Todd: growth: increase in size
Development: progress toward maturity
Krogman: increase in size
: change in proportion and progressive complexity
Meridth: segmental anatomic and physiologic changes taking place from beginning of prenatal life to senility
Moyers: quantitative aspect of biologic development per unit of time
Moss: change in any morphologic parameter which is measurable.
By bone remodeling there is several changes in: size, shape, proportion, relationship with adjacent structure.
Maxillary sinus:
Like other paranasal sinuses are rudimentary at birth, they grew slowly until the age of 6 -7 years, then they enter the spurt specially the maxillary sinus. At 8 years it has a pyramidal form that will length after eruption of canine and last molar
Function of sinuses:
1- Lightening of skull weight
2- Resonance of voice
3- Conditioning of air
4- Craniofacial protection
Fate of pharyngeal arches:
Mesodermal core of each pharyngeal arch and neural crest cells which migrate into the arches differentiate into:
1- Skeletal elements
2- Vascular elements
3- Nervous elements
4- Muscular elements
Growth center Growth site
Growth indicator Growth adjustor
Pushes a part Pulled a part
Tissue separating force No tissue separating force
As: nasal cartilage
Spheno occipital synchondrosis As: condyle and suture
Synchondrosis Epiphyseal plate
1- Cranial base Long bones
2- Interstitial growth Appositional
3- Bone replaced on both sites so it considered as double action of epiphyseal plate At one site
Center of ossification of maxilla start around the anterior superior dental arch of inferior orbital nerve and spread:
Anterior: --- premaxilla
Posterior ----zygomatic process of maxilla
Superior ---- frontal process of maxilla
Inferior: ------periosteum of alveolar process of maxilla
Medial: ------- hard palate
N: B:
Types of bone remodeling:
1- Biomechanical remodeling: continuous deposition and removal of ions to maintain the mineral content
2- Growth remodeling: constant replacement of bone during childhood
3- Haversian remodeling: cortical reconstruction as primary vascular bone is replaced
4- Regeneration and reconstruction of bone following pathology or trauma
Endochondral bone formation:
= on the cartilage surface, there is -------chondroblast arranged in parallel columns while the matrix is being deposited among the columns of cells
= chondroblast ----- hypertrophic and there is a lacuna become wide and so there is small strand of matrix between each cell
= this matrix starts of mineralization after appear of nuclei then chondroblast ----------- chondrocyte ---------- degenerative and disappear after loss of nutrition fluids.
= after time there is vascular invasion so; perichondrium changed into periosteum and the osteoblast start its action for osteoid formation
= by this process there is a formation of central core of mineraliz
The document discusses prenatal and postnatal growth of the mandible. It describes how the mandible develops from mesenchymal condensations in the pharyngeal arches during prenatal development. It forms through both intramembranous and endochondral ossification. The condyle, coronoid process, and mental region develop through endochondral ossification of cartilage models. Postnatally, the mandible grows downward and forward through appositional bone growth at the condyle, ramus, and alveolar processes to accommodate the permanent dentition. The chin develops through periosteal bone apposition on the lingual surface in males during late growth.
The document discusses growth and development of the maxilla from prenatal to postnatal periods. It describes how the maxilla develops from maxillary processes in the embryo. During prenatal growth, the maxilla is displaced downward and forward as the cranial base grows. Postnatally, the maxilla grows through bone deposition, remodeling at sutures, and expansion of the maxillary sinus. The primary palate develops early from the median palatine process, while the secondary palate forms from the palatine shelves fusing in the midline.
prenatal and post natal growth of mandiblemahesh kumar
The document discusses the prenatal and postnatal development of the mandible. Key points include:
1) The mandible initially develops from Meckel's cartilage during prenatal development and undergoes intramembranous and endochondral ossification.
2) Postnatally, the mandible grows at the condylar cartilage, posterior border of the ramus, and alveolar ridges. Growth occurs through remodeling and apposition of bone.
3) Mandibular growth is influenced by functional matrices like muscles and teeth which cause regional changes through resorption and displacement as the mandible grows in a downward and forward direction like an "expanding V".
The document discusses the development of the mandible and maxilla. It begins by explaining that the mandible develops from Meckel's cartilage in the first branchial arch, with intramembranous ossification forming the body and endochondral ossification contributing to growth. Secondary cartilages, like the condylar cartilage, aid further growth. The maxilla develops via intramembranous ossification from the maxillary process, with the premaxilla developing separately and fusing later. Both bones form alveolar processes to surround developing tooth buds. Their shapes and positions change with age as growth and remodeling occur.
PRENATAL GROWTH OF MANDIBLE
Occurs between the 4th and 7th week of intrauterine life.
4th week of intrauterine life
Formation of the head fold
Following which the developing brain and the pericardium form 2 prominent bulges on the ventral aspect of the embryo.
The 2 bulges are separated from each other by a shallow depression called stomatoedum (corresponding to the primitive mouth).
Floor of the stomatodeum is formed by the Buccopharyngeal membrane, which separates the stomatodeum from the foregut.Soon, mesoderm covering the developing forebrain proliferates, and forms a downward projection that overlaps the upper part of the stomatodeum – this downward projection is called frontonasal process.
Development of mandible / fixed orthodontics courses for general dentistsIndian dental academy
The mandible develops from neural crest cells that migrate to form the mandibular arch. It ossifies from mesenchymal condensation lateral to Meckel's cartilage. The condyle develops from secondary cartilage and serves as the main site of postnatal growth through endochondral ossification. Remodeling occurs throughout development in response to functional forces from muscles and teeth, leading to changes in shape, size, and positioning of mandibular components. The chin develops largely during adolescence under sexual influences.
Indian Dental Academy: will be one of the most relevant and exciting training center with best faculty and flexible training programs for dental professionals who wish to advance in their dental practice,Offers certified courses in Dental implants,Orthodontics,Endodontics,Cosmetic Dentistry, Prosthetic Dentistry, Periodontics and General Dentistry.
The document discusses prenatal and postnatal growth of the mandible. It describes how the mandible develops from mesenchymal condensations in the pharyngeal arches during prenatal development. It forms through both intramembranous and endochondral ossification. The condyle, coronoid process, and mental region develop through endochondral ossification of cartilage models. Postnatally, the mandible grows downward and forward through appositional bone growth at the condyle, ramus, and alveolar processes to accommodate the permanent dentition. The chin develops through periosteal bone apposition on the lingual surface in males during late growth.
The document discusses growth and development of the maxilla from prenatal to postnatal periods. It describes how the maxilla develops from maxillary processes in the embryo. During prenatal growth, the maxilla is displaced downward and forward as the cranial base grows. Postnatally, the maxilla grows through bone deposition, remodeling at sutures, and expansion of the maxillary sinus. The primary palate develops early from the median palatine process, while the secondary palate forms from the palatine shelves fusing in the midline.
prenatal and post natal growth of mandiblemahesh kumar
The document discusses the prenatal and postnatal development of the mandible. Key points include:
1) The mandible initially develops from Meckel's cartilage during prenatal development and undergoes intramembranous and endochondral ossification.
2) Postnatally, the mandible grows at the condylar cartilage, posterior border of the ramus, and alveolar ridges. Growth occurs through remodeling and apposition of bone.
3) Mandibular growth is influenced by functional matrices like muscles and teeth which cause regional changes through resorption and displacement as the mandible grows in a downward and forward direction like an "expanding V".
The document discusses the development of the mandible and maxilla. It begins by explaining that the mandible develops from Meckel's cartilage in the first branchial arch, with intramembranous ossification forming the body and endochondral ossification contributing to growth. Secondary cartilages, like the condylar cartilage, aid further growth. The maxilla develops via intramembranous ossification from the maxillary process, with the premaxilla developing separately and fusing later. Both bones form alveolar processes to surround developing tooth buds. Their shapes and positions change with age as growth and remodeling occur.
PRENATAL GROWTH OF MANDIBLE
Occurs between the 4th and 7th week of intrauterine life.
4th week of intrauterine life
Formation of the head fold
Following which the developing brain and the pericardium form 2 prominent bulges on the ventral aspect of the embryo.
The 2 bulges are separated from each other by a shallow depression called stomatoedum (corresponding to the primitive mouth).
Floor of the stomatodeum is formed by the Buccopharyngeal membrane, which separates the stomatodeum from the foregut.Soon, mesoderm covering the developing forebrain proliferates, and forms a downward projection that overlaps the upper part of the stomatodeum – this downward projection is called frontonasal process.
Development of mandible / fixed orthodontics courses for general dentistsIndian dental academy
The mandible develops from neural crest cells that migrate to form the mandibular arch. It ossifies from mesenchymal condensation lateral to Meckel's cartilage. The condyle develops from secondary cartilage and serves as the main site of postnatal growth through endochondral ossification. Remodeling occurs throughout development in response to functional forces from muscles and teeth, leading to changes in shape, size, and positioning of mandibular components. The chin develops largely during adolescence under sexual influences.
Indian Dental Academy: will be one of the most relevant and exciting training center with best faculty and flexible training programs for dental professionals who wish to advance in their dental practice,Offers certified courses in Dental implants,Orthodontics,Endodontics,Cosmetic Dentistry, Prosthetic Dentistry, Periodontics and General Dentistry.
The document discusses the growth and development of the mandible. It begins with an overview of the prenatal development, including how the mandibular arch forms from the pharyngeal arches and contains Meckel's cartilage. Meckel's cartilage provides a template for the mandible to develop around it through intramembranous ossification beginning in the 7th week of prenatal development. The mandible continues developing and forming after birth through both intramembranous and endochondral ossification.
The document discusses the development of the mandible from early embryogenesis through postnatal growth. It begins with the formation of Meckel's cartilage from the first pharyngeal arch which later contributes to mandibular formation. Ossification begins around the mental nerve and spreads to form the body and ramus. Secondary cartilage appears including the condylar, coronoid, and symphyseal cartilage. The mandible continues developing after birth through remodeling processes like at the condyle which causes downward and forward growth of the mandible.
A detailed description of pre-natal and post-natal development of the mandible, with a brief description of theories of growth, for education purposes by Post Graduate students of Orthodontics and Dentofacial Orthopaedics
The skeletal system develops from mesoderm and neural crest cells. Paraxial mesoderm forms somites which differentiate into sclerotome and dermomyotome. Sclerotome cells form the mesenchyme which can become bone, cartilage or connective tissue. Bones form through intramembranous or endochondral ossification, where cartilage templates are replaced by bone. The axial skeleton includes the skull, vertebrae, ribs and sternum, while the appendicular skeleton comprises the shoulder and pelvic girdles and limb bones.
