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

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

  1. 1. FACTORS AFFECTING AND THEORIES OF GROWTH AND DEVELOPMENT INDIAN DENTAL ACADEMY Leader in continuing dental education www.indiandentalacademy.com www.indiandentalacademy.com
  2. 2. Factors affecting growth and development. VAN LIMBORGHIntrinsic Genetic-Heredity Local-Muscle, Function, Neurotrophism Epigenetic GeneralHormones,Neural www.indiandentalacademy.com
  3. 3. Local- Habits Environmental General- Secular trends www.indiandentalacademy.com
  4. 4. Miscellaneous – Nutrition,Illness,Race,Climate and Season,Exercise,Family size & Birth order, Socioeconomic status, Psychological disturbances. •Prenatal •Natal •Postnatal www.indiandentalacademy.com
  5. 5. PRENATAL FACTORS Chromosomal abnormalities(Klinefelters syndrome,Turners syndrome) Teratogens Congenital infectionsRubella,CMV,HSV,HIV,Syphillis Nutritional status of mother Multiple birth Congenital defects- Cleft lip &palate www.indiandentalacademy.com
  6. 6. NATAL FACTORS Birth trauma Intrauterine moulding Forcep delivery www.indiandentalacademy.com
  7. 7. POSTNATAL FACTORS Heredity Epigenetic factors Environment Miscellaneous www.indiandentalacademy.com
  8. 8. GENETIC FACTORS Body size,shape,fat deposition,growth pattern Male – female growth differences Advancement of girl over boy Y chromosome Actual outcome = Genetic potential+Environmental influences. www.indiandentalacademy.com
  9. 9. STOCKARD STUDY www.indiandentalacademy.com
  10. 10. Methodically crossbred dogs Inheritance of facial characteristics – major cause malocclusion. Dog carry gene for achondroplasia. www.indiandentalacademy.com
  11. 11. Investigations in Hawaii – Chung et al www.indiandentalacademy.com
  12. 12. TWIN STUDY www.indiandentalacademy.com
  13. 13. Lundstrom(1963) conducted a study on 100 pair of twins, half of which were monozygotic and half were dizygotic. Both skeletal and dental overjets were measured. More variations in the dizygotic than monozygotic. Larger genetic variations for skeletal pattern than dental overjet. www.indiandentalacademy.com
  14. 14. Lauweryns et al - concluded that 40% of the dental and skeletal variations can be attributed to hereditary factors. www.indiandentalacademy.com
  15. 15. FAMILIAL STUDY www.indiandentalacademy.com
  16. 16. PARENT-CHILD CORRELATION COEFFICIENTS: Facial skeletal dimensions-0.5 Dental characteristics -max for overjet-0.5 -min for overbite-0.15 Suzuki(1961) - studied 243 Japanese families. -1 parent had anomaly- 20% children affected. -Both parents had anomaly- 40% children affected. www.indiandentalacademy.com
  17. 17. Cephalometric analysis of siblings participated in BOLTON-BRUSH STUDY www.indiandentalacademy.com
  18. 18. Heritability for - craniofacial growth, high. - dental growth , low. Dental variation – influenced by environment. Inheritance for mandibular prognathism is strong. www.indiandentalacademy.com
  19. 19. TERATOGENS Chemicals & other agents capable of producing embryological defects if given at critical time. Low level – Specific defects High level – Lethal defects www.indiandentalacademy.com
  20. 20. www.indiandentalacademy.com
  21. 21. TRAUMA DURING BIRTH Major impact Unlikely to produce long term deformity. www.indiandentalacademy.com
  22. 22. Forcep delivery - www.indiandentalacademy.com
  23. 23. EPIGENETIC FACTORS Indirect genetic control (MOSS) Genetically determined but manifest influence indirectly on associated structures(GRABER) www.indiandentalacademy.com
