Prenatal and Postnatal
Growth of Midface

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INDIAN DENTAL ACADEMY
Leader in continuing dental education
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CONTENTS


Anatomy of Midface and associated structures.



Prenatal embryology



Origin of malformations



Post nat...
ANATOMY OF MAXILLA AND
ASSOCIATED STRUCTURES.


Consists of 5 parts
1. Body
2. Zygomatic
3. Frontal
4. Alveolar
5. Palati...
BODY OF THE MAXILLA


Four parts
1. Anterior
2. Infra temporal
3. Orbital
4. Nasal

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ZYGOMATIC PROCESS





Anterior
Posterior
Superior
Inferior

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FRONTAL PROCESS






Lateral
Medial
Superior border
Anterior border
Posterior border

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ALVEOLAR PROCESS

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PALTINE PROCESS





Superior
Inferior
Lateral
Medial

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MAXILLARY SINUS




Largest sinus
Pyramidal in shape
4 walls
Apex
Base
Roof
Floor
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PALATINE BONE




2 plates
Horizontal
Perpendicular
3 process
Pyramidal
Orbital
Sphenoidal
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NASAL BONE




2 surfaces
External
Internal
4 borders
Superior
Inferior
Lateral
Medial

R

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...
LACRIMAL BONE




2 surfaces
Lateral
Medial
4 borders
Anterior
Posterior
Superior
Inferior
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ETHMOID BONE


3 parts
Cribriform plates
Perpendicular plate
Ethmoidal labyrinths

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VOMER BONE
•Midline structure
•2 surface- lateral
•4 borders
Anterior
Posterior
Superior
Inferior
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ZYGOMATIC BONE




Quadrangular
in shape
Parts
3 surfaces
5 borders
2 process

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Nasal cavity

Lateral wall
Medial wall

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Nasal Cartilages

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Prenatal Embryology

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Outline







Formation of Branchial Arches
Development of Lip
Development of palatal shelves
Development of maxill...
Formation of Branchial Arches


1- 4 weeks –
Ovum



Zygote

Blastocyst

Gastrula

Neurulation

4- 5 weeks –
Formation o...
Origins of mid face at 5 weeks






Appearance of nasal pits by thickening of
the ectoderm ( ecto – ectodermal
intera...
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Face at 6 – 8 weeks





Change In the optical axes
Fusion of the medial nasal processes and
maxillary process giving r...
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Development of Lip




Occurs during the 5th week during the fusion
of maxillary and medial nasal process.
Occurs in 3 s...
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Development of the palate



5 weeks – palatine process of the maxilla
Separated by the tongue

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



6 weeks – growth of the palatine shelves
caudally
7 weeks – descend of the tongue caudally.

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Elevation of the palate






Region specific synthesis and accumulation
of the hyaluronan
It binds with water by more ...






The process occurs when there is
maximum growth of the height of the head
Length of the meckels cartilage
Maxill...


Woo 1949–
Separate center of ossification for each premaxilla and
maxillary centers of ossification near the canine fos...
The 7 Stages

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1st stage


Fusion of Premaxilla and maxilla



Radiation of the trabecule from the future
canine alveolus



K-shaped ...
1st stage

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2nd stage – 9 weeks


Begins with ossification of the alveolar
crypts of the central and lateral incisors.



Thin trabe...
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3rd stage – 10 weeks






Appearance of the infravomerine processes
Separate centers and fuse quickly
Appearance of v...
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4th stage – 11 weeks





Increase in depth of alveolar sockets
A pointed bony process midway on the
lingual alveolar b...
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5th stage - 13 weeks




Left and right palatal processes of the maxilla
and palatine bones have reached almost to the
m...




Buccal alveolar borders of the incisors,
canine, and primary first molar have now
assumed their characteristically c...
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6th stage - 14 weeks




Two halves of the palatal processes are in
apposition. at the mid-line, although no
fusion has ...
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7th stage – 15 week

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Development of the maxillary
complex

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Sagittal and transverse Growth of
Nasomaxillary complex from 12 – 24
weeks


Alphonse Burdi ; J. Dent. Res. 1965



Land...
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Transverse growth


Palatal Breadth To Palatal Length:



The mean value is around 82 per cent for adults.
In fetuses th...
Midface before birth – Changes in the
facial propotions
CHANGES FROM 12TH – 36 WEEKS
 Length – 18mm > 120mm
 Width – 12m...




Prior to the 5th month the increase in height
is the greatest
Cranial vault : face > 40 : 1- embryo
> 5 : 1 – 4 mont...
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“And

the end of all our
exploring
Will be to arrive where we
started
And know the place for the
first time”

Thank you
ww...
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Growth of midface /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.


