Frontal Bone Morphology in Different Age and Gender Groups Using Computed Tomography

Abstract

Background The shape of the forehead is primarily determined by the frontal bone, which holds significance for health and aesthetics. This study evaluated the morphology of the frontal bone in different age groups and genders using computed tomography (CT).

Methods This cross-sectional study was conducted on CT scan results of 220 patients divided into three age groups: 20–29.27, 29.27–47.54, and 47.54–95 years. The investigation explored the lower and upper angles compared with the Sella–Nasion (SN) line, the maximum frontal projection with Nasion in the SN plan, and the variations in frontal thickness across different angles (15, 30, 45, 60, 75, and 90 degrees) relative to the SN plane. All data were analyzed using R software, considering the significance level p < 0.05.

Results Of 220 patients, 119 were men, and the mean age of the participants was 41.09 ± 18.06 years. The average upper frontal slope (UFS) angle was 56.96 ± 8.17 degrees, which was 59.35 ± 7.92 degrees in females and 54.94 ± 7.86 degrees in males. The mean lower frontal slope (LFS) angle was 86.30 ± 7.96 degrees, which was 90.71 ± 6.67 degrees in females and 82.55 ± 7.00 degrees in males. The average contour nasion (C–N) distance was 7.51 ± 3.72 mm. Also, the frontal thickness at an angle of 15 degrees had the highest value of 13.08 ± 2.68 mm and at 30 degrees had the lowest value of 5.81 ± 1.56 mm. A significant difference was observed between the UFS and LFS among males and females (p < 0.001). Across all age groups, men exhibited a steeper angle, indicating a greater posterior inclination than women. Moreover, males with upper ages reported a significant increase in C–N distance and frontal projection (p < 0.05).

Conclusion Our findings emphasize the importance of considering gender-specific variations in frontal bone structure when planning cosmetic or reconstructive procedures involving the forehead.

Keywords

frontal bone - frontal thickness - upper frontal slop - lower frontal slop

Ethical Approval

The study was approved by the medical ethics committee of the Qazvin University of Medical Sciences, Qazvin, Iran (IR.QUMS.REC.1402.075). All methods were performed in accordance with relevant guidelines and regulations that is Declaration of Helsinki.

Patient Consent

All subjects gave their informed consent to participate in the study.

Availability of Data and Materials

The datasets used and/or analyzed in the current study are available from the corresponding author upon reasonable request.

Authors' Contributions

A.H.B, A.N., A.K., and M.T. participated in the research design. A.H.B., F.T-D., and A.N. participated in writing the first draft. A.H.B., M.T., and A.A. participated in the performance of the research and analytic tools. A.H.B., A.A., and A.K. participated in data analysis. All authors reviewed and confirmed the final manuscript.

^* These authors contributed equally to the article.

