Growth and Development of Craniofacial Complex I

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Introduction to Orthodontics
Fifth Year

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Growth and Development of Craniofacial Complex I

  1. 1. Third Lecture Growth and Development of The Craniofacial Complex
  2. 2. Outlines Craniofacial Complex. Why you should be interested in growth and development? Factors influencing the development of occlusion: Definitions: Growth Development March 5, 2012 Dr. Ahmed Basyouni 2
  3. 3. Outlines Types of bone formation: Intramembranous bone Endochondrial bone Sites of skull growth: Growth of the head: Growth of the cranium: Cranial vault. Cranial base. March 5, 2012 Dr. Ahmed Basyouni 3
  4. 4. Outlines Growth of the face: Growth of the upper face (nasomaxillary complex). Growth of the mandible. How to assess growth. Why do we assess growth. Human head shape. March 5, 2012 Dr. Ahmed Basyouni 4
  5. 5. The Craniofacial Complex Consists of: I. Cranium: Cranial vault Cranial base II. Face: Upper face (Nasomaxillary complex) Mandible March 5, 2012 Dr. Ahmed Basyouni 5
  6. 6. Why you should be interested in growth and development? 1. Knowledge of general and facial growth provides a background of the etiology and development of malocclusion. 2. As observer of the growing child all dentists should be able to identify abnormal or unusual skeletal growth patterns. 3. The dentist should be able to identify abnormal occlusal development at an early stage in order to undertake suitable interceptive orthodontic treatment. March 5, 2012 Dr. Ahmed Basyouni 6
  7. 7. Why you should be interested in growth and development? 4. Poorly timed extraction (early or delayed loss) performed by dentist during growth, cause malocclusion. 5. Many malocclusion are due to skeletal discrepancies between the jaws (maxilla and mandible) due to improper differential growth of the jaws. 6. Orthodontic treatment may make use of high growth rates attained during puberty “Growth modification”. 7. Orthognathic surgery is considered only after facial growth has been completed. 8. Growth effects have long term effects on the stability of the occlusion after treatment. March 5, 2012 Dr. Ahmed Basyouni 7
  8. 8. Factors influencing the development of occlusion: 1. Bone growth & development. 2. Soft tissue morphology & behavior. 3. The relationship of size of dentition to size of dental arch. 4. Forces of occlusion. 5. Skeletal pattern. March 5, 2012 Dr. Ahmed Basyouni 8
  9. 9. Definitions Growth: It is a physiochemical process by which an organism becomes larger. Development: It is sequence of changes from fertilization of the ovum to maturity, It is related to cell division, differentiation, and organization up to maturity. March 5, 2012 Dr. Ahmed Basyouni 9
  10. 10. The Growing Face At birth, the largest to smallest dimensions of the face are width, height and depth. Postnatally, the face grows most rapidly in depth, followed by height, with slowest rate of growth being found in width. March 5, 2012 Dr. Ahmed Basyouni 10
  11. 11. The Growing Face 8 months, 6 y, 8 y and 20 y old March 5, 2012 Dr. Ahmed Basyouni 11
  12. 12. Changes in Overall Body Proportions 12% 25% 50% Cephalocaudal Growth Gradient: means increasing growth rate from head to feet. March 5, 2012 Dr. Ahmed Basyouni 12
  13. 13. Not all tissue systems of the body grow at the same rate or mature at the same time Scammon’s Curve: Growth curves of four major tissue systems. March 5, 2012 Dr. Ahmed Basyouni 13
  14. 14. At Birth: Infant’s Face / head = 1/8 due to the advanced state of brain growth. In Adults: Face / head = 1/3 to 1/2 due to postnatal facial growth. March 5, 2012 Dr. Ahmed Basyouni 14
  15. 15. Types of Bone formation Bone is mesodermal in origin: The mesenchymal C. T. would be differentiated into: Mesenchymal C. T. Mucous membrane Cartilage (Fibrous C.T.) Bone formed from fibrous C.T. is called Bone formed from cartilage is called Intramembranous bone Endochondrial bone March 5, 2012 Dr. Ahmed Basyouni 15
