Growth of Palate and Face

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SUBMITTED TO:- SUBMITTED BY:-

DR. RITU JINDAL NEHA

HEAD OF DEPARTMENT OF ROLL NO-38

PEDODONTICS B.D.S. IV TH PROF


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INDEX DEFINITIONS

GROWTHDEVELOPMENT

DIFFERENCE BETWEEN GROWTH ANDDEVELOPMENT

PRENATAL PERIOD* Development of FACE* Development of FACE in LATERAL ASPECT

* Derivation of Part of face

* Development Anomalies of FACE

* Development of PALATE* Anomalies of PALATE

* Classification of CLEFT PALATE

POST NATAL GROWTH OF MAXILLA AND

MANDIBLE


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GROWTH It is defined as developmental increase in mass In other

words, it is a process that leads to an increase in thephysical size of cells, tissues,organism as whole(Stewart 1982)

It refers to an increase in size or number(Proffit 1986)

It is defines as normal changes in the amount of livingsubstance(Moyer 1988)

It is an increase in size of a living being or any of its partsoccuring in process of development(Stedman 1990)

It signifies an increase ,expansion or extension of anygiven tissue(Pinkham 1994)


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DevelopmentAn increase in complexity(Todd 1931)

An increase in skill and complexity offunctions(Lowrey 1951)

It addresses the progressive evolution of atisssue(Pinkham 1994)

It refers to all the naturally occuring unidirectionalchanges in the life of an individual from its existenceas a single cell to its elaboration as a multifunctionalunit terminating in death (Moyer 1988)


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Difference between

Growth and Development

Therefore ,Growth is a dynamic process with a stablepattern of changes resulting in the increase in physicalsize and mass during its course of development thiscan be predicted with reasonable certainty

Therefore Development comprises all the normal

sequential series of events which result in theincreased complexity or maturity in the course ofnatural progression from a single cell to themultifunctional organism ending at death.


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Prenata Per oTOTAL PERIOD OFPRENATAL LIFE :It consist of 40 weeks and

after 28 week the fetus

is consider viablet classified into 3 phases Period of ovum(from

fertilization to 14thday)

Period of embryo(from 14thto56thday)

Period of foetus(56thday tobirth)


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Development of FaceIt includes following parts

Upper face1. Lower lip

2. Upper lip

3. Nose4. Cheeks

5. Eye

6. External ear

Lower face1. Mandible


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Development Face is derived from

following structures that liearound stomodeum:-

1. The frontonasal process

2. The first pharyngeal

/mandibular arch of eachside

The mandibular arch dividesinto :-

1. Maxillary process

2. Mandibular process


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The ectoderm overlying thefrontonasal process soonshows bilateral localizedthickening that are situated

little above the stomodeum. These are called nasal

placodes

These placodes soon sink

below the surface to formnasal pits


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The Edge of each pit are raised above thesurface

1. The Medial raised edge is called theMEDIAL NASAL PROCESS

2. The lateral raised edge is called the

LATERAL NASAL PROCESS


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Upper lip:-Each maxillary process now grows medially and fuses with

lateral nasal process and then with medial nasal process

The medial and lateral nasal processes also fuses with eachother

In this way the nasal pits are cut off from the stomodeumand called external nares


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The Mesodermal lateral part of lip is formed frommaxillary process

The overlying skin derived from ectoderm covering thisprocess

The Mesodermal median part of lip called Philtrum

formed from the medial nasal process


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Lower lip:-1. The mandibular processes

of two sides grow towardseach other and fuse inmidline

2. They now form the lowermargin of stomodeum

3. Thus these mandibularprocess fusion in midlineresult in formation of lower

lip and lower jaw.


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CheeksAfter formation of upper and

lower lip,the stomodeum isvery broad

In its lateral part , it isbounded above by maxillaryprocess and below bymandibular process.

The medial nasal processfuses with maxillary processto form cheek


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NoseTheNOSEdevelop

from:-1. The frontonasal

process2. The medial and

lateral nasal process The medial nasal

process fuses to form

crest and tip of nose The lateral nasalprocess fuses to form

Ala ,lateral wall of

nose


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EYE The region of eye is first seen

as an ectodermal thickening ,

The lensplacode whichappears on the ventro-lateral

side of the developingforebrain lateral to nasalplacode

The lens placode sinks andproduce bulging representfuture eyeball are directedlaterally


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It lie in angle between maxillary processes andlateral nasal processes

With narrowing of frontonasal process they cometo face forward


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Ear It is formed around

dorsal part of the firstectodermal cleft

A series of mesodermal

thickening appear onmandibular and hyoidarch where they adjointhis cleft

Pinna formed by fusionof these thickenings.


