DEVELOPMENT OF FACE
Moderator: Dr. Chaitanya
By: Dr. Muhammad.Haneef
Post Graduate Trainee 1st year
OMFS
CONTENTS
 INTRODUCTION
 EARLY EMBRYONIC DEVELOPMENT
 DEVELOPMENT OF BRANCHIAL ARCHES
 DEVELOPMENT OF FACE
 DEVELOPMEN...
OUR FACE FROM FISH TO MAN
THE MOBILE MASK IN FRONT OF HUMAN BRAIN
BEGAN TO ATTRACT OUR ATTENTION WHEN
WE WERE BABIES AND C...
CONTENTS
 INTRODUCTION
 EARLY EMBRYONIC DEVELOPMENT
 DEVELOPMENT OF BRANCHIAL ARCHES
 DEVELOPMENT OF FACE
 DEVELOPMEN...
INTRODUCTION
 An individual spends 9 months, 38 weeks,
266 days nearly 383040minutes of his life
his mothers womb. Human ...
DEVELOPMENT:
Todd “ Is progress towards maturity”.
Moyers “ All the naturally occurring
unidirectional changes in life of ...
SIGNIFICANCE
 Progress in surgery, especially in the pediatric age
group has made knowledge of human development
more cli...
 In 40 to 60% of persons with birth defects, the
cause of congenital anomaly is unknown.
 Genetic factors, such as chrom...
CONTENTS
 INTRODUCTION
 EARLY EMBRYONIC DEVELOPMENT
 DEVELOPMENT OF BRANCHIAL ARCHES
 DEVELOPMENT OF FACE
 DEVELOPMEN...
EARLY EMBRYONIC DEVELOPMENT
1. PERIOD OF OVUM- From fertilization to 14th day.
2. PERIOD OF EMBRYO- From 14th day to 56th ...
FETAL PERIOD
 Last 7 months of fetal life are devoted to very
rapid growth and repositioning of body
components, with lit...
CONTENTS
 INTRODUCTION
 EARLY EMBRYONIC DEVELOPMENT
 DEVELOPMENT OF BRANCHIAL
ARCHES
 DEVELOPMENT OF FACE
 DEVELOPMEN...
DEVELOPMENT OF
BRANCHIAL/PHARENGIAL ARCHES
 APPEARS DURING THE 4th & 5th WEEK OF INTRA UTERINE
DEVELOPMENT.
 CONSISTS OF...
CONTENTS
 INTRODUCTION
 EARLY EMBRYONIC DEVELOPMENT
 DEVELOPMENT OF BRANCHIAL ARCHES
 DEVELOPMENT OF FACE
 DEVELOPMEN...
DEVELOPMENT OF FACE
Development of face depends upon the
inductive activities of organizing centres
Procencephalic Rhomben...
 Face develops from 5 prominences that
surround the stomatodeum
- Frontonasal
- Paired maxillary processes.
- Paired mand...
 Frontonasal prominence formed by
proliferation of mesenchyme ventral to the
forebrain. It forms
- Lateral optic divertic...
 Mesenchyme proliferates around the placodes
producing medial and lateral nasal
prominences
Lateral nasal prominence sepa...
 Fusion of medial nasal prominences and the maxillary
and lateral nasal prominences requires disintegration
of nasal fin....
Midline merging of medial nasal process
Forms:
- Philtrum of upper lip.
- Tip of the nose.
- Primary palate.
Merging of me...
Merging of mandibular process in midline
Forms lower jaws and lips
CONTENTS
 INTRODUCTION
 EARLY EMBRYONIC DEVELOPMENT
 DEVELOPMENT OF BRANCHIAL ARCHES
 DEVELOPMENT OF FACE
 DEVELOPMEN...
DEVELOPMENT OF NOSE
 The nose is a complex of
contributions from:
- Frontal prominence 
The bridge.
- Medial nasal promi...
CONTENTS
 INTRODUCTION
 EARLY EMBRYONIC DEVELOPMENT
 DEVELOPMENT OF BRANCHIAL ARCHES
 DEVELOPMENT OF FACE
 DEVELOPMEN...
Paranasal Sinuses
 Paranasal sinuses develop during late fetal life the
remainder develops after birth.
 They form as ou...
 Expand in nasal fossae
by growth of mucous
membrane sacs-
primary pneumatization
 Enlarged by secondary
pneumatization
...
CONTENTS
 INTRODUCTION
 EARLY EMBRYONIC DEVELOPMENT
 DEVELOPMENT OF BRANCHIAL ARCHES
 DEVELOPMENT OF FACE
 DEVELOPMEN...
DEVELOPMENT OF PALATE
 Palatogenesis begins towards the end of 5th
week and is completed by about 12th week.
 The palate...
CONTENTS
 INTRODUCTION
 EARLY EMBRYONIC DEVELOPMENT
 DEVELOPMENT OF BRANCHIAL ARCHES
 DEVELOPMENT OF FACE
 DEVELOPMEN...
 EACH OF THE FIVE ARCHES CONTAIN
1. A CENTRAL CARTILAGE THAT FORMS SKELETON OF
ARCH
2. MUSCULAR COMPONENT OR BRANCHIOMERE...
4 ½ week embryo
ROLE OF MECKEL’S CARTILAGE
DERIVED FROM FIRST PHARYNGEAL ARCH AROUND
41TH – 45TH DAY I.U.L
EXTENDS FROM OTIC CAPSULE -TH...
REMANANTS OF MECKEL’S CARTILAGE:
MAJOR PART OF THE MECKEL’S CARTILAGE DISAPPEARS
DURING GROWTH
1. MENTAL OSSICLES
2. IN...
TYPES OF OSSIFICATION:
MANDIBLE IS THE SECOND BONE IN THE BODY TO BE
OSSIFIED
THERE ARE TWO TYPES OF OSSIFICATION :
1. ...
2. CARTILAGENOUS TYPE:
FORMATION OF BONE IS PRECEDED BY FORMATION OF
CARTILAGENOUS MODEL
CONDENSATION OF MESENCHYMAL CEL...
PARTS OF MANDIBLE DERIVED FROM
1. INTRAMEMBRANOUS OSSIFICATION
i) WHOLE BODY OF MANDIBLE EXCEPT THE ANTERIOR PART
Ii) ...
SUMMARY
MANDIBLE DEVELOPS FROM FIRST PHARYNGEAL ARCH
SEVERAL CHANGES OCCUR IN THE MANDIBLE DURING THE
DEVELOPMENTAL PER...
CONTENTS
 INTRODUCTION
 EARLY EMBRYONIC DEVELOPMENT
 DEVELOPMENT OF BRANCHIAL ARCHES
 DEVELOPMENT OF FACE
 DEVELOPMEN...
Associated with the formation of ear ossicles,
a new jaw joint
TMJ made its first appearance in mammals.
Secondary joint /...
Difference in
Mammalian jaw-joint Non mammalian jaw-joint
A) Concavo-Convex joint surface Concave
B) Intra-articular disk ...
EMBRYOLOGY
-Develops late in embryonic life.
-Compared with large joints of extremities.
-Associated with its late evoluti...
7 week old embryo
-Meckel’s cartilage extends all the way from chin to base of the
skull.
-Serves as a scaffolding or stru...
Articular Disc:
-Earliest appearance in 6 week old embryo.
-Muscular derivative of 1st branchial arch.
-Disc analge- vague...
Articular Disc:
-At its anterior end, mesenchymal analge extends laterally
from superior border of Lateral pterygoid muscl...