This document discusses prenatal and postnatal growth and development of the mandible. It describes the three phases of prenatal life and outlines the formation and development of structures like the pharyngeal arches, meckel's cartilage, and bones in the mandible through intramembranous and endochondral ossification. It also discusses changes that occur in mandibular growth patterns after birth through childhood and adolescence, including growth at specific sites like the condyle, ramus, and alveolar process.
This document provides an overview of cranial and facial development from prenatal through postnatal periods. It discusses how the cranium develops from both membranous and cartilaginous components, and how growth occurs after birth through processes like sutural growth, cortical drift and synchondrosis elongation. Premature fusion of sutures or synchondroses can lead to craniosynostosis and impact midfacial development and dental alignment. Genetic syndromes associated with abnormal skull growth are also mentioned.
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
This chapter discusses the anatomy of edentulous ridges and the healing process after tooth extraction. It describes how the alveolar ridge changes after tooth loss, becoming less pronounced over time. Socket healing after extraction involves initial blood clot formation, wound cleansing by immune cells, new tissue growth including woven bone, and eventual remodeling into lamellar bone. The quality and quantity of remaining bone in edentulous sites is classified. Topography differences exist between the maxilla and mandible, and between anterior and posterior regions, affecting mucosal coverage of the ridge.
This document summarizes the prenatal development and postnatal growth of the mandible. It begins with an overview of the formation of pharyngeal arches during embryonic development, including the mandibular arch which gives rise to the lower jaw. Meckel's cartilage provides a template for mandibular growth. Ossification begins in the mandible through intramembranous and endochondral bone formation. After birth, various regions such as the ramus, body, angle, and condyle continue growing through bone deposition and resorption to accommodate the erupting teeth and enlarging muscles. Growth generally ceases around age 20.
This document discusses several theories of craniofacial growth and development:
- Sicher's sutural dominance theory proposed that sutures between bones force them apart, allowing appositional growth along bone borders. However, growth still occurs without sutures.
- Scott's nasal septum/cartilaginous theory argued that the nasal septum cartilage controls maxillary growth, while synchondroses elongate the cranial base and condylar cartilage controls mandibular growth.
- Moss' functional matrix theory proposed that genetic coding is outside bones, which grow in response to intrinsic growth of surrounding tissues like muscles.
- Petrovic's servosystem theory viewed craniofacial
This document provides an overview of the mandible, including its development, anatomy, age-related changes, and clinical applications. It discusses how the mandible develops from the first pharyngeal arch and ossifies through both intramembranous and endochondral bone formation. The anatomy of the mandible is described in detail, including its various parts and structures. Age-related changes to the mandible from birth through adulthood and old age are also reviewed. Finally, the document discusses some applied clinical aspects of the mandible relating to dislocations, fractures, and considerations for surgery.
This document provides an overview of the mandible, including its development, anatomy, age-related changes, and clinical applications. It discusses how the mandible develops from the first pharyngeal arch and ossifies through both intramembranous and endochondral bone formation. The anatomy of the mandible is described in detail, including its various parts and structures. Age-related changes to the mandible from birth through adulthood and old age are also reviewed. Finally, the document discusses some applied clinical aspects of the mandible relating to dislocations, fractures, and considerations for surgery.
This document provides an overview of the mandible, including its development, anatomy, age-related changes, and clinical applications. It discusses how the mandible develops from the first pharyngeal arch and ossifies through both intramembranous and endochondral bone formation. The anatomy of the mandible is described in detail, including its various parts and surrounding structures. Age-related changes to the mandible from birth through adulthood and old age are also reviewed. Finally, the document discusses some applied clinical aspects of the mandible relating to dislocations, fractures, and considerations for surgery.
“Growth was concieved by an anatomist, born to a biologist, delivered by a physician, left on a chemist doorstep, and adopted by a physiologist.At an early age- she eloped with a statistician, divorced him for a psycologist, and is now wooed, alternatively and concurrently, by an endrocrinologist, a biochemist,a physicist, a mathematician, an orthodontist, a eugenicist and the children’s bureau”.
THE PRENATAL LIFE IS DIVIDED INTO THREE PERIODS –
1.PERIOD OF THE OVUM
2.PERIOD OF THE EMBRYO
3.PERIOD OF THE FETUS
About the fourth week of intrauterine life, the pharyngeal arches are laid down
The first arch is called the mandibular arch and the second arch the hyoid arch.
The mandible develops from the first pharyngeal arch. Meckel's cartilage appears around the 6th week as a template for mandibular development. Ossification begins in membrane covering Meckel's cartilage, forming the body of the mandible around the mental and incisive nerves. Endochondral ossification forms the condylar process, mental region, and coronoid process. Postnatally, the mandible undergoes significant growth mediated by genetic and functional factors to accommodate the dentition and masticatory muscles.
The document provides an overview of the surgical anatomy of the mandible. It discusses the parts and features of the mandible, including the body, rami, coronoid and condylar processes. It details the growth and development of the mandible from the prenatal period through adulthood. Key anatomical structures are described, such as ligaments, muscles, nerves, blood vessels and lymph nodes associated with the mandible. Clinical considerations for surgical procedures involving the mandible are also mentioned.
The document summarizes growth patterns in different areas of the skull. It discusses three main types of growth: hypertrophy, hyperplasia, and extracellular secretion. Growth of the cranial vault occurs primarily at sutures through periosteal activity. The cranial base grows through endochondral ossification at synchondroses. The maxilla grows both by displacement from cranial base growth until age 6 and then by sutural growth, with bone remodeling on its surfaces. Mandibular growth involves both endochondral growth at the condyle and periosteal growth along the posterior ramus surface.
This document provides definitions of growth and development and discusses the prenatal and postnatal development of the maxilla. It defines growth as an increase in size and development as progress towards maturity. It describes early embryonic events and development of the face between 4-8 weeks of gestation. Postnatally, it explains that growth of the maxilla occurs through displacement, remodeling, and growth at sutures in the transverse, anteroposterior, and vertical dimensions. It highlights several key factors that influence maxillary growth including the lacrimal suture, maxillary tuberosity, nasal airway, palatal remodeling, and orbital growth.
The document discusses human craniofacial development from conception through fetal stages. It covers the origin of the human embryo from fertilization, the formation of germ layers, development of branchial arches and clefts, and the differentiation of tissues and structures from the germ layers and arches in the lower, middle, and upper thirds of the face. Key topics include mesenchymal condensations that form the mandibular arch and maxillary processes, ossification centers of the maxilla, and cartilage contributions to mandibular growth.
Growth and Development of Craniofacial Structure, Dentition and OcclusionHermie Culeen Flores
The document discusses growth and development of craniofacial structures, dentition, and occlusion. It covers:
- Mechanisms of bone growth including endochondral and intramembranous formation.
- Hypotheses of craniofacial growth including genetic and functional theories.
- Development of specific craniofacial regions like the cranial vault, basicranium, and nasomaxillary complex.
- Eruption sequences and development of the primary and permanent dentitions from prenatal to postnatal stages.
- Characteristics and phases of the mixed and permanent dentitions.
- Static and dynamic aspects of occlusion and types of occlusion like ideal, normal, and functional.
Stomatognathic system
- Muscle function
- Form and function of jaws
Trajectories of the jaws
- Trajectories force
- Buttresses
Closed functional system
- Basal arches
- Lip, cheek, tongue morphology
-
Dynamics of mandible
Mastication
- Dynamic of mastication
- Mastication after teeth eruption
- Respiration during mastication
- Masticatory efficiency
Swallowing
- Stages of swallowing
- Tongue thrust and malocclusion
Respiration
Speech
TM articulation
- TM articulation disorders
Effect of different form of malocclusion
Introduction
Significance of proper interproximal contact relation
Factors affecting inter-proximal contact relations
Description of inter-proximal contact
Labio lingual aspect
\Incisal and occlusal aspects
Size of contact
Shape of contact
Benefits of ideal contact
Hazards of faulty reproduction of contact point
Conclusion
The document discusses the growth and development of the mandible. It begins with an overview of the prenatal development, including how the mandibular arch forms from the pharyngeal arches and contains Meckel's cartilage. Meckel's cartilage provides a template for the mandible to develop around it through intramembranous ossification beginning in the 7th week of prenatal development. The mandible continues developing and forming after birth through both intramembranous and endochondral ossification.
The document discusses the development of the mandible from early embryogenesis through postnatal growth. It begins with the formation of Meckel's cartilage from the first pharyngeal arch which later contributes to mandibular formation. Ossification begins around the mental nerve and spreads to form the body and ramus. Secondary cartilage appears including the condylar, coronoid, and symphyseal cartilage. The mandible continues developing after birth through remodeling processes like at the condyle which causes downward and forward growth of the mandible.
A detailed description of pre-natal and post-natal development of the mandible, with a brief description of theories of growth, for education purposes by Post Graduate students of Orthodontics and Dentofacial Orthopaedics
The skeletal system develops from mesoderm and neural crest cells. Paraxial mesoderm forms somites which differentiate into sclerotome and dermomyotome. Sclerotome cells form the mesenchyme which can become bone, cartilage or connective tissue. Bones form through intramembranous or endochondral ossification, where cartilage templates are replaced by bone. The axial skeleton includes the skull, vertebrae, ribs and sternum, while the appendicular skeleton comprises the shoulder and pelvic girdles and limb bones.
This document discusses prenatal and postnatal growth and development of the mandible. It describes the three phases of prenatal life and outlines the formation and development of structures like the pharyngeal arches, meckel's cartilage, and bones in the mandible through intramembranous and endochondral ossification. It also discusses changes that occur in mandibular growth patterns after birth through childhood and adolescence, including growth at specific sites like the condyle, ramus, and alveolar process.
This document provides an overview of cranial and facial development from prenatal through postnatal periods. It discusses how the cranium develops from both membranous and cartilaginous components, and how growth occurs after birth through processes like sutural growth, cortical drift and synchondrosis elongation. Premature fusion of sutures or synchondroses can lead to craniosynostosis and impact midfacial development and dental alignment. Genetic syndromes associated with abnormal skull growth are also mentioned.
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
This chapter discusses the anatomy of edentulous ridges and the healing process after tooth extraction. It describes how the alveolar ridge changes after tooth loss, becoming less pronounced over time. Socket healing after extraction involves initial blood clot formation, wound cleansing by immune cells, new tissue growth including woven bone, and eventual remodeling into lamellar bone. The quality and quantity of remaining bone in edentulous sites is classified. Topography differences exist between the maxilla and mandible, and between anterior and posterior regions, affecting mucosal coverage of the ridge.
This document summarizes the prenatal development and postnatal growth of the mandible. It begins with an overview of the formation of pharyngeal arches during embryonic development, including the mandibular arch which gives rise to the lower jaw. Meckel's cartilage provides a template for mandibular growth. Ossification begins in the mandible through intramembranous and endochondral bone formation. After birth, various regions such as the ramus, body, angle, and condyle continue growing through bone deposition and resorption to accommodate the erupting teeth and enlarging muscles. Growth generally ceases around age 20.
