Development and growth of maxilla Prenatal growth of maxilla Post natal growth of maxilla Clinical implication development of palate cleft

1. Growth of Maxilla
Department of orthodontics and dentofacial orthopedics
Presented by :
Sushant Pandey
Resource faculties :
Dr. Prabhat Ranjan Pokhrel
Dr. Rajesh Gyawali
Dr. Jamal Giri
Dr. Mona Pokhrel

2. Contents
1. Prenatal growth of maxilla
2. Post natal growth of maxilla
3. Clinical implication

4. Why is it important to us ?

5. Anatomy of maxilla
BODY - pyramidal in shape.
FOUR PROCESSES. Frontal, Zygomatic, Alveolar, Palatine
Maxilla houses the largest sinus of the face, the maxillary sinus

6. Development of maxilla
By 4th and 5th week of IUL, pharyngeal arches develop. 1st arch
(mandibular arch) contributes to development of maxilla.
Neural crest cells form the skeletal components of face.

7. Development of maxilla
5th week of IUL

8. Development of maxilla

9. Development of maxilla
Maxillary prominence enlarge to form cheek and maxilla

10. Center of Ossification of maxilla
• Develops in the mesenchyme of the maxillary
process.
• Intramembranous ossification.
• One center of ossification
• Lies above that part of the dental lamina from
which the enamel organ of the canine develops.

11. Development of palate
Intermaxillary segment is formed by the fusion of two medial nasal
prominence. Forms primary palate.
Palatal shelves are derived from maxillary process. Form secondary
palate.

12. Development of palate

13. Development of palate

14. Clefts
Due to lack of fusion of maxillary prominence with medial
nasal prominence or from lack of fusion of palatine shelves

15. Postnatal growth of maxilla
Mechanism of growth
1. Displacement
2. Growth at sutures
3. Surface remodeling

16. 1. Displacement
•Secondary displacement = Downward & Forward
Till the age of 7 years

17. 1. Displacement
•Primary displacement
After the age of 7 years

18. 2. Growth at sutures
These sutures are oblique and almost parallel to each other.
Allow downward and forward repositioning of maxilla.

19. 3. Surface remodeling
Resorption and deposition of bone. Bone
drifts in the direction of deposition

20. 3. Surface remodeling
Maxillary tuberosity
•Deposition along the posterior surface
Cause lengthening of the arch and increases A-P diameter of the maxilla

21. 3. Surface remodeling
Remodeling of orbit
•Resorption: lateral wall of orbit

22. 3. Surface remodeling
V-principle
Bone deposition occurs on the inner side and at the ends of the
arms of the V and resorption occurs on outer surface.

23. 3. Surface remodeling
Remodeling of orbit
•Orbit follows ‘V’ principle
of growth.
•Most of the roof and the
floor are depository.
•Maximum remodelling of
roof till 7 years of age.

24. 3. Surface remodeling
Nasal cavity = resorption on lateral wall and
floor of nose

25. 3. Surface remodeling
Palate : follows V principle

26. 3. Surface remodeling
Alveolar process remodeling
•Develops with eruption of teeth
Increases the maxillary height and palatal depth.

27. 3. Surface remodeling
Zygomatic arch: Relocated posteriorly &
laterally
Resorption on the medial side
Deposition on the lateral side.
Increases the width of maxilla.

28. 3. Surface remodeling
Maxillary sinus
All walls of maxillary sinus except
the mesial wall undergoes
resorption: Sinus enlarges.

29. 3. Surface remodeling
Most of the anterior surface of maxilla: resorptive
Key ridge

30. Clinical uses :

31. Summary
Change in height = palatal remodeling, eruption of teeth,
displacement
Change in width = midpalatine suture, remodeling at lateral
surface of alveolar process
Change in length (A-P) = maxillary tuberosity, displacement

32. References:
1. Orthodontics the art and science S.I. Bhalaji, 6th edition
2. Growth and remodeling of the human maxilla DONALD H.
ENLOW, and SEOSG BANG
3. Contemporary orthodontics, William R. Proffit 4th edition
4. Textbook of Craniofacial Growth, Sridhar Premkumar
5. Langman’s medical embryology, 12th edition

33. Questions ??

34. Thank you