Growth & development

FACTORS AFFECTING ANDFACTORS AFFECTING AND
THEORIESTHEORIES
OFOF
GROWTH ANDGROWTH AND
DEVELOPMENTDEVELOPMENT
www.indiandentalacademy.comwww.indiandentalacademy.com

Factors affecting growth andFactors affecting growth and
development.development.
VAN LIMBORGH-VAN LIMBORGH-
Intrinsic Genetic-HeredityIntrinsic Genetic-Heredity
EpigeneticEpigenetic
Local-Muscle, Function,
Neurotrophism
General-
Hormones,Neural

Environmental
Local- Habits
General- Secular trends

Miscellaneous –
Nutrition,Illness,Race,Climate and
Season,Exercise,Family size & Birth
order, Socioeconomic status,
Psychological disturbances.
•Prenatal
•Natal
•Postnatal

PRENATAL FACTORSPRENATAL FACTORS
Chromosomal abnormalities(KlinefeltersChromosomal abnormalities(Klinefelters
syndrome,Turners syndrome)syndrome,Turners syndrome)
TeratogensTeratogens
Congenital infections-Congenital infections-
Rubella,CMV,HSV,HIV,SyphillisRubella,CMV,HSV,HIV,Syphillis
Nutritional status of motherNutritional status of mother
Multiple birthMultiple birth
Congenital defects- Cleft lip &palateCongenital defects- Cleft lip &palate

NATAL FACTORSNATAL FACTORS
Birth traumaBirth trauma
Intrauterine mouldingIntrauterine moulding
Forcep deliveryForcep delivery

POSTNATAL FACTORSPOSTNATAL FACTORS
HeredityHeredity
Epigenetic factorsEpigenetic factors
EnvironmentEnvironment
MiscellaneousMiscellaneous

GENETIC FACTORSGENETIC FACTORS
Body size,shape,fat deposition,growthBody size,shape,fat deposition,growth
patternpattern
Male – female growth differencesMale – female growth differences
Advancement of girl over boy YAdvancement of girl over boy Y
chromosomechromosome
Actual outcome = GeneticActual outcome = Genetic
potential+Environmental influences.potential+Environmental influences.

STOCKARD STUDYSTOCKARD STUDY

Methodically crossbred dogsMethodically crossbred dogs
Inheritance of facial characteristics –Inheritance of facial characteristics –
major cause malocclusion.major cause malocclusion.
Dog carry gene for achondroplasia.Dog carry gene for achondroplasia.

Investigations in Hawaii – ChungInvestigations in Hawaii – Chung
et alet al

TWIN STUDYTWIN STUDY

Lundstrom(1963) conductedLundstrom(1963) conducted
a study on 100 pair of twins,a study on 100 pair of twins,
half of which werehalf of which were
monozygotic and half weremonozygotic and half were
dizygotic.dizygotic.
Both skeletal and dentalBoth skeletal and dental
overjets were measured.overjets were measured.
More variations in theMore variations in the
dizygotic than monozygotic.dizygotic than monozygotic.
Larger genetic variations forLarger genetic variations for
skeletal pattern than dentalskeletal pattern than dental
overjet.overjet. www.indiandentalacademy.comwww.indiandentalacademy.com

Lauweryns et al - concluded that 40% ofLauweryns et al - concluded that 40% of
the dental and skeletal variations can bethe dental and skeletal variations can be
attributed to hereditary factors.attributed to hereditary factors.

FAMILIAL STUDYFAMILIAL STUDY

PARENT-CHILD CORRELATIONPARENT-CHILD CORRELATION
COEFFICIENTS:COEFFICIENTS:
Facial skeletal dimensionsFacial skeletal dimensions-0.5-0.5
Dental characteristicsDental characteristics
-max for overjet-0.5-max for overjet-0.5
-min for overbite-0.15-min for overbite-0.15
Suzuki(1961)Suzuki(1961) - studied 243 Japanese- studied 243 Japanese
families.families.
-1 parent had anomaly- 20% children-1 parent had anomaly- 20% children
affected.affected.
-Both parents had anomaly- 40% children-Both parents had anomaly- 40% children
affected.affected. www.indiandentalacademy.comwww.indiandentalacademy.com

Cephalometric analysis of siblingsCephalometric analysis of siblings
participated in BOLTON-BRUSHparticipated in BOLTON-BRUSH
STUDYSTUDY

Heritability for - craniofacial growth, high.Heritability for - craniofacial growth, high.
- dental growth , low.- dental growth , low.
Dental variation – influenced byDental variation – influenced by
environment.environment.
Inheritance for mandibular prognathism isInheritance for mandibular prognathism is
strong.strong.

