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Development of palate /certified fixed orthodontic courses by Indian dental academy

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The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and offering a wide range of dental certified courses in different formats.

The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and offering a wide range of dental certified courses in different formats.

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  • ……………………..fision of the 3 palatal components initially prodices a flat , unarched roof of the mouth.the fusing lateral palatal shelves overlap the anterior palatal shelves as indicated later by the sloping pathways of the junctional incisive neurovascular canals that carry the previously formed incisive nerves and blood vesels.the site of junction the 3 palatal components is marked by the incisive papilla overlying the incisive canal.the line of fusion of the palatal shelves in adults is traced by the midpalatal suture .and on the surface by the raphae. This fusion seam is reducd in soft palate by the invasion of extraterritorial mesenchyme.
  • Palatopharyngeal incompetance due to muscle hypoplasis of uvula.paralysis following diphtheria due to action of toxin on nerve cells of medulla oblongata. Voice becoms nasal and fluid regurgiatesinto nose.palate is motionless and anaesthetic.other pathology of glossopharyngeal vagus accessory nerve or their nuclei in medulla odlongata causes palatal paralysis.
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    • 1. DEVELOPMENT OF PALATE INDIAN DENTAL ACADEMY Leader in continuing dental education www.indiandentalacademy.com www.indiandentalacademy.com
    • 2. FERTILIZATION BLASTOCYST MORULA 2 CELL STAGE 4 CELL STAGE 16 CELL STAGE www.indiandentalacademy.com
    • 3. PRENATAL DEVELOPMENT 3 – 7 weeks first 2 weeks 3 STAGES GERMINAL EMBRYONIC 8 wks – 9 mths www.indiandentalacademy.com FETAL
    • 4. 3 WEEKS 4 5 WEEKS WEEKS 6 WEEKS 7 WEEKS IN FOCUS . . . www.indiandentalacademy.com
    • 5. The normal …. at a glance. www.indiandentalacademy.com
    • 6. The Hard Palate . . . MID PALATINE ZONE GLANDULAR RAPHE INCISIVE PAPILLA FATTY ZONE RUGAE www.indiandentalacademy.com
    • 7. Two sides of the same coin . . . NASAL SIDE COLUMNAR CILIATED ORAL SIDE STRATIFIED SQUAMOUS www.indiandentalacademy.com
    • 8. The Bony Palate . . . HORIZONTAL PLATE PALATINE PROCESS PALATO MAXILLARY INTERMAXILLARY INTERPALATINE F F.LESSER FORAMEN .GREATER PALATINE PREMAXILLA INCISIVE PALATINE OF PALATINE BONE OF SUTURE SUTURE MAXILLA SUTURE www.indiandentalacademy.com
    • 9. Nerve Supply . . . Blood LESSER PALATINE NASOPALATINE GREATER PALATINE ARTERY NERVE NERVE NERVE www.indiandentalacademy.com
    • 10. Soft Palate . . . REDDISH MUCOSA TASTE BUDS NON KERATINISED www.indiandentalacademy.com
    • 11. Soft Palate muscles . . . Tensor veli palatini Levator veli palatini Palatoglossus Palatopharyngeus Musculus uvulae www.indiandentalacademy.com
    • 12. Functions . . . Separation of the two system Swallowing Breathing Phonation Mastication Hearing Taste www.indiandentalacademy.com
    • 13. The Process of Development . . . www.indiandentalacademy.com
    • 14. PALATE DEVELOPMENT PRIMARY SECONDARY www.indiandentalacademy.com
    • 15. PRIMARY PALATE 4 th week of intrauterine life Fusion of medial nasal process Forms intermaxillary segment www.indiandentalacademy.com
    • 16. PRIMARY PALATE FRONTAL VIEW VENTRAL VIEW Medial nasal process INTERMAXILLARY SEGMENT PRIMARY PALATE www.indiandentalacademy.com