At 7 weeks: the future condyle is still only a condensation of
mesenchyme resting on osseous lamella, which forms the mand...
The articular capsule:
-Becomes recognizable during twelth week as a faint cellular
condensation along the medial and late...
By 26th week:
All components of TMJ present except articular eminence.
Meckel’s cartilage still extends through GF, but by...
CONTENTS
 INTRODUCTION
 EARLY EMBRYONIC DEVELOPMENT
 DEVELOPMENT OF BRANCHIAL ARCHES
 DEVELOPMENT OF FACE
 DEVELOPMEN...
 Tongue appears to begin to form in 4th week
of intra uterine life from 1st pharangeal arch
 Second swelling, copula/hyp...
CONTENTS
 INTRODUCTION
 EARLY EMBRYONIC DEVELOPMENT
 DEVELOPMENT OF BRANCHIAL ARCHES
 DEVELOPMENT OF FACE
 DEVELOPMEN...
CONTENTS
 INTRODUCTION
 EARLY EMBRYONIC DEVELOPMENT
 DEVELOPMENT OF BRANCHIAL ARCHES
 DEVELOPMENT OF FACE
 DEVELOPMEN...
Introduction
 The oral cavity is kept moist by a film of fluid
called saliva, this complex salivary fluid is
secreted by ...
Types of salivary glands
I Based on anatomic location
 Parotid gland
 Sub mandibular gland
 Sub lingual gland
 Accesso...
Anatomy
 Development :individual salivary glands arise as a proliferation of oral
epithelial cells,forming focal thickeni...
CONTENTS
 INTRODUCTION
 EARLY EMBRYONIC DEVELOPMENT
 DEVELOPMENT OF BRANCHIAL ARCHES
 DEVELOPMENT OF FACE
 DEVELOPMEN...
FORMATION OF DENTAL LAMINA
 At about 21st day of embryonic life the embryo folds along two planes
rostocaudal and lateral...
 The band of epithelium that invades the underlying ectomysenchyme
along each of horse shoe shaped future dental arches c...
Dental lamina
STAGES IN TOOTH DEVELOPMENT
The stages are named after the shape of the epithelial part of the
tooth germ.
1) BUD STAGE:
a...
Bud stage
2) CAP STAGE:
This stage is characterized by the shallow invagination on the deep
surface of the bud as a result of contin...
Cap stage
3) BELL STAGE:
 The epithelial invagination deepens and the margins continue to grow,
thus the enamel organ assumes bell ...
Advanced bell stage
Bell stage with permanent tooth bud
4) ADVANCED BELL STAGE :
 Future dentino enamel junction.
 Cervical portion of enamel organ forms the hertwig’s
epitheli...
 Cementoblast form cementum over dentin.
 Epithelial diaphragm – the inner and outer enamel epithelium
bend at the futur...
Cervical loop
Heartwig’s epithelial root sheath and
forming root
CONTENTS
 INTRODUCTION
 EARLY EMBRYONIC DEVELOPMENT
 DEVELOPMENT OF BRANCHIAL ARCHES
 DEVELOPMENT OF FACE
 DEVELOPMEN...
Teratology
 Defnition: The sceince that studies birth
defects is teratology.
 The agents called as Teratogens.
 Maximum...
Principles of Teratology
 Susceptibility depends on genotype of
conception and the manner of interaction
with the environ...
6 general classes of congenital
abnormalities
1. Agenesis like absence of teeth.
2. Full/partial aplasia = incomplete deve...
CONTENTS
 INTRODUCTION
 EARLY EMBRYONIC DEVELOPMENT
 DEVELOPMENT OF BRANCHIAL ARCHES
 DEVELOPMENT OF FACE
 DEVELOPMEN...
Defects involving the pharyngeal region
 Involving the pharyngeal region
1. Ectopic thyroid and thymic tissue
2. Branchia...
Neural crest cells and craniofacial
defects
1.Treacher collin syndrome/ first arch
syndrome/ mandibulofacial dystosis
synd...
2. Robin sequence – may occur independently
or in association with other syndromes.
 May occur in oligohydroaminos due to...
3. Di george anomaly – it in includes
velocardiofacial syndrome or conotruncal anomlies of
face.
 Caused due to alcohol, ...
5. CROUZON’S SYNDROME/ CRANIOFACIAL
DYSTOSIS.
1.Associated with premature closure of the cranial sutures
leading to one of...
4. Hemifacial Microsomia/ Goldenhar syndrome/
oculoauriculovertebral syndrome.
 Maxilla, zygomatic, temporal bone are tin...
Defects arising in tongue
 Tongue tie or ankyologlossia
 Aglossia
 Macroglossia
 Microglossia
 Lingual thyroid nodule...
Defects of thyroid
1.Aberrant thyroid tissue
2.Cyst or fistula
Facial clefts
Palatal clefts
Defects of teeth
Size Related
 Microdontia
 Macrodontia
Shape related cusp
 Gemination
 Twinning
 Fusion
 Concrscens...
Congenital anomalies related to
Salivary Glands
 Aberrancy/ ectopic salivary glands –
staffne’s cyst
 Aplasia
 Hypoplas...
Congenital anomalies affecting
TMJ
 Hypoplasia of condyle – unilateral/ bilateral
 Hyperplasia of condyle – unilateral /...
Defects in development of Eye and
External Ear
 Ear – preauricular pits and appendages
 Eye -
Cyclopia or synopthalmia w...
CONTENTS
 INTRODUCTION
 EARLY EMBRYONIC DEVELOPMENT
 DEVELOPMENT OF BRANCHIAL ARCHES
 DEVELOPMENT OF FACE
 DEVELOPMEN...
SKELETAL SYSTEM
SKULL
NEURO CRANIUM
 THE MEMBRANOUS PART
 THE CARTILAGINOUS PART
OR CHONDROCRANIUM
VISCERO CRANIUM
 BON...
MEMBRANOUS NEUROCRANIUM
CARTILAGINOUS NEUROCRANIUM OR
CHONDROCRANIUM
DEVELOPMENT OF FACIAL SKELETON
 THE FACE MAY BE CONVIENTLY,IF SOME WHAT
ARBITARILY DIVIDED INTO UPPER, MIDDLE & LOWER
THI...
 UPPER THIRD OF FACE IS PREDOMINANTLY OF
NEUROCRANIAL COMPOSITION,WITH THE FRONTAL BONE OF
THE CALVARIA ,PRIMARILY RESPON...
 MIDDLE THIRD OF FACE IS SKELETALLY THE MOST
COMPLEX,BEING COMPOSED IN PART OF THE CRANIAL BASE &
INCORPORATING BOTH THE ...
 THE LOWER THIRD OF FACE COMPLETES THE MASTICATORY
APPARATUS, BEING COMPOSED OF THE SKELETON OF THE
MANDIBLE & ITS DENTIT...
 FACIAL BONES DEVELOP INTRA MEMBRANOUSLY FROM
OSSIFICATION CENTERS IN THE NEURAL CREST MESENCHYME OF
THE EMBRYONIC FACIAL...
THE ATTACHEMENT OF THE FACIAL SKELETON ANTERO –
INFERIORLY TO THE CALVARIA DETERMINES THE CHONDRO
CRANIAL INFLUENCE ON FAC...
CONTENTS
 INTRODUCTION
 EARLY EMBRYONIC DEVELOPMENT
 DEVELOPMENT OF BRANCHIAL ARCHES
 DEVELOPMENT OF FACE
 DEVELOPMEN...
