Dental Movement Biology

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Dental Movement Biology

  1. 1. Oral Biology 5670 <ul><li>Bone growth and development </li></ul><ul><li>Bone biology </li></ul><ul><li>Educational objectives </li></ul><ul><ul><li>Exposure to basic concepts of bone biology </li></ul></ul><ul><ul><li>Correlation of basic bone biology to clinical treatment </li></ul></ul><ul><ul><li>Special considerations / implications of bone biology to dentistry </li></ul></ul>
  2. 2. Clinical Correlates of Bone Growth and Development <ul><li>Facial skeletal development </li></ul><ul><li>Maxillary development </li></ul><ul><li>Mandibular development </li></ul>
  3. 3. Clinical Correlates of Bone Growth and Development <ul><li>Effect of congenital anonalies on facial growth and development </li></ul><ul><li>Effect of surgical correction of congenital anomalies on facial growth and development </li></ul><ul><li>Tooth development and retention influence on alveolar bone levels </li></ul>
  4. 4. Clincal Correlates of Bone Growth and Development <ul><li>Orthodontic tooth movement </li></ul><ul><li>Bone healing following tooth extraction </li></ul><ul><li>Bone response to alloplastic materials </li></ul><ul><li>Bone healing in approximation of dental implants </li></ul>
  5. 5. Clinical Correlates of Bone Growth and Development <ul><li>Bone grafting to treat dentoalveolar defects </li></ul><ul><li>Bone grafting to treat discontinuity defects </li></ul><ul><li>Fracture healing </li></ul>
  6. 6. Cellular Growth <ul><li>Hypertrophy </li></ul><ul><li>Hyperplasia </li></ul><ul><li>Secretion of extracellular material </li></ul><ul><li>Interstitial growth </li></ul>
  7. 7. Embryologic Type of Bone <ul><li>Endochondral </li></ul><ul><li>Intramembranous </li></ul>
  8. 19. Functional Matrix Theory of Growth <ul><li>“ Growth of the face occurs as a response to the functional need and is mediated by the soft tissue in which the bone is embedded” </li></ul><ul><li>Soft tissues grow, bone and cartilage react </li></ul>
  9. 20. Growth Control <ul><li>Bone is the determinant of its own growth </li></ul><ul><li>Cartilage is the determinant of bone growth </li></ul><ul><li>Soft tissue matrix is the determinant of growth </li></ul>
  10. 26. Orthodontic Tooth Movement <ul><li>Bone apposition and resorption </li></ul><ul><li>Effects on the pulp </li></ul><ul><li>Effects on the PDL </li></ul><ul><li>Effects on the tooth root </li></ul>
  11. 29. Effects of Periosteum <ul><li>Provision of undifferentiated mesechymal cells </li></ul><ul><li>Envelope to limit/regulate bone apposition </li></ul>
  12. 30. Introduction 10 y.o. female 12/98 <ul><li>CC: </li></ul><ul><ul><li>Noticed swelling in face on left side for two weeks </li></ul></ul><ul><li>HPI: </li></ul><ul><ul><li>Facial swelling </li></ul></ul><ul><ul><li>Left lower lip “tingles” </li></ul></ul><ul><ul><li>No pain or change in bite </li></ul></ul>
  13. 31. Examination <ul><li>Left lower facial swelling, without thrill/bruit </li></ul><ul><li>Lower vestibular swelling, L>R </li></ul><ul><li>No abnormal tooth mobility </li></ul><ul><li>Teeth 19-28 vital with EPT </li></ul><ul><li>CN II-XII grossly intact </li></ul>
  14. 32. Assessment <ul><li>Problem list: </li></ul><ul><ul><li>Multilocular radiolucent lesion </li></ul></ul><ul><ul><li>Teeth vital without resorption, displacement, or mobility </li></ul></ul><ul><ul><li>Apparent cortical expansion </li></ul></ul><ul><li>Diff. Dx: </li></ul><ul><ul><li>Central Giant Cell Lesion </li></ul></ul><ul><ul><li>Ameloblastomic Fibroodontoma </li></ul></ul><ul><ul><li>Ameloblastoma </li></ul></ul>
  15. 33. Treatment Plan <ul><li>Impressions for splint fabrication </li></ul><ul><li>Screening labs Ca, alk phos, PTH </li></ul><ul><ul><li>All WNL </li></ul></ul><ul><li>CT of mandible: </li></ul><ul><ul><li>Multilocular radiolucents, from infer border to encompass tooth roots superiorly </li></ul></ul><ul><ul><li>Buccal and lingual cortices intact, although expansion present </li></ul></ul><ul><li>Incisional bx </li></ul>

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