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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
What does the condylar unit articulate with?
Temporalis
26
What does the angular unit form in response to?
Lateral pterygoid + masseter muscles
27
What does the coronoid unit form in response to?
Temporalis
28
When does the alveolar unit form?
Forms when teeth form
29
When does the body of the mandible form?
Forms in response to the IAN
30
What are the 3 main sites of secondary cartilage formation in the mandible?
1. Condylar cartilage - Growth continues till 20yrs 2. Coronoid cartilage - Growth disappears long before birth 3. Symphyseal - Growth disappears just after birth
31
When do secondary cartilages appear?
Between 12-14wks IU
32
When does ossification of the face + skull occur?
At about 7-8wks
33
What does the neurocranium encase?
The brain
34
What does the viscerocranium form?
The face
35
What is a primary abnormality?
Defect in structure of organ that can be traced back to an anomlay in its development
36
Examples of primary abnormality (3)
Spina bifida Cleft lip CHD
37
What is a secondary abnormality?
Interruption of the normal development of an organ that can be traced back to other influences
38
Examples of a secondary abnormality (2)
Infection - rubella virus | Trauma - amniotic bands
39
Define deformation
Anomalies that occur due to outer mechanical effects on existing structures
40
Define agenesia
Absence of an organ due to failed development during embryonic period
41
Define sequence
Single factor results in numerous secondary effects
42
Define syndrome
Group of anomalies that can be traced to a common origin | DS
43
Examples of maxillary hypoplasia (5)
1. Aperts syndrome 2. Foetal alcohol syndrome 3. Achondroplasia 4. Downs syndrome 5. Cleft lip + palate
44
Examples of mandibular problems (4)
1. Treacher collins syndrome 2. Pierre robin 3. Van der woude syndrome 4. Hemifacial microsomia
45
List facial syndromes that arise from early problems with facial development (1-8wks)
ENVIRONMENTAL 1. Foetal alcohol syndrome GENETIC MULTIFACTORIAL 1. Hemifacial microsomia 2. Treacher collins syndrome 3. Clefts of lip + palate
46
Features of foetal alcohol syndrome
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
How does hemifacial microsomia present?
1. Unilateral mandibular hypoplasia 2. High arched palate 3. Malformed pinna - Deafness Neural crest cell migration (day 19-28)
48
Implications of hemifacial microsomia (2)
1. Deafness | 2. Cardiac + renal problems
49
How does treacher collins - mandibulofacial dysostosis occur?
Deformity of 1st + 2nd branchial arches (day 19-28)
50
How does treacher collins syndrome present?
1. Plosis of upper eyelid | 2. Malformed ear
51
What gender does cleft lip + palate affect more?
Males over females (day 28-38)
52
What gender does cleft palate affect more?
Females
53
What side does a cleft lip happen more frequently in?
Left
54
Genetic aetiology for clefts (3)
1. Monozygotic twins 2. Ethnic distribution 3. Sex ratio
55
Environmental aetiology for clefts (3)
1. Social deprivation 2. Smoking 3. Alcohol
56
Multivitamins and cleft link
If taken at right time can help decrease risk by 25%
57
Dental features of a cleft lip and palate (6)
1. Impacted teeth 2. Crowding 3. Hypodontia - absence 4. Supernumeraries 5. Hyoplastic 6. Caries
58
Why does a cleft palate not cause any dental problems?
As it does not cross over alveolus
59
Why does a cleft lip cause dental problems?
Can cross the alveolus
60
List some syndromes associated with skull + facial bone development (3)
1. Achondroplasia 2. Crouzons 3. Aperts
61
How does achondroplasia arise?
Endochondral ossification problem
62
How does crouzons occur?
Premature closure of cranial sutures | - especially coronal + lambdoid
63
How does aperts occur?
Premature closure of almost all cranial sutures

Orthodontics (8 decks)

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