CONCLUSION
JUST AS THE CLINICIAN NEEDS THE MEDICAL
HISTORY TO MAKE A LOGICAL DIAGNOSIS,
SO TOO THE GROWTH AND DEVELOPMENT
...
CONTENTS
 INTRODUCTION
 EARLY EMBRYONIC DEVELOPMENT
 DEVELOPMENT OF BRANCHIAL ARCHES
 DEVELOPMENT OF FACE
 DEVELOPMEN...
References
 T.W. Saddler “Langman’s Medical Embryology”. 5th
edition.
 G.H. Sperber “Craniofacial embryology”. 4th editi...
Thank you
Development of face
Development of face
Development of face
Development of face
Development of face
Development of face
Development of face
Development of face
Development of face
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Development of face
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Development of face
Development of face
Development of face
Development of face
Development of face
Development of face
Development of face
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Development of face
Development of face
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Development of face

  1. 1. DEVELOPMENT OF FACE Moderator: Dr. Chaitanya By: Dr. Muhammad.Haneef Post Graduate Trainee 1st year OMFS
  2. 2. CONTENTS  INTRODUCTION  EARLY EMBRYONIC DEVELOPMENT  DEVELOPMENT OF BRANCHIAL ARCHES  DEVELOPMENT OF FACE  DEVELOPMENT OF NOSE  DEVELOPMENT OF PARA NASAL SINUSES  DEVELOPMENT OF PALATE  DEVELOPMENT OF JAWS  DEVELOPMENT OF TMJ  DEVELOPMENT OF TONGUE  DEVELOPMENT OF EXTERNAL EAR  DEVELOPMENT OF SALIVARY GLANDS  DEVELOPMENT OF TOOTH  TERATOLOGY  CONGENITAL ANOMALIES  SUMMARY  REFERENCES
  3. 3. OUR FACE FROM FISH TO MAN THE MOBILE MASK IN FRONT OF HUMAN BRAIN BEGAN TO ATTRACT OUR ATTENTION WHEN WE WERE BABIES AND CONTINUES TO FASCINATE US AS LONG AS WE LIVE W. K. GREGORY
  4. 4. CONTENTS  INTRODUCTION  EARLY EMBRYONIC DEVELOPMENT  DEVELOPMENT OF BRANCHIAL ARCHES  DEVELOPMENT OF FACE  DEVELOPMENT OF NOSE  DEVELOPMENT OF PARA NASAL SINUSES  DEVELOPMENT OF PALATE  DEVELOPMENT OF JAWS  DEVELOPMENT OF TMJ  DEVELOPMENT OF TONGUE  DEVELOPMENT OF EXTERNAL EAR  DEVELOPMENT OF SALIVARY GLANDS  DEVELOPMENT OF TOOTH  TERATOLOGY  CONGENITAL ANOMALIES  SUMMARY  REFERENCES
  5. 5. INTRODUCTION  An individual spends 9 months, 38 weeks, 266 days nearly 383040minutes of his life his mothers womb. Human development is continuous process and does not stop at birth. Human brain triples its weight between birth and 16 years.  Anatomical structures are more diverse in the mouth than in any other region.
  6. 6. DEVELOPMENT: Todd “ Is progress towards maturity”. Moyers “ All the naturally occurring unidirectional changes in life of an individual from its existence as a single cell to its elaboration as a multifunctional unit terminating in death”. Development is growth + differentiation + translocation. Growth according to MOSS is change in morphological parameters which is measurtable.
  7. 7. SIGNIFICANCE  Progress in surgery, especially in the pediatric age group has made knowledge of human development more clinically significant. The understanding and correction of most congenital malformations (e.g. Cleft palate) depend on the knowledge of normal development and of the deviations that have occurred.  An understanding of common congenital malformations and their causes also enable doctors, dentists and others to explain the developmental basis of abnormalities often dispelling parental guilty feelings.
  8. 8.  In 40 to 60% of persons with birth defects, the cause of congenital anomaly is unknown.  Genetic factors, such as chromosome abnormalities and mutant genes, account for approximately 15% of abnormalities.  Environmental factors produce approximately 10% of abnormalities.  Multifactorial inheritance produces 20 to 25%;  Twinning causes 0.5 to 1% of abnormalities.
  9. 9. CONTENTS  INTRODUCTION  EARLY EMBRYONIC DEVELOPMENT  DEVELOPMENT OF BRANCHIAL ARCHES  DEVELOPMENT OF FACE  DEVELOPMENT OF NOSE  DEVELOPMENT OF PARA NASAL SINUSES  DEVELOPMENT OF PALATE  DEVELOPMENT OF JAWS  DEVELOPMENT OF TMJ  DEVELOPMENT OF TONGUE  DEVELOPMENT OF EXTERNAL EAR  DEVELOPMENT OF SALIVARY GLANDS  DEVELOPMENT OF TOOTH  TERATOLOGY  CONGENITAL ANOMALIES  SUMMARY  REFERENCES
  10. 10. EARLY EMBRYONIC DEVELOPMENT 1. PERIOD OF OVUM- From fertilization to 14th day. 2. PERIOD OF EMBRYO- From 14th day to 56th day. 3. PERIOD OF FETUS- From 56th day till birth.
  11. 11. FETAL PERIOD  Last 7 months of fetal life are devoted to very rapid growth and repositioning of body components, with little further organogenesis or tissue differentiation. - 4 months human face is seen - By 4th month sex of fetus is known - Last 2 months of fetal life fat is deposited subcutaneously.
  12. 12. CONTENTS  INTRODUCTION  EARLY EMBRYONIC DEVELOPMENT  DEVELOPMENT OF BRANCHIAL ARCHES  DEVELOPMENT OF FACE  DEVELOPMENT OF NOSE  DEVELOPMENT OF PARA NASAL SINUSES  DEVELOPMENT OF PALATE  DEVELOPMENT OF JAWS  DEVELOPMENT OF TMJ  DEVELOPMENT OF TONGUE  DEVELOPMENT OF EXTERNAL EAR  DEVELOPMENT OF SALIVARY GLANDS  DEVELOPMENT OF TOOTH  TERATOLOGY  CONGENITAL ANOMALIES  SUMMARY  REFERENCES
  13. 13. DEVELOPMENT OF BRANCHIAL/PHARENGIAL ARCHES  APPEARS DURING THE 4th & 5th WEEK OF INTRA UTERINE DEVELOPMENT.  CONSISTS OF BARS OF MESENCHYMAL TISSUE SEPARATED BY DEEP CLEFTS KNOWN AS PHARYNGEAL (BRANCHIAL) CLEFTS.  ON DEVELOPMENT, A NO OF OUT POCKETING APPEARS, ALONG THE LATERAL WALLS OF THE PHARYNGEAL GUT WHICH ARE THE PHARYNGEAL POUCHES.  CONTRIBUTE NOT ONLY TO THE FORMATION OF THE NECK BUT ALSO PLAY AN IMPORTANT ROLE IN THE FORMATION OF THE FACE. THOUGH DEVELOPMENT OF THESE ( ARCHES, CLEFTS & POUCHES ) RESEMBLES FORMATION OF GILLS IN FISHES & AMPHIBIA,IN THE HUMAN EMBRYO REAL GILLS ARE NEVER FORMED. THEREFORE THE TERM PHARYNGEAL ARCHES HAS BEEN ADOPTED.
