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Growth /fixed orthodontic courses /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
00919248678078

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Growth /fixed orthodontic courses /certified fixed orthodontic courses by Indian dental academy

  1. 1. GROWTH INDIAN DENTAL ACADEMY Leader in continuing dental education www.indiandentalacademy.com www.indiandentalacademy.com
  2. 2. Changes in Overall Body Proportions www.indiandentalacademy.com
  3. 3. Not all tissue systems of the body grow at the same rate Scammon’s Curve www.indiandentalacademy.com
  4. 4. Variability Not everyone is alike in the way that they grow Percentile growth/ standard deviation to the norm Racial and ethnic differences Boys vs Girls www.indiandentalacademy.com
  5. 5. Growth Curves Boys: 2 to 18 years Girls: 2 to 18 years Boys reach most of their height at age of 17 www.indiandentalacademy.com whereas girls reach theirs at around 15.
  6. 6. Deviations from the norm in growth Sickness - nutrition late/early maturers problems with growth (hormones or genetics) www.indiandentalacademy.com
  7. 7. Why do we assess growth? To determine optimum time for treatment (growth modification and surgery) to determine the amount of growth left to determine type of growth www.indiandentalacademy.com
  8. 8. How to assess growth Hand wrist x-ray sexual maturity: onset of menarche in girls, voice changes and facial hair in boys lateral cephalogram tracings: www.indiandentalacademy.com superimpositions
  9. 9. Other indicators of growth Ask parents how much the child grew last year (height and shoe size) look at parent’s phenotype: tall or short www.indiandentalacademy.com
  10. 10. Principles of Tissue Growth Hypertrophy hyperplasia increased production of extracellular matrix (cell independent) www.indiandentalacademy.com
  11. 11. Bone, muscle and soft tissue growth All are dependent on each other to some degree www.indiandentalacademy.com
  12. 12. Growth of the soft and cartilaginous tissues = interstitial growth Growth of mineralized tissues = can be done in the surface only (periosteum)= surface apposition of bone www.indiandentalacademy.com
  13. 13. Growth of Cartilage/ Endochondral Ossification Long bones Epiphyseal plate contains dividing cartilaginous cells Rate of growth and maturation of cells need to be equal for growth to occur Epiphyseal plate www.indiandentalacademy.com Proliferating cartilage
  14. 14. Intramembranous Bone Formation Cranial Vault and jaws Meckel’s cartilage will be transformed into middle ear ossicles and sphenomandibular ligament and is not involved with the bone formation of the jaws www.indiandentalacademy.com
  15. 15. The growing face 8 months, 6 y, 8 y and 20 y old www.indiandentalacademy.com
  16. 16. The Human Head Shape Brachycephalic Dolichocephalic • short and wide • tall and narrow www.indiandentalacademy.com
  17. 17. Reasons for Describing Head and Face Shape The growth direction of the face and jaws is different in each type of head and/or face. www.indiandentalacademy.com
  18. 18. Reasons for Describing Head and Face Shape “Brachy” tends to grow horizontally; “dolicho” tends to grow vertically. Knowing the general pattern of growth and the expected direction can be helpful in orthodontic diagnosis and treatment planning. www.indiandentalacademy.com
  19. 19. Soft Tissue Profile Convex retrognathic straight orthognathic www.indiandentalacademy.com concave prognathic
  20. 20. Soft Tissue Changes with Growth Soft tissue profile tends to flatten with growth Nose and chin growth at teenage years may change facial appearance Boy growing normally Black - 10 yo red - 14 yo www.indiandentalacademy.com
  21. 21. Theories of Craniofacial Growth Classical: bone growth is primary, soft tissues adjust to the growth of the bones. Functional matrix: soft tissue functional demands are primary, bones grow in response to functional demands. www.indiandentalacademy.com
  22. 22. Principles of Growth Resorption apposition surface remodeling of a bone in the opposite direction to that in which it is being translated www.indiandentalacademy.com by growth of adjacent structures
  23. 23. Growth of the Craniofacial Complex Cranial Vault Cranial Base Maxilla Mandible www.indiandentalacademy.com
  24. 24. Cranial Vault Growth Apposition of bone in the cranial sutures accounts for growth after birth. Pressure from the growing brain promotes resorption of bone in the inner surfaces of the cranial vault = www.indiandentalacademy.com remodeling allows for changes
  25. 25. Growth of the Cranial Base The cranial base is composed mostly by bones formed by endochondral ossification. Bands of cartilage are formed between centers of ossification called synchondrosis: Spheno-occiptal synchondrosis intersphenoid synchondrosis spheno-ethmoidal synchondrosis www.indiandentalacademy.com
  26. 26. Growth of the Cranial Base Cranial base grows by endochondral ossification that occurs at both margins of the synchondrosis. www.indiandentalacademy.com
  27. 27. Growth of the Maxilla Remodeling of the palatal vault moves it in the same direction as it is being translated bone is removed from the floor of the nose and added to the roof of the mouth www.indiandentalacademy.com
  28. 28. Growth of the Maxilla On the anterior surface, bone is removed, partially cancelling the forward translation. As the vault moves downward, the same process of bone remodeling also widens it. www.indiandentalacademy.com
  29. 29. Growth of the Maxilla Growth of the surrounding soft tissues translates the maxilla downward and forward, opening spaces in the sutures where bone is added. www.indiandentalacademy.com
  30. 30. Growth of the Maxilla Midpalatal suture is opened until teenage years. Apposition of bone in the molar area accounts for space for the third molars. www.indiandentalacademy.com
  31. 31. Growth of the Maxilla Summary: growth of the maxilla occurs in 2 ways: by apposition of bone in the sutures that connect the maxilla to the cranial base by surface remodeling. www.indiandentalacademy.com
  32. 32. Growth of the Mandible Remodeling is done by resorption in the anterior part of the ramus and deposition in the posterior part of the ramuswww.indiandentalacademy.com
  33. 33. Growth of the Mandible Overall growth direction results in a downward and forward displacement with most of growth occurring in the ramus. www.indiandentalacademy.com
  34. 34. Growth of the Mandible Mandibular symphysis is closed by age of 1 year. Late mandibular growth: can occur in the late teenage years or adulthood most often seen in asians and males can cause incisor crowding when there is a tight occlusion (overbite/overjet) www.indiandentalacademy.com
  35. 35. When things go wrong Congenital craniofacial malformations: cleft lip/palate, syndromes (Apert, Crouzon, etc..), craniosynostosis Non-syndromic craniosynostosis Trauma Ankylosis Juvenile rheumatoid arthritis www.indiandentalacademy.com
  36. 36. When things go wrong Trauma Blow to one side of the mandible may fracture the condylar process on the opposite side pull of the lateral pterygoid muscle distracts the condylar fragment including all the cartilage = resorption occurs www.indiandentalacademy.com
  37. 37. Thank you www.indiandentalacademy.com Leader in continuing dental education www.indiandentalacademy.com

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