  24. 24. Muscles1.Important part – functional matrix 2.Formation & Growth – bones 3.Loss underdevelopment www.indiandentalacademy.com
  25. 25. 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 www.indiandentalacademy.com
  26. 26. NeurotrophismNervous 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) www.indiandentalacademy.com
  27. 27. Neuroepithelial,Neuroviseceral, Neuromuscular. Axioplasmic transport - www.indiandentalacademy.com
  28. 28. NEUROMUSCULAR TROPHIC RELATION www.indiandentalacademy.com
  29. 29. NEUROEPITHELIAL TROPHIC RELATION www.indiandentalacademy.com
  30. 30. Neurotrophic control of genetic activity• Interferes – Genomic potential to final functional differences. • Protein & specific enzyme synthesis. •Synthesis of DNA,RNA. www.indiandentalacademy.com
  31. 31. 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. www.indiandentalacademy.com
  32. 32. NEURAL CONTROL Centre hypothalamus Keep children on genetically determined growth curves. At birth – size to accommodate birth process. After birth – destined to become large. Growth burst – first 2 years. www.indiandentalacademy.com
  33. 33. 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: - www.indiandentalacademy.com
  34. 34. HORMONES www.indiandentalacademy.com
  35. 35. 1. 2. 3. GROWTH HORMONE – Ant pituatory General body growth Regulates metabolism Gigantism , Acromegaly(In adulthood) Dwarfism www.indiandentalacademy.com
  36. 36. 1. 2. 3. 4. 5. THYROID HORMONE – T3 , T4 (Follicular cells) Calcitonin (Parafollicular cells) B.M.R Growth & Development Ca homeostasis Graves disease – Exopthalmos. Cretinism , Myxedema. www.indiandentalacademy.com
  37. 37. 1. 2. 3. PTH – Chief cells Increases osetoclast – bone resorption Increases Ca level – bone & kidney. Osteitis fibrosa cystica. Tetany. www.indiandentalacademy.com
  38. 38. ACTH – 1. Zona glomerulosa – Mineralocorticoids – aldosterone – Na & K level 2. Zona fasiculata – Glucocorticoids – Cortisol,Corticosterone Cortisone – Protein catabolism Glucogenesis Lipolysis Stress resistance. www.indiandentalacademy.com
  39. 39. 3. Zona reticularis – Androgen (male sex hormone) Addisons disease. Cushing syndrome. www.indiandentalacademy.com
  40. 40. SEX HORMONES – 1. Estrogen & Progestrone – Feminine secondary sex characteristics. 2. Testosterone – Masculine secondary characteristics. www.indiandentalacademy.com
  41. 41. ENVIRONMENTAL Habits – 1. Thumb sucking , Mouth – breathing , Tongue thrusting. 2. Breaks functional equilibrium. www.indiandentalacademy.com
  42. 42. Secular trends – Size and maturational changes seen in population occuring with time. www.indiandentalacademy.com
  43. 43. MISCELLANEOUS 1. 2. 3. Nutrition – Proper diet. Malnutrition. Growth catch up. www.indiandentalacademy.com
  44. 44. www.indiandentalacademy.com
  45. 45. www.indiandentalacademy.com
  46. 46. IllnessShort term. Long term. Reduced GH – Increased cortisone. www.indiandentalacademy.com
  47. 47. RACIAL & ETHINIC DIFFERENCES – www.indiandentalacademy.com
  48. 48. CLIMATE & SEASONAL CHANGES HT. Spring then in autumn. WT. Autumn then in spring. HT. & teeth eruption more in night. Fluctuation in hormone release. www.indiandentalacademy.com
  49. 49. SOCIO ECONOMIC STATUS – 1. Nutrition. 2. Variation in ht. & wt. ratio. www.indiandentalacademy.com
  50. 50. EXERCISE – No direct effect on linear growth. Muscle mass, fitness, general well being. www.indiandentalacademy.com
  51. 51. FAMILY BIRTH ORDER – First born child weighs less at birth & higher I.Q. www.indiandentalacademy.com
