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Cranial MMS Variations
ANTERIOR NASAL SPINE
Score 1: Slight
Minimal-to-no projection of the anterior nasal spine beyond the inferior nasal aperture
ANTERIOR NASAL SPINE
Score 2: Intermediate
A moderate projection of the anterior nasal spine beyond the inferior nasal aperture
ANTERIOR NASAL SPINE
Score 3: Marked
A pronounced projection of the anterior nasal spine beyond the inferior nasal aperture
INFERIOR NASAL APERTURE
Score 1: Deep, posterior sloping
An inferior sloping of the nasal floor which begins within the nasal cavity and terminates on the vertical surface of the maxilla, producing a smooth transition. The morphology is distinct from INA 2 regarding the more posterior origin and the greater slope of INA 1
INFERIOR NASAL APERTURE
Score 2: Slight, anterior sloping
Sloping of the nasal aperture beginning more anteriorly than in INA 1, and with more angulation at the exit of the nasal opening
INFERIOR NASAL APERTURE
Score 3: No Sloping or Sill
The transition from nasal floor to the vertical maxilla is not sloping, nor is there an intervening projection, or sill. Generally, this morphology is a right angle, although a more blunted form may be observed
INFERIOR NASAL APERTURE
Score 4: Weak Ridge
Any superior incline of the anterior nasal floor, creating a weak (but present) vertical ridge of bone that traverses the inferior nasal border (partial nasal sill)
INFERIOR NASAL APERTURE
Score 5: Pronounced Ridge
A pronounced ridge (nasal sill) obstructing the nasal floor-to-maxilla transition
INTERORBITAL BREADTH
Score 1: Narrow
A narrow IOB or 1:5 ratio of the interorbital space relative to the facial skeleton
INTERORBITAL BREADTH
Score 2: Medium
A medium IOB or 1:4 ratio of the interorbital space relative to the facial skeleton
INTERORBITAL BREADTH
Score 3: Broad
A broad IOB or 1:3 ratio of the interorbital space relative to the facial skeleton
MALAR TUBERCLE
Score 0: No Projection
There is no projection of bone
MALAR TUBERCLE
Score 1: Trace
There is a trace tubercle below the ruler’s edge; approximately 2 mm or less
MALAR TUBERCLE
Score 2: Medium
The tubercle exhib its a medium protrusion below the ruler’s edge; approximately 2 to 4 mm
MALAR TUBERCLE
Score 3: Pronounced
There is a pronounced tubercle that protrudes approximately 4 mm or more below the ruler’s edge
NASAL APERTURE SHAPE
Score 1: Teardrop
The nasal aperture exhibits a teardrop shape, with a projection of the lateral margins intermediate to character states 2 and 3
NASAL APERTURE SHAPE
Score 2: Bell-Shaped
The nasal aperture exhibits a bell shape, with the greatest projection of the lateral mar gins at the inferior portion of the nasal aperture
NASAL APERTURE SHAPE
Score 3: Bowed
The nasal aperture is bowed, and the greatest projection of the lateral margins is at the midline
A narrow NAW or 1:5 ratio relative to the facial skeleton
NASAL APERTURE WIDTH
Score 2: Medium
An intermediate NAW or 1:4 ratio relative to the facial skeleton
NASAL APERTURE WIDTH
Score 3: Broad
A broad NAW or 1:3 ratio relative to the facial skeleton
NASAL BONE CONTOUR
Score 0: Low, rounded, circular
Exhibits a low and rounded nasal bone contour
NASAL BONE CONTOUR
Score 1: High rounded, oval
Exhibits an oval contour with elongated, high, and rounded lateral walls
NASAL BONE CONTOUR
Score 2: Broad plateau
This character state exhibits steep lateral walls and a broad (approximately 7 mm or more), flat plateau. On the contour gauge, the plateau is identified by a flat cluster of seven or more needles at the same height
NASAL BONE CONTOUR
Score 3: Narrow plateau
Exhibits steep sided lateral walls and a narrow surface plateau.
NASAL BONE CONTOUR
Score 4: Triangular
This character state is triangular in cross section and lacks a surface plateau.
NASAL BONE SHAPE
Score 1: No Nasal Pinch
The lateral edges of the nasal bones show no pinching. The nasal bones here may be wide or narrow in shape.
NASAL BONE SHAPE
Score 2: Superior Pinch, Minimal Lateral Bulge
In this character state, the nasal bones exhibit a superior pinch and minimum bulging on the lateral edges of the bones.
NASAL BONE SHAPE
Score 3: Superior Pinch, Pronounced Lateral Bulge
The lateral edges of the nasal bones exhibit a superior pinch and a pronounced lateral bulging of the inferior region.
