N Engl J Med 329:821–827PubMedCrossRef
13.
go back to reference Garmel SH, D’Alton ME (1994) Diagnostic ultrasound in pregnancy: an overview. Semin Perinatol 18:117–132PubMed Garmel SH, D’Alton ME (1994) Diagnostic ultrasound in pregnancy: an overview. Semin Perinatol 18:117–132PubMed
14.
go back to reference Garne E, Loane M, Dolk H et al (2005) Prenatal diagnosis of severe structural congenital malformations in Europe. Ultrasound Obstet Gynecol 25:6–11PubMedCrossRef Garne E, Loane M, Dolk H et al (2005) Prenatal diagnosis of severe structural congenital malformations in Europe. Ultrasound Obstet Gynecol 25:6–11PubMedCrossRef
15.
go back to reference Gillham JC, Anand S, Bullen PJ (2009) Antenatal detection of cleft lip with or without cleft palate: incidence of associated chromosomal and structural anomalies. Ultrasound Obstet Gynecol 34:410–415PubMedCrossRef Gillham JC, Anand S, Bullen PJ (2009) Antenatal detection of cleft lip with or without cleft palate: incidence of associated chromosomal and structural anomalies. Ultrasound Obstet Gynecol 34:410–415PubMedCrossRef
16.
go back to reference Götzmann L, Schönholzer SM, Köble N et al (2002) Suspected fetal malformation in ultrasound examination: effects on the psychological well-being of pregnant women. Ultraschall Med 23:33–40PubMedCrossRef Götzmann L, Schönholzer SM, Köble N et al (2002) Suspected fetal malformation in ultrasound examination: effects on the psychological well-being of pregnant women. Ultraschall Med 23:33–40PubMedCrossRef
17.
go back to reference Grandjean H, Larroque D, Levi S (1999) The performance of routine ultrasonographic screening of pregnancies in the Eurofetus Study. Am J Obstet Gynecol 181:446–454PubMedCrossRef Grandjean H, Larroque D, Levi S (1999) The performance of routine ultrasonographic screening of pregnancies in the Eurofetus Study. Am J Obstet Gynecol 181:446–454PubMedCrossRef
18.
go back to reference Hsieh YY, Chang CC, Tsai HD et al (1999) The prenatal diagnosis of Pierre-Robin sequence. Prenat Diagn 19:567–569PubMedCrossRef Hsieh YY, Chang CC, Tsai HD et al (1999) The prenatal diagnosis of Pierre-Robin sequence. Prenat Diagn 19:567–569PubMedCrossRef
19.
go back to reference Lee W, McNie B, Chaiworapongsa T et al (2002) Three-dimensional ultrasonographic presentation of micrognathia. J Ultrasound Med 21:775–781PubMed Lee W, McNie B, Chaiworapongsa T et al (2002) Three-dimensional ultrasonographic presentation of micrognathia. J Ultrasound Med 21:775–781PubMed
20.
go back to reference Levi S, Schaaps JP, De Havay P et al (1995) End-result of routine ultrasound screening for congenital anomalies: the Belgian Multicentric Study 1984-92. Ultrasound Obstet Gynecol 5:366–371PubMedCrossRef Levi S, Schaaps JP, De Havay P et al (1995) End-result of routine ultrasound screening for congenital anomalies: the Belgian Multicentric Study 1984-92. Ultrasound Obstet Gynecol 5:366–371PubMedCrossRef
21.
go back to reference Levi S (2003) Mass screening for fetal malformations: the Eurofetus study. Ultrasound Obstet Gynecol 22:555–558PubMedCrossRef Levi S (2003) Mass screening for fetal malformations: the Eurofetus study. Ultrasound Obstet Gynecol 22:555–558PubMedCrossRef
22.
