GROWTH HORMONE AND CRANIOFACIAL DEVELOPMENT

Growth hormone (GH) is a key regulator of somatic and craniofacial development, exerting its effects directly via GH receptors and indirectly through insulin-like growth factor-I (IGF-I). The GH/IGF-I axis influences bone modelling, remodelling, and soft tissue growth, essential for normal facial morphology. GH also stimulates osteoblast proliferation, enhances osteoclastic activity, and supports periosteal apposition at the cellular level. Secondary cartilage in the mandibular condyle exhibits GH and IGF-I receptor expression, highlighting their role in endochondral ossification and mandibular development. Additionally, GH impacts dental tissues by promoting odontogenic proliferation and facilitating dentin and cementum formation. Growth hormone deficiency (GHD) often presents with distinctive craniofacial anomalies, including reduced cranial base length, mandibular retrognathia, increased gonial angles, and delayed dental maturation. Cephalometric studies reveal smaller maxillary and mandibular dimensions in GHD patients. Recombinant human GH (rhGH) therapy has demonstrated improvements in mandibular growth and facial balance, though complete normalization is rare. In contrast, GH excess, as seen in acromegaly, results in mandibular prognathism, macroglossia, and dental malocclusions due to excessive periosteal bone deposition and soft tissue hypertrophy. Recognizing the pivotal role of GH in craniofacial development is essential for clinicians. Dentists and orthodontists, in particular, can identify early signs of GH dysregulation, facilitating timely diagnosis and intervention to optimize growth outcomes.