  14. 14. CONTENTS  INTRODUCTION  EARLY EMBRYONIC DEVELOPMENT  DEVELOPMENT OF BRANCHIAL ARCHES  DEVELOPMENT OF FACE  DEVELOPMENT OF NOSE  DEVELOPMENT OF PARA NASAL SINUSES  DEVELOPMENT OF PALATE  DEVELOPMENT OF JAWS  DEVELOPMENT OF TMJ  DEVELOPMENT OF TONGUE  DEVELOPMENT OF EXTERNAL EAR  DEVELOPMENT OF SALIVARY GLANDS  DEVELOPMENT OF TOOTH  TERATOLOGY  CONGENITAL ANOMALIES  SUMMARY  REFERENCES
  15. 15. DEVELOPMENT OF FACE Development of face depends upon the inductive activities of organizing centres Procencephalic Rhombencephalic Induces the inner ear apparatus and upper third of face Induces the middle and external ear apparatus and the middle and lower third of face
  16. 16.  Face develops from 5 prominences that surround the stomatodeum - Frontonasal - Paired maxillary processes. - Paired mandibular processes.
  17. 17.  Frontonasal prominence formed by proliferation of mesenchyme ventral to the forebrain. It forms - Lateral optic diverticula  eyes - Forehead (between the eyes) - Nasal placodes
  18. 18.  Mesenchyme proliferates around the placodes producing medial and lateral nasal prominences Lateral nasal prominence separated from maxillary process by nasolacrimal groove
  19. 19.  Fusion of medial nasal prominences and the maxillary and lateral nasal prominences requires disintegration of nasal fin.  Failure of normal disintegration of nasal fin cause cleft of upper lip and anterior palate.
  20. 20. Midline merging of medial nasal process Forms: - Philtrum of upper lip. - Tip of the nose. - Primary palate. Merging of medial nasal and maxillary process Continuity of the upper jaw and lip. Causes separation of nasal pits from stomodeum
  21. 21. Merging of mandibular process in midline Forms lower jaws and lips
  22. 22. CONTENTS  INTRODUCTION  EARLY EMBRYONIC DEVELOPMENT  DEVELOPMENT OF BRANCHIAL ARCHES  DEVELOPMENT OF FACE  DEVELOPMENT OF NOSE  DEVELOPMENT OF PARA NASAL SINUSES  DEVELOPMENT OF PALATE  DEVELOPMENT OF JAWS  DEVELOPMENT OF TMJ  DEVELOPMENT OF TONGUE  DEVELOPMENT OF EXTERNAL EAR  DEVELOPMENT OF SALIVARY GLANDS  DEVELOPMENT OF TOOTH  TERATOLOGY  CONGENITAL ANOMALIES  SUMMARY  REFERENCES
  23. 23. DEVELOPMENT OF NOSE  The nose is a complex of contributions from: - Frontal prominence  The bridge. - Medial nasal prominence  Median ridge and tip - Lateral nasal prominence  The alae - The cartilage of nasal capsule  the septum and nasal conchae
  24. 24. CONTENTS  INTRODUCTION  EARLY EMBRYONIC DEVELOPMENT  DEVELOPMENT OF BRANCHIAL ARCHES  DEVELOPMENT OF FACE  DEVELOPMENT OF NOSE  DEVELOPMENT OF PARA NASAL SINUSES  DEVELOPMENT OF PALATE  DEVELOPMENT OF JAWS  DEVELOPMENT OF TMJ  DEVELOPMENT OF TONGUE  DEVELOPMENT OF EXTERNAL EAR  DEVELOPMENT OF SALIVARY GLANDS  DEVELOPMENT OF TOOTH  TERATOLOGY  CONGENITAL ANOMALIES  SUMMARY  REFERENCES
  25. 25. Paranasal Sinuses  Paranasal sinuses develop during late fetal life the remainder develops after birth.  They form as outgrowths or diverticula of the walls of the nasal cavities and become air filled extensions of the nasal cavities in the adjacent bone.  Frontal  Ethmoidal  Maxillary  Sphenoidal
  26. 26.  Expand in nasal fossae by growth of mucous membrane sacs- primary pneumatization  Enlarged by secondary pneumatization  Retain communication with nasal fossae through ostia
  27. 27. CONTENTS  INTRODUCTION  EARLY EMBRYONIC DEVELOPMENT  DEVELOPMENT OF BRANCHIAL ARCHES  DEVELOPMENT OF FACE  DEVELOPMENT OF NOSE  DEVELOPMENT OF PARA NASAL SINUSES  DEVELOPMENT OF PALATE  DEVELOPMENT OF JAWS  DEVELOPMENT OF TMJ  DEVELOPMENT OF TONGUE  DEVELOPMENT OF EXTERNAL EAR  DEVELOPMENT OF SALIVARY GLANDS  DEVELOPMENT OF TOOTH  TERATOLOGY  CONGENITAL ANOMALIES  SUMMARY  REFERENCES
  28. 28. DEVELOPMENT OF PALATE  Palatogenesis begins towards the end of 5th week and is completed by about 12th week.  The palate develops from two primordia.  Primary palate  Secondary palate
  29. 29. CONTENTS  INTRODUCTION  EARLY EMBRYONIC DEVELOPMENT  DEVELOPMENT OF BRANCHIAL ARCHES  DEVELOPMENT OF FACE  DEVELOPMENT OF NOSE  DEVELOPMENT OF PARA NASAL SINUSES  DEVELOPMENT OF PALATE  DEVELOPMENT OF JAWS  DEVELOPMENT OF TMJ  DEVELOPMENT OF TONGUE  DEVELOPMENT OF EXTERNAL EAR  DEVELOPMENT OF SALIVARY GLANDS  DEVELOPMENT OF TOOTH  TERATOLOGY  CONGENITAL ANOMALIES  SUMMARY  REFERENCES
  30. 30.  EACH OF THE FIVE ARCHES CONTAIN 1. A CENTRAL CARTILAGE THAT FORMS SKELETON OF ARCH 2. MUSCULAR COMPONENT OR BRANCHIOMERE 3. VASCULAR COMPONENT 4. NEURAL ELEMENT  MANDIBLE IS THE DERIVATIVE OF THE FIRST PHARYNGEALARCH  DORSAL PORTION IS KNOWN AS MAXILLARY PROCESS  VENTRAL PORTION KNOWN AS MANDIBULAR PROCESS OR MECKEL’S CARTILAGE  DEVELOPMENT OF MANDIBLE STARTS AT 4TH WEEK I.U.L  CENTER OF FACE FORMED BY STOMODEUM, SURROUNDED BY FIRST PAIR OF PHARYNGEALARCHES
  31. 31. 4 ½ week embryo
  32. 32. ROLE OF MECKEL’S CARTILAGE DERIVED FROM FIRST PHARYNGEAL ARCH AROUND 41TH – 45TH DAY I.U.L EXTENDS FROM OTIC CAPSULE -THE MIDLINE OR SYMPHYSIS FIRST OSSIFICATION CENTER ARISES AT 6TH WEEK I.U.L IN THE REGION OF BIFURCATION OF THE INFERIOR ALVEOLAR NERVE THE CENTER IS LOCATED LATERAL TO THE MECKEL’S CARTILAGE FROM THIS “PRIMARY CENTER”- OSSIFICATION SPREADS “BELOW AND AROUND” THE INFERIOR ALVEOLAR NERVE AND THEN MOVES “UPWARDS” OSSIFICATION THEN SPREADS “DORSALLY AND VENTRALLY” TO FORM RAMUS AND THE BODY OF MANDIBLE AS OSSIFICATION CONTINUES MECKEL’S CARTILAGE BECOMES SURROUNDED BY BONE
  33. 33. REMANANTS OF MECKEL’S CARTILAGE: MAJOR PART OF THE MECKEL’S CARTILAGE DISAPPEARS DURING GROWTH 1. MENTAL OSSICLES 2. INCUS AND MALLEUS 3. SPINE OF SPHENOID 4. ANTERIOR LIGAMENT OF MALLEUS 5. SPHENOMANDIBULAR LIGAMENT
