Swift Growth Slides
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Transcript of Swift Growth Slides
Oral Biology 5670
• Bone growth and development• Bone biology• Educational objectives
– Exposure to basic concepts of bone biology– Correlation of basic bone biology to clinical
treatment– Special considerations / implications of bone
biology to dentistry
Clinical Correlates of Bone Growth and Development
• Facial skeletal development
• Maxillary development
• Mandibular development
Clinical Correlates of Bone Growth and Development
• Effect of congenital anonalies on facial growth and development
• Effect of surgical correction of congenital anomalies on facial growth and development
• Tooth development and retention influence on alveolar bone levels
Clincal Correlates of Bone Growth and Development
• Orthodontic tooth movement
• Bone healing following tooth extraction
• Bone response to alloplastic materials
• Bone healing in approximation of dental implants
Clinical Correlates of Bone Growth and Development
• Bone grafting to treat dentoalveolar defects
• Bone grafting to treat discontinuity defects
• Fracture healing
Cellular Growth
• Hypertrophy
• Hyperplasia
• Secretion of extracellular material
• Interstitial growth
Embryologic Type of Bone
• Endochondral
• Intramembranous
Functional Matrix Theory of Growth
• “Growth of the face occurs as a response to the functional need and is mediated by the soft tissue in which the bone is embedded”
• Soft tissues grow, bone and cartilage react
Growth Control
• Bone is the determinant of its own growth
• Cartilage is the determinant of bone growth
• Soft tissue matrix is the determinant of growth
Orthodontic Tooth Movement
• Bone apposition and resorption
• Effects on the pulp
• Effects on the PDL
• Effects on the tooth root
Effects of Periosteum
• Provision of undifferentiated mesechymal cells
• Envelope to limit/regulate bone apposition
Introduction10 y.o. female 12/98
• CC:– Noticed swelling in
face on left side for two weeks
• HPI:– Facial swelling
– Left lower lip “tingles”
– No pain or change in bite
Examination
• Left lower facial swelling, without thrill/bruit
• Lower vestibular swelling, L>R
• No abnormal tooth mobility
• Teeth 19-28 vital with EPT
• CN II-XII grossly intact
Assessment
• Problem list:– Multilocular
radiolucent lesion
– Teeth vital without resorption, displacement, or mobility
– Apparent cortical expansion
• Diff. Dx:– Central Giant Cell
Lesion
– Ameloblastomic Fibroodontoma
– Ameloblastoma
Treatment Plan
• Impressions for splint fabrication• Screening labs Ca, alk phos, PTH
– All WNL
• CT of mandible:– Multilocular radiolucents, from infer border to
encompass tooth roots superiorly
– Buccal and lingual cortices intact, although expansion present
• Incisional bx