Development of human craniofacial morphology during the late embryonic and early fetal periods.

After formation of the primary palate during the fifth and sixth weeks postconception (PC), human facial morphology develops rapidly and by 10 weeks PC the face has a typically human appearance. The objective of this study was to review major growth changes associated with development of face shape during this period. Morphometric evaluation of staged human embryos and fetuses in the Carnegie Embryological Collection showed that between 7 and 10 weeks PC when crown-rump (CR) length increased from 18 to 49 mm, facial structures grew predominantly in the sagittal plane, with a four-fold increase in length, a two-fold increase in height, but little change in width. These growth changes altered relations of oronasal structures and at 8 weeks PC the palatal shelves elevated. The sagittal position of the maxilla and the mandible to the anterior cranial base increased by 25 degrees and 30 degrees, respectively, and the mandible was prognathic during secondary palate closure in the first 2 weeks of fetal development. Both the mean cranial base angulation--which remained unchanged at 128 degrees--and the achieved maxillary position of 84 degrees were similar to the angulations present later, prenatally and postnatally. Therefore, human patterns of cranial base angulation and maxillary position appear to develop during the late embryonic period when the chondrocranium and Meckel's cartilage form the continuous craniofacial skeleton. The results suggest that rapid directional growth of the primary cartilages is important to development of normal human facial morphology and that interference with normal growth changes during this early critical period may produce irreversible effects on the face.