This document discusses several theories of craniofacial growth and development:
- Sicher's sutural dominance theory proposed that sutures between bones force them apart, allowing appositional growth along bone borders. However, growth still occurs without sutures.
- Scott's nasal septum/cartilaginous theory argued that the nasal septum cartilage controls maxillary growth, while synchondroses elongate the cranial base and condylar cartilage controls mandibular growth.
- Moss' functional matrix theory proposed that genetic coding is outside bones, which grow in response to intrinsic growth of surrounding tissues like muscles.
- Petrovic's servosystem theory viewed craniofacial
This document provides an overview of the mandible, including its development, anatomy, age-related changes, and clinical applications. It discusses how the mandible develops from the first pharyngeal arch and ossifies through both intramembranous and endochondral bone formation. The anatomy of the mandible is described in detail, including its various parts and structures. Age-related changes to the mandible from birth through adulthood and old age are also reviewed. Finally, the document discusses some applied clinical aspects of the mandible relating to dislocations, fractures, and considerations for surgery.
This document provides an overview of the mandible, including its development, anatomy, age-related changes, and clinical applications. It discusses how the mandible develops from the first pharyngeal arch and ossifies through both intramembranous and endochondral bone formation. The anatomy of the mandible is described in detail, including its various parts and structures. Age-related changes to the mandible from birth through adulthood and old age are also reviewed. Finally, the document discusses some applied clinical aspects of the mandible relating to dislocations, fractures, and considerations for surgery.
This document provides an overview of the mandible, including its development, anatomy, age-related changes, and clinical applications. It discusses how the mandible develops from the first pharyngeal arch and ossifies through both intramembranous and endochondral bone formation. The anatomy of the mandible is described in detail, including its various parts and surrounding structures. Age-related changes to the mandible from birth through adulthood and old age are also reviewed. Finally, the document discusses some applied clinical aspects of the mandible relating to dislocations, fractures, and considerations for surgery.
“Growth was concieved by an anatomist, born to a biologist, delivered by a physician, left on a chemist doorstep, and adopted by a physiologist.At an early age- she eloped with a statistician, divorced him for a psycologist, and is now wooed, alternatively and concurrently, by an endrocrinologist, a biochemist,a physicist, a mathematician, an orthodontist, a eugenicist and the children’s bureau”.
THE PRENATAL LIFE IS DIVIDED INTO THREE PERIODS –
1.PERIOD OF THE OVUM
2.PERIOD OF THE EMBRYO
3.PERIOD OF THE FETUS
About the fourth week of intrauterine life, the pharyngeal arches are laid down
The first arch is called the mandibular arch and the second arch the hyoid arch.
The mandible develops from the first pharyngeal arch. Meckel's cartilage appears around the 6th week as a template for mandibular development. Ossification begins in membrane covering Meckel's cartilage, forming the body of the mandible around the mental and incisive nerves. Endochondral ossification forms the condylar process, mental region, and coronoid process. Postnatally, the mandible undergoes significant growth mediated by genetic and functional factors to accommodate the dentition and masticatory muscles.
The document provides an overview of the surgical anatomy of the mandible. It discusses the parts and features of the mandible, including the body, rami, coronoid and condylar processes. It details the growth and development of the mandible from the prenatal period through adulthood. Key anatomical structures are described, such as ligaments, muscles, nerves, blood vessels and lymph nodes associated with the mandible. Clinical considerations for surgical procedures involving the mandible are also mentioned.
The document summarizes growth patterns in different areas of the skull. It discusses three main types of growth: hypertrophy, hyperplasia, and extracellular secretion. Growth of the cranial vault occurs primarily at sutures through periosteal activity. The cranial base grows through endochondral ossification at synchondroses. The maxilla grows both by displacement from cranial base growth until age 6 and then by sutural growth, with bone remodeling on its surfaces. Mandibular growth involves both endochondral growth at the condyle and periosteal growth along the posterior ramus surface.
This document provides definitions of growth and development and discusses the prenatal and postnatal development of the maxilla. It defines growth as an increase in size and development as progress towards maturity. It describes early embryonic events and development of the face between 4-8 weeks of gestation. Postnatally, it explains that growth of the maxilla occurs through displacement, remodeling, and growth at sutures in the transverse, anteroposterior, and vertical dimensions. It highlights several key factors that influence maxillary growth including the lacrimal suture, maxillary tuberosity, nasal airway, palatal remodeling, and orbital growth.
The document discusses human craniofacial development from conception through fetal stages. It covers the origin of the human embryo from fertilization, the formation of germ layers, development of branchial arches and clefts, and the differentiation of tissues and structures from the germ layers and arches in the lower, middle, and upper thirds of the face. Key topics include mesenchymal condensations that form the mandibular arch and maxillary processes, ossification centers of the maxilla, and cartilage contributions to mandibular growth.
Growth and Development of Craniofacial Structure, Dentition and OcclusionHermie Culeen Flores
The document discusses growth and development of craniofacial structures, dentition, and occlusion. It covers:
- Mechanisms of bone growth including endochondral and intramembranous formation.
- Hypotheses of craniofacial growth including genetic and functional theories.
- Development of specific craniofacial regions like the cranial vault, basicranium, and nasomaxillary complex.
- Eruption sequences and development of the primary and permanent dentitions from prenatal to postnatal stages.
- Characteristics and phases of the mixed and permanent dentitions.
- Static and dynamic aspects of occlusion and types of occlusion like ideal, normal, and functional.
Stomatognathic system
- Muscle function
- Form and function of jaws
Trajectories of the jaws
- Trajectories force
- Buttresses
Closed functional system
- Basal arches
- Lip, cheek, tongue morphology
-
Dynamics of mandible
Mastication
- Dynamic of mastication
- Mastication after teeth eruption
- Respiration during mastication
- Masticatory efficiency
Swallowing
- Stages of swallowing
- Tongue thrust and malocclusion
Respiration
Speech
TM articulation
- TM articulation disorders
Effect of different form of malocclusion
Introduction
Significance of proper interproximal contact relation
Factors affecting inter-proximal contact relations
Description of inter-proximal contact
Labio lingual aspect
\Incisal and occlusal aspects
Size of contact
Shape of contact
Benefits of ideal contact
Hazards of faulty reproduction of contact point
Conclusion
Factors affect Development of Occlusion and its Stability.pdfDr.Mohammed Alruby
Factors affect Development of
Occlusion
And
Its
Stability
Prepared by:
Dr. Mohammed Alruby
Factors affect development of occlusion
1- Factors determine tooth position during eruption
2- Dimensional changes in dental arches:
- Width
- Length
- Arch circumference
Factors affect occlusal stability and tooth position:
1- Force act against the teeth
Force of occlusion
2- Drifting of teeth
3- Facial growth
Factors affect development of occlusion
1- Factors determining tooth position during eruption:
The tooth passes through 4 distinct stages during its eruption, the tooth position during each is affected by several factors
a- Stage 1: tooth germ, the position of tooth germ is greatly determined by genetics
b- Stage 2: during intra-bony eruption, the tooth position is affected by:
- Presence or absence of adjacent teeth
- Rate of resorption of primary roots
- Localized pathologic lesion
- Any other factors that alter growth of alveolar process
N: B:
The teeth have mesial shifting tendency even before they appear in the oral cavity
c- Stage 3: intra-oral or pre-occlusion stage of eruption, the position of the tooth at this stage is affected by:
- Lip, tongue and c, tongue and cheek musculature
- External objects brought into the mouth as thumb and pencil
- Tooth can be moved mesially into spaces created by inter-proximal caries or extraction
d- Stage 4: this stage is affected by most complicated system of force:
1- Musculature:
= Muscles of deglutition, expression and mastication have direct effect on the dento-alveolar structure
= The tongue exerts very powerful anterior and lateral force on the dentition which resist and balanced the inward force of orbicularis oris muscle and buccinator mechanism, in addition to its molding effect on the palate
= Lip and cheek musculatures
= Masseter, temporalis, and medial pterygoid muscles: support the mandible against gravity and downward pull of submandibular muscles
2- Proximal contact: also the transeptal fibers
The proximal contact of adult’s dentition is maintained by:
- The tendency of posterior teeth to move forward by anterior component force and this force become active by the eruption of 1st molars
- Distal and lingual forces: which act upon the teeth and produced by muscles of lips, orbicularis oris, caninus, zygomaticus, mentalis and buccinators
- The inter-action between these two opposite forces will guided by the proximal contact between the teeth
2-Dimensional changes in the dental arches:
The usual arch dimensions measured are:
- Width: at canine region – at premolar region – at 1st molar region
- Length of the arch
- Circumference of dental arch
a- Width:
At canine region:
It is the distance of anterior region of the dental arch from canine to canine, the significant increase in intercanine width occurs during eruption of permanent incisors and movement of primary canine distally into primate space
Delayed
Tooth
Eruption
Prepared by:
Dr. Mohammed Alruby
Delayed tooth eruption
Definition DTE:
It is the emergence of a tooth into the oral cavity at a time that deviates significantly from norms established for different races, ethnicities, and sexes
Eruption:
The developmental process responsible for moving a tooth from its crypt position through the alveolar process into the oral cavity to its final position of occlusion with its antagonists.
Physiologic process that strongly influences the normal development of the craniofacial complex.
Its dynamic process that encompasses:
1- Completion of root development.
2- Establishment of the periodontium.
3- Maintenance of the functional occlusion.
Factors influencing tooth eruption:
- Broad chronologic age range.
- Race
- Sex
- Ethnic
- Individual variation
Emergence (Moment of eruption):
The moment of appearance of any part of the cusp or crown
through the gingiva.
Impacted teeth:
Teeth prevented from erupting by some physical barrier path.
Etiology:
1- Lack of space Due to crowding of the dental arches or premature loss of deciduous teeth
2- Rotation or other positional deviation of the tooth buds.
Results in teeth that are “aimed” in the wrong direction, leading to impaction.
Primary retention:
- Cessation of eruption of a normally placed and developed tooth germ before emergence.
- No physical barrier.
Pseudo-anodontia
Clinical but not radiographic absence of teeth that should normally be present in the patient’s dental and chronologic age.
the deciduous teeth have been shed, but the permanent ones failed to erupt.
Primary or idiopathic failure of eruption :(Proffit and Vig):
Non-ankylosed teeth fail to erupt fully or partially
- Because of malfunction of eruption mechanism.
- No barrier to eruption.
- Primary defect in in the eruptive process.
Arrested eruption or non-eruption:
- Ankylosis
- Impaction
- Idiopathic failure of eruption
Embedded teeth:
Unerupted due to lack of eruptive force.
No obvious physical obstruction.