  34. 34. TYPES OF OSSIFICATION: MANDIBLE IS THE SECOND BONE IN THE BODY TO BE OSSIFIED THERE ARE TWO TYPES OF OSSIFICATION : 1. INTRAMEMBRANOUS TYPE : FORMATION OF BONE IS NOT PRECEDED BY FORMATION OF CARTILAGENOUS MODEL BONE IS DIRECTLY LAID INTO FIBROUS MEMBRANE THERE IS CONDENSATION OF MESENCHYMAL CELLS SOME CELLS FORM OSTEOBLAST AND SECRETE OSTEIOD DEPOSITION OF CALCIUM SALTS INTO THE OSTEOID LEADS TO CONVERSION OF OSTEOID INTO LAMELLA
  35. 35. 2. CARTILAGENOUS TYPE: FORMATION OF BONE IS PRECEDED BY FORMATION OF CARTILAGENOUS MODEL CONDENSATION OF MESENCHYMAL CELLS TO FORM CHONDROBLASTS-- LAY DOWN HYALINE CARTILAGE CARTILAGE IS SURROUNDED BY PERICHONDRIUM — VASCULAR AND CONTAINS OSTEOGENIC CELLS INTERCELLULAR CELLS SURROUNDING CARTILAGE CELLS CALCIFY DUE TO THE ACTION OF ALKALINE PHOSPHATASE NUTRITION TO THE CELLS IS CUT– LEADING TO DEATH--- FORMATION OF EMPTY SPACES— PRIMARYAREOLAE BLOOD VESSELS AND OSTEOGENIC CELLS INVADE THE CALCIFIED CARTILAGENOUS MATRIX WHICH IS NOW REDUCED TO BARS OR WALLS– FORMATION OF LARGER SPACES----SECONDARYAREOLAE
  36. 36. PARTS OF MANDIBLE DERIVED FROM 1. INTRAMEMBRANOUS OSSIFICATION i) WHOLE BODY OF MANDIBLE EXCEPT THE ANTERIOR PART Ii) RAMUS OF MANDIBLE AS FAR AS MANDIBULAR FORAMEN 2. ENDOCHONDRAL OSSIFICATION i) ANTERIOR PORTION OF THE MANDIBLE (SYMPHYSIS) ii) PART OF RAMUS ABOVE THE MANDIBULAR FORAMEN Iii) CORONOID PROCESS iv) CONDYLAR PROCESS
  37. 37. SUMMARY MANDIBLE DEVELOPS FROM FIRST PHARYNGEAL ARCH SEVERAL CHANGES OCCUR IN THE MANDIBLE DURING THE DEVELOPMENTAL PERIOD ANY DISTURBANCE DURING THE NORMAL GROWTH OF THE MANDIBLE REFLECTS AS A ANOMALY
  38. 38. CONTENTS  INTRODUCTION  EARLY EMBRYONIC DEVELOPMENT  DEVELOPMENT OF BRANCHIAL ARCHES  DEVELOPMENT OF FACE  DEVELOPMENT OF NOSE  DEVELOPMENT OF PARA NASAL SINUSES  DEVELOPMENT OF PALATE  DEVELOPMENT OF JAWS  DEVELOPMENT OF TMJ  DEVELOPMENT OF TONGUE  DEVELOPMENT OF EXTERNAL EAR  DEVELOPMENT OF SALIVARY GLANDS  DEVELOPMENT OF TOOTH  TERATOLOGY  CONGENITAL ANOMALIES  SUMMARY  REFERENCES
  39. 39. Associated with the formation of ear ossicles, a new jaw joint TMJ made its first appearance in mammals. Secondary joint / Squamosodentary joint [As it is present between squamous part of temporal bone and the mandible (dentary)]. - One can imagine this evolutionary transmission occurring by means of a bony process which appeared on the mandibular anterior to quadratoarticular joint which at one time became large enough to contact the skull.
  40. 40. Difference in Mammalian jaw-joint Non mammalian jaw-joint A) Concavo-Convex joint surface Concave B) Intra-articular disk Absent
  41. 41. EMBRYOLOGY -Develops late in embryonic life. -Compared with large joints of extremities. -Associated with its late evolutionary development. -During the 7th prenatal week, the jaw joint lacks: -Condylar growth cartilage. -Joint cavities. -Synovial tissues -Articular capsule. 2 skeletal elements : mandible and temporal bone are not yet in contact with each other.
  42. 42. 7 week old embryo -Meckel’s cartilage extends all the way from chin to base of the skull. -Serves as a scaffolding or strutt against which the mandible develops. -Provides a temporary articulation between mandible and base of the skull until TMJ takes over. -Near end of fetal life Meckel’s cartilage completes its transformation: -Incus -Malleus -Anterior ligament of malleus -Sphenomandibular ligament Meckel’s cartilage plays an a basic role in setting the evolutionary stage for the emergence of this joint.
  43. 43. Articular Disc: -Earliest appearance in 6 week old embryo. -Muscular derivative of 1st branchial arch. -Disc analge- vague layer of mesenchyme stretching across upper end of mandibular ramus. -No capsule. -No condyle.
  44. 44. Articular Disc: -At its anterior end, mesenchymal analge extends laterally from superior border of Lateral pterygoid muscle, to medial side of masseter muscle. -At the end of 6th week, lateral pterygoid inserts not on the mandibular but on the posterior end of Meckel’s cartilage. -During 7th week – (lateral pterygoid) joins upper end of mandibular ramus; also continues posteriorly beyond this point with mesenchyme analge des abv; these 2 structures insert in common part of Meckel’s cartilage which becomes the malleus.
  45. 45. At 7 weeks: the future condyle is still only a condensation of mesenchyme resting on osseous lamella, which forms the mandibular ramus. 12 week – condylar growth cartilage makes its 1st appearance and begins to develop a hemi-spherical articular surface. By 13th week – condyle and articular disc having moved up into contact with temporal bone. Only when such articular contact has been made do the joint cavities develop. Inferior space appearing first. Disc begins to get compressed. When central portion of disc is compressed this part becomes avascular.
  46. 46. The articular capsule: -Becomes recognizable during twelth week as a faint cellular condensation along the medial and lateral sides of joint connecting mandible with temporal bone. -Articular disc merges peripherally with these condensations. -Formation of capsule posterior to joint does not occur until twenty-second week; when the Glaserian fissure; becomes narrow; encroaching upon Meckel’s cartilage as it passes into middle ear. -Articular disc becomes intercepted at the Glaserian fissure, loses its continuity with malleus and develops definitive attachment to anterior lip of GF. -Joint cavities are now lined by synovial tissue and according to Symons (1952), temporal bone now shows area of secondary cartilage in medial part of the joint.
  47. 47. By 26th week: All components of TMJ present except articular eminence. Meckel’s cartilage still extends through GF, but by thirty- first week is transformed into sphenomandibular ligament. By 39th week: Ossification of bones in this region has proceeded to the point where; ligament gains its apparent attachment to spine of sphenoid.
