ORTHODONTICS LECTURE

Dr. Mendoza

(Growth and Development of the craniofacial complex) CORRELATES OF HUMAN DENTAL OCCLUSION 1. Growth and development of craniofacial complexBone system 2. Growth and development of Occlusion- Tooth System 3. Growth and development of the nervous and muscleNeuromuscular System ---Why do we assess growth---1. To determine optimum time for treatment (growth modification and surgery) 2. To determine the amount of growth 3. to determine the type of growth Growth and Development Growth - normal changes in the amount of the living substance -emphasizes the normal dimensional changes during development - growth in changes in quantity

Displacement- is the movement of a whole bone away from other bones. Primary displacement /Translation - it is the physical movement of a whole bone. It occurs while the bone grows and remodels by resorption and deposition. - as the bone grows by surface deposition in a given direction, it is simultaneously displaced in the opposite direction. Secondary displacement- it is the movement of a whole bone caused by the separate enlargement of other bones, which maybe nearby or quite distant. Remodeling- is the process of reshaping and resizing as a consequence of progressive and continuous relocation.

Relocation- is the progressive sequential movement of components part as the bone enlarges. DRIFT- direct growth movements of any given area of a bone produced by the deposition of new bone on the surface Development -refers to the naturally occurring unidirectional changes in facing toward the direction of progressive growth and the life of an individual from its existence as a single cell to resorption on the surface facing away. its elaboration as a multifunctional unit terminating in death. Development Embryo neonate child adult OSTEOGENESIS Two Basic Models of bone Growth ( named after the site death of appearance) 1. Endochondral Bone Formation ***Development events in a single life cycle*** -cartilage Development= growth + differentiation+ translocation -ex. Movable joints including head of the condyle, cranial base. 2. Intramembranous Bone Formation BASIC CONCEPTS OF GRWOTH AND CHANGE - membranous connective tissue Appositional growth- refers to an increase in size -ex. Periosteum, endosteum, sutures, periodontal membrane. by surface addition Endochondral Bone Formation - Original mesenchymal tissue will undergo Interstitial growth- means an increase in size by chondrogenesis cartilage cartilage cell will expansion from within undergo hypertrophy matrix becomes calcified Sutural appositional- is an increase in size of a cell degenerate osteogenic tissues invade the bone by addition of bone at the sutural interchange. dying and disintegrating cartilage bone replaces the cartilage Intramembranous Bone Formation - Undifferentiated mesenchymal cell of the membranous connective tissue osteoblast elaborate and calcify the osteoid matrix or interstitial substance bone.

ORTHODONTICS LECTURE

Dr. Mendoza

Cartilage Vs. Bone CARTILAGE BONE -rigid, firm but not hard -hard -grows appositionally and -appositionally interstitially -perichondrium -periostium -matrix is non-calcified -matrix calcified -non-vascular -vascular -pressure- related -tension-adapted -chondrogenesis -osteogenesis

2. Scotts Theory ( Nasal Septum) - Known as the Cartilaginous Growth Theory or Naso,axillary growth Theory - Believes that the major controlling factors are intrinsic genetic factors present in the cartilage and in the periostium - Cartilaginous part of the skull must be recognized as primary growth center with the nasal septum being a major contributor in maxillary growth - Recognizes Sutural growth as secondary.

3. Moss Theory - Known as the Functional Matrix Theory - Believes that the major controlling factors are the Local epigenic factors, those are genetically GROWTH OF THE SKULL determined but which manifest their influence in an Controlling the modification factor indirect way by intermediary action on associated structures. 1. Intrinsic Genetic factors- genetic factors inherent to the Ex. Brain eyes, tongue skull issue. - Stress the dominance of non- osseous structures of Ex. RNA, DNA the craniofacial complex over the bony parts and that growth of the skeletal components is largely 2. Local Epigenetic factors- genetically determine dependent on the growth of the functional matrices influences originating from adjacent structures. Ex. Brain, eyes 4. Genetic theory - States that the genes determine all 3. General Epigenetic factors- genetically determined influence originating from distant structure. 5. Servosystem theory ( Petrovics Theory) Ex. Sex hormones - This theory provides a cybernetic model of craniofacial growth which is based upon established 4. Local environmental factors- non genetic influences biological principles concerning growth and function originating from external environment. secondary cartilages and the sutures. Ex. Muscle forces - The strength of this theory is that it incorporates both genetic and environmental influences and 5. General environmental factors- general non- genetic assumes a role or both cartilaginous and periosteal influence originating from external environment tissues during growth of the head. Ex. Food and oxygen supply THEORIES OF GROWTH 1. Sichers Theory - known as the Sutural Dominance Theory - considered to be the traditional theory of skull growth - Intrinsic genetic factors or those inherent in the skull tissue themselves are the major controlling factors - States that proliferation of tissues and its replacement by bone in the sutures is the primary consideration ** Alexandre Petrovic proposed two factors that determine the growth of the craniofacial region: 1. Genetically generated growth of the primary cartilages within the cranial base and septum determine growth of the midface and provide a constantly changing reference input, which is mediated via dental occlusion. 2. the mandible is able to respond to its changing occlusal reference by muscular adaptation and l ocally induced condylar growth.