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.for more details please visit
www.indiandentalacademy.com
2. Growth relativity hypothesis
Hypothesis presented for the
mechanism of condylar-fossa growth
modification with propulsive
mandibular appliances, such as the
Herbst & Twin-block
www.indiandentalacademy.com
6. Growth relativity hypothesis
cybernetic theory – hyperactivity of LPM
anatomic research – no significant
attachment of LPM to thecondyle
other muscle& tendon attachments– deep
masseter , temporalis- Rees
www.indiandentalacademy.com
13. Growth relativity hypothesis
Evidenceof decreased muscleactivity – use
of propulsiveorthopaedic appliances
Causefor growth modulation?
www.indiandentalacademy.com
14. Growth relativity hypothesis
Mandibular growth is a composite
of regional forces & functional agents
of growth control that interact in
response to specific extracondylar
activating signals – Endow & Hans
Extrinsic signals – basis of “Growth
relativity theory”
www.indiandentalacademy.com
15. Growth relativity hypothesis
Growth relativity – growth that isrelative
to thedisplaced condylesfrom actively
relocating glenoid fossa
Growth – long term retention results
short term treatment outcomes
www.indiandentalacademy.com
16. Extension of Wolff’s law
Growth relativity states that –
“with orthopaedically displaced condyle , the bone
architecture is influenced by the neuromusculature & the
contiguous, non – muscular , viscoelastic tissues anchored
to the glenoid fossa & the altered dynamics of the fluids
enveloping bone”
www.indiandentalacademy.com
17. Growth relativity hypothesis
3 main foundations
Displacement
Viscoelasticity
Referred force (transduction)
www.indiandentalacademy.com
18. Growth relativity hypothesis
Viscoelasticity
-applied to elastic tissues – muscles
In G R it applies to all non – calcified tissues
Elasticity of --retrodiskal tissues
--fibrous capsule
-- Synovial fluid flow
-- LPM perimycium
-- TMJ tendons & ligaments
-- Other soft tissues
-- Body fluids
www.indiandentalacademy.com
26. Light bulb analogy of condylar
growth & retention
www.indiandentalacademy.com
27. Discussion
Epiphysis Vs condyle
Tissue separating forces
Ephiphyseal cartilages - little
short term adaptation potential
No fibrocartilagenous cap
No significant tissue separating
forces
Significant short term adaptation
potential
Presence of fibrocartilagenous
cap
www.indiandentalacademy.com
29. Epiphysis Vs condyle
Condyle dissimilar to epiphysis
…functionally
…anatomically
…immunologically
…chemically &
…ontogenetically
condyle does not act like an
epiphysis during orthopaedic
treatment
www.indiandentalacademy.com
30. Retention relapse
Deactivation of modification due to
compression of retrodiskal tissues
Hence long term adaptation is not
clinically significant
www.indiandentalacademy.com
33. conclusion
No measurable long-term benefits for the
mandible are derived from the first phase of
“functional” appliance therapy in a two phase
treatment.
www.indiandentalacademy.com
34. Future studies
Synovial fluid dynamics
Study conducted on primates – using
full occlusal coverage herbst block &
twin block appliances – hence
oppurtunity to use
cephalometric
histomorphometric
electromyographic methods
to investigate observed changes
www.indiandentalacademy.com
36. Bibliography
1. Contemporary orthodontics –
william R.Proffit ; 3rd
edn
2. Orthodontics – Principles and practice
-T.M.Graber ; 3rd
edn
3. The primary role of functional matrices in
facial growth – AJO-DO 1969 jun :(20-31)
4. The doctrine of functional matrices-
AJO-DO 1969 july; 56:no.1
www.indiandentalacademy.com
37. Bibliography
5. Twenty years of functional cranial
analysis – AJO-DO 1972 may;61:no.5
6. The role of functional matrix in
mandibular growth – AJO-DO 1968
apr;38:no.2
7. The capsular matrix –AJO-DO 1969
nov;56:no.5
8. Genetics , epigenetics and causation-
AJO-DO 1981 oct;(366-75)
www.indiandentalacademy.com
38. Bibliography
The functional matrix hypothesis revisited
9. The role of mechanotransduction – AJO-DO
1997 July;112:8-11
10.The role of an osseous connected cellular
network- AJO-DO 1997 Aug;112;221-26
11.The genomic thesis – AJO –DO 1997
Sep;112:338-42
12.The epigenetic antithesis and the resolving
synthesis – AJO-DO 1997 oct;112:410-7
www.indiandentalacademy.com
39. Bibliography
13.Factors affecting the growth of the midface
–The functional matrix hypothesis :
reflections in a jaundiced eye – Lysle
E.Johnston Jr
GROWTH RELATIVITY HYPOTHESIS
14. Improved clinical use of Twin-block and
Herbst as a result of viscoelastic tissue
forces on the condyle and fossa in
treatment and long – term retention :
Growth relativity
AJO-DO 2000 Mar;117:247-66
www.indiandentalacademy.com