go back to reference Li SL, Chen XL, Ouyang SY et al (2008) Analysis of 993 cases of fetal malformations from 1999 to 2006. Zhongguo Yi Xue Ke Xue Yuan Xue Bao 30:69–74PubMed Li SL, Chen XL, Ouyang SY et al (2008) Analysis of 993 cases of fetal malformations from 1999 to 2006. Zhongguo Yi Xue Ke Xue Yuan Xue Bao 30:69–74PubMed
23.
go back to reference Luedders DW, Bohlmann MK, Germer U et al (2011) Fetal micrognathia: objective assessment and associated anomalies on prenatal sonogram. Prenat Diagn 31:146–151PubMedCrossRef Luedders DW, Bohlmann MK, Germer U et al (2011) Fetal micrognathia: objective assessment and associated anomalies on prenatal sonogram. Prenat Diagn 31:146–151PubMedCrossRef
24.
go back to reference Maarse W, Bergé SJ, Pistorius L et al (2010) Diagnostic accuracy of transabdominal ultrasound in detecting prenatal cleft lip and palate: a systematic review. Ultrasound Obstet Gynecol 35:495–502PubMedCrossRef Maarse W, Bergé SJ, Pistorius L et al (2010) Diagnostic accuracy of transabdominal ultrasound in detecting prenatal cleft lip and palate: a systematic review. Ultrasound Obstet Gynecol 35:495–502PubMedCrossRef
25.
go back to reference Maarse W, Pistorius LP, Van Eeten WK et al (2011) Prenatal ultrasound screening for orofacial clefts. Ultrasound Obstet Gynecol 38:434–439PubMedCrossRef Maarse W, Pistorius LP, Van Eeten WK et al (2011) Prenatal ultrasound screening for orofacial clefts. Ultrasound Obstet Gynecol 38:434–439PubMedCrossRef
26.
go back to reference Martinez-Ten P, Adiego B, Illescas T et al (2012) First-trimester diagnosis of cleft lip and palate using three-dimensional ultrasonography. Ultrasound Obstet Gynecol 40:40–46PubMedCrossRef Martinez-Ten P, Adiego B, Illescas T et al (2012) First-trimester diagnosis of cleft lip and palate using three-dimensional ultrasonography. Ultrasound Obstet Gynecol 40:40–46PubMedCrossRef
27.
go back to reference Merz E, Eichhorn KH, Hansmann M et al (2002) Quality demands on continuing differential diagnostic sonography in prenatal diagnostics (DEGUM stage II) during the 18th to 22nd weeks of gestation. Ultraschall Med 23:11–12PubMedCrossRef Merz E, Eichhorn KH, Hansmann M et al (2002) Quality demands on continuing differential diagnostic sonography in prenatal diagnostics (DEGUM stage II) during the 18th to 22nd weeks of gestation. Ultraschall Med 23:11–12PubMedCrossRef
28.
go back to reference Merz E, Wellek S (1996) Normal fetal growth profile—a uniform model for calculating normal curves for current head and abdomen parameters and long limb bones. Ultraschall Med 17:153–162PubMedCrossRef Merz E, Wellek S (1996) Normal fetal growth profile—a uniform model for calculating normal curves for current head and abdomen parameters and long limb bones. Ultraschall Med 17:153–162PubMedCrossRef
29.
go back to reference Nicolaides KH, Salvesen DR, Snijders RJ et al (1993) Fetal facial defects: associated malformations and chromosomal abnormalities. Fetal Diagn Ther 8:1–9PubMedCrossRef Nicolaides KH, Salvesen DR, Snijders RJ et al (1993) Fetal facial defects: associated malformations and chromosomal abnormalities. Fetal Diagn Ther 8:1–9PubMedCrossRef
30.
go back to reference Offerdal K, Jebens N, Syvertsen T et al (2008) Prenatal ultrasound detection of facial clefts: a prospective study of 49,314 deliveries in a non-selected population in Norway. Ultrasound Obstet Gynecol 31:639–646PubMedCrossRef Offerdal K, Jebens N, Syvertsen T et al (2008) Prenatal ultrasound detection of facial clefts: a prospective study of 49,314 deliveries in a non-selected population in Norway. Ultrasound Obstet Gynecol 31:639–646PubMedCrossRef
31.
