## 4 Discussion  
The early diagnosis of [PERSON] syndrome is very important, especially during the neonatal period, in order to improve the treatment steps. [PERSON] syndrome is a complex disorder with an involvement of the hypothalamus affecting the skeletal development, the endocrine function, and the intellect among other issues. Cranio-facial alterations have been present in the description of the syndrome, and the results of multiple studies stated them as a consequence of the disorder. The monitoring and management are crucial in these cases, as the complications can lead to an undesired outcome. Figure 6: Results of the SEM models: (**a**) Prader–Willii sample—first set of indicators; (**b**) control sample—first set of indicators; (**c**) Prader–Willii sample—second set of indicators; (**d**) control sample—second set of indicators Source: authors’ configuration in Stata 16. The facial morphology of the PWS patients showed reduced cranio-facial dimensions, affecting the growth of the maxilla and mandible [24]. [PERSON] et al. [24] in their study concluded that patients diagnosed with PWS developed a dysfunction of their oral motor function suggesting that an early interdisciplinary approach treatment is necessary in order to modify the maxillofacial growth pattern. [PERSON] et al. [25] were among the first that reported an obvious reduction of the mandibular length in patients with PWS. A study conducted by [PERSON] et al. [26] that included 32 patients diagnosed with Prader-Willi syndrome showed that 40% of them had a reduction in the maxillofacial skeletal measurements. [PERSON] et al. [14] concluded after the examination of 20 patients with PWS that a reduction is common in the total mandibular length, the body of the mandible, the length of the ramus, the maxillary length, the mid-facial and posterior facial height. The position of the maxillary bone in the sagittal plane was the subject of previous studies that reported an increased SNA angle in PWS patients [27]. Our results are in line with [PERSON] et al. [14] and [PERSON] et al. [27] that have obtained similar reduced dimensions for the majority of parameters when compared to the control sample. Also, after the cephalometric analysis that certified a reduction of the mandible, concerning the body and ramus, allowed several conclusions regarding the incidence of sleep apnea in patients with PWS [28]. The cephalometric analysis is the first step in acknowledging the alterations of the cranio-facial features, the measurements need to be correlated in order to evaluate the growth pattern and assign early treatment to avoid potential complications. [PERSON] et al. [29] stated the fact that after the treatment with growth hormone the facial convexity decreased, the posterior facial height and mandibular length increased in time. The first set of GGMs entailed the importance of posterior cranial base (SAr), posterior facial height (S-Go), the mandibular plane (SN-MP) and its inclination (FH-MP), and Sella-Nasion line (SN) as important fundamentals that stand out through their strong direct (positive) and indirect (negative) interconnections in the Prader-Willi sample. On the other hand, in the control sample, S-Go is strongly and negatively connected with NSBa (cranial base flexure angle) and positively connected with the upper anterior facial height (ANS-N) and the angle of facial convexity (N-A-PG). The second set of Gaussian models reveal different patterns of relationship between specific cranial, facial and oral credentials in the two samples considered for analysis. For the Prader-Willi sample, the GGMs processed through EBICglasso and partial correlations reveal that ANB, SNA, SNB and AnPog, Co-A, Co-Gn and U1-L1 are essential credentials with strong interlinkages amongst them (both positive and negative). In the control sample, however, all the connections are strapping and robust, being hard to distinguish certain relationships as being more important than the others.