PRENATAL AND

POSTNATAL
DEVELOPMENT
OF MANDIBLE
Dr Shrikant Shivale
PRENATAL
DEVELOPMENT
OF MANDIBLE
 CONTENTS
1. Period of Ovum

2. Period of Embryo

3. Period of Fetus

4. Meckel’s cartilage

5. Neonatal mandible
 Period of Ovum
• 2 weeks

• 1.5 mm in length

• Cephalad differentiation not begun

 Embryonal Period
• 14th to 56th day

• 3rd week- 3 mm

• 4th week- 5mm

4 week embryo
 Contents of Mandibular Arch
1. Meckel’s cartilage

2. Musculature

3. Mandibular nerve

4. Maxillary and External Carotid Artery

 Fetal period
• 8th week till birth

• Tremendous acceleration is the theme

• Meckel’s cartilage- precursor of

mandibular mesenchyme
 Mandibular changes
• STUDY OF HUMAN FETAL
MANDIBLE—Ingham, J. Dent. Res, 1932

• Observations:-
1. The alveolar plate lengthens more
rapidly than ramus

2. The ratio of alveolar plate length to total

mandibular length is reasonably constant
3. The width of the alveolar plate shows a
more rapid increase than does total width

4. The ratio of the width between the

mandibular angle to the total width is
relatively constant during fetal life
 Meckel’s Cartilage
• 41st – 45th day of IUL

• Template

• Otic capsule - Symphysis

 Ossification of Meckel’s
cartilage
• Mandibular nerve

Neurotrophic
factor

Osteogenesis
Ossification of Meckel’s
cartilage
Ectomesenchymal condensation at 36-38 days

Osteogenic membrane

Primary ossification

Intramembraneous bone lateral to cartilage

 Ossification of Meckel’s
cartilage
• Begins during 7th week
Woven bone

Lamellar bone

Haversian system– 5th month

 Fate of Meckel’s Cartilage
1. Disappears by 24th week

2. Sphenomandibular ligament

3. Resorbs on lateral surface dorsal to

mental foramen

4. Ventrally- Accessory Endochondral

Ossicles
Fate of Meckel’s Cartilage

10th & 14th week

Sec. accessory
cartilages appear
 Condylar Cartilage
Growth rate increases at
puberty(12 1/2-- 14 yrs) and
ceases by 20 yrs
 Types of Ossification
• 1st one to ossify- 6th week of I.U.L

• Two types of ossification:-

1. INTRAMEMBRANEOUS

2. ENDOCHONDRAL
 Parts of Mandible derived from
• INTRAMEMBRANEOUS Ossification
1. Whole of body except anterior part
2. Ramus as far as mandibular foramen

• ENDOCHONDRAL Ossification
1. Anterior part of mandible
2. Ramus above mandibular foramen
3. Coronoid process
4. Condylar process
 NEONATAL MANDIBLE
• Low and wide ascending ramus

• Coronoid process is large

• Body- open shell

• Mandibular canal runs low

NEONATAL MANDIBLE
 Differential Growth

Fetal life At Birth

8 weeks– mandible>maxilla Mandible retrognathic

11 weeks– mandible=maxilla Early post natal life

Becomes orthognathic
13-20 weeks– maxilla>mandible
POST NATAL GROWTH OF
MANDIBLE
 Contents
1. Theories of growth
2. Mechanisms of bone growth
3. Skeletal units of mandible
4. Main sites of growth of mandible
5. Condyle and great puzzle
6. Current concept
7. Age changes in mandible
 Theories of Growth
1. Genetic theory- Brodie,1941

2. Scott’s hypothesis, 1953

3. Sutural dominance theory- Sicher, 1955

4. Functional matrix theory- Moss, 1962

5. Van limborgh theory- 1970

 Mechanisms of Bone Growth
1. REMODELING

2. DISPLACEMENT:-
• Primary displacement
• Secondary displacement
 Enlow’s “V” Principle
• Growth movement
and enlargement of
many facial and
cranial bones or
parts of bones
occur towards the
wide ends of “V”
 Enlow’s Counterpart Principle
• Growth of any given facial or cranial part
relates specifically to other structural and
geometric “counterparts” in the face and
cranium

Regional part Counter part

Balanced growth
 Growth Timings
• Overall growth of mandible takes place
at different stages

• First there is increase in its

1. Width
2. Length
3. Height
Skeletal Units of Mandible
Main sites of growth of Mandible
• Mandible undergoes largest amount of
growth postnatally and exhibits largest
variability in morphology

• Principal growth sites are:-

1. Posterior surface of ramus
2. Condylar process
3. Coronoid process/ alveolar process
 Symphysis Menti
• 4-12th month after birth, syndesmosis is
converted to synostosis

• No widening after fusion

Mental Foramen
 Alveolar Process
• Adds to height of mandible

• Tooth absent- process fails to develop

• After tooth extraction, alveolar process

resorbs
 Alveolar Process
• Buffer zone

• Adaptive
remodeling
makes
orthodontic tooth
movement
possible
 Ramus
• Bridges pharyngeal
compartment
• Mandible in
occlusion with
maxilla
• Remodeled in a
posterosuperior
manner
Ramus to Corpus Remodeling
Bicondylar dimension established early
in childhood
 Ramus to Corpus Remodeling
• Making room for
molars
Ramus and Middle Cranial Fossa
• Provides developmental potential for
adaptations required to place the corpus in
a continuously functional position because
of variations elsewhere in the face and
neurocranium.
• Antegonial notch-
• Single field of
resorption