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Derivation of Parts of Face

1) Mandibular prominences Lower jaw and lip

2)Frontonasal prominence

Upper part :- Forehead

Lower part :- Nasal PlacodesMedial Nasal process

Nasal Pits

Lateral Nasal process


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3)Lateral nasal process Ala of nose

Lateral wall of nose

4)Medial nasal process Tip of nose

5)Maxillary process Nasolacrimal duct

6)Stomodeum Oral cavity

7)Nasal pits Nasal cavity


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Development Anomalies of Face

Hare lip

Oblique facial cleft

Macrostomia

Microstomia Proboscis

Mandibulo facial dysostosis

Retrognathia Hypertelorism

Congenital lip pits


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Anomalies of face

D t P t


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Deve opment o Pa ate(weeks 5-12)

From each maxillaryprocess, a plate like likeshelfgrows medially this is

called palatine process The palate will be

formed from:-1. The two palatal

process2. A primitive palate

formed fromfrontonasal process


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The fusion begins anteriorly and proceed backwards

At later stage,the mesoderm in the palate undergoesintramembranous ossification to form Hard palate

However ossification does not extend to posterior portion

which remain as soft palate.The part of palate derived from frontonasal process formPremaxillawhich carries incisor teeth.


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Anomalies of Palate

Cleft palateit result in anomalous communications between the mouthand the nose


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Classification of Cleft Palate

Davis and Ritchie

ClassificationVeau Classification

Kernahan Classification


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Davies and Ritchie ClassificationGroup 1: Cleft anterior to

alveolusGroup 2: Post alveolar

clefts

V Cl ifi i


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Group I : Defect of soft palate

only

Group II: Defect involving

hard palate and soft palate

Group III: Defect involving

soft palate to alveolus,usuallyinvolving the lip

GroupIV: Complete bilateralclefts

Veau Classification


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Block 1 and 4 Lip

Block 2 and 5 Alveolus

Block 3 and 6 Hard palateanterior to the incisive foramen

Block 7 and 8 Hard palateposterior to the incisive foramen

Block 9 Soft palateH


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Types of Cleft Palate Deformity

PRENATAL DEVELOPMENT OF


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PRENATAL DEVELOPMENT OF

MANDIBLE

The lower part of face accompnied by a rodshaped bar called meckelscartilage


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Sutural Growth


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Sutural Growth

There are system of suturesthat unites bone of upperpart of face to the craniuminclude

Frontonasal suture,

Frontomaxillary suture

Zygomatico-temporal

Zygomatico-maxillary

Pterygo-palatine

The growth in these areasserve to move maxilla inforward and downwarddirection

Surface Apposition and


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Surface Apposition and

Resorption

This takes place on most offacial and anterior surface ofmaxilla

Apposition takes place onoutersurface of supraorbitalregion of frontal bone

Similarly resorption on

lateral surface of orbital rimlead to lateral movement ofeye ball


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Bone resorption occur onlateral wall of nose leading to

an increase in size of nasalcavity

Bone resorption seen on floorof nasal cavity to compensatethere is bone deposition onpalatal side

Anterior nasal spineprominence increase due to

bone deposition

Growth of Palate


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Bone deposition alongposterior margin ofmaxillary tuberositycauses lengthening ofdental arch andenlargement of antero-post. Dimension ofmaxillary body

It help to accommodate

erupting molar.andcausing an deepning topalate

Growth of Palate


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Summarize of Maxillary Growth

Length increasesby:-

1. Sutural growth

2. Surface appositionat maxillarytuberosity

Width increasesby:-

1. Growth at medianpalatine suture

2. Apposition atzygomatic bone


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Height

increasesby:-

1. Sutural

growth2. Surface

apposition

3. Alveolargrowth


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POST NATAL Growth Of Lower Face

/Mandible

At birth mandible islittle more curved

bar of boneThe coronoid and

angular and alveolar

processes are notformed


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Coronoid process growsby addition to itsposterior surface andresorption at the anteriorborder

Angle of mandible isaugmented by addition ofbone to the posteriorborder of ramus

The alveolar processgrows upwards andoutwards and forwards


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Summary Of Mandibular Growth

Length increases by:-

Surface apposition at

posterior border of ramusand resorption at anteriorborder

Deposition at chin

Growth at condylar cartilage


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Height increases by:-

Surface apposition at alveolar border Apposition at lower border of

mandible

Growth at condylar cartilage

Width increased by:-

Sutural growth upto ist yearpostnatally

Later surface apposition at outer

surface

M dib l G th


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Mandibular Growth


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REFERENCE Text book of Pedodontics 2ndedition Shobha Tandon

Textbook of Orthodontics 3rdedition M.S.Rani

Textbook of Orthodontics S.I.Bhalaji


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Growth of Palate and Face

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