Submerged teeth and inclusion/re-inclusion of teeth:
- After eruption, teeth become ankylosed.
- Lose their ability to maintain the continuous eruptive potential as the jaws grow.
- Lose contact with their antagonists.
- Might re-include in the oral tissue.
Eruption is normal according to chronologic and biologic parameters (root formation), BUT the process was haltered.
Controversy between the terms:
“delayed”, “late”, “retarded”, “depressed” and “impaired”
a- Root development as a basis for distinguishing some of these terms (Gron,1962):
Under normal circumstances, tooth eruption begins when ¾ of its final root length is established.
- Mandibular canines and second molars root development > ¾of final root length.
- Mandibular central incisors and first molars root development < ¾ final root length.
b- Root Development alone should be the basis for defining the expected time of eruption for diff
Curve of Spee
Prepared by:
Dr. Mohammed Alruby
Curve of spee
In anatomy, the Curve of Spee is defined as the curvature of the mandibular occlusal plane beginning at the tip of the lower cuspid and following the buccal cusps of the posterior teeth, continuing to the terminal molar.
It is named for the German embryologist Ferdinand Graf von Spee (1855–1937), who was first to describe the anatomic relations of human teeth in the sagittal plane
According to another definition the Curve of Spee is an anatomic curvature of the occlusal alignment of the teeth, beginning at the tip of the lower canine, following the buccal cusps of the natural premolars and molars and continuing to the anterior border of the ramus
Assess the depth of curve from premolar cusps to a flat plane on distal cusps of first molars and incisors. Only one
value is given for the arch, and only if the premolars have not been assessed separately as crowded. Allow 1 mm
space for 3 mm depth of curve, 1.5 mm for 4 mm depth, and 2 mm space for a 5 mm curve (usually no allowance
is necessary).
Exaggerated curve of Spee is frequently observed in dental malocclusions with deep overbites. Such excessive curve of Spee alters the muscle imbalance, ultimately leading to the improper functional occlusion.
It has been proposed that an imbalance between the anterior and the posterior components of occlusal force can cause the lower incisors to over erupt, the premolars to infra-erupt, and the lower molars to be mesially inclined.
This altered condition requires specialized skills for the practitioner. It would be useful if we have a thorough knowledge of how and when this curve of Spee develops, so that it will aid us in our treatment.
In humans, an increased curve of Spee is often seen in brachycephalic facial patterns and associated with short mandibular bodies
According to Root and Fidler et al when a skeletal open bite is not present, the curve of Spee in Class II malocclusions is deeper than in other malocclusions
Andrews noted that the occlusal planes in 120 non-orthodontically treated and having normal occlusions varied from being generally flat to a slight curve of Spee.
This finding led him to believe that the presence of a curve of Spee could be associated with post-orthodontic treatment relapse.
Andrews concluded, “even though not all of the orthodontic normal had flat planes of occlusion, I believe that a flat plane should be a treatment goal as a form of overtreatment.”
A deep curve of Spee may make it almost impossible to achieve a Class I canine relationship, though it may also result in occlusal interferences that will manifest during mandibular function.
Curve of spee from flat to mild:
It has been suggested that the deciduous dentition has a curve of Spee ranging from flat to mild, whereas the adult curve of Spee is more pronounced. The findings were supported by Ash.
Its greatest increase occurs in the early mixed d
Definition
Types of rotation
Etiology of rotation
Winging and counter winging rotation
Advantages of derotation
Biomechanics of rotation correction
Methods of correction rotation
Management of molar derotation
Retention of rotated tooth
Methods to prevent relapse
Active retention
Torque when, where, how?
Importance of torque
Biomechanics in torque
Torque expression in slot 0.018 and 0.022
Expression of torque
Mode of ligation and torque
Types of torque
- Passive
- Active
Factors affect torque
Torque with different appliances
Torque in base and face
Torque prescription in different techniques
Class II malocclusion and torque
Torque control in different treatment steps
Differential torque
Torque clearance
Intrusion and torque
Torque and intra-oral elastics
Extra-oral forces
And
Appliances
Prepared by:
Dr. Mohammed Alruby
Definition
Philosophy
History and development
Classification of extra-oral forces
Advantages of extra-oral forces
Disadvantages of extra-oral forces
Uses of extra-oral forces
Headgear
Appliance enhanced the action of headgear
Protraction appliances
Types of reversed headgear
Chin cup appliance
Orthopedic correction of class III
Orthopedic correction of open bite
Orthopedic correction of class II
Retention after orthopedic correction
Definition
It is a force derived from an extra-oral appliance that uses the forehead, the top of the head or the back of the neck as anchorage to apply forces to the dental or basal arch. It may be orthodontic force or orthopedic force to move the dentition, or restrict or redirect the growth respectively.
Philosophy:
The philosophy beyond the use of extra-oral force is based upon the old concept that, (the application of appreciable amount of force against the growing bone con modify or alter the direction of bone growth and consequently alter the shape and position of the bone
= the well-known best examples are the induced skull deformation in Colombia –India and feet deformation in Chinese girls
History and development:
Appliances resembling chin cups have been in use since the early 1800's. According to Graber, the early attempts with the chin cup were not successful because of incomplete knowledge of mandibular and facial growth, its use on non-growing patients, and an inadequate understanding of the forces generated by the chin cup.
1802: Cellier and Josef Fox in 1803, utilized chin caps in combination with bite blocks to correct the “underslung chin”
1866: Norman Kingsley introduced extra-oral head cap anchorage or force for maxillary distal movement
1880: Kingsley described an appliance that could influence the position of the dentition in upper jaw with the aid of extra-oral forces
1887: E.H.Angle recommended the use of occipital bandage in treatment of maxillary protrusion
1904: Jackson was first describing the facial mask
1892: headgear appliance was originally designed by Kingsley
1920: Angle and his followers were convinced that class II and class III elastics not only moved teeth but cause a significant skeletal changes: stimulate growth of one and restrain growth for the other so we not need to use any extra-oral force just wait until permanent dentition is completed
1923: Case recommend the use of extra-oral force against maxilla in treatment of class II and class I maxillary protrusion
1947: Kleohn, presented his treatment results with cervical neck strap, subsequent to this report, many other variation of the headgear appliance were presented
1960: Delaire facemask
Classification of extra-oral force appliances according to uses
The extra-oral pull is generally applied bilaterally, for three main purposes:
(1) as a restraining force
(2)
Effects of extra-oral appliances
And
Forces
Prepared by
Dr. Mohammed Alruby
Factors affect extra-oral force
Studies of maxillary protraction force
Results of extra-oral force
Effects of extra-oral appliances
The effects of extra-oral forces on dentofacial structure depend on the following factors:
- Direction of force
- Magnitude of force
- Duration of force
- Growth
- Patient cooperation
1- Direction of force:
Kloehn 1953, Gould 1975, Greenspan 1970, Merrifield and Cross 1970, and Worms et al 1973, all give an adequate description for the direction of force application and their effect on maxillary molar position, tipping, bodily, extrusion, intrusion movement
The direction of force should be adjusted according to the patient needs and objective of treatment as:
- When bodily movement is required, the force should pass through the center of resistance of molars (at the tri-furcation of roots) and the extra-oral tube should be placed gingivally as possible
- When bodily displacement of maxilla is required, the force should pass through the center of maxillary resistance (zygomatic bone)
- When extrusion of molars is required, (in case of deep bite) the force should pass below the center of resistance (below the level of occlusal plane)- cervical headgear is the best choice
- When intrusion is required (open bite cases) the force should pass above the level of occlusal plane
- In occipital headgear, the vector of force may pass through the center of resistance of 1st molar and thus causes: -------------- distal translation of 1st molar
- If the vector of force passes above the center of resistance causing:
a- Distal root torque
b- Mesial crown tipping
c- Intrusion of maxillary 1st molar ---- that, ----- closing the bite and same can occurs in the vertical or high pull headgear
== the direction of force can be determined by adjusting the outer bow in relation to the occlusal plane or center of resistance
== the best method for recording the force direction is the lateral cephalometric radiograph with the appliance in place, then the outer bow is adjusted in relation to the occlusal plane and the center of resistance of tooth or jaw
= in Kloehn’s face bow, the direction of force is 25 – 30 degree below the occlusal plane so that, the vector of force is far away from the center of resistance of 1st molars, thus cervical headgear causes distal tipping and extrusion of 1st molars and open bite
The direction of force depends upon the following variables:
I- Vertical position of the outer bow relative to the center of resistance:
= force applied by oblique headgear passing through the center of resistance will cause translation of the tooth and make intrusion at the same time
= force applied by oblique headgear passing above the occlusal plane
but below the center of resistance will cause:
a- Distal crown tipping, mesial root torque
b- Extrusion of mesial marginal ri
Characteristic of light
History
Laser physics and properties
Component of laser
Classification of laser
Biological effect of laser
Laser effect on dental tissues
Laser safety in dental practice
General application of laser
Personal protective equipment
Types of laser intensity in orthodontics
Uses of laser in orthodontics
Effect of laser in orthodontics
Introduction
History
Classification of maxillary fractured Lefort
Special consideration for orthognathic surgery
- Patient selection:
Age of patient
Assessment of patient motivation and expectation
The nature and severity of skeletal dysplasia
Systemic evaluation
- Patient evaluation:
(1) General evaluation
(2) Esthetic evaluation
(3) Functional evaluation
(4) Radiographic evaluation
a- Ceph ---
PA
Lateral: ------ soft and hard
b- Panorama
c- CBCT
d- Periapical
Protocol for basic orthognathic record collection
Treatment planning
- Time of treatment
- Objective of orthodontic treatment
Pre-surgical
Post-surgical
- Sequence of treatment:
Pre-surgical phase
Orthodontic in theatre
Post-surgical treatment
Surgery without orthodontics
Stability and clinical success
complications
Medical glossary
Prepared by:
Dr. Mohammed Alruby
Medical glossary
Aberrancy: occurring or developing away from the normal situation
Acantholysis: loss of coherence between epithelial cells due to degeneration of desmosomes (intercellular bridge) this will lead to the formation of intra-epithelial clefts, vesicle and bullae
Acanthosis: epithelial hyperplasia, mainly of the stratum spinosum, leading to increase thickness of the stratum granulosum due to increased number of cell layers of prickle cells
Achondroplasia: an autosomally inherited disorder characterized by abnormality of conversion cartilage into bone predominantly affecting the epiphyses of long bones, leading to retarded growth at the epiphyses and resulting in dwarfism with short extremities but normal trunk
Acidogenic: referring to organisms capable of producing acid
Aciduric: referring to organisms capable of surviving and metabolizing under highly acidic conditions
Acquired: a term used to describe a condition, habit or other characteristic which is not present at birth, which developed in the individuals by reaction to some environmental factor (to acquire is to obtain)
Agenesis: failure of formation leading to absence of a part or organ
Aglossia: failure of formation leading to absence of the tongue
Agnathia: absence of the jaw, usually the lower jaw, usually accompanied by approximation of the ears
Amyloid: pertaining of starch, having the characteristic of starch. A protein compound of albumin and chondroitin sulphate which resembles starch in appearance and may be pathologically deposited in certain tissues
Anaplasia: atypical differentiation or lack of differentiation of epithelial cells occurring in the malignant disease. Anaplastic cells have large, hyperchromatic, irregularly shaped nuclei and frequently show a typical mitosis.