Indian dental academy provides dental crown & Bridge,rotary endodontics,fixed orthodontics,
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Growth of midface /certified fixed orthodontic courses by Indian dental academy

  1. 1. Prenatal and Postnatal Growth of Midface www.indiandentalacademy.com
  2. 2. INDIAN DENTAL ACADEMY Leader in continuing dental education www.indiandentalacademy.com www.indiandentalacademy.com
  3. 3. CONTENTS  Anatomy of Midface and associated structures.  Prenatal embryology  Origin of malformations  Post natal Development  Theories of growth www.indiandentalacademy.com
  4. 4. ANATOMY OF MAXILLA AND ASSOCIATED STRUCTURES.  Consists of 5 parts 1. Body 2. Zygomatic 3. Frontal 4. Alveolar 5. Palatine process www.indiandentalacademy.com
  5. 5. BODY OF THE MAXILLA  Four parts 1. Anterior 2. Infra temporal 3. Orbital 4. Nasal www.indiandentalacademy.com
  6. 6. ZYGOMATIC PROCESS     Anterior Posterior Superior Inferior www.indiandentalacademy.com
  7. 7. FRONTAL PROCESS      Lateral Medial Superior border Anterior border Posterior border www.indiandentalacademy.com
  8. 8. ALVEOLAR PROCESS www.indiandentalacademy.com
  9. 9. PALTINE PROCESS     Superior Inferior Lateral Medial www.indiandentalacademy.com
  10. 10. MAXILLARY SINUS    Largest sinus Pyramidal in shape 4 walls Apex Base Roof Floor www.indiandentalacademy.com
  11. 11. PALATINE BONE   2 plates Horizontal Perpendicular 3 process Pyramidal Orbital Sphenoidal www.indiandentalacademy.com
  12. 12. NASAL BONE   2 surfaces External Internal 4 borders Superior Inferior Lateral Medial R www.indiandentalacademy.com L
  13. 13. LACRIMAL BONE   2 surfaces Lateral Medial 4 borders Anterior Posterior Superior Inferior www.indiandentalacademy.com
  14. 14. ETHMOID BONE  3 parts Cribriform plates Perpendicular plate Ethmoidal labyrinths www.indiandentalacademy.com
  15. 15. VOMER BONE •Midline structure •2 surface- lateral •4 borders Anterior Posterior Superior Inferior www.indiandentalacademy.com
  16. 16. ZYGOMATIC BONE   Quadrangular in shape Parts 3 surfaces 5 borders 2 process www.indiandentalacademy.com
  17. 17. Nasal cavity Lateral wall Medial wall www.indiandentalacademy.com
  18. 18. Nasal Cartilages www.indiandentalacademy.com
  19. 19. Prenatal Embryology www.indiandentalacademy.com
  20. 20. Outline       Formation of Branchial Arches Development of Lip Development of palatal shelves Development of maxillary complex Sagittal and transverse Growth of Nasomaxillary complex Midface before birth – Changes in the facial propotions www.indiandentalacademy.com
  21. 21. Formation of Branchial Arches  1- 4 weeks – Ovum  Zygote Blastocyst Gastrula Neurulation 4- 5 weeks – Formation of 6 arches Face develops from 1 and 2 branchial arches www.indiandentalacademy.com
  22. 22. Origins of mid face at 5 weeks     Appearance of nasal pits by thickening of the ectoderm ( ecto – ectodermal interactions) Forward and downward growth of the face Formation of medial and lateral nasal process Migration of neural crest cells www.indiandentalacademy.com
  23. 23. www.indiandentalacademy.com
  24. 24. Face at 6 – 8 weeks    Change In the optical axes Fusion of the medial nasal processes and maxillary process giving rise to – Lip Philtrum Primary palate Fusion of the facial primordias www.indiandentalacademy.com
  25. 25. www.indiandentalacademy.com
  26. 26. Development of Lip   Occurs during the 5th week during the fusion of maxillary and medial nasal process. Occurs in 3 stages 1. Contact of the epithelia 2. Fusion of the epithelial process 3. Invasion of the connective tissues www.indiandentalacademy.com
  27. 27. www.indiandentalacademy.com
  28. 28. Development of the palate   5 weeks – palatine process of the maxilla Separated by the tongue www.indiandentalacademy.com
  29. 29.   6 weeks – growth of the palatine shelves caudally 7 weeks – descend of the tongue caudally. www.indiandentalacademy.com
  30. 30. www.indiandentalacademy.com
  31. 31. Elevation of the palate    Region specific synthesis and accumulation of the hyaluronan It binds with water by more than 1000 times of its own weight causing swelling and expansion of the shelves Alignment of the collagen fibrils and the cells of the mesenchyme (contraction) www.indiandentalacademy.com
