Origin of malformations /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,
Dental implants courses.for details pls visit www.indiandentalacademy.com ,or call
0091-9248678078

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Origin of malformations /certified fixed orthodontic courses by Indian dental academy

  1. 1. Origin of Malformations INDIAN DENTAL ACADEMY Leader in continuing dental education www.indiandentalacademy.com www.indiandentalacademy.com
  2. 2. Maxillary hypoplasia with narrow or high arched palate         Achondroplasia Apert syndrome Cleidocranial Dysostosis Crouzon syndrome Marfan’s syndrome Treacher Collin’s syndrome Fetal alcohol , Valproate syndrome Cleft lip and palate www.indiandentalacademy.com
  3. 3. Malar hypoplasia    Treacher Collins Syndrome Blooms syndrome Trisomy 13 and 18 www.indiandentalacademy.com
  4. 4. Achondroplasia  Megalocephaly – small foramen magnum  Early spheno-occipital closure  Low nasal bridge Prominent forehead  Midfacial hypoplasia, narrow nasal passages www.indiandentalacademy.com
  5. 5. Apert syndrome  Short a-p diameter of skull  Early Craniosynostosis of coronal suture  Small nose, maxillary hypoplasia  Narrow palate, with or with out cleft lip or palate  Delayed or ectopic eruption of the teeth www.indiandentalacademy.com
  6. 6. Crouzon syndrome      Ocular proptosis Frontal bossing Hypoplasia of the maxilla Curved parrot – like nose, inverted V shaped palate Short A – P diameter and lateral diameter of the skull www.indiandentalacademy.com
  7. 7. Treacher Collin’s syndrome       Improper migration of neural crest cells Malar hypoplasia Malformation of the auricles Ear defects Cleft of the palate Incompetent soft palate www.indiandentalacademy.com
  8. 8. Fetal Alcohol syndrome     Microcephaly Short palpebral fissures Maxillary hypoplasia Short nose, smooth philtrum and lip www.indiandentalacademy.com
  9. 9. CLEFT OF THE LIP and PALATE  Cleft lip and palate occur in 1 out of 800 live births www.indiandentalacademy.com
  10. 10. Types  Cleft of the Lip (Unilateral / Bilateral)  Complete or Incomplete When unilateral it is often on the Left side When bilateral it usually also affects the palate. rare. Isolated cleft lip is www.indiandentalacademy.com
  11. 11.  Cleft of the Lip and Palate  (Unilateral / Bilateral) Unilateral: May include the hard palate and the soft palate. Sometimes, only one structure affected. Bilateral: Usually the most severe type of cleft. Has severe tissue deficiency. www.indiandentalacademy.com
  12. 12. Cleft of the Lip and Palate www.indiandentalacademy.com
  13. 13.  Submucous cleft Seen in the soft palate. Lack of muscle in the velum; but there is presence of mucosal tissue. Often discovered late in childhood. Often is accompanied with bifid uvula.  Bifid Uvula www.indiandentalacademy.com
  14. 14. Other classification  Veau Classification - 1931     Veau Class I: isolated soft palate cleft Veau Class II: isolated hard and soft palate Veau Class III: unilateral CLAP Veau Class IV: bilateral CLAP www.indiandentalacademy.com
  15. 15. Etiology  Genetic Disorders: More than 400 syndromes known to cause cleft of lip and palate.  Chromosomal Aberrations  Teratogenically Induced Disorders  Drugs: Dilantin, thalidomide, aspirin (when used in excess), retinoid, etc.  Excessive alcohol, nicotine, caffeine. www.indiandentalacademy.com
  16. 16. Etiology  X-rays, some viral infections, etc.  Mechanically Induced Abnormalities  Amniotic rupture  Intra-uterine tumors  Irregularly shaped uterus, etc. www.indiandentalacademy.com
  17. 17. Theories of growth www.indiandentalacademy.com
  18. 18. Sutural Theory Weinman & Sicher      Sutures have innate growth potential Push bones apart Oblique in nature Sliding effect Resultant thrust in the anterior and inferior direction www.indiandentalacademy.com