Aneuploidy: an abnormal number of chromosomes in a nucleus. This usually arise from failure of paired chromosomes or sister chromatids to disjoin at anaphase of cell division
Aneurysm: circumscribed dilatation of an artery
Aneurysmal: relating to an aneurysm. The term applied to a type of cyst that produce bony expansion simulating the expansion of an artery produced by a vascular aneurysm
Angiogenesis: development of blood vessels
Angioma: a swelling or mass due to proliferation with or without dilatation of vascular channels
Anhydrosis: absence of sweating due to absence of sweat glands
Ankyloglossia: tongue tie, usually due to a short lingual frenum or one attached too near the tip of the tongue, may be due to failure of separation of tongue from the floor of the mouth during embryogenesis
Ankylosis: stiffening or fixation of a joint as a result of a disease process
Anodontia: absence of teeth
Anomaly: deviation from the normal, anything structurally unusual or irregular
Antigen: a substance that can induce an antibody response
Antimongoloid slant: an obliquity of the palpebral fissures laterally
Muscles
Part 3
Prepared by
DR. Mohammed Alruby
Development of oropharyngeal function
Neuromuscular regulation of jaw positions and functions
Muscles controlling mandibular postures
- Muscles of mastication
- Submandibular muscles
- Extensor and flexor muscles of neck
Positions of mandible
Some clinical implications
Development of oropharyngeal function
1- Prenatal maturation:
= During prenatal life, the neuromuscular system does not mature evenly, it is not accidentally that the orofacial region matures a head of limb region
= In human fetus, by about the 8 week, generalized uniform reflex movement of entire body can be elicited by tactile stimulation
Diffuse spontaneous movements in response to as yet unidentified stimuli have been observed as early as 9.5 weeks
Localized specific and more peripheral responses cannot be produced before 11 weeks, and at this time, stimulation of the nose-mouth region causes lateral body flexion
By 14 weeks, the movements have become much more individualized. Stimulation of the mouth area, the general bodily movements no longer are seen but instead facial and orbicular muscle response are produced
Stimulation of the upper lip causes the mouth to close and often deglutition occurs
Respiratory movements of the chest and abdomen are seen first at about 16 week
The gag reflex has been demonstrated in human fetus of 18.5 weeks. By 25v weeks, respiration is shallow but may support life for few hours
Stimulation of the mouth at 29 weeks’ menstrual age has elicited sucking through complete suckling and swallowing is not thought to be developed until at least 32 week
2- Neonatal oral functions:
a- The mouth as sensory instrument:
= At birth, the orofacial region is a very active perceptual system, the infant finds the mouth nipple = more tactile than the visual sensation
At birth, the tactile sense already is more highly developed in the lips and mouth than in the fingers
= The neonate’s slobbers, drools, chew his toe, sucks his thumb and discovers the gurgling sounds can be made with his mouth
= oral function of the neonate is guided primarily by local tactile stimuli, particularly those from the lips and anterior part of the tongue
= the posture’s of neonate’s tongue is between the gum pads and often for enough forward to rest between the lips, where it can perform its role of sensory guidance more easily
= the mouth of infant is used for many purpose, the perceptual functions of the tongue, lips, and facial skin are mingled with the sensory function of taste, smell and jaw position.
= the sensitivity of tongue and lips is greater than other area of the body and the sensory guidance for oral functioning, including jaw movements is from remarkably large area
b- Infant suckling and swallowing:
= Infant suckling and swallowing have been the subjects of much research due to the effectiveness of these activities is a good indication of the neurologic ma
Muscles
Part 2
Prepared by:
Dr. Mohammed Alruby
Muscle function and malocclusion
Muscle development and skull form in relation to function
Facial balance, muscle balance, and orthodontic therapy
EMG response of muscles
Myofunctional therapy
Basic concepts of neuromuscular physiology
Muscle function and malocclusion
Muscle function is a factor in shaping the dental arches and is important in maintaining the stability of the teeth following orthodontic treatment
Muscle fibers contract in response to change in electrical potential of its investing membrane, proprioceptors located in the muscles and the periodontal membrane make possible a high degree of accuracy in bringing the teeth in contact
Class II malocclusion:
The muscle function is usually normal in class I malocclusion with the exception of class I Openbite
In class I cases, the teeth are in state of balance with environmental force, although the actual measurements of tongue and lip forces showed that, they are not equal at any area during particular function
Class I openbite:
= Usually caused by thumb sucking, retained infantile tongue swallowing or both, the child begins with finger habits of sufficient intensity and duration to deform the maxillary anterior segment forcing the incisors labially and allowing the tongue to move farther in forward direction
= the tongue continues to thrust instead of entering the transitional phase, a large part of this activity may be compensatory or adaptive to produce anterior seal with lower lip during swallowing
=such activity accentuates the openbite, prevent complete eruption of incisors and increase the overjet to the extent that the lower lip may cushion behind the maxillary incisors during rest and functional movements
- The upper lip become more hypotonic
- The lower lip become hyperactive
- Chin puckering can see with each swallowing
= the hyperactive mentalis muscle, retroclined, imprecate and flatten the mandibular anterior segment
= the tongue drop downward and mouth breathing become a dominate pattern, as the tongue thrust forward, it elongates in shape thus alter the balance with buccinator mechanism resulting in:
- Collapse of posterior segment
- V-shaped palate
- Buccal cross bite
This occurs also as a result of molding effect of the tongue upon the hard palate
Mouth breathing:
Is the good explain for these changes a result of underdeveloped nasopharyngeal structures and subsequently maxillary deficiency
Class II division 1 malocclusion:
= In contrast to class I class II div 1 involve an abnormal muscle function from beginning
= As abnormal muscle function in class II div 1 is a compensatory or adaptive and is secondary to skeletal relationship
= Because of large overjet, there is lack of the lip seal during rest and various functions so, mouth breathing is developed
= Some individuals translate the mandible forward to effect lip seal and to improv
Muscles
Part 1
Prepare by
Dr. Mohammed Alruby
Histology of muscles
Physiology of muscles
Muscles development
Orofacial muscles
- Facial muscles
- Jaw muscles
- Portal muscles
Methods of studying muscles
Muscle changes during growth
Muscle function and facial development
Histology of muscles
The structural and functional unit of the muscles is the muscle fiber
Muscle fiber: elongated cylinder measure about 10 to 80 microns in thickness and from 1 to 15cm in length
= Each muscle fiber contains an acidophilic granular cytoplasm (sarcoplasm) that rich in:
Glycogen, mitochondria, Golgi apparatus, protein (actin, myosin, tropomyosin),
Large number of myofibrils (sarcostyles) which responsible for muscle contraction
= the muscle fiber is covered by thick membrane called (sarcolemma) and surrounded by CT called (endomysium)
= the muscle fibers are coalescing together to form bundles; each bundles are covered by C T septa called perimysium
= the muscle bundles are coalescing together to the whole muscle which is covered by CT fascia called epimysium, these CT contain: blood vessel, lymph vessel, and nerves, that firmly attach the muscle bundles to each other and attach the whole muscle to its tendon
= the myofibrils (sarcostyles)are the contractile units of the muscle, in skeletal muscle they are transversely striated due to presence of dark and light bands
The dark bands are formed of thick myosin filaments rich in Ca, the light bands are formed of thin actine filaments rich in water, there is a pale line in at the center of dark band called (Henesen’s disk), There is dark line at the center of light bands called (Krauses membrane) or Z line
The distance between the two lines called (sarcomere) which is a contraction unit of the muscle.
During the muscle contraction there the Sarcomere is shortened due to sliding of the light bands over the dark bans. The energy required for contraction is derived from transformation of ATP ------ ADP
Physiology of muscles:
Man has 639 muscles, composed of 6 billion muscle fibers, each fiber has 1000 fibrils, which means that there are 6000 billion fibrils at work at one of time or another.
Elasticity: muscle can be stretched behind its original length and return to the original shape after relaxation (normal muscle can be elongated about 6/10 of its length
Contractility: it is the ability of muscle to shorten its length under nerve impulse, this contraction is stimulated by acetyl choline, glycogen is partially oxidized to provides energy and lactic acid that carried away by blood stream
Excessive accumulation of lactic acid can produce fatigue
Isometric contraction: (stretching): the muscle is simply resisting the external forces without actual shortening
Isotonic contraction: there is an actual shortening of the muscle, the strength of isometric contraction is much greater than that of isotonic contraction as the stre
diagnostic aids part 3, photograph and radiograph.docxDr.Mohammed Alruby
Diagnostic Aids
Part 3
{Radiographs and Photographs}
{BMR and EMG}
Prepared by
Dr. Mohammed Alruby
Radiographs
Means: A procedure that uses a type of high-energy radiation called x-rays to take pictures of areas inside the body. X-rays pass through the body onto film or a computer, where the pictures are made
Types:
Intra-oral radiographs:
Periapical radiographs:
It is necessary for any orthodontic diagnosis for the following reasons:
The pattern and amount of root resorption of deciduous teeth
Presence or absence of permanent teeth, their size, shape, position and relative state of development
Congenital absence of teeth or presence of supernumerary teeth
Character of alveolar bone, lamina dura, and periodontal membrane
Morphology and inclination of permanent teeth roots
Pathological oral condition such as thickened periodontal membrane, periapical infection, root fractures, cysts, retained deciduous teeth
Abnormal path of eruption of permanent teeth
Malposition of individual as: rotation, which requires a larger space on the arch
Very useful in mixed dentition analysis
Recognition of exact position of impacted tooth by using method of parallax: that determine whether the unerupted tooth is located labially or palatally. Two periapical radiograph is taken with the film in the same position in each exposure, but the tube is moved in second exposure about 10cm. if the impacted tooth is moved in the same direction as the tube so the tooth is impacted palatally and the reverse is versa.