    • 17. PRIMARY PALATE Intermaxillary segment forms the primary palate which becomes the future premaxilla, bearing the four incisor teeth www.indiandentalacademy.com
    • 18. SECONDARY PALATE Starts at the 6 th week Palatine shelves emerges laterally from maxillary process First descends vertically downwards due to presence of tongue Tongue drops, shelves ascends to a horizontal position Moves towards each other www.indiandentalacademy.com Fuses with each other
    • 19. Secondary palate . . . FRONTAL SECTION NASAL SEPTUM MAXILLARY PROCESS PRIMITIVE MOUTH TH MOU Stark compares . . . O UE NG T Shelves fuse with each other, With base of the shelves assume a Tongue drops & nasal septum Vertically downward orientation & With primary palate anteriorly Horizontal position. www.indiandentalacademy.com of shelves. BASSET HOUND
    • 20. SECONDARY PALATE VENTRAL VIEW Coordinated formation of the primary palate, secondary palate & nasal septum www.indiandentalacademy.com
    • 21. SEM view of various stages Downward shelf orientation PRIMARY PALATE 7 WEEKS Horizontal orientation 8 WEEKS Fused shelves 9 www.indiandentalacademy.com WEEKS 22 WEEKS
    • 22. Behind The Scene . . . www.indiandentalacademy.com
    • 23. Shelf elevation . . . ? Tongue depression . . .? Shelves meet . . . ? Shelf fusion . . . ? Shelf position . . . ? www.indiandentalacademy.com
    • 24. Shelf elevation . . . ? Hydration & Polymerization Hyaluronic acid Seratonin & Acetylcholine release Swelling of extra cellular matrix Biosynthetic activity Pushed by the tongue Epithelial plug of external nares www.indiandentalacademy.com
    • 25. Tongue depression . . . ? Growth of Meckel’s cartilage Myoneural activity of tongue Maxilla – Cranium Growth of head Muscle traction Swallowing & Hiccups Withdrawal of head from heart www.indiandentalacademy.com
    • 26. Shelves meet . . . ? Rapid cell proliferation Muscle segment homeobox Bone morphogenic protein Sonic hedge hog www.indiandentalacademy.com
    • 27. Shelf fusion . . . ? 3 mechanisms ... Necrosis of MES due to lysosomal autolysis Transformation of basal MEE to mesenchyme Migration of epithelial cells nasally or orally www.indiandentalacademy.com
    • 28. ADHESION OF SHELVES SURFACE EPITHELIUM BASAL EPITHELIUM GLYCOPROTEIN RICH SEAM MEDIAN EPITHELIAL COAT BEFORE 24-36 HOURS - DNA SYNTHESIS STOPS www.indiandentalacademy.com
    • 29. EPITHELIAL - MESENCHYMAL TRANSFORMATION II I TßR TßR Serine – Threonine Kinases Indispensable TGF-ß Betaglycan III Direct modulator TßR www.indiandentalacademy.com
    • 30. II TGF-ß3 I TGF-ß3 II I III TGF-ß3 TGF-ß3 III III III III TGF-ß3 I II II I III TGF-ß3 III III I TGF-ß3 I III II I II II I III TGF-ß3 TGF-ß3 III I TGF-ß3 I II I III II III IIII I TGF-ß3 I II II II III I TGF-ß3 I III II III II I II III III II III SMAD PROTEINS www.indiandentalacademy.com I
    • 31. VERTICAL POSITION HORIZONTAL POSITION WITH MEE HORIZONTAL POSITION WITHOUT MEE www.indiandentalacademy.com
    • 32. Shelf position . . . ? Growth of the mandible Swallowing of amniotic fluid www.indiandentalacademy.com
    • 33. Back to basics . . . www.indiandentalacademy.com
    • 34. Origin of mesenchyme . . . Neurulution From mid & hindbrain into branchial arches Pluripotent Cells Facial mesenchyme Homeobox genes www.indiandentalacademy.com
    • 35. Differentiates . . . OSTEOBLASTS MYOBLASTS Bone formation Muscle development HAEMOCYTOBLASTS LYMPHOBLASTS Blood vessels Lymphoid tissue www.indiandentalacademy.com