TERATOGENSTERATOGENS
Chemicals & other agents capable ofChemicals & other agents capable of
producing embryological defects if given atproducing embryological defects if given at
critical time.critical time.
Low level – Specific defectsLow level – Specific defects
High level – Lethal defectsHigh level – Lethal defects

TRAUMA DURING BIRTHTRAUMA DURING BIRTH
Major impactMajor impact
Unlikely to produceUnlikely to produce
long term deformity.long term deformity.

Forcep delivery -Forcep delivery -

EPIGENETIC FACTORSEPIGENETIC FACTORS
Indirect genetic control (MOSS)Indirect genetic control (MOSS)
Genetically determined but manifestGenetically determined but manifest
influence indirectly on associatedinfluence indirectly on associated
structures(GRABER)structures(GRABER)

Muscles-
1.Important part –
functional matrix
2.Formation & Growth –
bones
3.Loss -
underdevelopment

Function –
1.Primary factor – CF
Growth (MOSS)
2.Absence – distortion of
bone morphology
3.EX – NM disorders,
TMJ ankylosis
4.Malfunction – abnormal
growth
5.EX – Tongue thrust

Neurotrophism-
Nervous control of skeletal growth
assumedly by transmission of
substance through axon of nerves
(MOYERS)
Interaction btw nerves & other cells
which initiate or control molecular
modifications in other cells (GUTH)

Neuroepithelial,Neuroviseceral,Neuroepithelial,Neuroviseceral,
Neuromuscular.Neuromuscular.
Axioplasmic transport -Axioplasmic transport -

NEUROMUSCULAR TROPHIC RELATION

NEUROEPITHELIAL TROPHIC RELATION

Neurotrophic control of genetic activity-
• Interferes – Genomic potential to final
functional differences.
• Protein & specific enzyme synthesis.
•Synthesis of DNA,RNA.

Intra oral & external epithelium growth in
leaps following sensory nerve contact.
Max & Mand hypoplasia – intra oral & intra
nasal sensory deficits.
Nerves – Soft tissue growth &function –
Skeletal growth & morphology.

NEURAL CONTROLNEURAL CONTROL
Centre hypothalamusCentre hypothalamus
Keep children on genetically determinedKeep children on genetically determined
growth curves.growth curves.
At birth – size to accommodate birthAt birth – size to accommodate birth
process.process.
After birth – destined to become large.After birth – destined to become large.
Growth burst – first 2 years.Growth burst – first 2 years.

Children normally grow very rapidly
during the first two years of life.
Between two years of age and the onset
of puberty, children grow slowly. They
begin to grow rapidly again during the
teen years.
- Growth & Weight: -

HORMONESHORMONES

GROWTH HORMONEGROWTH HORMONE
––
1.1. Ant pituatoryAnt pituatory
2.2. General body growthGeneral body growth
3.3. Regulates metabolismRegulates metabolism
Gigantism ,Gigantism ,
Acromegaly(InAcromegaly(In
adulthood)adulthood)
DwarfismDwarfism

THYROID HORMONE –THYROID HORMONE –
1.1. T3 , T4 (Follicular cells)T3 , T4 (Follicular cells)
2.2. Calcitonin (ParafollicularCalcitonin (Parafollicular
cells)cells)
3.3. B.M.RB.M.R
4.4. Growth & DevelopmentGrowth & Development
5.5. Ca homeostasisCa homeostasis
Graves disease –Graves disease –
Exopthalmos.Exopthalmos.
Cretinism , Myxedema.Cretinism , Myxedema.

PTH –PTH –
1.1. Chief cellsChief cells
2.2. Increases osetoclast –Increases osetoclast –
bone resorptionbone resorption
3.3. Increases Ca level –Increases Ca level –
bone & kidney.bone & kidney.
Osteitis fibrosa cystica.Osteitis fibrosa cystica.
Tetany.Tetany.

ACTH –ACTH –
1.1. Zona glomerulosa –Zona glomerulosa –
Mineralocorticoids –Mineralocorticoids –
aldosterone – Na & K levelaldosterone – Na & K level
2.2. Zona fasiculata –Zona fasiculata –
Glucocorticoids –Glucocorticoids –
Cortisol,CorticosteroneCortisol,Corticosterone
Cortisone –Cortisone –
Protein catabolismProtein catabolism
GlucogenesisGlucogenesis
LipolysisLipolysis
Stress resistance.Stress resistance.