  52. 52. PSCHYOLOGICAL FACTORS www.indiandentalacademy.com
  53. 53. PARADIGM www.indiandentalacademy.com
  54. 54. PARADIGMS Normal science – research that members of specific group of scientist recognize as central to their field. (KUHN 1970) Theory – assumption based on certain evidences but lacking scientific proof. Hypothesis- assumption not proved by experiment,conclusion drawn before all facts are established & tentatively accepted. www.indiandentalacademy.com
  55. 55. Paradigm – Conceptual scheme that encompasses individual theories and is accepted by scientific community as a model and foundation for further research. Define relevant data Scientist can reject wrong paradigms. www.indiandentalacademy.com
  56. 56. www.indiandentalacademy.com
  57. 57. Paradigms in craniofacial biology Craniofacial biology is a study of growth,function and adaptation,both phylogenetically and ontogenetically of the craniofacial skeleton and related structure. www.indiandentalacademy.com
  58. 58. 1920 – 1940 GENOMIC PARADIGM CFG – Genetically predetermined. Classic triad :Sutures-primary growth sites. Cranial vault growth- periosteal deposition & endosteal resorption. Cephalic cartilages – primary growth centre. www.indiandentalacademy.com
  59. 59. 1940-1960 PERIOD OF SCIENTIFIC REVOLUTION. Emphasis – Functional factors Experiments. Periosteal & Sutural bone growth – removed. www.indiandentalacademy.com
  60. 60. 1960-1980 FUNCTIONAL PARADIGM. Melvin Moss www.indiandentalacademy.com
  61. 61. Moss (1981)“Origin ,Growth and Maintenance of all skeletal tissue and organs are always secondary,compensatory and obligatory responses to temporally and operationally prior events or processes that occur in specifically related non skeletal tissues , organs or functioning spaces(Functional Matrices).” www.indiandentalacademy.com
  62. 62. CRANIOFACIAL BIOLOGY Genomic paradigm - Genetic predetermination. - Popular among clinical orthodontist. FUNCTIONAL PARADIGM - Functional matrix hypothesis. - Popular among scientist & orthodontics believing in functions & physical interrelationship. www.indiandentalacademy.com
  63. 63. EVOLUTION OF THEORIES www.indiandentalacademy.com
  64. 64. EVOLUTION OF THEORIES Galileo(1638) Monro(1776) – Bone shape. Meyers(1853) – Mechanics of human skeleton. www.indiandentalacademy.com
  65. 65. www.indiandentalacademy.com
  66. 66. Cullman – stress trajectories. Meyers 1867 publication – bony trabecular structures were attributed to specific trajectories of bone. www.indiandentalacademy.com
  67. 67. www.indiandentalacademy.com
  68. 68. Wolff – Internal organization of femur(1870). + interstitial bone growth _ bone resorption- Wegner & Koelliker (1872) Form & Function interaction – Wilhelm Roux(1881) Roux argued – Functional stimulus shaped bone.ex:Fibula & Tibia. www.indiandentalacademy.com
  69. 69. 1892 JULIUS WOLFF Law of bone transformation “Every change in form & functions of bones,or of their function alone, is followed by certain definite changes in their internal architecture and equally definite secondary alteration in their external conformation in accordance with mathematical laws.” www.indiandentalacademy.com
  70. 70. GENETIC THEORY www.indiandentalacademy.com
  71. 71. GENETIC THEORY Genetic determination. Genetic control varied – Bone Cartilage, bone responds passively Soft tissue matrix, others controlled epigenetically. www.indiandentalacademy.com
  72. 72. SUTURAL THEORY – (SICHER) www.indiandentalacademy.com