go back to reference Otto C, Platt LD (1991) The fetal mandible measurement: an objective determination of fetal jaw size. Ultrasound Obstet Gynecol 1:12–17PubMedCrossRef Otto C, Platt LD (1991) The fetal mandible measurement: an objective determination of fetal jaw size. Ultrasound Obstet Gynecol 1:12–17PubMedCrossRef
32.
go back to reference Paladini D, Morra T, Teodoro A et al (1999) Objective diagnosis of micrognathia in the fetus: the jaw index. Obstet Gynecol 93:382–386PubMedCrossRef Paladini D, Morra T, Teodoro A et al (1999) Objective diagnosis of micrognathia in the fetus: the jaw index. Obstet Gynecol 93:382–386PubMedCrossRef
33.
go back to reference Paladini D (2010) Fetal micrognathia: almost always an ominous finding. Ultrasound Obstet Gynecol 35:377–384PubMedCrossRef Paladini D (2010) Fetal micrognathia: almost always an ominous finding. Ultrasound Obstet Gynecol 35:377–384PubMedCrossRef
34.
go back to reference Pilu G, Reece EA, Romero R et al (1986) Prenatal diagnosis of craniofacial malformations with ultrasonography. Am J Obstet Gynecol 155:45–50PubMedCrossRef Pilu G, Reece EA, Romero R et al (1986) Prenatal diagnosis of craniofacial malformations with ultrasonography. Am J Obstet Gynecol 155:45–50PubMedCrossRef
35.
go back to reference Pilu G, Romero R, Reece EA et al (1986) The prenatal diagnosis of Robin anomalad. Am J Obstet Gynecol 154:630–632PubMedCrossRef Pilu G, Romero R, Reece EA et al (1986) The prenatal diagnosis of Robin anomalad. Am J Obstet Gynecol 154:630–632PubMedCrossRef
36.
go back to reference Pilu G, Segata M (2007) A novel technique for visualization of the normal and cleft fetal secondary palate: angled insonation and three-dimensional ultrasound. Ultrasound Obstet Gynecol 29:166–169PubMedCrossRef Pilu G, Segata M (2007) A novel technique for visualization of the normal and cleft fetal secondary palate: angled insonation and three-dimensional ultrasound. Ultrasound Obstet Gynecol 29:166–169PubMedCrossRef
37.
go back to reference Platt LD, Devore GR, Pretorius DH (2006) Improving cleft palate/cleft lip antenatal diagnosis by 3-dimensional sonography: the “flipped face” view. J Ultrasound Med 25:1423–1430PubMed Platt LD, Devore GR, Pretorius DH (2006) Improving cleft palate/cleft lip antenatal diagnosis by 3-dimensional sonography: the “flipped face” view. J Ultrasound Med 25:1423–1430PubMed
38.
go back to reference Richmond S, Atkins J (2005) A population-based study of the prenatal diagnosis of congenital malformation over 16 years. BJOG 112:1349–1357PubMedCrossRef Richmond S, Atkins J (2005) A population-based study of the prenatal diagnosis of congenital malformation over 16 years. BJOG 112:1349–1357PubMedCrossRef
39.
go back to reference Roelfsema N, Hop W, Wladimiroff J (2006) Three-dimensional sonographic determination of normal fetal mandibular and maxillary size during the second half of pregnancy. Ultrasound Obstet Gynecol 28:950–995PubMedCrossRef Roelfsema N, Hop W, Wladimiroff J (2006) Three-dimensional sonographic determination of normal fetal mandibular and maxillary size during the second half of pregnancy. Ultrasound Obstet Gynecol 28:950–995PubMedCrossRef
40.