3.3. Zona reticularis – Androgen (male sexZona reticularis – Androgen (male sex
hormone)hormone)
Addisons disease.Addisons disease.
Cushing syndrome.Cushing syndrome.

SEX HORMONES –SEX HORMONES –
1.1. Estrogen & Progestrone –Estrogen & Progestrone –
Feminine secondary sex characteristics.Feminine secondary sex characteristics.
2.2. Testosterone –Testosterone –
Masculine secondary characteristics.Masculine secondary characteristics.

ENVIRONMENTALENVIRONMENTAL
Habits –Habits –
1.1. Thumb sucking , Mouth – breathing ,Thumb sucking , Mouth – breathing ,
Tongue thrusting.Tongue thrusting.
2.2. Breaks functional equilibrium.Breaks functional equilibrium.

Secular trends –Secular trends –
Size and maturational changes seen inSize and maturational changes seen in
population occuring with time.population occuring with time.www.indiandentalacademy.comwww.indiandentalacademy.com

MISCELLANEOUSMISCELLANEOUS
Nutrition –Nutrition –
1.1. Proper diet.Proper diet.
2.2. Malnutrition.Malnutrition.
3.3. Growth catch up.Growth catch up.

Illness-Illness-
Short term.Short term.
Long term.Long term.
Reduced GH – Increased cortisone.Reduced GH – Increased cortisone.

RACIAL & ETHINIC DIFFERENCES –RACIAL & ETHINIC DIFFERENCES –

CLIMATE & SEASONAL CHANGESCLIMATE & SEASONAL CHANGES
HT. Spring then in autumn.HT. Spring then in autumn.
WT. Autumn then in spring.WT. Autumn then in spring.
HT. & teeth eruption more in night.HT. & teeth eruption more in night.
Fluctuation in hormone release.Fluctuation in hormone release.

SOCIO ECONOMIC STATUS –SOCIO ECONOMIC STATUS –
1.1. Nutrition.Nutrition.
2.2. Variation in ht. & wt. ratio.Variation in ht. & wt. ratio.

EXERCISE –EXERCISE –
No direct effect on linear growth.No direct effect on linear growth.
Muscle mass, fitness, general well being.Muscle mass, fitness, general well being.

FAMILY BIRTH ORDER –FAMILY BIRTH ORDER –
First born child weighs less at birth &First born child weighs less at birth &
higher I.Q.higher I.Q.

PSCHYOLOGICAL FACTORSPSCHYOLOGICAL FACTORS

PARADIGMPARADIGM

PARADIGMSPARADIGMS
Normal science – research that membersNormal science – research that members
of specific group of scientist recognise asof specific group of scientist recognise as
central to their field. (KUHN 1970)central to their field. (KUHN 1970)
Theory – assumption based on certainTheory – assumption based on certain
evidences but lacking scientific proof.evidences but lacking scientific proof.
Hypothesis- assumption not proved byHypothesis- assumption not proved by
experiment,conclusion drawn before allexperiment,conclusion drawn before all
facts are established & tentativelyfacts are established & tentatively
accepted.accepted.

Paradigm –Paradigm –
Beliefs,values and techniques shared byBeliefs,values and techniques shared by
members of a given community.members of a given community.
Define relevant dataDefine relevant data
Scientist can reject wrong paradigms.Scientist can reject wrong paradigms.

Paradigms in cranio facial biologyParadigms in cranio facial biology
Cranio facial biology is a study ofCranio facial biology is a study of
growth,function and adaptation,bothgrowth,function and adaptation,both
phylogenetically and onto genetically ofphylogenetically and onto genetically of
the craniofacial skeleton and relatedthe craniofacial skeleton and related
structure.structure.

1920 – 1940 GENOMIC1920 – 1940 GENOMIC
PARADIGMPARADIGM
CFG – Genetically predetermined.CFG – Genetically predetermined.
Moss-Classic triad :-Moss-Classic triad :-
Sutures-primary growth sites.Sutures-primary growth sites.
Cranial vault growth- periosteal depositionCranial vault growth- periosteal deposition
& endosteal resorption.& endosteal resorption.
Cephalic cartilages – primary growthCephalic cartilages – primary growth
centre.centre.

