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BDS3 Orthodontics > Facial Growth II > Flashcards

Facial Growth II Flashcards

1
Q

what are the two ways in which the bones of the face and skull form

A

intramembranous or endochondral ossification

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2
Q

what are examples of the pre-exising cartilaginous skeletons for the face

A

nasal capsule
meckel’s cartilage

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3
Q

by which growth pattern does the maxilla and mandible develop by

A

intramembranous

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4
Q

by which type of ossification does the cranial base form by

A

endochondral ossification

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5
Q

by which type of ossification does the cranial vault develop by

A

intramembranous ossifiaction

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6
Q

what are the differences in the neo-natal face

A

small compared to the cranium
large eyes
ears low set

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7
Q

what are the three sites for facial growth

A

sutures
synchondroses
surface deposition

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8
Q

what type of joints are sutures

A

specialised fibrous joints

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9
Q

what does each suture contain

A

band of connective tissue with osteogenic cells in the centre

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10
Q

cells in what area of the sutures matrix causes bone growth

A

on the periphery

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11
Q

in what does growth at sutures occur in response to

A

growing structures separating the bones (ie the brain)

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12
Q

what occurs with sutures when facial growth is complete

A

sutures fuse and become inactive

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13
Q

where are synchondroses found

A

midline

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14
Q

in what direction does growth occur in synchondroses

A

both direction

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15
Q

what happens to the bone on either side of a synchondrosis when growth occurs

A

they are moved apart

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16
Q

what occurs in the synchondrosis when the bones either side are pushed apart

A

new cartilage is formed in the centre of the synchondrosis and the cartilage at the periphery is turned into bone

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17
Q

what occurs during the process of surface deposition

A

new bone is deposited beneath the periosteum over the surface of both cranial and facial bones

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18
Q

what occurs during surface deposition that allows bones to maintain their shape

A

resorption

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19
Q

what is another term for change in position of bone due to remodelling

A

cortical drift

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20
Q

at what age does the cranial vault stop expanding

A

age 7

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21
Q

when is rate of growth of the cranial vault at its highest

A

first 3 years of life

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22
Q

what two ways does bone growth occur in the cranial vault

A

bone growth at sutures
external and internal surfaces are remodelled through surface deposition

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23
Q

why does the forehead continue to enlarge after neural growth ceases

A

to accommodate expanding air sinuses (pneumatisation)

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24
Q

in what two ways does growth occur in the cranial base

A

endochondral ossification
surface remodelling

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25
Q

what age does the soheno-ethmoidal synchondrosis fuse at

A

around 7 years old

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26
Q

what age does the spheno-occipital synchondrosis close at

A

13-15 in females
15-17 in males

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27
Q

what age does the spheno-occipital synchondrosis fuse at

A

around 20 years old

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28
Q

what does a small angle of the cranial base infer

A

associated with a class III skeletal relationship

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29
Q

what does a large angle of the cranial base infer

A

associated with class II skeletal pattern

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30
Q

what does forward displacement of the maxilla complex provide

A

space posteriorly for the development of the maxillary tubersosities and eruption of the molars

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31
Q

where does sutural growth occur in the maxilla

A

zygomatic and frontal bones and mid palatine suture

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32
Q

where does surface deposition occur in the maxilla

A

deposition on the lower border of the hard palate and the alveolar process
resorption of the floor of the nasal cavities and the floor of the orbits

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33
Q

what are three sites of growth

A

sutures
synchondroses
surface deposition

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34
Q

what are sutures

A

connective tissues that lay down bone when structures push it apart

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35
Q

what are synchondroses

A

cartilage based growth centre with growth occuring in both directions as they are moved apart

36
Q

what is surface deposition

A

new bone deposited under the periosteum

37
Q

what is cortical drift

A

change in position of a bone due to remodelling

38
Q

what are the two way growth occurs in the cranial vault

A

bone growth at sutures
external and internal surfaces are remodelled through surface deposition

39
Q

when does the spehnoid-occipital synchondroses fuse

A

20 years

40
Q

when does the speheno-ethmoidal synchondroses fuse

A

7 years

41
Q

what does the maxilla articulate with

A

anterior cranial base

42
Q

what is the mandible closely associated with

A

posterior cranial base

43
Q

how does the maxilla grow

A

displaced downwards and forwards

44
Q

where does sutural growth occur in the maxilla

A

zygomatic and frontal bones
mid palatine suture

45
Q

how does the mandible grow

A

downwards and forwards

46
Q

where does sutural growth occur in the mandible

A

condylar cartilage by surface remodelling

47
Q

what are three differences in growth between maxilla and mandible

A

mandible increases in length more
growth accelerates in the mandible during pubertal growth spurt but maxilla stops around 7 years old
growth slows earlier in maxilla