  19. 19. Shortcomings - Bone tissue in not capable of growth in a field that requires level of compression needed to produce a pushing type of displacement - Suture is essentially a ‘tension’ adapted tissue - Sutures do not have inbuilt growth potential • www.indiandentalacademy.com
  20. 20. Cartilagenous theory James Scott  Nasal sept um has innat e gr owt h pot ent ial  Thur st ef f ect by sept omaxillar y ligament  Bone enlar ges at t he sut ur es in r esponse t o t he t ension cr eat ed by displacement www.indiandentalacademy.com
  21. 21.   Removal of the nasal septum lead to decreased A – P growth Vertical growth was unaffected www.indiandentalacademy.com
  22. 22.  Shortcomings Extripation of septum caused tissue destruction Concept of multiple assurance; latham and scott – growth mechanisms are multifactorial Compensation of growth occurs in the neighbouring tissues www.indiandentalacademy.com
  23. 23. THE FUNCTIONAL MATRIX HYPOTHESIS One Function Functional Cranial Component Functional Matrix Skeletal Unit 1. Periosteal Matrix -------------------------------> 2. Capsular Matrix --------------------------------> a. Masses b. Functioning spaces www.indiandentalacademy.com 1. Microskeletal 2. Macroskeletal
  24. 24.   The growth of cranifacial cartilage is entirely secondary to the growth of functional matrices Translation of the bones of the face is due to the primary expansion of the oro and naso pharyngeal cartilages www.indiandentalacademy.com
  25. 25. Postnatal growth of the midface www.indiandentalacademy.com
  26. 26. Outline   The Nasomaxillary Remodeling Quantitative description of the growth in three planes of the space www.indiandentalacademy.com
  27. 27. The Nasomaxillary Remodeling www.indiandentalacademy.com
  28. 28. The Nasomaxillary Remodeling 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. The Maxillary tuberosity The Lacrimal Suture Key ridge Vertical drift of teeth Nasal airway Palatal remodelling Downward maxillary displacement Maxillary sutures The Cheekbone and Zygomatic Arch Orbital Growth A - point www.indiandentalacademy.com
  29. 29. The Maxillary tuberosity      Depository field Backward facing periosteal surface Widening of the arches Tension produced by the displacement of the bone Clinical implication – distalization of the molars www.indiandentalacademy.com
  30. 30. The Lacrimal Suture     Surrounded by sutures Slippage during the growth Co-ordinates with growth of the surrounding bones Undergoes remodelling rotations www.indiandentalacademy.com
  31. 31. The Lacrimal Suture www.indiandentalacademy.com
  32. 32. Key ridge   Posterior depository field Anterior resoptive field www.indiandentalacademy.com
  33. 33. Vertical drift of teeth  Vertical and horizontal drift of the alveolus  Remodeling of the Pdl  Partially bonded cases ex; 2 X 4 app to control the vertical drift www.indiandentalacademy.com
  34. 34. Nasal airway    Lateral and anterior expansion Downward relocation of the palate Vertical expansion of the vomer www.indiandentalacademy.com
  35. 35. Nasal airway www.indiandentalacademy.com
  36. 36. Nasal airway www.indiandentalacademy.com
  37. 37. Palatal remodelling  Follows the ‘V’ principle  Palate in child is completely replaced  Process of RME is not a biologic process www.indiandentalacademy.com
  38. 38. Palatal remodelling www.indiandentalacademy.com
  39. 39. Downward maxillary displacement    Frontal slide at sutural junctions with the lacrimal zygomatic, nasal and ethmoidal bones. Increase in the height of maxilla RME and face mask therapy www.indiandentalacademy.com