  32. 32.     The process occurs when there is maximum growth of the height of the head Length of the meckels cartilage Maxillary cranial base angle – 84 deg Fusion occurs late in females - 7 days www.indiandentalacademy.com
  33. 33.  Woo 1949– Separate center of ossification for each premaxilla and maxillary centers of ossification near the canine fosse Two centers on either side have fused to form the corpus There is no longer any morphologically separate premaxilla at the end of 8th week  Bertram Kraus (J. D. Res. 1960) – 7 morphological levels www.indiandentalacademy.com
  34. 34. The 7 Stages www.indiandentalacademy.com
  35. 35. 1st stage  Fusion of Premaxilla and maxilla  Radiation of the trabecule from the future canine alveolus  K-shaped configuration www.indiandentalacademy.com
  36. 36. 1st stage www.indiandentalacademy.com
  37. 37. 2nd stage – 9 weeks  Begins with ossification of the alveolar crypts of the central and lateral incisors.  Thin trabecularized network of bone of the palate  Vomer bones have appeared www.indiandentalacademy.com
  38. 38. www.indiandentalacademy.com
  39. 39. 3rd stage – 10 weeks     Appearance of the infravomerine processes Separate centers and fuse quickly Appearance of various bony trabeculae for the formation of the palate and the palatine bone Formation of the first primary molar www.indiandentalacademy.com
  40. 40. www.indiandentalacademy.com
  41. 41. 4th stage – 11 weeks    Increase in depth of alveolar sockets A pointed bony process midway on the lingual alveolar border of the central and lateral incisors Anterior bony margin of the incisive suture www.indiandentalacademy.com
  42. 42. www.indiandentalacademy.com
  43. 43. 5th stage - 13 weeks   Left and right palatal processes of the maxilla and palatine bones have reached almost to the mid-line and have achieved their maximum overlap. Divided into three zones Anterior - deeply stained trabeculae of the maxilla Middle - superior layer of palatine bone and an inferior layer of maxillary bone Posterior - horizontal trabeculae of the palatine bone www.indiandentalacademy.com
  44. 44.   Buccal alveolar borders of the incisors, canine, and primary first molar have now assumed their characteristically curved shape Posterior portion of the medial edge of palate is rounded – absence of PNS www.indiandentalacademy.com
  45. 45. www.indiandentalacademy.com
  46. 46. 6th stage - 14 weeks   Two halves of the palatal processes are in apposition. at the mid-line, although no fusion has taken place and the two processes are generally not in contact. Formation of Posterior nasal spine www.indiandentalacademy.com
  47. 47. www.indiandentalacademy.com
  48. 48. 7th stage – 15 week www.indiandentalacademy.com
  49. 49. Development of the maxillary complex www.indiandentalacademy.com
  50. 50. Sagittal and transverse Growth of Nasomaxillary complex from 12 – 24 weeks  Alphonse Burdi ; J. Dent. Res. 1965  Landmarks – Nasion (N) Sella (S) Basion (Ba) Crista galli (CG) Septal point (SP) Anterior nasal spine (ANS) Posterior nasal spine Uvular point (UP). www.indiandentalacademy.com
  51. 51. www.indiandentalacademy.com
  52. 52. www.indiandentalacademy.com
  53. 53. www.indiandentalacademy.com
  54. 54. www.indiandentalacademy.com
  55. 55. www.indiandentalacademy.com
  56. 56. www.indiandentalacademy.com
  57. 57. www.indiandentalacademy.com
  58. 58. www.indiandentalacademy.com
  59. 59. Transverse growth  Palatal Breadth To Palatal Length:  The mean value is around 82 per cent for adults. In fetuses this relationship begins with 167 per cent and decreases to 125 per cent. This decrease is achieved by a constantly increasing rate of acceleration of palatal length relative to that of palatal breadth.  www.indiandentalacademy.com
  60. 60. Midface before birth – Changes in the facial propotions CHANGES FROM 12TH – 36 WEEKS  Length – 18mm > 120mm  Width – 12mm > 74 mm  Height – 20 mm > 100mm www.indiandentalacademy.com
  61. 61.   Prior to the 5th month the increase in height is the greatest Cranial vault : face > 40 : 1- embryo > 5 : 1 – 4 months > 8: 1 – birth > 2 : 1 - adult www.indiandentalacademy.com
  62. 62. www.indiandentalacademy.com
  63. 63. “And the end of all our exploring Will be to arrive where we started And know the place for the first time” Thank you www.indiandentalacademy.com

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