  73. 73. SUTURAL THEORY Sutures btw membranous bones of cranium & jaws. _ Transplanted. + Compressed. www.indiandentalacademy.com
  74. 74. CARTILAGENOUS THEORY(JAMES SCOTT) www.indiandentalacademy.com
  75. 75. CARTILAGENOUS THEORY Prenatal cartilagenous portions –head, nasal capsule, mandible, cranial base. Growth centres. www.indiandentalacademy.com
  76. 76. www.indiandentalacademy.com
  77. 77. www.indiandentalacademy.com
  78. 78. _ Transplanted condylar fracture in child –condylar regeneration + Epiphyseal cartilage, nasal septum. www.indiandentalacademy.com
  79. 79. FUNCTIONAL MATRIX THEORY(MELVIN MOSS) www.indiandentalacademy.com
  80. 80. FUNCTIONAL MATRIX HYPOTHESIS 1948 – 1951 Studied- Dept. Anatomy,Columbia university. Thesis. The development of vertebrate skullGaven de Beer. Growth & Form – Thompson www.indiandentalacademy.com
  81. 81. 1951 – 1960 Calvarial sutures extripation-no size reduction of neural skull. Sutures are not primary growth sites. No genetically predetermined boundaries to calvarial bones. Work of Vander Klaauw – experimentally verified & expanded by Moss. 1960- Paper published-Functional approach to craniological problems. www.indiandentalacademy.com
  82. 82. 1961 – 1971 Orthodontic field introduced to functional matrix. Two types not yet arisen. Cleared: Conference – 1968  Sutural tissues & Cartilages.  Active transformation & passive translation www.indiandentalacademy.com
  83. 83. FUTURE Neurotrophic regulation – controlled matrix growth primarily,responsive skeletal tissue growth. www.indiandentalacademy.com
  84. 84. FMH Head – Function occurs Function – FCC FCC – Functional matrix (Function) - Skeletal unit (Protect/Support fm) Growth changes in size,shape,spatial position are secondary to primary changes in their specific functional matrices. www.indiandentalacademy.com
  85. 85. SKELETAL UNIT Bone,Cartilage or Tendinous tissue Microskeletal units. Mandible – condyle coronoid ramus alveolus www.indiandentalacademy.com
  86. 86. Maxilla – nasal orbital pneumatic basal alveolar www.indiandentalacademy.com
  87. 87. Macroskeletal unit EX –Endocranial surface of the calvaria. www.indiandentalacademy.com
  88. 88. FUNCTIONAL MATRIX Muscle,Gland,Nerves,Vessels,Fats,Teeth, Functioning spaces. FM – Periosteal matrices Capsular matrices www.indiandentalacademy.com
  89. 89. PERIOSTEAL MATRIX Temporalis & Coronoid process. Fibers – indirectly to periosteum. directly into skeletal tissue. www.indiandentalacademy.com
  90. 90.  Removal / Deinnervation  Functional hypertrophy / hyperactivity  Growth changes in coronoid process (size & shape) morphogenetically derived temporalis muscle function.  Osseous responses osseous deposition & resorption. www.indiandentalacademy.com
  91. 91. CAPSULAR MATRICES Change in size &shape – Periosteal matrix Capsular matrix ??? Neurocranial capsule <skin + duramater> Orofacial capsule <skin + mucosa> www.indiandentalacademy.com
  92. 92. NCC Capsule composed – Scalp,Bone,Two layers of duramater. NCC =Calvarial bone (microskeletal unit + periosteal matrix) Neural mass volume – morphogenetically significant. Expansion of this capsular matrix – primary event. Translation + periosteal apposition & resorption. www.indiandentalacademy.com
  93. 93. OFC FCC arise,grow,maintain within OFC Capsule – Oronasopharyngeal functioning spaces. Volumetric growth of these spaces is primary morphogenetic event. www.indiandentalacademy.com