  48. 48. CONTENTS  INTRODUCTION  EARLY EMBRYONIC DEVELOPMENT  DEVELOPMENT OF BRANCHIAL ARCHES  DEVELOPMENT OF FACE  DEVELOPMENT OF NOSE  DEVELOPMENT OF PARA NASAL SINUSES  DEVELOPMENT OF PALATE  DEVELOPMENT OF JAWS  DEVELOPMENT OF TMJ  DEVELOPMENT OF TONGUE  DEVELOPMENT OF EXTERNAL EAR  DEVELOPMENT OF SALIVARY GLANDS  DEVELOPMENT OF TOOTH  TERATOLOGY  CONGENITAL ANOMALIES  SUMMARY  REFERENCES
  49. 49.  Tongue appears to begin to form in 4th week of intra uterine life from 1st pharangeal arch  Second swelling, copula/hypobronchial eminence is formed second third and partly fourth mesoderm arches.  Part of fourth arch forms the epiglottis. Behind this there is laryngeal inlet flanked arytenoid swelling.
  50. 50. CONTENTS  INTRODUCTION  EARLY EMBRYONIC DEVELOPMENT  DEVELOPMENT OF BRANCHIAL ARCHES  DEVELOPMENT OF FACE  DEVELOPMENT OF NOSE  DEVELOPMENT OF PARA NASAL SINUSES  DEVELOPMENT OF PALATE  DEVELOPMENT OF JAWS  DEVELOPMENT OF TMJ  DEVELOPMENT OF TONGUE  DEVELOPMENT OF EXTERNAL EAR  DEVELOPMENT OF SALIVARY GLANDS  DEVELOPMENT OF TOOTH  TERATOLOGY  CONGENITAL ANOMALIES  SUMMARY  REFERENCES
  51. 51. CONTENTS  INTRODUCTION  EARLY EMBRYONIC DEVELOPMENT  DEVELOPMENT OF BRANCHIAL ARCHES  DEVELOPMENT OF FACE  DEVELOPMENT OF NOSE  DEVELOPMENT OF PARA NASAL SINUSES  DEVELOPMENT OF PALATE  DEVELOPMENT OF JAWS  DEVELOPMENT OF TMJ  DEVELOPMENT OF TONGUE  DEVELOPMENT OF EXTERNAL EAR  DEVELOPMENT OF SALIVARY GLANDS  DEVELOPMENT OF TOOTH  TERATOLOGY  CONGENITAL ANOMALIES  SUMMARY  REFERENCES
  52. 52. Introduction  The oral cavity is kept moist by a film of fluid called saliva, this complex salivary fluid is secreted by the salivary gland which is exocrine in nature . Saliva’s important function is to maintain the well being of mouth hence any Individuals with a deficiency of salivary secretion experience difficulty eating, speaking, swallowing and prone to mucosal infections .
  53. 53. Types of salivary glands I Based on anatomic location  Parotid gland  Sub mandibular gland  Sub lingual gland  Accessory glands (labial, lingual, palatal buccal,glossopalatine and retromolar) III Based on size and amount of secretion Major salivary glands Minor salivary glands II Based on type of secretion  Serous:parotid ,submandibular and von ebners glands  Mucous : sub lingual,labial ,buccal,palatine ,glossopalatine,posterir part of tongue  Mixed:sub mandibular, sub lingual ,anterio labial buccal and lingual minor glands
  54. 54. Anatomy  Development :individual salivary glands arise as a proliferation of oral epithelial cells,forming focal thickening that grows into underlying ectomesenchyme Parotid : 6 th week of I U : corners of stomatidium Sub mandibular : end of 6 th week of I U : floor of mouth Sub lingual : 8 th week of I U: lateral to primordium Minor salivary gland : 12 th week of I U :buccal epithelium
  55. 55. CONTENTS  INTRODUCTION  EARLY EMBRYONIC DEVELOPMENT  DEVELOPMENT OF BRANCHIAL ARCHES  DEVELOPMENT OF FACE  DEVELOPMENT OF NOSE  DEVELOPMENT OF PARA NASAL SINUSES  DEVELOPMENT OF PALATE  DEVELOPMENT OF JAWS  DEVELOPMENT OF TMJ  DEVELOPMENT OF TONGUE  DEVELOPMENT OF EXTERNAL EAR  DEVELOPMENT OF SALIVARY GLANDS  DEVELOPMENT OF TOOTH  TERATOLOGY  CONGENITAL ANOMALIES  SUMMARY  REFERENCES
  56. 56. FORMATION OF DENTAL LAMINA  At about 21st day of embryonic life the embryo folds along two planes rostocaudal and lateral.  The head fold is critical for the formation of primitive stomatodeum or oral cavity, lined by stratified squamous epithelium, oral ectoderm. Neural Crest Cells: This is ectomesenchymal tissue, termed neural crest from its site of origin, arises from crest of neural fold, where neutralizing and epidermalizing influences the interact. - Pleuripotential cells with great migratory propensities. Primary Epithelial Band: Roughly horse shoe shaped epithelial bands corresponding in position to future upper and lower jaws. Formed as a result of change in orientation of mitotic spindle and cleavage plain of dividing cells and gives rise to dental lamina and vestibular lamina.
  57. 57.  The band of epithelium that invades the underlying ectomysenchyme along each of horse shoe shaped future dental arches called Dental lamina at about 6th week of embryonic life. Importance:  Primordium for the ectodermal portion of deciduous teeth.  Successional tooth buds .  Buds for permanent molars from distal extension of dental lamina.  Dental lamina degenerates at about 5th year of life.  Remnants persist as epithelial pearls / islands. Vestibular Lamina / Lip Furrowband:  Epithelial thickening labial and buccal to dental lamina in each dental arches.  Forms oral vestibule.
  58. 58. Dental lamina
  59. 59. STAGES IN TOOTH DEVELOPMENT The stages are named after the shape of the epithelial part of the tooth germ. 1) BUD STAGE: a) The ectodermal cells along the dental lamina multiply rapidly in to round or ovoid swellings at different points corresponding to the position of future deciduous teeth. b) These form the primordium for the enamel organs of the tooth bud. c) It consist of i. low columnar cells at periphery and polygonal cells at the centre. ii. Dental papilla. iii. Dental sac.
  60. 60. Bud stage
  61. 61. 2) CAP STAGE: This stage is characterized by the shallow invagination on the deep surface of the bud as a result of continued proliferation.  In this stage cells of enamel organ can be histologically differentiated as follows:  Outer enamel epithelium (OEE). – peripheral cuboidal cells.  Inner enamel epithelium (IEE) – columnar cells.  Stellate reticulum –polygonal cells located in the center. –provides cushion like effect, thus supports and protects delicate enamel forming cells  Enamel knot – the densely packed cells in the center enamel organ.  Enamel cord – a vertical extension of the enamel knot between inner and outer enamel epithelium.  Dental papilla – the ectomesenchymal cells proliferate and condense under the influence of proliferating epithelium.  Dental sac – the dense fibrous layer.
  62. 62. Cap stage
  63. 63. 3) BELL STAGE:  The epithelial invagination deepens and the margins continue to grow, thus the enamel organ assumes bell shape.  Stage consist of  IEE – Single layer of tall columnar cells called ameloblasts.  Stratum Intermedium – squamous cells present in between IEE and stellate reticulum. Shows high degree of mitotic activity.  Stellate reticulum – star shaped cells. Collapses before enamel formation.  OEE – flattens to low cuboidal form. – surface laid in folds at the end of bell stage prior to enamel formation begins.  Dental lamina  Dental papilla – odonto blasts differentiation.  membrane performativa.  Dental sac – circular arrangement of fibers and resembles capsular structure.
