Escolar Documentos
Profissional Documentos
Cultura Documentos
development
Aslam Alkadhimi
Orthodontic Registrar StR 2
Eastman Dental Institute and Buckinghamshire Healthcare NHS Trust
Contents
• Philosophy behind growth and development!
• Terminology
• Why do we need to know about G&D
• Prenatal growth
• Postnatal growth
• Relevance of G&D to clinical practice
• Importance of G&D in orthodontics
• There must be a beginning of any great matter, but the
continuing unto the end until it be thoroughly finished yields
the true glory. Sir Francis Drake 1578
• The only true wisdom is in knowing you know nothing.
Socrates
• According to Socrates, we are full of wisdom when it comes
to facial growth!!
Terminology
• Growth refers to changes in magnitude and size.
• This is why economists refer to growth of economy when they mean
expansion of economy in amount and magnitude.
• Growth is divided into pre and postnatal growth; the prenatal growth
starts from the second trimester until birth while the postnatal one
starts from birth until death.
• On the other hand, development accounts for how growth happens.
• The term development is used almost always to refer to an increase
in complexity.
Terminology
Critical period
• Genes orchestrate the phenomena of growth and development
• The stage at which individual has reached a particular age is referred
to as maturational/biological age
• Critical period
• Most brain cells form by 6 months of age
• Bone and cartilage continue to divide until 15-20 years …NB
• During fetal and early infancy, brain is susceptible to damage
What tissues does our head develop from?
Pre somite Somite Post somite
8-21 days 21-31 days 32-56 days
Prenatal growth
Neural crest
Endoderm
Ectoderm
What gives rise to the face?
Frontonasal prominence
1st pharyngeal arch
2nd pharyngeal arch
Midface development
Fetal period
• 9th week to birth
• At the beginning of 3rd month, the head constitutes half of overall length
• Beginning of 5th month, head is 1/3rd of the total length
• At birth, it is 1/4th of total length
Developmental anomalies
There are four clinically significant types of congenital anomaly
• Malformation : A morphological defect of an organ, part of an organ, or
larger region of the body that results from an intrinsically abnormal
developmental process.
• Disruption :A morphological defect of an organ, part of an organ, or a
larger region of the body that results from the extrinsic breakdown of, or
an interference with, an originally normal developmental process
• Deformation : An abnormal form, shape, or position of a part of the body
that results from mechanical forces
• Dysplasia : An abnormal organization of cells into tissue (s) and its
morphological result (s).
Chromosome abnormalities
• TURNER’S SYNDROME:- Turner syndrome is
caused by the absence of two complete
copies of the X chromosome in some or all
the cells.
• Multiple eye findings including cataract,
blue sclera.
• Colour Blindness
• Depressed Corners of mouth
• High arched palate
• Dental malocclusion
• Micrognathia
Chromosome abnormalities
TRISOMY 21/DOWNS SYNDROME:-
E, ear malformations;
M, mandibular hypoplasia;
N, facial nerve paralysis;
O, orbital anomalies;
S, soft tissue deficiency.
Mandibular asymmetry
Mandibular asymmetry
Mandibular asymmetry
What is going
on here?
Mandibular asymmetry
An example of a Technetium
isotope scan used to assess the
growth activity of skeletal sites.
• Within this theory, great emphasis was placed upon the role of
cartilage in producing the driving force of craniofacial growth: in
particular, the nasal septal cartilage generating a downward and
forward displacement of the maxillary complex, synchondroses
elongating the cranial base and the condylar cartilage directing
downward and forward growth of the mandible (Scott, 1 954). The
mandible was perceived as essentially a bent long bone, with the
mandibular condylar cartilage being equivalent to the epiphyseal
plates of long bones whose growth forces the mandible
downward and forward away from the cranial base.
4-The functional matrix theory/Moss’
hypothesis
• Melvin Moss, who suggested that the genetic control of growth is
lying in the soft tissue only while hard tissues respond to
functional adaptation of soft tissues, adopted it (Moss, 1 968, Moss
and Rankow, 1 968, Moss, 1 997a, Moss and Salentijn,1 969, Moss,
1 997b).
• Craniofacial skeleton composed of many functional cranial
components each functional cranial component is comprised of the
following two elements: skull=skeletal unit+ functional matrices
5-The servosystem theory/Petrovic’s
hypothesis
• Frontal bossing