  94. 94. HEAD FCC Skeletal Unit Microskeletal -Mandible -Maxilla Functional Matrix Macroskeletal -Calvaria Periosteal -Coronoid & Temporalis www.indiandentalacademy.com Capsular NCC OFC
  95. 95. EX- MANDIBULAR GROWTH :- www.indiandentalacademy.com
  96. 96. www.indiandentalacademy.com
  97. 97. www.indiandentalacademy.com
  98. 98. POINTS IN FAVOUR www.indiandentalacademy.com
  99. 99. FMH – REFLECTIONS IN A JAUNDICED EYE:JOHNSTON Not a unitary mechanism. Physical forces. Bl. Condylectomy surgery not completed till OCT.1961 ; Conclusions made in 1962 – Provisional. www.indiandentalacademy.com
  100. 100. Did not specify – capsular growth is primary/secondary to expanding space. Initially macroskeletal unit – two or more adjacent bones,later – set of microskeletal units. Genetic control – soft tissue matrix , later – nervous system. www.indiandentalacademy.com
  101. 101. “All research has no true completion but, rather is only the beginning of yet another cycle of work.” - MELVIN .L.MOSS www.indiandentalacademy.com
  102. 102. References  T.M. Graber – Orthodontics: Principles &      Practice, III Ed. Proffit – Contemporary Orthodontics, III Ed. Moyers – Handbook of Orthodontics, IV Ed. Bishara – Textbook of Orthodontics, I Ed.. Tortora – Principles of Anatomy & Physiology, VIII Ed. Guyton & Hall – Textbook of Medical Physiology, IX Ed. www.indiandentalacademy.com
  103. 103. Moss,Primary role of functional matrix in facial growth – Am J Orthod, 1969 June (20-31) Moss,The capsular matrix – Am J Orthod,1969 Nov :(56) Moss,Twenty years of functional cranial analysis Am J Orthod,1981 Oct:(366-75) Lysle E Johnston Jr – Factors affecting the growth of the mid face – The functional matrix hypothesis:The Reflections in Jaundiced Eye. www.indiandentalacademy.com
  104. 104.  David S Carlson – Craniofacial biology a normal science.  Bone Biodynamics in Orthodontic & Orthopedic Treatment – David S Carlson & Steven A Goldstein.  Control Mechanisms in craniofacial growth – James Mc Namara Jr. www.indiandentalacademy.com
  105. 105. Contribution of Condylar Growth to Mandibular Morphogenesis www.indiandentalacademy.com
  106. 106. Condyles – Growth centres / Growth sites??? Site – Moss & Salentijin Centre – Charles,Brodie,Rushton,Sicher,Symons, Scott. www.indiandentalacademy.com
  107. 107. Transplantation experiments. Bernabei & Johnston`76. 200 day old female rats – 45. www.indiandentalacademy.com
  108. 108. www.indiandentalacademy.com
  109. 109. www.indiandentalacademy.com
  110. 110. Discussion. Growth after condylectomy(Bl/Unilateral) Fuller experiment (`74) – 20-30 day old guinea pig – 20 unilateral condylectomy Control side – Sham operation. www.indiandentalacademy.com
  111. 111. Petrovic et al – occlusion (maxilla) play imp role as a regulating mechanism in growth of condyles. Stress on local factors Lateral pterygoid. www.indiandentalacademy.com
  112. 112. Conclusion Studies add upto our knowledge By no means conclusive. May/May not be similar effects in other mammals,specifically in man. www.indiandentalacademy.com
  113. 113. Reference Bernabei,R.L. and L.E.Johnston -A cephalometric investigation of the growth, in situ, of “isolated” mandibular condyles in adult rats following the administration of bovine growth hormone. Am. J. Orthodont. (In press), 1976. JAMES A. McNAMARA, Jr. - Factors affecting the growth of midface, C.F.S, 6: 381-391, 1976. www.indiandentalacademy.com
  114. 114. Thank you www.indiandentalacademy.com Leader in continuing dental education www.indiandentalacademy.com

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