DEVELOPMENT

AND GROWTH
OF MANDIBLE

Learning Outcomes
At the end of the lecture, students should be
able to:
a. Describe the prenatal growth of the mandible
b. Explain the ossificaton of the mandible.
c. The timing of the growth
d. The muscle attachment of the mandible
e. Age changes in the mandible
f.
Clinical implication during the growth of the
mandible
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INTRODUCTION

Mandible is
-largest & lowest bone of
face.

Horseshoe shaped body

which is curved
horizontally.

Two ramii vertically with

two processes one
condylar & other is
coronoid process.
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PRE
NATAL
GROWTH
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 The

basic growth of the mandible

starts in the 7th week of
fertilization.

It

is formed from the tissues of the

1st brachial arch.

The

cartilage of the 1st arch

(Meckels cartilage) forms the
lower jaw in primitive vertebrates.

But

in humans the Meckels

cartilage has a close potential
relationship to the developing
mandible but makes no
contribution to it.
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These arches appear in the

fourth and fifth weeks of
development and contribute to
the characteristic external
appearance of the embryo.

At the end of the fourth week,

the centre of the face is formed
by the stomodeum, surrounded
by the first pair of pharyngeal
arches.

The first four branchial arches

are well developed in humans.

The first arch is also called

the MANDIBULAR ARCH.

The cartilage of the first arch

is called the MECKELS
CARTILAGE

Nerve - Mandibular nerve

Muscles of Arch medial and

lateral pterygoids , masseter ,
temporalis , mylohyoid ,
anterior belly of diagastric ,
tensor tympani , tensor palati

The mandibular arch forms

lateral wall of the
stomodeum .
It gives a bud from its
dorsal end called the
MAXILLARY PROCESS.
It grows ventro-medially
cranial to the main part of
the arch which is called the
MANDIBULAR PROCESS.
The right and left
mandibular processes meet
in the midline and fuse.
They form the lower lip and
lower jaw
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The mandible is derived from

the ossification of an
osteogenic membrane formed
from the ectomesenchymal
condensation at around 36 to
38 days IU
Some mesenchymalcells
enlarges , acquire a
basophilic cytoplasm and
form osteoblasts
These osteoblasts secrete a
gelatinous matrix called
osteoid and result in
ossification of an osteogenic
membrane
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The resulting intramembranous bone

lies lateral to meckels cartilage.

In the sixth week of the intrauterine

life a single ossification centre for
each half of the mandible arises in the
bifurcation of inferior alveolar nerve
into mental and incisive branches .

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During seventh week of IU bone begin to

develop lateral to meckel's cartilage &
continues until the posterior aspect is
covered with bone

Between eight & twelfth week of IU life,

mandibular growth accelerate , as a result
mandibular length increases.

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Ossification stops at a point , which later

become mandibular lingula, the remaining part
of meckels cartilage continues to form
sphenomandibular ligament & spinous process
of sphenomandibular ligament & spinous
process of sphenoid.

Secondary accessory cartilage appear between

10th and 14th week of intrauterine life to form
head of condyle , part of coronoid process &
mental protuberance.

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OSSIFICATION

Both endochondral and

intramembranous type.

ENDOCHONDRAL OSSIFICATION
The bone formation is preceded by
the formation of a CARTILAGENOUS
MODEL Which is subsequently
replaced( not converted into) by
bone.

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 Endochondral

bone
formation is seen only in
3 areas of mandible:
1.The Condylar Process
2.The Coronoid Process
3.The Mental Region

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Intramembranous
ossification

Intramembranous ossification is the formation of bone

directly from or within fibrous connective tissue
membranes.

It occurs in
1)Whole body of mandible except the anterior part
2)Ramus of mandible as far as mandibular foramen

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RAMUS

The ramus of the

mandible develops by a
rapid spread of
ossification backwards
into the mesenchyme of
the first branchial arch
diverging away from
Meckels cartilage.
This point of divergence is
marked by the mandibular
foramen.

