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
what age does the soheno-ethmoidal synchondrosis fuse at
around 7 years old
26
what age does the spheno-occipital synchondrosis close at
13-15 in females 15-17 in males
27
what age does the spheno-occipital synchondrosis fuse at
around 20 years old
28
what does a small angle of the cranial base infer
associated with a class III skeletal relationship
29
what does a large angle of the cranial base infer
associated with class II skeletal pattern
30
what does forward displacement of the maxilla complex provide
space posteriorly for the development of the maxillary tubersosities and eruption of the molars
31
where does sutural growth occur in the maxilla
zygomatic and frontal bones and mid palatine suture
32
where does surface deposition occur in the maxilla
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
33
what are three sites of growth
sutures synchondroses surface deposition
34
what are sutures
connective tissues that lay down bone when structures push it apart
35
what are synchondroses
cartilage based growth centre with growth occuring in both directions as they are moved apart
36
what is surface deposition
new bone deposited under the periosteum
37
what is cortical drift
change in position of a bone due to remodelling
38
what are the two way growth occurs in the cranial vault
bone growth at sutures external and internal surfaces are remodelled through surface deposition
39
when does the spehnoid-occipital synchondroses fuse
20 years
40
when does the speheno-ethmoidal synchondroses fuse
7 years
41
what does the maxilla articulate with
anterior cranial base
42
what is the mandible closely associated with
posterior cranial base
43
how does the maxilla grow
displaced downwards and forwards
44
where does sutural growth occur in the maxilla
zygomatic and frontal bones mid palatine suture
45
how does the mandible grow
downwards and forwards
46
where does sutural growth occur in the mandible
condylar cartilage by surface remodelling
47
what are three differences in growth between maxilla and mandible
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
in what order do the different ways in growth stop in the mandible and maxilla
width first then length then height
49
when is growth in width of both jaws finished
before pubertal growth spurt
50
what are the theories of craniofacial growth
remodelling theory sutural theory cartilaginous theory functional matrix theory
51
what is the accepted theory of control of growth
combination of genetic and envirnemtal influences growth in one part of the skull influences another
52
what two structures are considered to have intrinsic growth potential and exert a genetic influence on growth
primary cartilages of cranial base and the nasal septum
53
what is considered to maintain the occlusal relationship when jaws are growing
maxilla grows first and then the mandible grows to reflect this so it can sit in the glenoid fossa
54
what can functional appliances be used for during growth
to correct a class II malocclusion
55
what is rapid maxillary expansion appliances (RME)
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
when is protraction headgear used
to treat class III malocclusion early on less than aged 10 years works best
57
how are overbites treated
encourage continual growth of the alveolar bone of the maxilla
58
what are growth rotations
occurs due to an imbalance in the anterior and posterior face height
59
what is the growth of the anterior face height controlled by
teeth erupting growth of alveolus and anterior muscles of face and neck
60
what is growth of the posterior face height influenced by
condylar growth spheno-occipital synchondrosis
61
what is a forward rotation of the mandible (anticlockwise rotation)
greater growth in posterior part of the face compared to anterior
62
what is backwards rotation of the mandible (clockwise rotation)
less growth in posterior part of the face than the anterior
63
what do forward growth rotations result in
short face and deep bite
64
what do backwards growth rotations result in
long face and anterior opern bite
65
how can you measure facial growth changes
casts of the face cephalometry 3D laser scanning 3d photogrammetry
66
what are indications for taking a lateral cephalogram
aid diagnosis treatment planning progressive monitoring
67
how do you take a lateral cephalogram
position patient in cephalostat - head held still with ear rods and forehead rest
68
what is essential in a lateral cephalogram
Frankfort plane horizontal to the floor and the teeth in retruded contact position mid sagittal plane parallel to the film
69
what information does a lateral cephalogram provide
relationship between upper and lower jaw relationship between jaws and cranial base soft tissue profile position of teeth relative to jaws
70
what is the S point referring to on a lateral ceph
midpoint of the sella turcica
71
what is the N point referring to on a lateral ceph
nasion - meeting point of frontal bone and nasal bone
72
what is the A point on a lateral ceph
maximum concavity on the anterior maxilla
73
what is the B point on a lateral ceph
maximum concavity on the anterior mandible
74
what is ANS and PNS on a lateral ceph
anterior nasal spine and posterior nasal spine
75
what is the P point on a lateral ceph
pogonion - most anterior part on bony symphysis of the chin
76
what is the Or point on a lateral ceph
orbitale - inferior border of orbit
76
what is the Or point on a lateral ceph
orbitale - inferior border of orbit
77
what is the Me point on a lateral ceph
menton - most inferior point on bony symphysis of chin
77
what is the Po point on a lateral ceph
where the EAM is
78
what landmarks make up the sella-nasion plane
sella turcica and nasion (anterior cranial base)
79
what landmarks makes up the Frankfort plane
porion and orbitale
80
what landmarks on a lateral ceph make up the maxillary plane
ANS to PNS
81
what angles would you use to measure the AP position of the maxilla and mandible relative to base of skull
SNA and SNB
82
what angles would you use to measure the position of the mandible relative to the maxilla
ANB (AP) MMPA or FMPA (vertical)
83
what is the relative face height
the ratio of the LAFH to the total face height
84
what are some errors in cephalometry
magnification/ distortion non-linear fields