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Ortho > Craniofacial growth > Flashcards

Craniofacial growth Flashcards

1
Q

Describe the size of the head related to the body at:

  • 2 months IU
  • at birth
  • adult male
A
  • 2m IU = half of body size
  • birth = 1/4 body side
  • adult male - 1/8 body size
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2
Q

What is the curve that demonstrates postnatal growth

A

Scammon’s growth curve

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3
Q

What does Scammon’s growth curve show us about the growth of the maxilla and the mandible?

A
  • Maxilla is close to the cranium and is influence by earlier growth in this region (therefore it grows before the mandible)
  • Mandible follows general body growth therefore it grows later on
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4
Q

What are the examples of growth curves that can be plotted

A
  • distance curves (cumulative graph of heigh vs age)

- Velocity curves (incremental graph of change in height vs age)

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5
Q

What is ossification

A

Process by which new mineralised bone is formed

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6
Q

What are the two ways ossification occurs in the craniofacial complex

A

Endochondral

Intramembranous

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7
Q

What is endochondral growth

A

Bones are formed via replacement of the cartilage, which is seen at epiphyseal plates of the long bones and the synchondroses of the cranial base

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8
Q

What are synchondroses?

A

Cartilaginous joint that act as growth centres

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9
Q

What do the synchondroses make up?

A

The ethmoid, sphenoid and basioccipital bones (thus the cranial base)

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10
Q

Describe what happens with growth at the synchondroses

A

Bones either side of the synchondroses move apart thus lengthening the cranial base

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11
Q

List the synchondroses

A

Interspehnoidal
Spehno-ethmoidal
Spehno-occipital

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12
Q

What is intramembranous growth

A

Bone is laid down and resorbed by investing periosteum and endosteum (bone remodelling)

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13
Q

Describe how intramembranous growth occurs

A

Periosteal activity at the surfaces of the bone and remodelling and growth at periosteal lined contact areas (called sutures)

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14
Q

What is the role of sutures in CFC growth

A

Bones of the skull and face articulate at sutures and the growth occurs along the sutures

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15
Q

Which bones are formed via intramembranous growth

A

Cranial vault
Facial bones
Mandible
Maxilla

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16
Q

What is the importance of the speno-occopital synchondrosis

A

Growth at the SOS influences the overall facial skeletal pattern as it increases the length of the cranial base

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17
Q

How does SOS growth of the cranial base affect occlusion

A

The mandible and maxilla are connected to the cranial base

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18
Q

Describe cranial base relationship with skeletal pattern

A
  • Long cranial base associated with class II

- Short cranial base angle associated with class III

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19
Q

What are the two theories for control of facial growth

A

1) Tight genetic control that has no influence of environmental factors
2) Controlled loosely by genetics and takes place in response to growth of surrounding tissues

20
Q

what is the evidence of genetics as a role in facial growth?

A

Families tend to have similar facial growth

21
Q

What is the general pattern of facial growth as you age

A

Rapid in early years then slows in prepubertal period

Rapid during puberty then slows down until adult levels reached

22
Q

When does puberty roughly occur?

A

12 in girls

14 in boys

23
Q

How does growth of the cranial vault (calvarium) occur

A
  • Combination of drift and displacement
24
Q

How does drift occur in cranial vault growth

A

Resorption of intracranial aspects of bone, whilst bone is laid down on external surfaces

25
Q

How does displacement occur in cranial vault growth

A

Bones are separated by the growth brain and bony infill occurs at the sutures

26
Q

When is cranial vault growth complete

A

7 yo

27
Q

How does growth of the cranial base occur?

A
  • Sutural infill and remodelling as the brain enlarges

- Length increases by growth at the SOS

28
Q

How does the maxilla grow

A

Intramembranous growth due to displacement and apposition at sutures and surface remodelling

29
Q

How does AP maxilla growth occur

A

Deposition of bone posterior to the tuberosities causing backward growth

30
Q

How does downward maxilla growth occur

A

Development of the alveolar process, tooth eruption and inferior drift of the hard palate

31
Q

How does lateral growth of the maxilla occur

A

Deposition of bone in the midline suture (pushes maxilla outwards)

32
Q

What types of growth is seen in the mandible

A

Endochondral and intramembranous

33
Q

Describe the role of endochondral growth in the mandible

A

Cartilage covers the condylar surface and there is endochondral replacement
This elongates the mandible

34
Q

Describe the role of intramembranous growth in the mandible

A

Surface apposition and remodelling maintains the shape of the mandible and allows an increase in width
- Bone laid down posterior to vertical ramus which lengthens the arches posteriorly

35
Q

When does AP growth of the maxilla cease in females and males

A

Females - 14-15

Males - 17

36
Q

When does AP growth of the mandible cease in females and males

A

Females - 16-17

Males - 19

37
Q

Where do growth rotations have the most effect

A

In the mandible

38
Q

What growth influences posterior face height

A

Growth at the condyles, SOS

Influence of masticatory musculature of the ramus

39
Q

What growth influences anterior face height

A

Eruption of the teeth and vertical growth of soft tissues

40
Q

What are the types of growth rotations

A

Forward (more common)

Backward (less common)

41
Q

What does MARKED forward growth rotation lead to

A

Reduced anterior vertical proportions and incr overbite

42
Q

What does MARKED backward growth rotation lead to

A

Increased anterior vertical skeletal proportions and a reduced overbite or skeletal AOB

43
Q

How does forward growth affect the lower labial segment

A

May cause retroclination of lower incisors and may contribute to late lower incisor crowding

44
Q

Impact of growth rotations on class II treatment

A

Forward growth will assist

Backward growth is unfavourable

45
Q

How to determine growth rotation pattern based on facial profile

A
  • Concave with marked antegonial notch = backward

- Convex - forward

Ortho (20 decks)

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