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CONDYLAR
PROCESS
At about 5th week of IUL, An area ofmesenchymal
condensation can be seen above the ventral part of
the developing mandible.

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Then this condensation develops into

a cone-shaped cartilage by about 10th
week called the condylar cartilage.
Ossification starts by 14th week

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Then it migrates inferiorly and fuses

withthe mandibular ramus by about 4
months.

Much of cone-shaped cartilage is

replaced by bone by the middle of fetal
life but its upper end persists into
adulthood acting both as agrowth
cartilage and an articular cartilage

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CORONOID
CARTILAGE

Secondary accessory cartilage appear in region of coronoid

process at about 10th --14th week of intrauterine life.
This cartilage become incorporated into expanding
intramembranous bone of ramus & disappear before birth.

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MENTAL REGION

In mental region, on either side of symphysis ,

one or two small cartilage appear and ossify in
seventh week of IUL to become mental
ossicles.

These ossicles become incorporated into

intramembranous bone when symphysis ossify
completely.

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THE ALVEOLAR PROCESS

It starts when the

deciduous tooth germs
reach the early bell
stage.

The bone of the mandible

begins to grow on each
side of the tooth germ.

By this growth the tooth

germs come to be in a
trough or groove of bone,
which also includes the
alveolar nerves and blood
vessels.
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Later on, septa of bone between the

adjacent tooth germs develop,
keeping each tooth separate in its
bony crypt.

The mandibular canal is separated

from the bony crypts by a horizontal
plate of bone.

The alveolar processes grow at a

rapid rate during the periods of
tooth eruption.

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REMNANTS OF MECKEL CARTILAGE

Greater part of Meckel's

cartilage disappears without
contributing to the formation of
mandible.
The most posterior extremity
forms the malleus of the inner
ear & the spheno alveolar
ligament.
From the sphenoid to the
division of the mandibular nerve
into its alveolar & lingual
branches , the cartilage is lost
totally, but its fibrocellular
capsule persists as the
sphenomandibular ligament.

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From the lingula forward to

the division of the alveolar
nerve into its incisor & mental
branches , Meckels cartilage
is resorbed completely.

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Timing of Growth in Width

Length and Height:

Growth in width is completed 1st then

growth in length and finally growth in
height (W>L>H).

Mandibular intercanine width is more likely

to decrease than increase after age 12.

Intercanine width is essentially

completed by the end of ninth year in girls
and the tenth year in boys.

Both molar and bicondylar widths show

small increases until the end of growth in
length .
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continues at a relatively steady

rate before puberty.

On the average, ramus height

increases 1-2 mm/year.

body length increases 2-3

mm/year.

In girls growth in length of the

jaw has ceased by age 14-15
years.
In boys, it does not decline to the
basal adult level until 18 years.

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This process occurs with:

1. Growth by secondary
Cartilage.
2. Growth with the alveolar
process
3. Subperiosteal bone
apposition and bone
resorption.
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Growth by secondary Cartilage

It occurs by secondary cartilages (mainly
condylar cartilage), this helps in:

Increase in height
of the mandibular
ramus

Increase in the overall

length of the mandible

Increase of the inter

condylar distance
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SECONDARY CARTILAGE
Dual in function
a) Articular
b) Growth
Not a primary centre for growth, but
) Secondary in evolution
) Secondary in embryonic origin
) Secondary in adaptive responses to
changing developments.

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GROWTH WITH THE ALVEOLAR PROC

Due to the increase in the space between the
upper and lower jaws, a space created
between the opposing teeth to erupt.
At the same time bone apposition occurs at
the crest of the alveolar process and the
fundus of the alveolus.
The deposited bone at the fundus of
alveolus counts later to the body of
mandible.
Responsible for the distance between
mandibular canal and the apices of
premolars and first two molars.

the
the
the
the

Bone deposition contributes to the growth of

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bperiosteal bone apposition and bone resorpt

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Mandibular growth is combination of

morphologic effect of both capsular
& periosteal matrices.

Capsular matrices growth causes

expansion of orofacial capsule.