48
Q

in what order do the different ways in growth stop in the mandible and maxilla

A

width first
then length
then height

49
Q

when is growth in width of both jaws finished

A

before pubertal growth spurt

50
Q

what are the theories of craniofacial growth

A

remodelling theory
sutural theory
cartilaginous theory
functional matrix theory

51
Q

what is the accepted theory of control of growth

A

combination of genetic and envirnemtal influences
growth in one part of the skull influences another

52
Q

what two structures are considered to have intrinsic growth potential and exert a genetic influence on growth

A

primary cartilages of cranial base and the nasal septum

53
Q

what is considered to maintain the occlusal relationship when jaws are growing

A

maxilla grows first and then the mandible grows to reflect this so it can sit in the glenoid fossa

54
Q

what can functional appliances be used for during growth

A

to correct a class II malocclusion

55
Q

what is rapid maxillary expansion appliances (RME)

A

used to widen the palate
patient is asked to turn the midline screw every 2 weeks
once this is achieved it needs to remain in this position

56
Q

when is protraction headgear used

A

to treat class III malocclusion early on
less than aged 10 years works best

57
Q

how are overbites treated

A

encourage continual growth of the alveolar bone of the maxilla

58
Q

what are growth rotations

A

occurs due to an imbalance in the anterior and posterior face height

59
Q

what is the growth of the anterior face height controlled by

A

teeth erupting
growth of alveolus and anterior muscles of face and neck

60
Q

what is growth of the posterior face height influenced by

A

condylar growth
spheno-occipital synchondrosis

61
Q

what is a forward rotation of the mandible (anticlockwise rotation)

A

greater growth in posterior part of the face compared to anterior

62
Q

what is backwards rotation of the mandible (clockwise rotation)

A

less growth in posterior part of the face than the anterior

63
Q

what do forward growth rotations result in

A

short face and deep bite

64
Q

what do backwards growth rotations result in

A

long face and anterior opern bite

65
Q

how can you measure facial growth changes

A

casts of the face
cephalometry
3D laser scanning
3d photogrammetry

66
Q

what are indications for taking a lateral cephalogram

A

aid diagnosis
treatment planning
progressive monitoring

67
Q

how do you take a lateral cephalogram

A

position patient in cephalostat - head held still with ear rods and forehead rest

68
Q

what is essential in a lateral cephalogram

A

Frankfort plane horizontal to the floor and the teeth in retruded contact position
mid sagittal plane parallel to the film

69
Q

what information does a lateral cephalogram provide

A

relationship between upper and lower jaw
relationship between jaws and cranial base
soft tissue profile
position of teeth relative to jaws

70
Q

what is the S point referring to on a lateral ceph

A

midpoint of the sella turcica

71
Q

what is the N point referring to on a lateral ceph

A

nasion - meeting point of frontal bone and nasal bone

72
Q

what is the A point on a lateral ceph

A

maximum concavity on the anterior maxilla

73
Q

what is the B point on a lateral ceph

A

maximum concavity on the anterior mandible

74
Q

what is ANS and PNS on a lateral ceph

A

anterior nasal spine and posterior nasal spine

75
Q

what is the P point on a lateral ceph

A

pogonion - most anterior part on bony symphysis of the chin

76
Q

what is the Or point on a lateral ceph

A

orbitale - inferior border of orbit

76
Q

what is the Or point on a lateral ceph

A

orbitale - inferior border of orbit

77
Q

what is the Me point on a lateral ceph

A

menton - most inferior point on bony symphysis of chin

77
Q

what is the Po point on a lateral ceph

A

where the EAM is

78
Q

what landmarks make up the sella-nasion plane

A

sella turcica and nasion (anterior cranial base)

79
Q

what landmarks makes up the Frankfort plane

A

porion and orbitale

80
Q

what landmarks on a lateral ceph make up the maxillary plane

A

ANS to PNS

81
Q

what angles would you use to measure the AP position of the maxilla and mandible relative to base of skull

A

SNA and SNB

82
Q

what angles would you use to measure the position of the mandible relative to the maxilla

A

ANB (AP)
MMPA or FMPA (vertical)

83
Q

what is the relative face height

A

the ratio of the LAFH to the total face height

84
Q

what are some errors in cephalometry

A

magnification/ distortion
non-linear fields

BDS3 Orthodontics (9 decks)

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