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Orthodontics > Facial Growth 1 > Flashcards

Facial Growth 1 Flashcards

1
Q

Why is facial growth so important?

A

Shape size and position of underlying jaws determine the position of teeth + the malocclusion

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2
Q

Class II div 1 patient with a mandibular retronaphia tx

A

Dont just bring her anteriors back
PROBLEM = lower jaw too small, need to bring lower jaw forward

GROWING PATIENT: via a functional appliance

ADULT: orthognathic surgery

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3
Q

Life in utero phases (2)

A

Embryonic 1-8wks

Foetal 8wks to term

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4
Q

What forms in utero during the first 2 months?

A

All the limbs + organs including the face

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5
Q

3 germ layers

A

Ectoderm mesoderm and endoderm

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6
Q

What germ layer makes up the mesoderm?

A

Ectoderm folds and makes it

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7
Q

At what stage is the neural tube formed?

A

4 weeks

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8
Q

How does spina bifida occur?

A

Failure of the neural folds to fuse and form the neural tube

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9
Q

Roughly when does the neural fold fuse?

A

Towards the end of week 3

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10
Q

Function of neural crest cells

A

Pulp
Dentine
Cementum
PDL

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11
Q

Timeframe for formation of the face

A

First 8 weeks after fertilisation

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12
Q

What cells form the face?

A

Migrating neural crest cells

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13
Q

How does cleft formation occur?

A

Failure of fusion between the facial processes or between the palatine processes may lead to cleft formation

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14
Q

When do the facial process being to appear?

A

5-7wks we see the extension + fusion of the facial processes

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15
Q

What 2 parts can the skull be divided into?

A
  1. Neurocranium
    - Forms a protective case around brain
    2 types of ossification:
    Intramembranous
    > Forms vault of skull, maxilla + mandible

Endochondral
> Long bones + base of skull bones

  1. Viscerocranium
    - Forms skeleton of the face
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16
Q

What forms the base of the skull?

A

Series of cartilage

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17
Q

What type of ossiifcation is the base of the skull formed by?

A

Endochondral ossification

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18
Q

What type of ossification is the vault of the skull formed by?

A

Intramembranous ossification

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19
Q

When does the anterior fontanelle close?

A

At about 2 years

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20
Q

When does the posterior fontanelle close?

A

At about 1 year

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21
Q

How long does the growth of the skull happen?

A

up to 7 years

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22
Q

What type of ossification forms the mandible and maxilla?

A

Intramembranously at 6wks

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23
Q

Function of fontanelles

A

Flexibility during birth

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24
Q

List the different units of the mandible (5)

A
  1. Condylar unit
  2. Angular unit
  3. Coronoid unit
  4. Alveolar unit
  5. Body of mandible
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25
Q

What does the condylar unit articulate with?

A

Temporalis

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26
Q

What does the angular unit form in response to?

A

Lateral pterygoid + masseter muscles

27
Q

What does the coronoid unit form in response to?

A

Temporalis

28
Q

When does the alveolar unit form?

A

Forms when teeth form

29
Q

When does the body of the mandible form?

A

Forms in response to the IAN

30
Q

What are the 3 main sites of secondary cartilage formation in the mandible?

A
  1. Condylar cartilage
    - Growth continues till 20yrs
  2. Coronoid cartilage
    - Growth disappears long before birth
  3. Symphyseal
    - Growth disappears just after birth
31
Q

When do secondary cartilages appear?

A

Between 12-14wks IU

32
Q

When does ossification of the face + skull occur?

A

At about 7-8wks

33
Q

What does the neurocranium encase?

A

The brain

34
Q

What does the viscerocranium form?

A

The face

35
Q

What is a primary abnormality?

A

Defect in structure of organ that can be traced back to an anomlay in its development

36
Q

Examples of primary abnormality (3)

A

Spina bifida
Cleft lip
CHD

37
Q

What is a secondary abnormality?

A

Interruption of the normal development of an organ that can be traced back to other influences

38
Q

Examples of a secondary abnormality (2)

A

Infection - rubella virus

Trauma - amniotic bands

39
Q

Define deformation

A

Anomalies that occur due to outer mechanical effects on existing structures

40
Q

Define agenesia

A

Absence of an organ due to failed development during embryonic period

41
Q

Define sequence

A

Single factor results in numerous secondary effects

42
Q

Define syndrome

A

Group of anomalies that can be traced to a common origin

DS

43
Q

Examples of maxillary hypoplasia (5)

A
  1. Aperts syndrome
  2. Foetal alcohol syndrome
  3. Achondroplasia
  4. Downs syndrome
  5. Cleft lip + palate
44
Q

Examples of mandibular problems (4)

A
  1. Treacher collins syndrome
  2. Pierre robin
  3. Van der woude syndrome
  4. Hemifacial microsomia
45
Q

List facial syndromes that arise from early problems with facial development (1-8wks)

A

ENVIRONMENTAL
1. Foetal alcohol syndrome

GENETIC

MULTIFACTORIAL

  1. Hemifacial microsomia
  2. Treacher collins syndrome
  3. Clefts of lip + palate
46
Q

Features of foetal alcohol syndrome

A
  1. Microcephaly
    - Smaller head than expected
  2. Short palpebral fissures
  3. Flat midface
  4. Indistinct philtrum
  5. Thin upper lip
  6. Short nose
  7. Low nasal bridge
  8. Minor ear abnormalities
  9. Micrognathia
    - Small lower jaw
47
Q

How does hemifacial microsomia present?

A
  1. Unilateral mandibular hypoplasia
  2. High arched palate
  3. Malformed pinna
    - Deafness

Neural crest cell migration (day 19-28)

48
Q

Implications of hemifacial microsomia (2)

A
  1. Deafness

2. Cardiac + renal problems

49
Q

How does treacher collins - mandibulofacial dysostosis occur?

A

Deformity of 1st + 2nd branchial arches (day 19-28)

50
Q

How does treacher collins syndrome present?

A
  1. Plosis of upper eyelid

2. Malformed ear

51
Q

What gender does cleft lip + palate affect more?

A

Males over females (day 28-38)

52
Q

What gender does cleft palate affect more?

A

Females

53
Q

What side does a cleft lip happen more frequently in?

A

Left

54
Q

Genetic aetiology for clefts (3)

A
  1. Monozygotic twins
  2. Ethnic distribution
  3. Sex ratio
55
Q

Environmental aetiology for clefts (3)

A
  1. Social deprivation
  2. Smoking
  3. Alcohol
56
Q

Multivitamins and cleft link

A

If taken at right time can help decrease risk by 25%

57
Q

Dental features of a cleft lip and palate (6)

A
  1. Impacted teeth
  2. Crowding
  3. Hypodontia - absence
  4. Supernumeraries
  5. Hyoplastic
  6. Caries
58
Q

Why does a cleft palate not cause any dental problems?

A

As it does not cross over alveolus

59
Q

Why does a cleft lip cause dental problems?

A

Can cross the alveolus

60
Q

List some syndromes associated with skull + facial bone development (3)

A
  1. Achondroplasia
  2. Crouzons
  3. Aperts
61
Q

How does achondroplasia arise?

A

Endochondral ossification problem

62
Q

How does crouzons occur?

A

Premature closure of cranial sutures

- especially coronal + lambdoid

63
Q

How does aperts occur?

A

Premature closure of almost all cranial sutures

Orthodontics (8 decks)

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