Aging of the craniofacial skeleton is not merely the result of bone atrophy but is also due to a change in the relative dynamics of bone expansion and bone loss.1 There is an appreciable reduction in facial height, which is mainly due to changes in the maxilla and mandible, and a modest increase in facial width and depth. The orbits increase in size, whereas the maxilla decreases in size, compounding the inferior displacement of the malar fat pad and accentuation of the nasolabial fold.2 Maxillary resorption can also lead to a loss of support in the upper lip, which contributes to perioral wrinkling.
In the mandible, tooth loss causes marked resorption of the alveolar ridge, and the shape and projection of the chin also change with age. There is a general coarsening of mandibular bony protuberances at the points of insertion of masticatory muscles (eg, the gonial angle and inferior edge of the zygomatic eminence), and a general softening throughout.
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