go back to reference Rotten D, Levaillant JM, Martinez H et al (2002) The fetal mandible: a 2D and 3D sonographic approach to the diagnosis of retrognathia and micrognathia. Ultrasound Obstet Gynecol 19:122–130PubMedCrossRef Rotten D, Levaillant JM, Martinez H et al (2002) The fetal mandible: a 2D and 3D sonographic approach to the diagnosis of retrognathia and micrognathia. Ultrasound Obstet Gynecol 19:122–130PubMedCrossRef
41.
go back to reference Schaefer RB, Stadler JA III, Gosain AK (2004) To distract or not to distract: an algorithm for airway management in isolated Pierre Robin sequenz. Plast Reconstr Surg 113:1113–1125PubMedCrossRef Schaefer RB, Stadler JA III, Gosain AK (2004) To distract or not to distract: an algorithm for airway management in isolated Pierre Robin sequenz. Plast Reconstr Surg 113:1113–1125PubMedCrossRef
42.
go back to reference Sepulveda W, Wong AE, Vinas F et al (2012) Absent mandibular gap in the retronasal triangle view: a clue to the diagnosis of micrognathia in the first trimester. Ultrasound Obstet Gynecol 39:152–156PubMedCrossRef Sepulveda W, Wong AE, Vinas F et al (2012) Absent mandibular gap in the retronasal triangle view: a clue to the diagnosis of micrognathia in the first trimester. Ultrasound Obstet Gynecol 39:152–156PubMedCrossRef
43.
go back to reference Sepulveda W, Wong AE, Castro F et al (2011) Feasibility of 3-dimensional sonographic examination of the fetal secondary palate during the second-trimester anatomy scan. J Ultrasound Med 30:1619–1624PubMed Sepulveda W, Wong AE, Castro F et al (2011) Feasibility of 3-dimensional sonographic examination of the fetal secondary palate during the second-trimester anatomy scan. J Ultrasound Med 30:1619–1624PubMed
44.
go back to reference Sepulveda W, Wong AE, Martinez-Ten P et al (2010) Retronasal triangle: a sonographic landmark for the screening of cleft palate in the first trimester. Ultrasound Obstet Gynecol 35:7–13PubMedCrossRef Sepulveda W, Wong AE, Martinez-Ten P et al (2010) Retronasal triangle: a sonographic landmark for the screening of cleft palate in the first trimester. Ultrasound Obstet Gynecol 35:7–13PubMedCrossRef
45.
go back to reference Sivan E, Chan L, Masllozzi-Eberle A et al (1997) Sonographic imaging of the fetal face and the establishment of normative dimensions for chin length and upper lip width. Am J Perinatol 14:191–194PubMedCrossRef Sivan E, Chan L, Masllozzi-Eberle A et al (1997) Sonographic imaging of the fetal face and the establishment of normative dimensions for chin length and upper lip width. Am J Perinatol 14:191–194PubMedCrossRef
46.
go back to reference Stoll C, Dott B, Alembik Y et al (1995) Evaluation of routine prenatal diagnosis by a registry of congenital anomalies. Prenat Diagn 15:791–800PubMedCrossRef Stoll C, Dott B, Alembik Y et al (1995) Evaluation of routine prenatal diagnosis by a registry of congenital anomalies. Prenat Diagn 15:791–800PubMedCrossRef
47.
go back to reference Teoh M, Meagher S (2003) First-trimester diagnosis of micrognathia as a presentation of Pierre Robin syndrome. Ultrasound Obstet Gynecol 21:616–618PubMedCrossRef Teoh M, Meagher S (2003) First-trimester diagnosis of micrognathia as a presentation of Pierre Robin syndrome. Ultrasound Obstet Gynecol 21:616–618PubMedCrossRef
48.