    • 36. Muscle development of soft palate… www.indiandentalacademy.com
    • 37. Tensor Veli Palatini 40 days Palatopharyngeous 45 Days Levator Veli Palatini 8th week Palatoglossus Uvular 9th week 11 week th www.indiandentalacademy.com
    • 38. Origin…. Levator Veli Palatini Palatopharyngeus & Palatoglossus Tensor Uvular Veli Palatini www.indiandentalacademy.com
    • 39. Ossification of Palate … www.indiandentalacademy.com
    • 40. INTRAMEMBRANOUS OSSIFICATION LOOSE MESENCHYME COLLAGEN FIBRES MESENCHYMAL CONDENSATION COLLAGEN FIBRE OSTEOID BUNDLES GELATINOUS MATRIX OSTEOBLASTS www.indiandentalacademy.com OSTEOCYTES
    • 41. OSSIFICATION OF PALATE At end of 7th week . . . At the junction of vertical plate & horizontal plate Tiny cresent places antero-posteriorly with concavity towards medial Extends upward to form vertical plate & medialward to form horizontal plate www.indiandentalacademy.com
    • 42. OSSIFICATION OF PALATE During the 8th week . . . spreads backward to form pyramidal process downwards to form tuberosity www.indiandentalacademy.com
    • 43. OSSIFICATION OF PALATE At the 9th week . . . the two branches of the pyramidal process are widely seperated for internal pterygoid plate vertical plate is at 45° later stages at right angles to the horizontal plate www.indiandentalacademy.com
    • 44. OSSIFICATION OF PALATE In the 10th week . . . the sphenoidal & orbital process develops at the junction bone extends forwards & overlaps maxillary bone vertical plate – fan horizontal plate – www.indiandentalacademy.com pyramidal
    • 45. Dimensions . . . Horizontal more than vertical- fetal Equal in length – at birth Vertical more than horizontal – after birth www.indiandentalacademy.com
    • 46. Mesenchymal condensation . . . Reorientation of the Golgi bodies Fibronectin for cluster formation Polysaccharide prevents aggregation Hyaluronidase breaks down inhibitors www.indiandentalacademy.com
    • 47. Sutures . . . www.indiandentalacademy.com
    • 48. Sutures . . . Site of cellular proliferation & fibre formation Appositional osteogenesis Growth occurs as compensation to separating forces Alternating oscillatory movement Responds towww.indiandentalacademy.com and tension pressure
    • 49. Mid palatal suture . . . Plane or butt-end type First evident at 10 ½ weeks i.u Growth ceases between 1 and 2 years Obliteration starts in adolescence Complete fusion rare until www.indiandentalacademy.com
    • 50. INFANCY www.indiandentalacademy.com Y
    • 51. CHILDHOOD www.indiandentalacademy.com T
    • 52. ADOLESENCE HIGHLYwww.indiandentalacademy.com INTERDIGITATED
    • 53. Ossifying centres . . . www.indiandentalacademy.com
    • 54. DISPUTES IN OSSIFYING CENTRES Kölliker One centre Albrecht Two centre www.indiandentalacademy.com
    • 55. More disputes . . . Callender – no centre of Schwink Piersol Rambaud & Renault 1 its own centre 3 centres Frasetto 5 centres Jarmer – – Fawcett – Prevomerine www.indiandentalacademy.com centre
    • 56. Essential facts . . . Premaxilla – 8 weeks Palatine bone – 9 weeks The centers fuse into a single mass before the 25 mm stage (CRL) Premaxilla contributes to anterior nasal process after fusion www.indiandentalacademy.com
    • 57. GROWTH www.indiandentalacademy.com
    • 58. CRANIAL Vs FACIAL GROWTH POSTNATAL – MORE FACIAL THAN CRANIAL www.indiandentalacademy.com
    • 59. REMODELING Vs DISPLACEMENT www.indiandentalacademy.com
    • 60. REMODELING Resorption & deposition Genic tissues Inferior direction Resorption on oral side & deposition on nasal side Relocation of the palate www.indiandentalacademy.com
