G & d

Growth of Maxilla &Growth of Maxilla &
MandibleMandible
Clinical Implications ofClinical Implications of
growth & developmentgrowth & development
www.indiandentalacademy.com

Concepts
of
growth
process

Concept 1
Facial growth and development is a
morphogenic process working toward
a composite state of aggregate
structural and functional balance
among all the multiple,regional
growing and changing hard and soft
tissue parts.

Concept 2
Bone grows by adding new bone tissue
on one side of bony cortex and taking it
away from other side.
-Deposition
-Resorption
-Cortical drift

Concept 3
The outside and inside surfaces of bone
are completely blanketed by a mosaic
like pattern of ‘growth field’.

Concept 4
Bone produced by
covering membrane
constitutes about ½ of all
cortical bone tissue
present ;bone laid down
by the lining membrane
makes up the other ½.

Concept 5
Bone doesn't grow by itself ,growth is
produced by the soft tissue matrix that
encloses each whole bone.

Concept 6
All the various resorptive and depository
growth fields throughout a bone don’t
have same rate of growth activity .Some
depository fields grow much more rapidly
than other.The same is true for
resorptive.These are called as growth
sites.

Concept 7
Remodeling is a process where bone deposition
and resorption occurs so as to bring about
change in size, shape , relationship of the bone.

Concept 8
Primary displacement-as bone enlarges
it is simultaneously carried away from
other bones in direct contact with it .

Concept 9
Secondary displacement-It is the movement of
a whole bone caused by the separate
enlargement of other bones.

Concept 10
Facial growth is a process that requires
intimate morphogenic interactions
among all of its component growing
,changing and functioning soft and hard
tissue parts.No part is developmentally
independent and self contained.

Growth of maxillaGrowth of maxilla
andand
mandiblemandible

Growth of maxillaGrowth of maxilla

-Develops intramembranously
-Growth by three mechanisms
Displacement
Growth at sutures
Surface remodeling

DisplacementDisplacement
Secondary displacement
-important growth mechanism of maxilla
[primary dentition ]
•-Nasomaxillary
complex is moved
in downward and
forward direction.

•Primary displacement
•-it moves maxilla in forward direction

Growth at suturesGrowth at sutures
Maxilla connected to the cranium and
cranial base by –
1]Fronto-nasal suture
2]Fronto-maxillary suture
3]Zygomatico-maxillary suture
4]Zygomatico-temporal suture
5]Pterygo-palatine suture

Surface remodelingSurface remodeling
It brings about
1]increase in size
2]change in shape of bone
3]change in functional
relationship
a) Orbit
b) Nose

•c) Palate
d) Maxillary
tuberosity –bone
deposition at
posterior margin

e) Zygomatic bone
–resorption on
anterior surface and
deposition on the
posterior surface
f) Alveolar process-grows downwards and forward
carrying teeth .This increases height and depth of
palate.

g) Sinus
h) Anterior nasal spine –prominence
increases by bone deposition .

Growth sitesGrowth sites
1]Maxillary tuberosity
2]Sutures
3]Alveolar border
4]Nasal septum

Growth of mandibleGrowth of mandible

IncludesIncludes
• Ramus
• Corpus or the body of mandible
• Angle of the mandible
• The lingual tuberosity
• The alveolar process
• The chin
• The condyle
• The coronoid process

RamusRamus
Functions ofFunctions of
remodelingremodeling
1]To accommodate
muscles
2]To accommodate
space
3]To facilitate the
lengthening of
mandibular body
•Moves progressively posterior by a combination
of deposition and resorption .

Corpus or the body of mandibleCorpus or the body of mandible
Displacement of the
ramus results in the
conversion of
former ramal bone
into the posterior
part of the body of
mandible.

Angle of the mandibleAngle of the mandible
Lingual-Resoption on the postero-
inferior aspect while deposition occurs
on the anterio-superior aspect
Buccal-resorption on the anterio-
superior part and deposition on the
postero-superior part .
Prominence of antegonial notch and
change in gonial angle

The lingual tuberosityThe lingual tuberosity
-It is an direct
equivalent of the
max tuberosity.

•-It moves posteriorly by deposition on
posteriorly facing surface.
•It also protrudes in a lingual direction .

The alveolar processThe alveolar process
Grows upwards ,outwards,forwards .
Develops in response to the tooth buds.
With increases by growth at suture at 1
year

The chinThe chin
Mental protuberance
forms by bone
deposition .
It is accentuated by
bone resorption that
occurs in the alveolar
region above it ,
creating a concavity.

The condyleThe condyle
Two schools of thoughtTwo schools of thought
1]earlier –growth occurs at the surface
of the condylar cartilage by means of
bone deposition .

•2]now –growth of soft tissues including
the muscles and connective tissue
carries the mandible .

The coronoid processThe coronoid process
Growth is by ‘V’ principle
Deposition occurs on the
medial surfaces of left
and right coronoid
process .
It brings about posterior
growth movement in the
‘V’ pattern .
Growth direction follows
the x arrows .

Growth sites of mandibleGrowth sites of mandible
1]mandibular condyle
2]posterior border of ramus
3]alveolar process
4]lower boarder of mandible
5]suture.

Clinical implication of
growth and development

Growth Sprut
The sudden increase in the growth of
general body is called as growth sprut.

Growth sprut
Woodside in study of Burlington group-
three main growth spruts
Girls Boys
1]Just after birth 3yrs 3yrs
2]Juvenile 6-7yrs 7-9yrs
3]Pubertal 10-12yrs 12-15yrs

-occurs nearly 2yrs earlier in girls than boys .
-remains for 2-2 1/2yrs for both sexes.
-Effected by genetic, environmental, sesonal
and cultural factors.
Major events during pubertal sprut
1]exchange from mixed to permanent dentition
2]acceleration in overall rate of facial growth
3]differential growth of jaws

Biological changes seen
during puberty
BOYS
Stage1-Fat sprut intially maturing boy gains
weight and becomes chubby
Stage 2-Sprut in height and development of
secondary sexual characteristics.
Stage 3-Coincides with peak velocity with gain in
height
Stage 4-Spurt in height ends .Indicates that
growth is complete.

GIRLS
Stage1-Appearance of secondary
sexual characteristics
Stage2-occurs 1-1 ½ yrs later stage
Stage 3-Marked by onset of
mensturatiion.Growth is complete.

IMPORTANCE OF GROWTH
SPRUT
1]offers best time for interceptive orthodontic
procedures.
Ex.mandibular retrognathism –activator
maxillary prognathism-headgear
mandibular prognathism-chincap with headgear
maxillary retrognathism-facemask
Activator Headgear

A]Early maturing girls-pubertal sprut precedes final
transition of dentition
B]Slow maturing boys
Chincap with Headgear Facemask

2]expansion-arch and skeletal
3]Excellent indicators for orthodontic treatment .
4]surgical correction
There should be correlation between
-skeletal age
-dental age
-chronological age
-morphological age
and onset of puberty.

Other uses
-important to determine the efficacy of
the therapy.
-to determine the predictability and
future growth direction
-recognition and diagnosis of deviation
from normal growth

THANK YOUTHANK YOU

G & d

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