CFD3- Craniofacial growth and functional appliances Flashcards
Name 3 post-natal craniofacial growth.
- Neural growth pattern
- Skeletal growth pattern
- Cephalocaudal gradient
Name 3 characteristics of growth.
- Individual variability
- Normal Variation (percentiles)
- Pattern v Timing
Name the types of growth in craniofacial complex.
- Cranial vault
- Cranial base
- Nasomaxillary Complex
- Mandible
what are the 3 distinct regions of the skull?
- desmocranium
- Chondrocranium
- Viscerocranium
what is the role of the 6 fontanelles.
- Membrane covered
- Intra-membranous ossification
- Facilitate birth
- Posterior, sphenoid and mastoid fuse early
- Anterior (superior) persists until 1.5 years
what occurs after fontanelle fusion?
sutural growth
what is remodelling in response to?
neural growth
what are types of pathology?
- Increase in intra-cranial pressure
- Hydrocephaly
- Microcephaly
- Craniosynostoses (FGFR-2)
Craniosynostoses.
- More than 100 syndromes
- Phenotypic delineation
- Overlapping clinical features
- Not confined to the Calvaria
- Facial, oral, cardiac, vertebral and renal
what does apert syndrome relate to?
coronal fusion- turricephaly
what does plagiocephaly relate to?
saggital and coronal fusion
what ossification forms the cranial base (chondrocranium)?
endochondral
name the synchondroses.
- sphenocciptial
- intersphenoid
- sphenoethmoidal
Describe the formation of chondrocranium.
- 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
what controls primary growth centre?
genetic and epigenetic control
Nasomaxillary complex.
- Nasal cartilage ?
- Intra-membranous (maxilla, nasal and zygomatic)
- Apposition of bone at the sutures
- surface remodelling
what is the precursor of the mandible?
meckels cartilage
what are the stages of facial growth?
1) gets bigger
2) down and out
3) it all happens at “the back”
4) timing is important
5) velocity varies with time
what can cause late lower incisor crowding?
- Wisdom tooth eruption
- Mesial drift
- Lack of attrition
- Occlusal forces
- Soft tissue maturation
- Mandibular growth
what affect does surgical iatrogenesis :CLP have?
Surgery has a significant impact on maxillary growth that becomes progressively apparent as patients reach maturity
what are the roles of homeobox genes?
a) craniofacial shape and patterning
b) patterning of the dentition
what are homeobox genes?
- Homeotic “Master” genes
- Encoding for transcription factors
- Involved in patterning, induction, apoptosis
- Control of epithelial /mesenchymal interaction
How do homeobox genes work?
• Through the neural crest cells (NCC)
• Ectomesenchyme of first branchial
arch derived from the NCC
• Migration directed by homeobox genes
Describe embryonic craniofacial morphogenesis.
- 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