1940-1960 PERIOD OF1940-1960 PERIOD OF
SCIENTIFIC REVOLUTION.SCIENTIFIC REVOLUTION.
Emphasis – Functional factorsEmphasis – Functional factors
Experiments.Experiments.
Periosteal & Sutural bone growth –Periosteal & Sutural bone growth –
removed.removed.

1960-1980 FUNCTIONAL1960-1980 FUNCTIONAL
PARADIGM.PARADIGM.
Melvin MossMelvin Moss
Moss (1981)-Moss (1981)-
““Both structure and function evolve alterations inBoth structure and function evolve alterations in
the biophysical,biomechanical & bioelectricalthe biophysical,biomechanical & bioelectrical
parameters of the developing organism bothparameters of the developing organism both
inter –intra cellularly.these alterations actinter –intra cellularly.these alterations act
significantly to regulate subsequentsignificantly to regulate subsequent
developmental stages,as well as to regulatedevelopmental stages,as well as to regulate
genomic reaction to these altered environmentalgenomic reaction to these altered environmental
states.”states.”

CRANIOFACIAL BIOLOGYCRANIOFACIAL BIOLOGY
Genomic paradigmGenomic paradigm
- GeneticGenetic
predetermination.predetermination.
- Popular amongPopular among
clinical orthodontist.clinical orthodontist.
FUNCTIONALFUNCTIONAL
PARADIGMPARADIGM
- Functional matrixFunctional matrix
hypothesis.hypothesis.
- Popular amongPopular among
scientist &scientist &
orthodontics believingorthodontics believing
in functions & physicalin functions & physical
interrelationship.interrelationship.

EVOLUTION OF THEORIESEVOLUTION OF THEORIES

EVOLUTION OF THEORIESEVOLUTION OF THEORIES
Galileo(1638) Monro(1776) – Bone shape.Galileo(1638) Monro(1776) – Bone shape.
Meyers(1853) – Mechanics of humanMeyers(1853) – Mechanics of human
skeleton.skeleton.

Cullman – stress trajectories.Cullman – stress trajectories.
Meyers 1867 publication – bony trabecularMeyers 1867 publication – bony trabecular
structures were attributed to specificstructures were attributed to specific
trajectories of bone.trajectories of bone.

Wolff – Internal organisation ofWolff – Internal organisation of
femur(1870).femur(1870).
+ intersitial bone growth+ intersitial bone growth
_ bone resorption- Wegner & Koelliker_ bone resorption- Wegner & Koelliker
(1872)(1872)
Form & Function interaction – WilhelmForm & Function interaction – Wilhelm
Roux(1881)Roux(1881)
Roux argued – Functional stimulusRoux argued – Functional stimulus
shaped bone.ex:Fibula & Tibia.shaped bone.ex:Fibula & Tibia.

1892 JULIUS WOLFF1892 JULIUS WOLFF
Law of bone transformationLaw of bone transformation
““Every change in form & functions ofEvery change in form & functions of
bones,or of their function alone, isbones,or of their function alone, is
followed by certain definite changes infollowed by certain definite changes in
their internal architecture and equallytheir internal architecture and equally
definite secondary alteration in theirdefinite secondary alteration in their
external conformation in accordance withexternal conformation in accordance with
mathematical laws.”mathematical laws.”

GENETIC THEORYGENETIC THEORY

GENETIC THEORYGENETIC THEORY
Genetic determination.Genetic determination.
Genetic control varied –Genetic control varied –
BoneBone
Cartilage, bone responds passivelyCartilage, bone responds passively
Soft tissue matrix, others controlledSoft tissue matrix, others controlled
epigenetically.epigenetically.

SUTURAL THEORY –SUTURAL THEORY –
(SICHER)(SICHER)

SUTURAL THEORYSUTURAL THEORY
Sutures btw membranous bones ofSutures btw membranous bones of
cranium & jaws.cranium & jaws.
_ Transplanted._ Transplanted.
+ Compressed.+ Compressed.

CARTILAGENOUSCARTILAGENOUS
THEORY(JAMES SCOTT)THEORY(JAMES SCOTT)

CARTILAGENOUS THEORYCARTILAGENOUS THEORY
Prenatal cartilagenous portions –head,Prenatal cartilagenous portions –head,
nasal capsule, mandible, cranial base.nasal capsule, mandible, cranial base.
Growth centres.Growth centres.