Bit-wing radiographs:
Is used mainly for detection of proximal cries, but it is of little value in orthodontic diagnosis
Occlusal film:
Occlusal projection is useful to locate the supernumerary teeth at the midline (mesiodens) and to determine accurately the position of impacted maxillary cuspids
Extra-oral radiographs:
Cephalometric radiographs:
Lateral cephalometric radiographs
PA cephalometric radiographs
Lateral oblique cephalogram:
The patient is directed by 45 degree and take the shot
Since dentofacial structure will be superimposed in the true lateral cephalometric projection, the lateral oblique direction is designed to gives a more accurate recording of the actual tooth position in either the left or right buccal segments depending on which side is approximately perpendicular to the central rays
The lateral oblique cephalogram combines most of advantages of the lateral views, intra-oral periapical survey and panoramic radiograph plus a standard cephalometric registration that makes possible measurements of bone size and eruptive movements so it is of particular size in analysis of developing dentition
Submental vertex cephalometric:
Is used to assess mandibular asymmetry in the transverse and anterior-posterior plane. It is an important aid in detecting asymmetry in the symphysis, body, ramus, and condyle of the mandible. In many cases of asymmetry, this view is important for evaluation of mandibular displacemen
Diagnostic Aids
{Study cast, Cast analysis}
Part (2)
Prepared by
Dr. Mohammed Alruby
Study cast
Definition: it is a positive replica of the teeth and their supporting structure, it should be reproducing accurately all the anatomical details of the teeth, alveolar process, mucobuccal folds, palate, frenal attachment as well as the exact relationship of the mandibular to the maxillary dental arch
Good models begin with good impression, orthodontic impression should displace the lips and cheeks, so that, the full depth of mucobuccal sulci is recorded. This over extension of impression is obtained by building up the tray periphery with wax or by using special orthodontic trays
The position of maximum intercuspation should be recorded by getting the patient to bite through softened wax, that is important for:
1- Recording the proper intercuspation specially in cases of poor occlusal fit due to extraction or tongue thrust. So it is wise to check the occlusion in the mouth and compare it to the occluded cast to insure that the model is correctly articulated
2- Trimming of the upper and lower cast together without change in occlusal relationship or fracture of teeth
Occlusal registration of wax bite:
= the position of maximum intercuspation as well as the centric relation must be registered
= a piece of soft wax large enough to cover the occlusal surface of maxillary teeth is shaped to the form of maxillary arch, then gently pressed against the maxillary teeth
= the patient instructed to relax and mandible is guided to most posterior and superior position of condyle within the glenoid fossa, while the teeth come into occlusion
= if there is shifting during closure due to cuspal interference, this mean that the occlusal position is not coincide with centric occlusal position, in this case, in this case two bites are taken one for usual occlusal position, and the other for centric occlusion
Ideal requirements of orthodontic study models:
1- They are symmetrical and pleasing to the eye and so that a symmetrical arch form can be readily recognized
2- The dental occlusion shows by setting the models on their backs
3- Clean, smooth, bubble free, with sharp angles where the cuts meet
4- Glossy in finish.
Trimming of study models:
There are two types of trimming:
a- Angle trimming:
The purpose of angle trimming is to added an appropriate proportional bases to the anatomical portion of dental casts which is important in:
- Registration of centric occlusion by having the posterior and lateral border of both casts on the same plane, so that cast may place on any side without change in its relationship
- Giving an idea about the relationship of the teeth to the alveolar process and basal bone
- Giving harmonizing appearance of the right and left sides of the cast which any a symmetry can be detected
- Detection of occlusion from any side, anterior as well as lateral sides
Principles:
1- The floor of the base is trimmed
diagnostic aids part 1 diagnosis, examination, BMR, EMG.docxDr.Mohammed Alruby
Introduction:
Proper treatment plane depends on prompt diagnosis, good clinician should have a bird’s eyes to first identify the problem and find its etiology
Definitions:
= Grabber and Rackosi: defined diagnosis as:
Recognition and systemic designation of anomalies, the practical synthesis of the finding, permitting therapy to be planned and identification to be determined
=a continuous evaluation process in orthodontics starting right from the first interaction with the patient continuing through different stages till end of treatment and course follow up visits
Goal of orthodontic diagnosis:
Is to produce a comprehensive description of the patient’s problem and then to synthesis the various elements of description into a rational problem list
Diagnostic aids:
Data required for orthodontic diagnosis are derived from routine essential diagnostic aids and also from supplemental aids when needed, Graber categorized the diagnostic aids into essential and supplemental aids
Essential:
- Case history
- Study models
- Certain radiographs: periapical, bite wing, panoramic radiograph
- Facial photographs
- Intra-oral photographs
Supplemental:
- Specialized radiographs: occlusal of maxilla and mandible, lateral cephalogram
- Hand &wrist radiograph
- Electromyography
- Endocrine test
- Basal metabolic rate
Case history:
Complete case history includes all the relevant information derived from the patient and parents and essential for planning
Personal details:
Name:
The patient’s name should be recorded for the purpose of identification and communications
Calling the patient by his/her name not only establishes a good report but also imparts confidence in the patient mind about treatment providers
In case of children, it might help to know their pet problems
Age:
= certain malocclusion occurring during growth period are transient and self-correcting
= growth modification procedures such as functional appliances can be carried out during growth periods
= surgical respective procedures such as orthognathic surgery are best carried out after cessation of growth
= chronological age is important for the maintaining of shedding and eruption time tables as well
Gender:
= recording gender of the patient is important for treatment planning, females are observed to precede males in growth related events such as onset of growth spurt, eruption of the teeth and onset of puberty
= gender may also have a bearing on patient’s compliance toward certain types of orthodontic treatment
Occupation and address:
Occupation of patient / or parents gives an idea about socioeconomic condition which might affect the selection of orthodontic appliances and can give an idea about awareness
Address of patient determine the sociality of the patient and this effect on the treatment because some countries have normally bi-maxillary protrusion and also determine the awareness of patient about treatment and oral hygiene
Patient behavior:
Behavior of patient depend on: patient
VEDANTA AIR AMBULANCE SERVICES IN REWA AT A COST-EFFECTIVE PRICE.pdfVedanta A
Air Ambulance Services In Rewa works in close coordination with ground-based emergency services, including local Emergency Medical Services, fire departments, and law enforcement agencies.
More@: https://tinyurl.com/2shrryhx
More@: https://tinyurl.com/5n8h3wp8
CHAPTER 1 SEMESTER V COMMUNICATION TECHNIQUES FOR CHILDREN.pdfSachin Sharma
Here are some key objectives of communication with children:
Build Trust and Security:
Establish a safe and supportive environment where children feel comfortable expressing themselves.
Encourage Expression:
Enable children to articulate their thoughts, feelings, and experiences.
Promote Emotional Understanding:
Help children identify and understand their own emotions and the emotions of others.
Enhance Listening Skills:
Develop children’s ability to listen attentively and respond appropriately.
Foster Positive Relationships:
Strengthen the bond between children and caregivers, peers, and other adults.
Support Learning and Development:
Aid cognitive and language development through engaging and meaningful conversations.
Teach Social Skills:
Encourage polite, respectful, and empathetic interactions with others.
Resolve Conflicts:
Provide tools and guidance for children to handle disagreements constructively.
Encourage Independence:
Support children in making decisions and solving problems on their own.
Provide Reassurance and Comfort:
Offer comfort and understanding during times of distress or uncertainty.
Reinforce Positive Behavior:
Acknowledge and encourage positive actions and behaviors.
Guide and Educate:
Offer clear instructions and explanations to help children understand expectations and learn new concepts.
By focusing on these objectives, communication with children can be both effective and nurturing, supporting their overall growth and well-being.
Emotional and Behavioural Problems in Children - Counselling and Family Thera...PsychoTech Services
A proprietary approach developed by bringing together the best of learning theories from Psychology, design principles from the world of visualization, and pedagogical methods from over a decade of training experience, that enables you to: Learn better, faster!
English Drug and Alcohol Commissioners June 2024.pptxMatSouthwell1
Presentation made by Mat Southwell to the Harm Reduction Working Group of the English Drug and Alcohol Commissioners. Discuss stimulants, OAMT, NSP coverage and community-led approach to DCRs. Focussing on active drug user perspectives and interests
Research, Monitoring and Evaluation, in Public Healthaghedogodday
This is a presentation on the overview of the role of monitoring and evaluation in public health. It describes the various components and how a robust M&E system can possitively impact the results or effectiveness of a public health intervention.
At Malayali Kerala Spa Ajman, Full Service includes individualized care for every client. We specifically design each massage session for the individual needs of the client. Our therapists are always willing to adjust the treatments based on the client's instruction and feedback. This guarantees that every client receives the treatment they expect.
By offering a variety of massage services, our Ajman Spa Massage Center can tackle physical, mental, and emotional illnesses. In addition, efficient identification of specific health conditions and designing treatment plans accordingly can significantly enhance the quality of massaging.
At Malayali Kerala Spa Ajman, we firmly believe that everyone should have the option to experience top-quality massage services regularly. To achieve that goal we offer cheap massage services in Ajman.
If you are interested in experiencing transformative massage treatment at Malayali Kerala Spa Ajman, you can use our Ajman Massage Center WhatsApp Number to schedule your next massage session.
Contact @ +971 529818279
Visit @ https://malayalikeralaspaajman.com/
Fit to Fly PCR Covid Testing at our Clinic Near YouNX Healthcare
A Fit-to-Fly PCR Test is a crucial service for travelers needing to meet the entry requirements of various countries or airlines. This test involves a polymerase chain reaction (PCR) test for COVID-19, which is considered the gold standard for detecting active infections. At our travel clinic in Leeds, we offer fast and reliable Fit to Fly PCR testing, providing you with an official certificate verifying your negative COVID-19 status. Our process is designed for convenience and accuracy, with quick turnaround times to ensure you receive your results and certificate in time for your departure. Trust our professional and experienced medical team to help you travel safely and compliantly, giving you peace of mind for your journey.www.nxhealthcare.co.uk
Mental Health and well-being Presentation. Exploring innovative approaches and strategies for enhancing mental well-being. Discover cutting-edge research, effective strategies, and practical methods for fostering mental well-being.
This particular slides consist of- what is hypotension,what are it's causes and it's effect on body, risk factors, symptoms,complications, diagnosis and role of physiotherapy in it.
This slide is very helpful for physiotherapy students and also for other medical and healthcare students.
Here is the summary of hypotension:
Hypotension, or low blood pressure, is when the pressure of blood circulating in the body is lower than normal or expected. It's only a problem if it negatively impacts the body and causes symptoms. Normal blood pressure is usually between 90/60 mmHg and 120/80 mmHg, but pressures below 90/60 are generally considered hypotensive.
nursing management of patient with Empyema pptblessyjannu21
prepared by Prof. BLESSY THOMAS, SPN
Empyema is a disease of respiratory system It is defines as the accumulation of thick, purulent fluid within the pleural space, often with fibrin development.
Empyema is also called pyothorax or purulent pleuritis.
It’s a condition in which pus gathers in the area between the lungs and the inner surface of the chest wall. This area is known as the pleural space.