  40. 40. The Cheekbone and Zygomatic Arch  The malar region and anterior part of the zygoma undergo posterior remodeling (relocation) movement  The inferior edge of the zygoma is heavily depository.  Zygomatic arch moves laterally by resorption on the medial side within the temporal fossa and by deposition on the lateral side. www.indiandentalacademy.com
  41. 41. The Cheekbone and Zygomatic Arch www.indiandentalacademy.com
  42. 42. Orbital Growth   Floor of the nasal cavity is lower than floor of the orbital cavity They are part of maxilla ; remodeling is in opposite directions www.indiandentalacademy.com
  43. 43. A - point  Reversal of the remodeling occurs www.indiandentalacademy.com
  44. 44. Quantitative description of the growth in three planes of the space A. Bjork and V. Skieller www.indiandentalacademy.com
  45. 45. Implant study     Tantalum implants 1.5 mm & 1.2 mm Lateral implants – 2 on each side of zygomatic process of the maxilla Anterior implants – 1 on each side below the ANS ; inserted at the age of 10 – 11 yrs www.indiandentalacademy.com
  46. 46. Parameters         Maxillary height Maxillary width Bimolar width Bicanine width Mutual rotation of the maxillae Vertical rotation Remodelling of the zygomatic process Alveolar process and dental arch www.indiandentalacademy.com
  47. 47. Growth of the maxilla from 4 to 10 yrs  Maxillary height www.indiandentalacademy.com
  48. 48.    No relation b/w growth in width of the median suture and the sutural growth of maxilla Transverse growth is indirectly proportional to the growth of the alveolar process Sutural growth is directly propotional to the growth of alveolar process and the orbital growth www.indiandentalacademy.com
  49. 49.  Maxillary width • Coincided with the maximum pubertal growth spurt www.indiandentalacademy.com
  50. 50.  Bimolar width – increases during puberty, followed by a small decrease  Bicanine width – decrease in the width from 4 yrs to the adult age www.indiandentalacademy.com
  51. 51. www.indiandentalacademy.com
  52. 52. www.indiandentalacademy.com
  53. 53. Growth of the maxilla from 10 yrs to the adult age Maxillary length There was no change in the sagittal relationship b/w anterior and lateral implants Hence the anterior surface is stable during the growth Change is produced by remodeling  www.indiandentalacademy.com
  54. 54.  Transverse growth www.indiandentalacademy.com
  55. 55.   Length of the dental arches decreases Increase in crowding www.indiandentalacademy.com
  56. 56. Vertical rotation  Nasal floor maintains itself constant in relation to the S-N plane  Forward rotation causes an incerased resorption in the anterior part of the nasal floor  www.indiandentalacademy.com
  57. 57.  Zygomatic process www.indiandentalacademy.com
  58. 58. www.indiandentalacademy.com
  59. 59. www.indiandentalacademy.com
  60. 60.  Dental arch www.indiandentalacademy.com
  61. 61. Summary  Growth at the median suture is an important factor in the growth of width of the maxilla  There is an decrease in the arch length during growth due to the transverse rotation of the maxillae  Sutural lowering of the maxilla is about half as great as appositional growth  Anterior portion of zygomatic arch can be used as reference structure www.indiandentalacademy.com
  62. 62.      Handbook of orthodontics - Moyers Hand Book of Facial Growth- ENLOW Grays Anatomy Factors affecting the growth of midface – monograph no 6 – James A McNamara Prenatal Growth and Morphology of the Human Bony Palate - BERTRAM S. KRAUS - J. Dent Res 1960; 1177 - 1199 www.indiandentalacademy.com
  63. 63.  Sagittal Growth of the Nasomaxillary Complex during the Second Trimester of Human Prenatal Development ALPHONSE R. BURDI - J. dent. Res ; 1965 – 112 - 125 www.indiandentalacademy.com
  64. 64. Thank you For more details please visit www.indiandentalacademy.com www.indiandentalacademy.com

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