• Mandibular foramen-
• Relocates backward
and upwards
• Sustains midway
location
Size of notch
depends
On angle
 Lingual tuberosity
• Anatomic equivalent of maxillary tuberosity

• Boundary between ramus and corpus

• Remodels in posterior and medial direction

• Resorptive field below forms Lingual

Fossa
 Coronoid Process
• Propeller like twist
Vertical V Horizontal V
 The Mandibular Condyle
• Historically- regarded as kind of
cornucopia

• No longer believed as a pacesetting

“master centre”

• Functions as regional field growth

 The Mandibular Condyle
• Dual function-
1. Articular
2. Growth

Not a primary center of growth but rather

1. Secondary in Evolution
2. Secondary in Embryonic origin
3. Secondary in Adaptive responses
 Condylar Growth Mechanism
• Special non vascular tissue

• Firm hydrophillic intercellular matrix

• Endochondral growth mechanism- specific

response to particular local circumstance
 Histology of Condyle
• Capsular layer- poorly
vascularised

• Proliferative layer-
prechondroblasts
closely packed with
scanty matrix

• Zone of Deposition
and Resorption
• Proliferative process
produces upward
and backward growth
movement

• Multidirectional
proliferative capacity
 Neck of the Condyle
• Lingual and buccal
surfaces resorptive
• Condyle becomes
neck after
remodeling
• Endosteal surfaces
faces growth
direction
• Periosteal surface
points away from it
• V principle
 The Condylar Question?
• Mandibles totally lacking condyles exist
in nature
• Occupy normal anatomic position and
proper occlusion

• 2 conclusions-
1. Not the master center
2. Displaced Anteriorly and Inferiorly
without a push
 The Condylar Question?
• 1955- Weinmann and Sicher
• Major growth center
• Explanation seems to be logical
• Charlier and Petrovic supported this
theory
• If correct then condyle would grow by 2
mechanisms-
1. Interstitial proliferation
2. Appositional growth
 The Condylar Question?
• 1962- Moss, Functional matrix Hypothesis

• Questions the primacy of Sicher theory

• Condyle is under influence of the growth of

orofacial capsular matrices

• Concept of dominance of epigenetic and

environmental factors is supported
 The Condylar Question?
• 1963- Koski et al
• Transplanted mandibular ramus of the rat
• Recovered tissue was same as original
• Condyles with part of ramus transplanted-
measurable growth

• 1968- Rankow and Moss

• Condylectomy in young female- immediate
downward and forward growth seen along
with basal mandibular translation and
increase in vertical height
 Current concept
• Enlow
• Condyle does have intrinsic genetic
programming but extra condylar factors
are needed
• Extra condylar factors are-
1. Intrinsic and extrinsic biomechanical
forces
2. Physiologic inductors
• More recent studies involve Nerve-Muscle-
Connective tissue pathways

• Periodontal membrane and soft tissue

matrix--- sensory input– higher centers–
motor input to muscles– repositions
mandible– affects growth and remodeling
of condyle
 Adaptive Role of Condyle
• Multidirectional growth potential

• If growth of mandible were

preprogrammed within condyle, mandible
cannot fit into maxilla and basicranium
 Chin
• Protrusive chin is characteristic of humans

• Males- more prominent

• Females- less prominent

 Mental Protuberance
• Formed by mental
ossicles

• Poorly developed in
infants

• Forms by osseous
deposition

• Reversal line
 Factors affecting mandibular
growth
• Systemic factors
1. Genetic
2. Hormonal
3. Nutritional
4. Illness
 Factors affecting mandibular
growth
• Local factors
1. Ankylosis
2. Trauma
3. Birth injury
4. Ear infection
 Anomalies of mandible
• Syndromes associated with mandible
1. Pierrie robin syndrome

2. Treacher collins syndrome

3. Marfan’s syndrome
 Anomalies of mandible
• Congenital anomalies
1. Agnathia
2. Micrognathia
3. Macrognathia
 Anomalies of mandible
• Developmental anomalies
1. Torus mandiularis
2. Stafne’s cyst
3. Achondroplasia
4. Odontogenic cyst
Touras mandibularis Stafne’s cyst
 Age changes of Mandible
At birth Adult Old age
1 Mental Near the lower Midway b/n upper Near the upper border
foramen border & lower border

2 Angle of the Obtuse Right angle Obtuse

mandible
3 coronoid & Coronoid is Condyle is above Condyle is above the
condyloid larger & above the coronoid coronoid but in
processes condyle extreme old age –bent
backwards
4 Mandibular Runs little Runs parallel to Runs close to the
canal above the the mylohyoid line upper border
mylohyoid line
5 Symphysis Present; two Represented by Not recognizable or
menti halves united faint ridge only in absent
fibrous tissue the upper part
 References
1. Human anatomy- B.D. Chaurasia

2. Human Embryology- I.B Singh

3. Craniofacial embryology – SPERBER

4. CranioFacial growth – ENLOW

5. Contemporary orthodontics – PROFFIT

6. Principles and practice of orthodontics –

T.M GRABER

7. Study of human fetal mandible–

INGHAM, J Dent Resarch, 1932

8. Text book of oral pathology- SHAFER’S

There is But there are
nothing lot of old
new under Things we
the sun don’t know
Thank You