  16. 16. Intramembranous bone: – by secretion of bone matrix directly within C.T. without any intermediate formation of cartilage – Through the activity of cells in the periosteum – Cranial vault, face (Mx & body of Md) and the clavicles. March 5, 2012 Dr. Ahmed Basyouni 16
  17. 17. Endochondrial bone: – Cartilage is replaced by bone – Cranial base, Md condyle Epiphyseal plate Proliferating cartilage March 5, 2012 Dr. Ahmed Basyouni 17
  18. 18. Sites of Skull Growth Sutural growth Surface apposition and remodeling resorption Growth of the contained organs as the brain, eye balls, and the tongue March 5, 2012 Dr. Ahmed Basyouni 18
  19. 19. Principles of Growth •Resorption •Apposition •Surface remodeling of a bone in the opposite direction to that in which it is being translated by growth of adjacent structures March 5, 2012 Dr. Ahmed Basyouni 19
  20. 20. Theories of Craniofacial Growth Classical: bone growth is primary, soft tissues adjust to the growth of the bones. Functional matrix: soft tissue functional demands are primary, bones grow in response to functional demands. March 5, 2012 Dr. Ahmed Basyouni 20
  21. 21. Growth of the Head Growth of the cranium: a) Cranial vault {completed at 8 years} Intramembranous b) Cranial base { Anterior C B at 10 years & Posterior C B at 20 years} Endochondrial March 5, 2012 Dr. Ahmed Basyouni 21
  22. 22. Growth of the Head Growth of the Face: a) Upper face (Nasomaxillary complex) {completed at 16-18 years} Intramembranous b) Mandible {completed at 20-25 years} Mixed March 5, 2012 Dr. Ahmed Basyouni 22
  23. 23. Growth of the Cranium Cranial vault is made up of frontal bone, the two parietals, squamous part of the temporal bone and squamous part of the occipital bone. All intramembranous, and separated by sutures. March 5, 2012 Dr. Ahmed Basyouni 23
  24. 24. Growth of the Cranium Cranial vault • Apposition of new bones at the cranial sutures, & periosteal activity (remodeling) due to the pressure from the growing brain. March 5, 2012 Dr. Ahmed Basyouni 24
  25. 25. Growth of the Cranium Cranial Base is made of midline base and three cranial fossae. The bones forming the floor of the anterior cranial fossa are the orbital plates of the frontal bone, the cribriform plates of the ethmoid and the lesser wings of the sphenoid. March 5, 2012 Dr. Ahmed Basyouni 25
  26. 26. Growth of the Cranium Cranial Base The bones forming the floor of the middle cranial fossa are the body and the greater wings of the sphenoid, the upper surface of the petrous temporal bone and the petrous part of the occipital bone. March 5, 2012 Dr. Ahmed Basyouni 26
  27. 27. Growth of the Cranium Cranial Base The bones forming the floor of the posterior cranial fossa are the occipital in its floor and the posterior surface of the petrous temporal bone in front. March 5, 2012 Dr. Ahmed Basyouni 27
  28. 28. Growth of the Cranium Bands of cartilage are formed between centers of ossification called synchondrosis: – a) Spheno-occipital synchondrosis – b) Inter-sphenoid synchondrosis – c) Spheno-ethmoid synchondrosis March 5, 2012 Dr. Ahmed Basyouni 28
  29. 29. Summary Craniofacial Complex Why you should be interested in growth and development? Factors influencing the development of occlusion: Definitions: Growth Development March 5, 2012 Dr. Ahmed Basyouni 29
  30. 30. Summary Types of bone formation: Intramembranous bone Endochondrial bone Sites of skull growth: Growth of the cranium: Cranial vault. Cranial base. March 5, 2012 Dr. Ahmed Basyouni 30
  31. 31. Who Works With Their Minds are Scientists. Who Works With Their Hearts are Artists. Who Works With Their Hands are Workers. Who Works With All of Them are Orthodontists. March 5, 2012 Dr. Ahmed Basyouni 31

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