_ Transplanted_ Transplanted
condylar fracture in child –condylarcondylar fracture in child –condylar
regenerationregeneration
+ Epiphyseal cartilage, nasal septum.+ Epiphyseal cartilage, nasal septum.

FUNCTIONAL MATRIXFUNCTIONAL MATRIX
THEORY(MELVIN MOSS)THEORY(MELVIN MOSS)

HYPOTHESISHYPOTHESIS
1948 – 19511948 – 1951
Studied- Dept. Anatomy,ColumbiaStudied- Dept. Anatomy,Columbia
university.university.
Thesis.Thesis.
The development of vertebrate skull-The development of vertebrate skull-
Gaven de Beer.Gaven de Beer.
Growth & Form – ThompsonGrowth & Form – Thompson

1951 – 19601951 – 1960
Calvarial sutures extripation-no sizeCalvarial sutures extripation-no size
reduction of neural skull.reduction of neural skull.
Sutures are not primary growth sites.Sutures are not primary growth sites.
No genetically predetermined boundariesNo genetically predetermined boundaries
to calvarial bones.to calvarial bones.
Work of Vander Klaauw – experimentallyWork of Vander Klaauw – experimentally
verified & expanded by Moss.verified & expanded by Moss.
1960- Paper published-Functional1960- Paper published-Functional
approach to craniological problems.approach to craniological problems.

1961 – 19711961 – 1971
Orthodontic field introduced to functionalOrthodontic field introduced to functional
matrix.matrix.
Two types not yet arisen.Two types not yet arisen.
Cleared: Conference – 1968Cleared: Conference – 1968
 Sutural tissues & Cartilages.Sutural tissues & Cartilages.
 Active transformation & passive translationActive transformation & passive translation

FUTUREFUTURE
Neurotrophic regulation – controlled matrixNeurotrophic regulation – controlled matrix
growth primarily,responsive skeletal tissuegrowth primarily,responsive skeletal tissue
growth.growth.

FMHFMH
Head – Function occursHead – Function occurs
Function – FCCFunction – FCC
FCC – Functional matrix (Function)FCC – Functional matrix (Function)
- Skeletal unit (Protect/Support fm)- Skeletal unit (Protect/Support fm)
Growth changes in size,shape,spatialGrowth changes in size,shape,spatial
position are secondary to primary changesposition are secondary to primary changes
in their specific functional matrices.in their specific functional matrices.

SKELETAL UNITSKELETAL UNIT
Bone,Cartilage orBone,Cartilage or
Tendinous tissueTendinous tissue
Microskeletal units.Microskeletal units.
Mandible – condyle
coronoid
ramus
alveolus

Maxilla – nasal
orbital
pneumatic
basal
alveolar

Macroskeletal unitMacroskeletal unit
EX –EndocranialEX –Endocranial
surface of thesurface of the
calvaria.calvaria.

Muscle,Gland,Nerves,Vessels,Fats,Teeth,Muscle,Gland,Nerves,Vessels,Fats,Teeth,
Functioning spaces.Functioning spaces.
FM – Periosteal matricesFM – Periosteal matrices
Capsular matricesCapsular matrices

PERIOSTEAL MATRIXPERIOSTEAL MATRIX
Temporalis & CoronoidTemporalis & Coronoid
process.process.
Fibers – indirectly toFibers – indirectly to
periosteum.periosteum.
directly into skeletaldirectly into skeletal
tissue.tissue.

 Removal / DeinnervationRemoval / Deinnervation
 Functional hypertrophy / hyperactivityFunctional hypertrophy / hyperactivity
 Growth changes in coronoid processGrowth changes in coronoid process
(size & shape) morphogenetically(size & shape) morphogenetically
derived temporalis muscle function.derived temporalis muscle function.
 Osseous responses osseousOsseous responses osseous
deposition & resorption.deposition & resorption.

CAPSULAR MATRICESCAPSULAR MATRICES
Change in size &shape –Change in size &shape –
Periosteal matrixPeriosteal matrix
Capsular matrix ???Capsular matrix ???
Neurocranial capsuleNeurocranial capsule
<skin + duramater><skin + duramater>
Orofacial capsule <skinOrofacial capsule <skin
+ mucosa>+ mucosa>

NCCNCC
Capsule composed – Scalp,Bone,Two layers ofCapsule composed – Scalp,Bone,Two layers of
duramater.duramater.
NCC =Calvarial bone (microskeletal unit +NCC =Calvarial bone (microskeletal unit +
periosteal matrix)periosteal matrix)
Neural mass volume – morpho geneticallyNeural mass volume – morpho genetically
significant.significant.
Expansion of this capsular matrix – primaryExpansion of this capsular matrix – primary
event.event.
Translation + periosteal apposition & resorption.Translation + periosteal apposition & resorption.