    • 61. REMODELING Changes bone size Relocates bone Shapes the bone Fine tune fitting of bone Adapts the bone www.indiandentalacademy.com
    • 62. FETAL SKULL ADULT SKULL Relocation Increase in vertical dimension www.indiandentalacademy.com
    • 63. REMODELING Resorption Nasal side Oral side Deposition Downwards www.indiandentalacademy.com
    • 64. REMODELING Resorption outer side Deposition inner side ds ar ow d t g en in r ov ide M W Change in position Change in size V rin P ple ci Palate becomes wider www.indiandentalacademy.com
    • 65. DISPLACEMENT Physical movement as a whole Expansive force of soft tissues Simultaneously remodels Primary / Secondary Forwards & Downwards www.indiandentalacademy.com
    • 66. DISPLACEMENT 1 2 3 REMODELLING DISPLACEMENT www.indiandentalacademy.com
    • 67. GROWTH ROTATION Compensatory remodeling rotation Fields reversed Displacement rotation www.indiandentalacademy.com
    • 68. Drift . . . drift is the movement of bone in space by virtue of apposition on one side of a cortex or surface & resorption on the other palatal drift - classic example nasal floor – resorptive & roof of mouth - depository www.indiandentalacademy.com
    • 69. VERTICAL DRIFT or ERUPTION Takes place in addition to eruption Occurs by resorption & deposition periodontal connective tissue membrane Provide adjustments for palatal displacement rotations to level the occlusal plane www.indiandentalacademy.com
    • 70. COUNTERPART PRINCIPLE growth of any given facial or cranial part relates specifically to other structural & geometric counterparts if each regional part & its counterpart enlarge to the same extent , balanced growth results www.indiandentalacademy.com
    • 71. COUNTERPART PRINCIPLE Anterior cranial palate fossa Palate www.indiandentalacademy.com Maxillary base
    • 72. THEORIES OF GROWTH SICHER’S THEORY SCOTT’S THEORY MOSS THEORY www.indiandentalacademy.com
    • 73. Sicher’s Sutural dominance theory . . . Reasons for failure . . . Growth site Vs Growth centre After transplantation tissue did not grow Suture are areas that react to stimulus www.indiandentalacademy.com
    • 74. Compare man . . . . . . & his best friend ! ...A www.indiandentalacademy.com
    • 75. Axis . Maxillo mandibular apparatus . . . Cranium . . . Less Big prominent Vertical More Smallprominent Horizontal Human skull Dog skull www.indiandentalacademy.com Striking differences . . .
    • 76. Reasonable hypothesis . . . Feature s Pronograde – four footed Olfactory sense – the first sense ! Tactile sensation of the snout Eating style Other functions – tactile, holding, breaking, fighting etc. www.indiandentalacademy.com
    • 77. Reasonable hypothesis . . . Plantigrade – two footed Well developed brain – frontal lobe Liberty of limb movements Eating style & defence Cooked food – weaker muscles Speech – broader arches ,forward chin www.indiandentalacademy.com Feature s
    • 78. Evolution of Palate . . . d ape - sh UA. Afarensis 3 7 4 DEEP . . . Homo Erectus H.Neanderthalensis 12 P.Robustus P.Boisie A. Africanus 14 www.indiandentalacademy.com SHALLOW . . . for speech. 8 Homo sapiens 15 c boli a Par
    • 79. Foramen . . . Constant remodeling throughout life Decreases in size – physiological or pathological contents are not affected in physiologic change compressed in pathologic conditions eg.cervical stenosis (intervertebral foramen) appears to change in position due to changes in neighboring structures eg. Mental foramen www.indiandentalacademy.com