Enclose macroskeletal unit

(mandible) passively & secondarily
translated in new position.

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Periosteal matrices related to

mandibular microskeletal units
responds to this volumetric expansion.

Such alterations in their spatial

position causes them to grow.

Both translation & change in form

comprises totality of mandibular
growth.

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MUSCLE ATTACHMENT

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MUSCLES ATTACHMENT ON
LATERAL SURFACE

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MUSCLES ATTACHMENT ON MEDIAL SURFACE

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GE CHANGES IN THE MANDIBL

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AT BIRTH

The body of the bone is a mere

shell, containing the sockets of
the two incisor, the canine, and
the two deciduous molar teeth.

The mandibular canal runs near

the lower border of the bone.
The mental foramen opens
beneath the socket of the first
deciduous molar tooth.
The angle is obtuse (175)
Condyloid portion is nearly in line with the body.
Coronoid process is of comparatively large size, and
projects above the level of the condyle.

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CHILDHOOD

he body becomes elongated in its whole length.

The depth of the body
increases owing to increased
growth of the alveolar part
The mandibular canal ,is situated
just above the level of the mylohyoid
line.
The mental foramen occupies the
position usual to it in the adult
The angle becomes less obtuse
About the fourth year it is 140.
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ADULTHOOD
The alveolar and subdental portions
of the body are usually of equal
depth.
The mental foramen opens midway
between the upper and lower
borders of the bone.
Mandibular canal runs nearly
parallel with the mylohyoid line.
The ramus is almost vertical in
direction.
The angle measuring from 110 to
120.
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OLD AGE
The bone becomes greatly reduced
in size, for with the loss of the teeth
the alveolar process is absorbed.
The chief part of the bone is below
the oblique line.

The mandibular canal, with the

mental foramen opening from it, is
close to the alveolar border.
The ramus is oblique in direction
The angle measures about 140

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Clinical considerations

In old age the bone is greatly reduced due to loss of teeth .

Remodelling is important in the areas with thin cortical

bone ie: lingual parts of the mandible .

The annual rate of reduction in height is about 0.1 to 0.2

mm .

Loss of sulcus width and depth

Loss of vertical dimension of occlusion

Reduction of lower facial height

Changes in alveolar ridge relationship

Anterior rotation of mandible (becomes wider and inclines

outwards)

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Mylohyoid ridge :

after resorption , it lies flush with the superior

surface of ridge posteriorly .

Relief is must as the mucosa can get easily

traumatized .

Mental foramen :
As resorption takes place , mental foramen
comes to lie closer to the crest of the ridge .
Mental nerve and vessels may be compressed by
the denture base unless relief is provided .

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Genial tubercles :
Usually lie away from crest of the
ridge but with resorption can
become increasingly prominent .
If activity of genioglossus muscle
displaces the lower denture or if
the tubercle cannot tolerate the
pressure , the genial turbercle is
removed and muscle detached .

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ANOMALIES
OF
DEVELOPMENT

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AGNATHIA

- Mandible grossly deficient or

absent.
- deficiency of neural crest tissue
in lower part of face.

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Hemifacial Microsomia

Also called goldenhar syndrome

Due to lack of mesenchymal tissue or neural

crest cells

Underdeveloped mandible

Unilateral and asymmetrical

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Mandibular Dysostosis

also called Treacher-collins syndrome

Due to disturbance in origins, migration &

interaction of neural crest cells.

Prevelance 1:25000

Hypoplasia of mandible

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Pierre Robin syndrome

Prevelance 1: 8500

Mandible is underdeveloped

Small body

Obtuse antigonial angle

Posteriorly placed condyle

Cleft palate
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Macrognathia

Produce prognathism
usually inherited
Abnormal growth
phenomenon
hyperpituitarism.
Anterior teeth settingedge to
edge/negative overjet
Posterior teeth
setting-crossbite
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Mandibular tori
Bony enlargements on the lingual
aspect
Premolar region
Provide adequate denture
relief
If relief cannot be
anticipated, surgical
removal is indicated

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