Pus is a fluid that’s filled with immune cells, dead cells, and bacteria.
Pus in the pleural space can’t be coughed out. Instead, it needs to be drained by a needle or surgery.
Empyema usually develops after pneumonia, which is an infection of the lung tissue. it is mainly caused due in infectious micro-organisms. It can be treated with medications and other measures.
The Ultimate Guide in Setting Up Market Research System in Health-TechGokul Rangarajan
How to effectively start market research in the health tech industry by defining objectives, crafting problem statements, selecting methods, identifying data collection sources, and setting clear timelines. This guide covers all the preliminary steps needed to lay a strong foundation for your research.
"Market Research it too text-booky, I am in the market for a decade, I am living research book" this is what the founder I met on the event claimed, few of my colleagues rolled their eyes. Its true that one cannot over look the real life experience, but one cannot out beat structured gold mine of market research.
Many 0 to 1 startup founders often overlook market research, but this critical step can make or break a venture, especially in health tech.
But Why do they skip it?
Limited resources—time, money, and manpower—are common culprits.
"In fact, a survey by CB Insights found that 42% of startups fail due to no market need, which is like building a spaceship to Mars only to realise you forgot the fuel."
Sudharsan Srinivasan
Operational Partner Pitchworks VC Studio
Overconfidence in their product’s success leads founders to assume it will naturally find its market, especially in health tech where patient needs, entire system issues and regulatory requirements are as complex as trying to perform brain surgery with a butter knife. Additionally, the pressure to launch quickly and the belief in their own intuition further contribute to this oversight. Yet, thorough market research in health tech could be the key to transforming a startup's vision into a life-saving reality, instead of a medical mishap waiting to happen.
Example of Market Research working
Innovaccer, founded by Abhinav Shashank in 2014, focuses on improving healthcare delivery through data-driven insights and interoperability solutions. Before launching their platform, Innovaccer conducted extensive market research to understand the challenges faced by healthcare organizations and the potential for innovation in healthcare IT.
Identifying Pain Points: Innovaccer surveyed healthcare providers to understand their difficulties with data integration, care coordination, and patient engagement. They found widespread frustration with siloed systems and inefficient workflows.
Competitive Analysis: Analyzed competitors offering similar solutions in healthcare analytics and interoperability. Identified gaps in comprehensive data aggregation, real-time analytics, and actionable insights.
Regulatory Compliance: Ensured their platform complied with HIPAA and other healthcare data privacy regulations. This compliance was crucial to gaining trust from healthcare providers wary of data security issues.
Customer Validation: Conducted pilot programs with several healthcare organizations to validate the platform's effectiveness in improving care outcomes and operational efficiency. Gathered feedback to refine features and user interface.
Test bank clinical nursing skills a concept based approach 4e pearson educati...rightmanforbloodline
Test bank clinical nursing skills a concept based approach 4e pearson education
Test bank clinical nursing skills a concept based approach 4e pearson education
Test bank clinical nursing skills a concept based approach 4e pearson education
Ensure the highest quality care for your patients with Cardiac Registry Support's cancer registry services. We support accreditation efforts and quality improvement initiatives, allowing you to benchmark performance and demonstrate adherence to best practices. Confidence starts with data. Partner with Cardiac Registry Support. For more details visit https://cardiacregistrysupport.com/cancer-registry-services/
2024 Media Preferences of Older Adults: Consumer Survey and Marketing Implica...Media Logic
When it comes to creating marketing strategies that target older adults, it is crucial to have insight into their media habits and preferences. Understanding how older adults consume and use media is key to creating acquisition and retention strategies. We recently conducted our seventh annual survey to gain insight into the media preferences of older adults in 2024. Here are the survey responses and marketing implications that stood out to us.
2024 Media Preferences of Older Adults: Consumer Survey and Marketing Implica...
growth and development.docx
1. 1
Dr. Mohammed Alruby
Growth and development
of craniofacial skeleton
Prepared by
Dr. Mohammed Alruby
Definitions
2. 2
Dr. Mohammed Alruby
Growth center and sites
Facial processes
Types of bone and bone cells
Growth of cranial vault
Growth of cranial base
Growth of maxilla
Growth of mandible
Age changes
Methods of studying bone growth
Growth indicators
Todd: growth: increase in size
3. 3
Dr. Mohammed Alruby
Development: progress toward maturity
Krogman: increase in size
: change in proportion and progressive complexity
Meridth: segmental anatomic and physiologic changes taking place from beginning of prenatal
life to senility
Moyers: quantitative aspect of biologic development per unit of time
Moss: change in any morphologic parameter which is measurable.
By bone remodeling there is several changes in: size, shape, proportion, relationship with adjacent
structure.
Maxillary sinus:
Like other paranasal sinuses are rudimentary at birth, they grew slowly until the age of 6 -7 years,
then they enter the spurt specially the maxillary sinus. At 8 years it has a pyramidal form that will
length after eruption of canine and last molar
Function of sinuses:
1- Lightening of skull weight
2- Resonance of voice
3- Conditioning of air
4- Craniofacial protection
Fate of pharyngeal arches:
Mesodermal core of each pharyngeal arch and neural crest cells which migrate into the arches
differentiate into:
1- Skeletal elements
2- Vascular elements
3- Nervous elements
4- Muscular elements
Growth center Growth site
Growth indicator Growth adjustor
Pushes a part Pulled a part
Tissue separating force No tissue separating force
As: nasal cartilage
Spheno occipital synchondrosis
As: condyle and suture
Synchondrosis Epiphyseal plate
1- Cranial base Long bones
2- Interstitial growth Appositional
3- Bone replaced on both sites so it
considered as double action of
epiphyseal plate
At one site
Center of ossification of maxilla start around the anterior superior dental arch of inferior orbital
nerve and spread:
Anterior: --- premaxilla
4. 4
Dr. Mohammed Alruby
Posterior ----zygomatic process of maxilla
Superior ---- frontal process of maxilla
Inferior: ------periosteum of alveolar process of maxilla
Medial: ------- hard palate
N: B:
Types of bone remodeling:
1- Biomechanical remodeling: continuous deposition and removal of ions to maintain the
mineral content
2- Growth remodeling: constant replacement of bone during childhood
3- Haversian remodeling: cortical reconstruction as primary vascular bone is replaced
4- Regeneration and reconstruction of bone following pathology or trauma
Endochondral bone formation:
= on the cartilage surface, there is -------chondroblast arranged in parallel columns while the
matrix is being deposited among the columns of cells
= chondroblast ----- hypertrophic and there is a lacuna become wide and so there is small strand
of matrix between each cell
= this matrix starts of mineralization after appear of nuclei then chondroblast -----------
chondrocyte ---------- degenerative and disappear after loss of nutrition fluids.
= after time there is vascular invasion so; perichondrium changed into periosteum and the
osteoblast start its action for osteoid formation
= by this process there is a formation of central core of mineralized cartilage surrounded by matrix
of bone -------- spongiosa---------- resorption of mineralized cartilage -------- degenerate space for
vascular invasion ----------- by time is filled by red bone marrow
Mandible:
Have two different ways of mandibular formation:
1- Primary intramembranous calcification center arise lateral to each half of Meckel’
cartilage around the nerve and blood supply: to start ossification spread ventrally and
laterally to forms body and ramus of mandible.
Meckel’ cartilage after time disappear except: incus, mellus, mental ossicles that
incorporated to mental region
2- Accessory cartilage:
a- Condyle center: starts as separate part to form condyle and posterior part of ramus
above inferior nerve
b- Coronoid center: form coronoid and anterior part of ramus above the inferior alveolar
nerve
c- Mental ossicles:
Types of bone:
1- Lamellar: collagen fibers run parallel to each other in lamellae as compact and spongy
2- Non lamellar: woven bone (embryonic bone)
3- Bundle bone: found adjacent to periosteum give attachment to ligament and tendon
Synchondrosis: layer of cartilage connect bone to bone
5. 5
Dr. Mohammed Alruby
Syndesmosis: layer of CT connect bone to bone
Synostosis: bridge of calcified tissue connect bone to bone
Cartilaginous area of facial skeleton:
1- Mandibular condyle
2- Nasal septum
3- Spheno-occipital synchondrosis at base of skull
Types of bone cells:
1- Osteoblast
2- Osteoclast
3- Osteocyte
4- Bone lining cells: will have major impact on Ca metabolism within the body
Cranial vault
Anatomy: 2 frontal bone------- metopic suture
2 parital bone --------sagittal suture
1 occipital bone
Coronal suture = lambdoid suture
Origin: intramembranous
Width: coronal suture and lambdoid suture
Cranial fontanelles; anterior: bregma: 2---3 years of life
Posterior: lambda: 1 years of life
2 anterior lateral: sphenoid petrion -------- close soon after birth
2 posterior lateral: mastoid sterion ---------close soon after birth
Cranial base
Origin: intramembranous and endochondral bone formation
Anatomy: anterior cranial base: nasion to sella
Posterior cranial base: sella to basion
Sutures:
1- Front- ethmoidal suture
2- Spheno-ethmoidal synchondrosis --------- 6 -7 years of age
3- Sphno-occipital synchondrosis ------------ 20 years of age
4- Inter-sphenoid ------- close before birth
5- Inter-occipital ------- 3 -5 years of age
Anterior-posterior direction:
= nasion to foramen cecaum: ----- thickness of frontal bone
= foramen cecaum to sella turcica; ------- include the length of cripriform plate of ethmoid which
is neural growth (eruption of U6 and L6)
= sella turcica to basion ------ skeletal growth (eruption of U8 and L8)
= cranial base complete more than half of its growth by age of 8 years
Vertical direction:
6. 6
Dr. Mohammed Alruby
At occipital bone, frontal bone, greater wing of sphenoid bone
Lateral direction: width:
7 to 8 years increase transverse size follow the neural pattern
Maxilla
Origin: intra-membranous bone formation
Formed of
1- Bone:
Palatal bone
Maxillary bone
Vomer
Malar bone
Zygomatic bone
Pterygoid plate of ethmoid
2- Sutures:
Fronto-maxillary suture
Zygomatico-maxillary suture
Zygomatico frontal suture
Zygomatico temporal suture
Fronto-nasal suture
Pterygo- palatine suture
Height:
Half of growth by displacement due to anterior cranial base and nasal cartilage due to respiratory
demands
The other half, by drift, reposition on the nasal floor and deposition of the palate and alveolar
process.