    • 80. The debated Premaxilla . . . www.indiandentalacademy.com
    • 81. PARTICIPANTS . . . Separate . . . VERSALIUS 1543 COLUMBUS 1559 FALLOPIUS 1561 CAMPER 1778 KOLLIKER 1882 FAWCETT 1911 ALBINUS 1746 Fused . . WOODJONES 1929 . LAWRENCE 1838 ROUSSEAU 1858 - 59 GOETHE 1786 KOSENMUELLER 1804 www.indiandentalacademy.com
    • 82. Premaxilla . . . A Problemaxilla? Separate . . Suture line - Fetal Fused . . No suture line - Adult Suture on palate Ossification defect Ossification time Later fuse All mammals Humans exception www.indiandentalacademy.com
    • 83. BAT AUSTRALOPITHECUS AFARENSIS PE A - CHIMPANZEE AUSTRALOPITHECUS AFRICANUS GORILLA HOMO SAPIENS E K LI 3RD BRANCH 4TH BRANCH www.indiandentalacademy.com 15TH BRANCH
    • 84. The difference of opinions . . Separate ossification centres Maxillary bone grows & spreads over the facial surface of premaxilla No separate centre for premaxill c – shaped maxillary centre www.indiandentalacademy.com
    • 85. Convincing Proof . . . Histological evidence . . . Distinction between calcified bone of maxilla and osteoid of the premaxilla www.indiandentalacademy.com
    • 86. Premaxilla . . . Problemaxilla? The argument continues . . . . . www.indiandentalacademy.com
    • 87. Dimensional changes . . . www.indiandentalacademy.com
    • 88. CHANGES IN UTERUS 7 - 18 WEEKS 4 MONTHS Length increases Width increases www.indiandentalacademy.com
    • 89. CHANGES OUT OF UTERUS AT BIRTH Equal POST NATAL Length increases www.indiandentalacademy.com
    • 90. The factors influencing. . . www.indiandentalacademy.com
    • 91. Genetics . . . IGF-II R / TGF-ß2 / cdK4 - Break In circuit TGF –ALPHA A2 MUTATION OF OSR-2 & TBX22 GENE FOR GAD67 www.indiandentalacademy.com
    • 92. Environmental . . . DRUGS Corticosteroids Anticonvulsants Benzodiazepines Methotrexate Thalidomide Phenobarbitones www.indiandentalacademy.com
    • 93. HABITS Smoking – Maternal smoking leads to cleft Thumb sucking Mouth breathing - leads to narrowing of palate www.indiandentalacademy.com
    • 94. DIETARY AGENTS Vitamin A Folate INVESTIGATIONS Radiation CVS testing www.indiandentalacademy.com L GU F AR W
    • 95. CVS TEST ( CARDIOVASCULAR SYSTEM ? ) (CHORIONIC VILLI SAMPLING) Detects chromosomal abnormalities Done at 10 – 12 weeks of pregnancy The sample is removed by suction Risk of miscarriage www.indiandentalacademy.com
    • 96. The abnormalities . . . www.indiandentalacademy.com
    • 97. CLEFT PALATE CROUZAN’S PIERRE ROBIN TREACHER COLLINS SPRENGEL’S MARFAN’S APERTS TREACHERROBINSYNDROME PIERRE COLLINS’ SYNDROME KLIPPEL FEILSYNDROME CROUZON’SSYNDROME MARFAN’S SYNDROME DOWN’S SYNDROME APERT’S SYNDROME www.indiandentalacademy.com
    • 98. Epstein’s pearls Bohn’s nodules Dental lamina cysts Nasopalatine duct cyst Torus platinus www.indiandentalacademy.com
    • 99. . . .of soft Palate muscle hypoplasia of musculus uvulae Paralysis www.indiandentalacademy.com
    • 100. Orthodontic perspectives…. www.indiandentalacademy.com
    • 101. Occlusion Landmark in cephalometrics Spongy bone Nasorespiratory function Mid Palatal suture Onplants Support www.indiandentalacademy.com baseplate
    • 102. Concluding . . . “If the rate of growth of the first month of embryonic life were to be maintained until adulthood, the resultant individual would be 1,28,350 to the 1,100 power of light years in length.” -Robert Bean ( Anatomist) www.indiandentalacademy.com
    • 103. 4 years . . . 6 years . . . Adult . . . www.indiandentalacademy.com
    • 104. Thank you . . . For the patience! www.indiandentalacademy.com