CFD3- Craniofacial growth and functional appliances Flashcards

1
Q

Name 3 post-natal craniofacial growth.

A
  • Neural growth pattern
  • Skeletal growth pattern
  • Cephalocaudal gradient
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2
Q

Name 3 characteristics of growth.

A
  • Individual variability
  • Normal Variation (percentiles)
  • Pattern v Timing
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3
Q

Name the types of growth in craniofacial complex.

A
  • Cranial vault
  • Cranial base
  • Nasomaxillary Complex
  • Mandible
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4
Q

what are the 3 distinct regions of the skull?

A
  • desmocranium
  • Chondrocranium
  • Viscerocranium
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5
Q

what is the role of the 6 fontanelles.

A
  • Membrane covered
  • Intra-membranous ossification
  • Facilitate birth
  • Posterior, sphenoid and mastoid fuse early
  • Anterior (superior) persists until 1.5 years
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6
Q

what occurs after fontanelle fusion?

A

sutural growth

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7
Q

what is remodelling in response to?

A

neural growth

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8
Q

what are types of pathology?

A
  • Increase in intra-cranial pressure
  • Hydrocephaly
  • Microcephaly
  • Craniosynostoses (FGFR-2)
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9
Q

Craniosynostoses.

A
  • More than 100 syndromes
  • Phenotypic delineation
  • Overlapping clinical features
  • Not confined to the Calvaria
  • Facial, oral, cardiac, vertebral and renal
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10
Q

what does apert syndrome relate to?

A

coronal fusion- turricephaly

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11
Q

what does plagiocephaly relate to?

A

saggital and coronal fusion

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12
Q

what ossification forms the cranial base (chondrocranium)?

A

endochondral

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13
Q

name the synchondroses.

A
  • sphenocciptial
  • intersphenoid
  • sphenoethmoidal
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14
Q

Describe the formation of chondrocranium.

A
  • Centers of ossification on either side of synchondrosis
  • Endochondral mechanism - cartilage grows rapidly & replaced by bone
  • Cartilage interposed between large sections of bone, which form of the ethmoid, sphenoid and basioccipital bones
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15
Q

what controls primary growth centre?

A

genetic and epigenetic control

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16
Q

Nasomaxillary complex.

A
  • Nasal cartilage ?
  • Intra-membranous (maxilla, nasal and zygomatic)
  • Apposition of bone at the sutures
  • surface remodelling
17
Q

what is the precursor of the mandible?

A

meckels cartilage

18
Q

what are the stages of facial growth?

A

1) gets bigger
2) down and out
3) it all happens at “the back”
4) timing is important
5) velocity varies with time

19
Q

what can cause late lower incisor crowding?

A
  • Wisdom tooth eruption
  • Mesial drift
  • Lack of attrition
  • Occlusal forces
  • Soft tissue maturation
  • Mandibular growth
20
Q

what affect does surgical iatrogenesis :CLP have?

A

Surgery has a significant impact on maxillary growth that becomes progressively apparent as patients reach maturity

21
Q

what are the roles of homeobox genes?

A

a) craniofacial shape and patterning

b) patterning of the dentition

22
Q

what are homeobox genes?

A
  • Homeotic “Master” genes
  • Encoding for transcription factors
  • Involved in patterning, induction, apoptosis
  • Control of epithelial /mesenchymal interaction
23
Q

How do homeobox genes work?

A

• Through the neural crest cells (NCC)
• Ectomesenchyme of first branchial
arch derived from the NCC
• Migration directed by homeobox genes

24
Q

Describe embryonic craniofacial morphogenesis.

A
  • Origin of facial mesenchyme is neural crest
  • Migration/division/differentiation
  • Neural, skeletal and connective tissue structures e.g. Maxilla, mandible, zygomatic nasal and cranial bones
25
Q

Describe morphogenetic cascade.

A

The basic morphogenetic processes of initiation, segmentation, patterning, migration and differentiation are medicated via a series of extracellular signalling molecules in a cascade of cellular events

26
Q

Describe homeobox genes and tooth development.

A

• MSX1 and MSX2 in the initiation, developmental position (patterning) and morphodifferentiation of tooth buds
• Information expressed through mesenchymal growth factors
(FGF, EGF, TGFs and BMPs)