So the nasal floor become in low level than orbital floor due to more reposition on nasal floor (V
principle) and eruption of teeth increase the alveolar height
Width:
Sutures, appositional, direction of eruption of teeth
Length:
1- Displacement to cranial base
2- Pnumatization of maxillary sinus
3- Deposition of bone at tuberosity area
4- Give chamber of eruption of 6,7 together with primary displacement
N: B:
Vomer:
One of unpaired facial bone of skull located at mid sagittal line
Articulate with sphenoid, ethmoid, right and left palatine bone, right and left maxillary bone
Vomer articulate with six bones:
Two with cranium: sphenoid and ethmoid
Four with face: two maxillary bone and two palatine bone. And also articulate with septal cartilage
of nose
Mandible
7. 7
Dr. Mohammed Alruby
Origin: endochondral and intramembranous bone formation
Endochondral sites: condyle, coronoid, mental ossicles, symphyseal cartilage
Sites of mandibular growth:
1- Symphysis: depend on symphyseal suture until 11 years and after that fusion complete
2- Condyle: appositional growth of cartilage at the perichondrium of condyle, it is the major
site of growth
3- Processes:
a- alveolar process
b- Muscular process:
1- Gonial process: --- masseter muscle and medial pterygoid
2- Coronoid process: temporalis muscle
3- Mental process: mentalis muscle
Height:
Surface apposition on the lower border of mandible
Development of alveolar arch with eruption of teeth
Width:
Symphyseal cartilage growth
V principle
Remodeling from inner and outer surface of mandible
Length:
Secondary displacement
Surface apposition
Relocation at ramus area
Mental foramen: early in life it is under mesial cusp of the 1st
deciduous molars, in adult is below
and between 1st
and 2nd
premolars due to backward and outward inclination of canal
Role of Meckel’s cartilage:
1- It guides the development of mandible forming morphogenic template which exert tension
on the ossification center
2- It participates in the development of symphysis menti
3- It serves as a means of attachment of the muscles of mastication and tongue muscles
4- It is involved in the development of middle ear ossicles
5- Contribute in the formation of articular disc of TMJ
6- It is important in shaping the palate
Section of Meckel’s cartilage regard to their position:
1- Proximal or tympanic portion give raise to the mellus and incus (Richary et al 1965)
2- Anterior process of mellus formed from osgonial
3- Portion from mellus of middle ear and lingualla of mandible is transformed into spheno-
mandibular ligament
4- Spin of sphenoid bone
5- Mental ossicles
Age change in the mandible:
8. 8
Dr. Mohammed Alruby
At birth:
= bone, mere shell containing sockets of two incisors, canine and two deciduous molars
= mandibular canal: large size and run near the lower border of the bone
= mental foramen opens beneath the socket of 1st
deciduous molar
= condyle portion in the line with the body
= coronoid process: large size and project above the level of condyle
Childhood:
= two segment of bone become joined at symphysis from below to upward in 1st
year, but trace of
separation may be present at 2nd
year
= body become elongated in whole length, but more especially behind the mental foramen to
provide space for the three molar developed
= depth increase to allow for roots (increase vertical growth)
= increase thickening of bone at sub-dental portion which enable the jaws to withstand the action
of muscle
= mandibular canal is just above the mylohyoid line
= mental foramen occupies the position that usually in adult
= mandibular angle become less obtuse 140 degrees
Adulthood:
= mental foramen opens midway between the upper and lower border of bone
= mandibular canal: parallel to mylohyoid line
= mandibular angle: 110 – 120 degrees
Old age:
= bone reduce in size with loss of teeth
= mandibular canal with mental opening from it and close to the alveolar border
= ramus: oblique in direction
= mandibular canal: 140
= neck of condyle: less bent backward
Methods of studying craniofacial bone growth
1- Vital staining:
In 1736 Belchier reported that bones of animals who had eaten the madder plant were stained red
color
In 1739 Duhamel fed madder plant to animal, withheld it for a period prior to sacrifice as a result,
the bone contained a band of red stain followed by unstained band
Alizarin red was the essential dye for madder plant
There are another dyes as: procion compound, trypan blue, acid alizarin blue, antibiotic
tetracycline
Value of such vital dyes:
1- Describe the pattern of postnatal bone deposition over an expected period in one animal
2- The manner in which the bone is laid out
3- The sites of growth
4- The direction of growth
5- The relation duration at different sites
2- Radio Isotopes:
9. 9
Dr. Mohammed Alruby
Used as un-vivo marker
Such labelled material is injected and then after time located within the growing bone by means
of:
- Giger counter
- Auto-radiographic technique
3- Implant:
Bjork method: implanting the bits of titanium into growing bone of animals or human being, this
will serve as reference marker during several cephalometric analysis
Implant growth studies: Bjork 1969:
Involve implanting of small bits of biological inert alloy into growing bone:-- titanium—1.5mm
length and 0.5 diameter
In maxilla:
- Hard palate behind the deciduous canine (prior eruption of maxillary permanent incisors)
- Below anterior nasal spin after eruption of maxillary incisors
- Two implant on either side of zygomatic process of maxilla
- Border between hard palate and alveolar process medial to 1st
molar
In mandible:
- Anterior aspect of symphysis in midline below root tips
- Two pins on right side of mandibular body, one under 1st
premolar and one below 2nd
premolar or 1st
molar
- One pin on the external aspect of the right ramus at the level of occlusal surface of molars
4- Comparative anatomy:
Significant contribution to the knowledge of human facial growth have been provided through
comparison with other species
5- Craniometry:
Measurements of skull to determine its characteristic related to sex, race, or body type
6- Genetic studies:
Used to study parents’ child relationship
There are different genetic factors in the dentofacial development
The problem is to identify the specify, site, timing, and mechanism of any such genetic control
7- Natural markers:
The persistence of certain developmental features of bone has led to their use as natural markers
using certain radiograph
- Trabecula
- Nutrient canal
- Incremental lines (lines arrested growth)
This can use for reference to study deposition, resorption, and remodeling
8- Removal of parts to study growth:
As cartilaginous nasal septum and its effect on the forward growth
9- Histologic study:
10. 10
Dr. Mohammed Alruby
Study matrix and its density
Beam of x-ray and microscopic level is passed through un-calcified thin section of bone placed
over sensitive emulsion
Different passage of ray, record on the film as varying ---- black, gray, while colors
10-Split line technique: Benninghoff 1925
Bone is partially decalcified making it soft enough and punched with needle
India ink inserted in these split to make them visible and fixes permanently (pattern of trabecula)
Growth indicators
History:
1896: Sydney Rowand record hand & wrist x-ray after 6 months from discover x-ray in London
1900: Pryor Rotch
1928: Helman and Haward
1936: Flory (Sesamoid) stage of begins calcification
1- Hand & wrist radiograph:
= Using left hand or use 1st
,2nd
, 3rd
finger on the front of cephalometric film in attempt to reduce
the dose of radiation
= Most common published by Greulish and Pyle in 1959
= TW2 (Tuner and white house 2) make developmental score with twenty bones on hand and wrist
= the long axis of third finger in direct line with axis of forearm
= the thumb is placed in the most comfortable natural degree of rotation with its long axis making
30 degree with 1st
finger
= tube is centered above the third metacarpal at a tube film distance of 30 inches or 75cm
= hand and wrist views may be interpreted by many ways:
a- Either comparing the radiograph with series of standard films represent normal children at
different age
b- Time of occurrence of certain ossification events in relation to spurte growth
c- By assessing score to developmental age of 20 bones in hand and wrist (TW2 1975)
(phalanx, radius, ulna)
Methods:
- Greulish Pyle 1959
- TW2 1975
- Singer method 1980
- Hagg and Taranger 1980
- Fishman
2- Adductor sesamoid:
Sesamoid of the adductor bravis muscle at the metacarpo-pharyngeal joint of thumb
Sesamoid bone: bone embedded within tendon or muscle, it is derived from Latin ward (sesamum)
(seasamy seads) due to small size. Sesamoid bone found on joint throughout the body:
a- Knee: the patella
b- Hand --- two sesamoid, most used that present within the tendon of adductor pollicis
c- Wrist: the pisiform of the wrist within tendon of flexor carpi ulnaris
d- In foot: 1st
metatarsal
11. 11
Dr. Mohammed Alruby
e- In neck
Described by Champan 1972 as the following:
ASO: no ossification
AS1: pin point ossification
AS2: ossification more than pin point but not identified
AS3: seed shape: well defined outline, measured about 3mm x2mm ------- short female and 3mm x
4mm -------- long male
3- Cervical vertebrae:
Lampanraski 1972
Hassel and Farman 1995
Fishman 1982
Baccelli et al 2000
Franchi and Macnamara
Anatomy:
C1: atlas:
Known as atlas vertebrae is the 1st
of upper most of 33 vertebrae of spinal column of cervical
vertebrae
1st
, 2nd
vertebrae are distinct from the other true vertebrae or removable vertebrae below them
within the neck
C2: axis:
2nd
cervical vertebrae, 2nd
upper most vertebrae
Name axis derived from its role in allowing the head to rotate from its support at C1 where the
skull attach the neck
C3:
Setting below the C2 axis, from C3 to C6 are grouped together
Composed of:
- Vertebral arch: protect spinal cord
- Ventral body centrum: provide strength, protection and mobility to the body
C4:
Small in relation to the other vertebrae but with large vertebral foramen for passage of nerves of
spinal
Cervical vertebrae maturation: CVM:
Depend on: C2, C3, C4
Definition of cervical vertebrae maturation stages:
Cs1: the lower border of all 3 vertebrae C2 – C4 are flat
The bodies of C3 and C4 are trapezoid in shape
Cs2: a concavity is present at the lower border of C2 in 80% of cases. The bodies of both C3 and
C4 are trapezoid in shape
Cs3: concavities at the lower border of both C2 and C3 are present. The bodies of C3 and C4 can
be either trapezoid or rectangular horizontal in shape.
Cs4: concavities at lower border of C2, C3 and C4 now present, the bodies of C3 and C4 are
rectangular horizontal in shape
Cs5: the concavities at lower border of C2, C3, C4 still present at least body of C3 or C4 square
in shape. If not square the body of others cervical vertebrae still rectangular horizontal
Cs6: the concavities at lower border of C2, C3 and C4 still present
12. 12
Dr. Mohammed Alruby
At least body of C3 or C4 is rectangular vertical in shape if not rectangular is square
4- Frontal sinus:
Rossow 1991: analysis the size of frontal sinus highest point and lowest point and relate to SN line
5- Dental development:
1- Nolla calcification stages 1960
2- Bjork and Hellman 1967
3- Hagg and Taranger 1982
4- Damaergian 1982
5- Chertknow 1980: calcification stage of permanent lower canine at the close to the
ossification on sesamoid of adductor
6- Lower third molar development:
a- Tooth germ visible
b- Cusp formation
c- Crown formation complete
d- Half of root formed
e- Root formation complete but apex not closed
7- Other indicators:
a- Body weight and hight
b- Chronological age
c- Growth velocity
d- Concentration of growth hormone