go back to reference Tsai MY, Lan KC, Ou CY et al (2004) Assessment of the facial features and chin development of fetuses with use of serial three-dimensional sonography and the mandibular size monogram in a Chinese population. Am J Obstet Gynecol 190:541–546PubMedCrossRef Tsai MY, Lan KC, Ou CY et al (2004) Assessment of the facial features and chin development of fetuses with use of serial three-dimensional sonography and the mandibular size monogram in a Chinese population. Am J Obstet Gynecol 190:541–546PubMedCrossRef
49.
go back to reference Turner GM, Twining P (1993) The facial profile in the diagnosis of fetal abnormalities. Clin Radiol 47:389–395PubMedCrossRef Turner GM, Twining P (1993) The facial profile in the diagnosis of fetal abnormalities. Clin Radiol 47:389–395PubMedCrossRef
50.
go back to reference Vettraino IM, Lee W, Bronsteen RA et al (2003) Clinical outcome of fetuses with sonographic diagnosis of isolated micrognathia. Obstet Gynecol 102:801–805PubMedCrossRef Vettraino IM, Lee W, Bronsteen RA et al (2003) Clinical outcome of fetuses with sonographic diagnosis of isolated micrognathia. Obstet Gynecol 102:801–805PubMedCrossRef
51.
go back to reference Watson WJ, Katz VL (1993) Sonographic measurement of the fetal mandible: standards for normal pregnancy. Am J Perinatol 10:226–228PubMed Watson WJ, Katz VL (1993) Sonographic measurement of the fetal mandible: standards for normal pregnancy. Am J Perinatol 10:226–228PubMed
52.
go back to reference Wayne C, Cook K, Sairam S et al (2002) Sensitivity and accuracy of routine antenatal ultrasound screening for isolated facial clefts. Br J Radiol 75:584–589PubMedCrossRef Wayne C, Cook K, Sairam S et al (2002) Sensitivity and accuracy of routine antenatal ultrasound screening for isolated facial clefts. Br J Radiol 75:584–589PubMedCrossRef
53.
go back to reference Wilhelm L, Borgers H (2010) The ‘equals sign’: a novel marker in the diagnosis of fetal isolated cleft palate. Ultrasound Obstet Gynecol 36:439–444PubMedCrossRef Wilhelm L, Borgers H (2010) The ‘equals sign’: a novel marker in the diagnosis of fetal isolated cleft palate. Ultrasound Obstet Gynecol 36:439–444PubMedCrossRef
54.
go back to reference Wilhelm L, Braumann B (2012) Sonographic evaluation of fetal clefts of the lip, alveolus and palate. Z Geburtshilfe Neonatol 216:63–72PubMedCrossRef Wilhelm L, Braumann B (2012) Sonographic evaluation of fetal clefts of the lip, alveolus and palate. Z Geburtshilfe Neonatol 216:63–72PubMedCrossRef
55.
go back to reference Zalel Y, Gindes L, Achiron R (2006) The fetal mandible: an in utero sonographic evaluation between 11 and 31 weeks’ gestation. Prenat Diagn 26:163–167PubMedCrossRef Zalel Y, Gindes L, Achiron R (2006) The fetal mandible: an in utero sonographic evaluation between 11 and 31 weeks’ gestation. Prenat Diagn 26:163–167PubMedCrossRef
Metadata
Title
Prenatal indices for mandibular retrognathia/micrognathia
Authors
Dr. J. Neuschulz
L. Wilhelm
H. Christ
B. Braumann
Publication date
01-01-2015
Publisher
Springer Berlin Heidelberg
Published in
Journal of Orofacial Orthopedics / Fortschritte der Kieferorthopädie / Issue 1/2015
Print ISSN: 1434-5293
Electronic ISSN: 1615-6714
DOI
https://doi.org/10.1007/s00056-014-0257-1

Other articles of this Issue 1/2015

Journal of Orofacial Orthopedics / Fortschritte der Kieferorthopädie 1/2015 Go to the issue

Informationen

Mitteilungsseiten