NASAL BONE SHAPE
Score 4: Triangular
The lateral edges of the nasal bones form a triangle.
NASAL OVERGROWTH
Score 0: No Overgrowth
No bony overgrowth at nasale inferious
NASAL OVERGROWTH
Score 1: Overgrowth
Any projection of bone from the lateral border of the nasal bones beyond the maxillary border at nasale inferious.
NASOFRONTAL SUTURE
Score 1: Round
In this character state, the nasofrontal suture is round and does not have any angles.
NASOFRONTAL SUTURE
Score 2: Square
2 = In this character state, the nasofrontal suture is square and contains approximate right angles at nasale superious.
NASOFRONTAL SUTURE
Score 3: Tented
The nasofrontal suture appears triangular.
NASOFRONTAL SUTURE
Score 4: Irregular
The nasofrontal suture is irregular and lacks any definitive shape.
ORBITAL SHAPE
Score 1: Rectangular
The eye orbits are rectangular in shape. The horizontal margins are longer than the vertical margins, and are mostly parallel.
ORBITAL SHAPE
Score 2: Circular
The eye orbits are circular in shape. The orbital margin is approximately equidistanct from the center at any point.
ORBITAL SHAPE
Score 3: Rhombic
The eye orbits are rhombic in shape. The medial border is shorter in height than the lateral border.
POSTBREGMATIC DEPRESSION
Score 0: Absent
No depression present posterior to bregma.
OSTBREGMATIC DEPRESSION
Score 1: Present
Any depression posterior to bregma along the mid-sagittal plane.
POSTERIOR ZYGOMATIC TUBERCLE
Score 0: No Projection
There is no projection of bone past the ruler’s edge.
POSTERIOR ZYGOMATIC TUBERCLE
Score 1: Weak Projection
There is a weak projection of bone that extends less than 4 mm past the ruler’s edge.
POSTERIOR ZYGOMATIC TUBERCLE
Score 2: Moderate Projection
There is a moderate projection of bone that extends approximately 4 to 6 mm past the ruler’s edge.
POSTERIOR ZYGOMATIC TUBERCLE
Score 3: Marked Projection
There is a marked projection of bone that extends >6 mm past the ruler’s edge.
SUPRANASAL SUTURE
Score 0: Obliterated
The suture is completely obliterated.
SUPRANASAL SUTURE
Score 1: Open, Unfused
The suture is open and unfused.
SUPRANASAL SUTURE
Score 2: Closed, Visible
The suture is closed but visible.
TRANSVERSE PALATINE SUTURE
Score 1: Straight
In this character state, the suture crosses the palate perpendicular to the median palatine suture. There is no significant deviation either anteriorly or posteriorly. The suture is relatively straight.
TRANSVERSE PALATINE SUTURE
Score 2: Anterior Bulge
The suture crosses the palate perpendicular to the median palatine suture, however there is an anterior deviation or bulge near the intersection of the two.
TRANSVERSE PALATINE SUTURE
Score 3: M-Shaped
As the suture crosses the palate, there are slight deviations both anteriorly and posteriorly resulting in a ‘M’ shape near the intersection with the median palatine suture.
TRANSVERSE PALATINE SUTURE
Score 4: Posterior Bulge
At the intersection with the median palatine suture, the TPS bulges posteriorly.
PALATE SHAPE
Score 1: Elliptical
Smooth, round curvature of the anterior portion of the palate combined with a mid arch (ca. M1 and M2) widening relative to M3, contributing to the appearance of constricted (medially positioned) 3rd molars.
Smooth rounded curvature of the anterior portion of the palate, combined with an even, gradual flaring of the posterior dentition.
PALATE SHAPE
Score 3: Parabolic B
Smooth, rounded curvature of the anterior portion of the palate, but combined with an even, gradual flaring of the posterior dentition. The only distinction is the longer relative length to breadth ration in Form B.
PALATE SHAPE
Score 4: Hyperbolic
Smooth, slightly flattened curvature of the anterior portion of the palate, combined with a straight, more or less parallel configuration of the posterior portions of the arch.
ZYGOMATICOMAXILLARY SUTURE
Score 0: No Angles
No angles, and the greatest lateral projection of the suture is at the infer ior margin of the malar.
ZYGOMATICOMAXILLARY SUTURE
Score 1: One Angle
One angle, and the greatest lateral projection is near the midline.
ZYGOMATICOMAXILLARY SUTURE
Score 2: Jagged/S-Shaped
Two or more angles that have a jagged or S shaped appearance. The greatest lateral projection of this character state is variable.