  64. 64. Advanced bell stage Bell stage with permanent tooth bud
  65. 65. 4) ADVANCED BELL STAGE :  Future dentino enamel junction.  Cervical portion of enamel organ forms the hertwig’s epithelial root sheath. Hertwig’s Epithelial Root Sheath and Root formation:  Root development starts after enamel and dentin formation reaches future cemento enamel junction.  Enamel organ forms hertwig’s epithelial root sheath consisting of inner and outer enamel epithelium. It modes the shape of roots and initiates radicular dentin formation.  The sheath looses its continuity after radicular dentin formation.
  66. 66.  Cementoblast form cementum over dentin.  Epithelial diaphragm – the inner and outer enamel epithelium bend at the future CEJ into horizontal plane narrowing wide cervical opening. The cells proliferate along with adjacent connective tissue cells of pulp.  Apical foramen opening is narrowed by the deposition of dentin and cementum at the apex of root.  In multi rooted teeth the differential growth of epithelial diaphragm causes division of root trunk in to two or three roots.  The long tongue like extensions of the horizontal diaphragm develops two in mandible, three maxilla. Before this the free ends grow towards each other and fuse.  The cervical opening of coronal enamel organ is divided in to two or three openings and dentin formation starts on the periphery of each opening.
  67. 67. Cervical loop Heartwig’s epithelial root sheath and forming root
  68. 68. CONTENTS  INTRODUCTION  EARLY EMBRYONIC DEVELOPMENT  DEVELOPMENT OF BRANCHIAL ARCHES  DEVELOPMENT OF FACE  DEVELOPMENT OF NOSE  DEVELOPMENT OF PARA NASAL SINUSES  DEVELOPMENT OF PALATE  DEVELOPMENT OF JAWS  DEVELOPMENT OF TMJ  DEVELOPMENT OF TONGUE  DEVELOPMENT OF EXTERNAL EAR  DEVELOPMENT OF SALIVARY GLANDS  DEVELOPMENT OF TOOTH  TERATOLOGY  CONGENITAL ANOMALIES  SUMMARY  REFERENCES
  69. 69. Teratology  Defnition: The sceince that studies birth defects is teratology.  The agents called as Teratogens.  Maximum susceptibility in from 3rd to 8th week of gestational period; The period of embryogenesis.
  70. 70. Principles of Teratology  Susceptibility depends on genotype of conception and the manner of interaction with the environment  Developmental stage at the time of exposure  Dose and duration of exposure  Mechanisms of interaction of teratogens and pathogenesis to anomaly  Manifestations include death, retardation, malformation and functional disorders,
  71. 71. 6 general classes of congenital abnormalities 1. Agenesis like absence of teeth. 2. Full/partial aplasia = incomplete development like cleft palate 3. Hyperplasia = excessive development like macrognathia, maxillary hyperplasia 4. Embryonic survival like thyroglossal cyst 5. Hemartoma, misplacement of normal tissue like lingual thyroid 6. Blastoma like teratoma in which there is atypical differentiation of embryonic tissue
  72. 72. CONTENTS  INTRODUCTION  EARLY EMBRYONIC DEVELOPMENT  DEVELOPMENT OF BRANCHIAL ARCHES  DEVELOPMENT OF FACE  DEVELOPMENT OF NOSE  DEVELOPMENT OF PARA NASAL SINUSES  DEVELOPMENT OF PALATE  DEVELOPMENT OF JAWS  DEVELOPMENT OF TMJ  DEVELOPMENT OF TONGUE  DEVELOPMENT OF EXTERNAL EAR  DEVELOPMENT OF SALIVARY GLANDS  DEVELOPMENT OF TOOTH  TERATOLOGY  CONGENITAL ANOMALIES  SUMMARY  REFERENCES
  73. 73. Defects involving the pharyngeal region  Involving the pharyngeal region 1. Ectopic thyroid and thymic tissue 2. Branchial fistulas
  74. 74. Neural crest cells and craniofacial defects 1.Treacher collin syndrome/ first arch syndrome/ mandibulofacial dystosis syndrome a) May be caused due to Vitamin A. b) Arises as autosomal dominant trait. c) May arise due to new mutations Due to retardation or failure of differentiation of maxillary mesoderm at or after 50mm stage of development of embryo. -malar, zygomatic hypoplasia, Mandibular hypoplasia. -lower eyelid colobomas. -malformed ears -lower eyelid colobomas
  75. 75. 2. Robin sequence – may occur independently or in association with other syndromes.  May occur in oligohydroaminos due to compression of chin against chest -micrognathia with mandible being affected severely. -cleft palate. -glossoptosis – posteriorly placed tongue.
  76. 76. 3. Di george anomaly – it in includes velocardiofacial syndrome or conotruncal anomlies of face.  Caused due to alcohol, maternal diabetes & retinoids.  All part of spectrum called as CATCH22  Due to deletion of long arm of chromosome 22 and the following:  Cardiac defects  Abnormal facies  Thymic hypoplasia  Cleft palate  Hypocalcemia
  77. 77. 5. CROUZON’S SYNDROME/ CRANIOFACIAL DYSTOSIS. 1.Associated with premature closure of the cranial sutures leading to one of the following a. Boat shaped skull b. Tower shaped skull c. Clover leaf shaped skull or Brachecephaly d. Egg shaped skull 2. Maxillary hyperplasia with high arched palate maybe associated with cleft 3.Increased interpupillary distance 4.Hypoplasia of the orbit 5. Congenital defects of the heart.
