Orthodontics and foetal pathology: a personal view on craniofacial patterning

Pathology is the field in medicine dealing with structural and functional changes in tissues and organs which cause or are caused by disease (Taylor, 1988). Foetal pathology is encountered in the foetus aborted either deliberately or spontaneously during the first trimesters of pregnancy (Keeling, 1994). Foetal pathology differs from general pathology in many ways; by focussing on the developmental disorders not compatible with life. The severity of foetal pathological conditions is more extreme than those seen after birth. Though less interest has traditionally been devoted to analysing these rare conditions, some pioneering researchers have been aware of the importance of diagnostics and systematization in the field of foetal pathology. New methods of prenatal diagnosis, particularly ultrasound, amniocentesis, and maternal serum alphafetoprotein estimation mean that many more severely malformed foetuses are identified and accordingly the need for exact prenatal diagnostics has significantly increased. Currently, the main textbooks in foetal pathology are Buyse (1990), Keeling (1993, 1994), Gilbert-Barness (1997), Gilbert-Barness and Debich-Spicer (2004), and Schumacher et al. (2004). Even though the discipline of foetal pathology gained more focus during the 1990s, particularly cranial analysis of aborted foetuses is still random and unsystematic. Diagnosing cranial malformations requires a detailed insight into normal embryological development of each cranial bone component. Furthermore, easy and rapid methods for routine cranial autopsy are urgently needed. Procedures for prenatal cranial analysis, based on faxitron radiography after procedures which were verified by serial sectioning and histological analysis of cranial components, were published by Kjær and Græm (1990) and shortly followed by research on abnormally developed foetal crania Orthodontics and foetal pathology: a personal view on