OFCOFC
FCC arise,grow,maintain within OFCFCC arise,grow,maintain within OFC
Capsule – Oronasopharyngeal functioningCapsule – Oronasopharyngeal functioning
spaces.spaces.
Volumetric growth of these spaces isVolumetric growth of these spaces is
primary morpho genetic event.primary morpho genetic event.

HEAD
FCC
Skeletal Unit Functional Matrix
Microskeletal Macroskeletal Periosteal Capsular
NCC
OFC
-Mandible
-Maxilla
-Calvaria
-Condyle
&
Temporalis

EX- MANDIBULAR GROWTH :-EX- MANDIBULAR GROWTH :-

POINTS IN FAVOURPOINTS IN FAVOUR

FMH – REFLECTIONS IN AFMH – REFLECTIONS IN A
JAUNDICED EYE:JOHNSTONJAUNDICED EYE:JOHNSTON
Not a unitary mechanism.Not a unitary mechanism.
Forces for brain & eyeball.Forces for brain & eyeball.
Physical forces.Physical forces.
Bl. Condylectomy surgery not completedBl. Condylectomy surgery not completed
till OCT.1961 ; Conclusions made in 1962till OCT.1961 ; Conclusions made in 1962
– Provisional.– Provisional.

Did not specify – capsular growth isDid not specify – capsular growth is
primary/secondary to expanding space.primary/secondary to expanding space.

““All research has no true completion but,All research has no true completion but,
rather is only the beginning of yet anotherrather is only the beginning of yet another
cycle of work.”cycle of work.”
- MELVIN .L.MOSS- MELVIN .L.MOSS

ReferencesReferences
1.1. T.M. Graber – Orthodontics: Principles &T.M. Graber – Orthodontics: Principles &
Practice, III Ed.Practice, III Ed.
2.2. Proffit – Contemporary Orthodontics, IIIProffit – Contemporary Orthodontics, III
Ed.Ed.
3.3. Moyers – Handbook of Orthodontics, IVMoyers – Handbook of Orthodontics, IV
Ed.Ed.
4.4. Bishara – Textbook of Orthodontics, I Ed..Bishara – Textbook of Orthodontics, I Ed..
5.5. Tortora – Principles of Anatomy &Tortora – Principles of Anatomy &
Physiology, VIII Ed.Physiology, VIII Ed.
6.6. Guyton & Hall – Textbook of MedicalGuyton & Hall – Textbook of Medical
Physiology, IX Ed.Physiology, IX Ed.www.indiandentalacademy.comwww.indiandentalacademy.com

7.7.Moss,Primary role of functional matrix inMoss,Primary role of functional matrix in
facial growth – Am J Orthod, 1969 Junefacial growth – Am J Orthod, 1969 June
(20-31)(20-31)
8.8.Moss,The capsular matrix – Am JMoss,The capsular matrix – Am J
Orthod,1969 Nov :(56)Orthod,1969 Nov :(56)
9.9.Moss,Twenty years of functional cranialMoss,Twenty years of functional cranial
analysis Am J Orthod,1981 Oct:(366-75)analysis Am J Orthod,1981 Oct:(366-75)
10.10.Lysle E Johnston Jr – Factors affectingLysle E Johnston Jr – Factors affecting
the growth of the mid face – Thethe growth of the mid face – The
functional matrix hypothesis:Thefunctional matrix hypothesis:The
Reflections in Jaundiced Eye.Reflections in Jaundiced Eye.

11.11. David S Carlson – Craniofacial biology aDavid S Carlson – Craniofacial biology a
normal science.normal science.
12.12. Bone Biodynamics in Orthodontic &Bone Biodynamics in Orthodontic &
Orthopedic Treatment – David S CarlsonOrthopedic Treatment – David S Carlson
& Steven A Goldstein.& Steven A Goldstein.
13.13. Control Mechanisms in craniofacialControl Mechanisms in craniofacial
growth – James Mc Namara Jr.growth – James Mc Namara Jr.

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