  78. 78. 4. Hemifacial Microsomia/ Goldenhar syndrome/ oculoauriculovertebral syndrome.  Maxilla, zygomatic, temporal bone are tiny and flat  Microtia/ anotia  Tumours or dermoids in eyeball  Fused hemivertebrae / spina bifida  Assymmetry  Cardiac abnormalities like - teratology of fallot - Venticulo-septal defects
  79. 79. Defects arising in tongue  Tongue tie or ankyologlossia  Aglossia  Macroglossia  Microglossia  Lingual thyroid nodule  Lymphoma of tongue  Haemangioma of tongue  Bifid tongue or scrotul or fissured tongue  Lingual cyst  Thyroglossal ductal cyst  Ankyloglossum superiosum  Lipoma of tongue  Teratoma of tongue
  80. 80. Defects of thyroid 1.Aberrant thyroid tissue 2.Cyst or fistula
  81. 81. Facial clefts
  82. 82. Palatal clefts
  83. 83. Defects of teeth Size Related  Microdontia  Macrodontia Shape related cusp  Gemination  Twinning  Fusion  Concrscense  Dens in dente  Talons cusp  Dilaceration  Dens evaginatus  Taurodontism Number related  Anodontia  Onligodontia  Supernumary tooth  Supernumary roots Structure related  Ameoleogenesis imperfecta  Dentino genesis imperfecta  Enamel hypoplasia Related to growth and eruption  Impected tooth  Transposition and ectopic eruption
  84. 84. Congenital anomalies related to Salivary Glands  Aberrancy/ ectopic salivary glands – staffne’s cyst  Aplasia  Hypoplasia / hyperplasia  Atresia- congenital occlusion or absence of one or more major salivary gland ducts  Accessory duct / accessory lobe
  85. 85. Congenital anomalies affecting TMJ  Hypoplasia of condyle – unilateral/ bilateral  Hyperplasia of condyle – unilateral / bilateral  Double condyle  Hyperplasia / hypoplasia of coronoid process  Malformed glenoid process or articular tubercle
  86. 86. Defects in development of Eye and External Ear  Ear – preauricular pits and appendages  Eye - Cyclopia or synopthalmia with probescis Absence of eye ie anopthalmia Colobomas of eyelids Congenital Ptosis Fusion of eyelids-cryptophalmos Epicanthal fold
  87. 87. CONTENTS  INTRODUCTION  EARLY EMBRYONIC DEVELOPMENT  DEVELOPMENT OF BRANCHIAL ARCHES  DEVELOPMENT OF FACE  DEVELOPMENT OF NOSE  DEVELOPMENT OF PARA NASAL SINUSES  DEVELOPMENT OF PALATE  DEVELOPMENT OF JAWS  DEVELOPMENT OF TMJ  DEVELOPMENT OF TONGUE  DEVELOPMENT OF EXTERNAL EAR  DEVELOPMENT OF SALIVARY GLANDS  DEVELOPMENT OF TOOTH  TERATOLOGY  CONGENITAL ANOMALIES  SUMMARY  REFERENCES
  88. 88. SKELETAL SYSTEM SKULL NEURO CRANIUM  THE MEMBRANOUS PART  THE CARTILAGINOUS PART OR CHONDROCRANIUM VISCERO CRANIUM  BONES OF THE FACE.  FORMED FROM THE FIRST TWO PHARYNGEALARCHES
  89. 89. MEMBRANOUS NEUROCRANIUM
  90. 90. CARTILAGINOUS NEUROCRANIUM OR CHONDROCRANIUM
  91. 91. DEVELOPMENT OF FACIAL SKELETON  THE FACE MAY BE CONVIENTLY,IF SOME WHAT ARBITARILY DIVIDED INTO UPPER, MIDDLE & LOWER THIRDS.  THE THREE PARTS CORRESPOND GENERALLY TO THE EMBRYONIC STRUCTURES NAMELY THE FRONTO NASAL, MAXILLARY & MANDIBULAR PROCESS.
  92. 92.  UPPER THIRD OF FACE IS PREDOMINANTLY OF NEUROCRANIAL COMPOSITION,WITH THE FRONTAL BONE OF THE CALVARIA ,PRIMARILY RESPONSIBLE FOR THE FORE HEAD.  INTIALLY GROWS MOST RAPIDLY KEEPING PACE WITH ITS NEUROCRANIAL ASSOCIATION & THE PRECOCIOUS DEVELOPMENT OF THE FRONTAL LOBES OF THE BRAIN.  ACHIEVES ITS ULTIMATE GROWTH POTENTIAL AT AN EARLY AGE, PRACTICALLY CEASING THE GROWTH SIGNIFICANTLY AFTER THE 12 YEARS OF LIFE.
  93. 93.  MIDDLE THIRD OF FACE IS SKELETALLY THE MOST COMPLEX,BEING COMPOSED IN PART OF THE CRANIAL BASE & INCORPORATING BOTH THE NASAL EXTENSIONS OF THE UPPER THIRD PART OF THE MAXILLARY APPARATUS.  GROWS MORE SLOWLY OVER A PROLONGED PERIOD, NOT CEASING THE GROWTH UNTIL THE LATE ADOLESENCE.
  94. 94.  THE LOWER THIRD OF FACE COMPLETES THE MASTICATORY APPARATUS, BEING COMPOSED OF THE SKELETON OF THE MANDIBLE & ITS DENTITION.  GROWS MORE SLOWLY , NOT CEASING THE GROWTH UNTIL THE LATE ADOLESENCE.
  95. 95.  FACIAL BONES DEVELOP INTRA MEMBRANOUSLY FROM OSSIFICATION CENTERS IN THE NEURAL CREST MESENCHYME OF THE EMBRYONIC FACIAL PROCESS.  IN THE FRONTONASAL PROCESS,INTRAMEMBRANOUS SINGLE OSSIFICATION CENTER APPEARS IN THE 3RD MONTH.  DURING 8TH WEEK A PRIMARY OSSIFICATION CENTER APPEARS FOR EACH MAXILLAAT THE TERMINATION OF INFRA ORBITAL NERVE JUST ABOVE THE CANINE TOOTH DENTAL LAMINA.  FURTHER TWO INTRA MEMBRANOUS PREMAXILLARY CENTERS APPEAR ANTERIORLY ON EACH SIDE IN THE 8TH WEEK & RAPIDLY FUSE WITH THE PRIMARY MAXILLA.  THE MANDIBULAR PROCESS DEVELOP BILATERALLY FROM A SINGLE INTRA MEMBRANOUS CENTRE.
  96. 96. THE ATTACHEMENT OF THE FACIAL SKELETON ANTERO – INFERIORLY TO THE CALVARIA DETERMINES THE CHONDRO CRANIAL INFLUENCE ON FACIAL GROWTH.
  97. 97. CONTENTS  INTRODUCTION  EARLY EMBRYONIC DEVELOPMENT  DEVELOPMENT OF BRANCHIAL ARCHES  DEVELOPMENT OF FACE  DEVELOPMENT OF NOSE  DEVELOPMENT OF PARA NASAL SINUSES  DEVELOPMENT OF PALATE  DEVELOPMENT OF JAWS  DEVELOPMENT OF TMJ  DEVELOPMENT OF TONGUE  DEVELOPMENT OF EXTERNAL EAR  DEVELOPMENT OF SALIVARY GLANDS  DEVELOPMENT OF TOOTH  TERATOLOGY  CONGENITALANOMALIES  SUMMARY  CONCLUSION  REFERENCES
  98. 98. CONCLUSION JUST AS THE CLINICIAN NEEDS THE MEDICAL HISTORY TO MAKE A LOGICAL DIAGNOSIS, SO TOO THE GROWTH AND DEVELOPMENT OF FACE IS ESSENTIAL FOR A LOGICAL EXPLANATION OF ANY STRUCTURAL AND FUNCTIONAL IMBALANCES IF IT DO OCCURS.
  99. 99. CONTENTS  INTRODUCTION  EARLY EMBRYONIC DEVELOPMENT  DEVELOPMENT OF BRANCHIAL ARCHES  DEVELOPMENT OF FACE  DEVELOPMENT OF NOSE  DEVELOPMENT OF PARA NASAL SINUSES  DEVELOPMENT OF PALATE  DEVELOPMENT OF JAWS  DEVELOPMENT OF TMJ  DEVELOPMENT OF TONGUE  DEVELOPMENT OF EXTERNAL EAR  DEVELOPMENT OF SALIVARY GLANDS  DEVELOPMENT OF TOOTH  TERATOLOGY  CONGENITAL ANOMALIES  SUMMARY  REFERENCES
  100. 100. References  T.W. Saddler “Langman’s Medical Embryology”. 5th edition.  G.H. Sperber “Craniofacial embryology”. 4th edition.  W.R. Proffit “Contemporary orthodontics”. 3rd edition.  S.I. Balaji “Orthodontics the art and science”. 2nd edition.  A.R. Tencate “Oral histology”. 5th edition.  Shafer “A textbook of Oral pathology”. 4th edition.  B.D. Chaurasia “Human anatomy Head and neck”. 3rd edition.  Orban’s oral histology &embryology  Textbook of Pedodontics –Shobha Tandon  Text book of oral medicine – Ghoms  Text book of embryology – Inderbere singh  Craniofacial Development, Geoffrey H. Sperber.
  101. 101. Thank you
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