Publikationsverlauf

Artikel online veröffentlicht:
11. November 2024

• References

• 1 Yi HS. Morphology of the aging forehead: a three-dimensional computed tomographic study. Arch Craniofac Surg 2015; 16 (02) 58-62
• 2 Frank K, Gotkin RH, Pavicic T. et al. Age and gender differences of the frontal bone: a computed tomographic (CT)-based study. Aesthet Surg J 2019; 39 (07) 699-710
• 3 Krishna D, Khan MM, Dubepuria R, Chaturvedi G, Cheruvu VPR. Reconstruction of scalp and forehead defects: options and strategies. Cureus 2023; 15 (07) e41479
• 4 Dumitru M, Vrinceanu D, Banica B. et al. Management of aesthetic and functional deficits in frontal bone trauma. Medicina (Kaunas) 2022; 58 (12) 58
• 5 Jeyaraj P. Frontal bone fractures and frontal sinus injuries: treatment paradigms. Ann Maxillofac Surg 2019; 9 (02) 261-282
• 6 Chattopadhyay C. Reconstruction of acquired frontal bone defects using titanium mesh implants: a retrospective study. J Maxillofac Oral Surg 2019; 18 (01) 34-39
• 7 Singh O, Varacallo M. Anatomy, Head and Neck, Frontal Bone. StatPearls [Internet]; 2018
• 8 Roumeliotis G, Inciarte M, Thomas G, Wall S, Mathijssen I, Johnson D. Congenital ossification defects of the frontal bone: description of a novel clinical entity and the management of four patients. J Craniofac Surg 2021; 32 (01) 92-96
• 9 Anderson PJ, Yong R, Surman TL, Rajion ZA, Ranjitkar S. Application of three-dimensional computed tomography in craniofacial clinical practice and research. Aust Dent J 2014; 59 (Suppl. 01) 174-185
• 10 Kapila SD. Cone Beam Computed Tomography in Orthodontics: Indications, Insights, and Innovations. John Wiley & Sons; 2014
• 11 Park J-A, Lee Y-J, Yeo I-S, Koh K-S, Song W-C. Three-dimensional linear and volumetric computed tomography analysis of the frontal sinus. Anat Cell Biol 2022; 55 (02) 142-147
• 12 Xue N, Ding X, Huang R. et al. Bone tissue engineering in the treatment of bone defects. Pharmaceuticals (Basel) 2022; 15 (07) 15
• 13 Garritano FG, Quatela VC. Surgical anatomy of the upper face and forehead. Facial Plast Surg 2018; 34 (02) 109-113
• 14 Kloss FR, Offermanns V, Kloss-Brandstätter A. Comparison of allogeneic and autogenous bone grafts for augmentation of alveolar ridge defects-A 12-month retrospective radiographic evaluation. Clin Oral Implants Res 2018; 29 (11) 1163-1175
• 15 Dova S, Karkos PD, Constantinidis J. Reconstruction of frontal defects with calvarial grafts. Rhinology 2018; 56 (03) 297-302
• 16 Petaros A, Garvin HM, Sholts SB, Schlager S, Wärmländer SKTS. Sexual dimorphism and regional variation in human frontal bone inclination measured via digital 3D models. Leg Med (Tokyo) 2017; 29: 53-61
• 17 Salinas CA, Liu A, Sharaf BA. Analysis of hairline and forehead sexual dimorphic aesthetics in 60 celebrities using artificial intelligence. Plast Reconstr Surg Glob Open 2023; 11 (07) e5107
• 18 Lee MK, Sakai O, Spiegel JH. CT measurement of the frontal sinus - gender differences and implications for frontal cranioplasty. J Craniomaxillofac Surg 2010; 38 (07) 494-500
• 19 Roosenboom J, Indencleef K, Lee MK. et al. SNPs associated with testosterone levels influence human facial morphology. Front Genet 2018; 9: 497
• 20 Toledo Avelar LE, Cardoso MA, Santos Bordoni L, de Miranda Avelar L, de Miranda Avelar JV. Aging and sexual differences of the human skull. Plast Reconstr Surg Glob Open 2017; 5 (04) e1297
• 21 Urban JE, Weaver AA, Lillie EM, Maldjian JA, Whitlow CT, Stitzel JD. Evaluation of morphological changes in the adult skull with age and sex. J Anat 2016; 229 (06) 838-846
• 22 Lipko-Godlewska S, Bolanča Ž, Kalinová L. et al. Whole-face approach with hyaluronic acid fillers. Clin Cosmet Investig Dermatol 2021; 14: 169-178
• 23 Belaldavar C, Kotrashetti VS, Hallikerimath SR, Kale AD. Assessment of frontal sinus dimensions to determine sexual dimorphism among Indian adults. J Forensic Dent Sci 2014; 6 (01) 25-30
• 24 Paskhover B, Durand D, Kamen E, Gordon NA. Patterns of change in facial skeletal aging. JAMA Facial Plast Surg 2017; 19 (05) 413-417