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BDS3 CLINICAL Ortho > Facial growth II > Flashcards

Facial growth II Flashcards

1
Q

What is the majority of the face derived from

A

neural crest cells

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2
Q

What brachial arch do the frontonasal process come from

A

1st

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3
Q

What is the pre existing cartilaginous skeleton for the maxilla

A

nasal capsule

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4
Q

What is the pre existing cartilaginous skeleton for the mandible

A

Meckel’s cartilage

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5
Q

What are features of the neo natal face

A

infant face is small compared to the cranium
eyes are large and ears are low set
forehead is upright and bulbous and face appears broad
nasal region is vertically shallow with nasal floor close to inferior orbital rim
in the adult the mid face expands the nasal floor descends

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6
Q

What are the sites of facial growth occur

A

sutures
synchondroses
surface deposition

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7
Q

What are sutures

A

specialized fibrous joints situated between intra membranous bone

each suture is a band of CT which has osteogenic cells in the centre and the most peripheral of these cells provide new bone growth

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8
Q

What does growth at the sutures occur in response to

A

growing structures separating the bone e.g growth of calvarium in response to development of brain
where the bones are pushed apart new bone forms in the suture
in the suture growth occurs in area of tension

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9
Q

Where are synchondroses

A

found at midline

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10
Q

Where do the synchondroses exist

A

between the ethmoid, sphenoid and occipital bone

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11
Q

How does growth occur at the synchondroses

A

it is a cartilage-based growth centre with growth occurring in both directions
the bones on either side of the synchondrosis are moved apart as growth takes place
new cartilage is formed in the centre of a synchondrosis as cartilage at the periphery’s transformed into bone

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12
Q

What is surface deposition

A

new bone is deposited beneath the periosteum over the surfaces of both cranial and facial bones
in order for the bones to maintain their shape as they grow, resorption is also taking place

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13
Q

What is the process of reposition and deposition known as

A

remodeling

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14
Q

What is the change in position of bone due to remodeling

A

known as drift (cortical drift)

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15
Q

What does the cranial vault expand in response to

A

growing brain until age of 7

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16
Q

When is the rate of growth of the cranial vault greatest

A

first 3 years of life

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17
Q

What are the 2 ways growth of cranial vault occurs

A

bone growth at sutures

external and internal surfaces are remodeled through surface deposition and resorption to displace the bones radially

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18
Q

After neural growth ceases what happens

A

the forehead continues to enlarge in response to accommodate expanding air sinuses
generally more pronounced in males

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19
Q

Where do fontanelles exist

A

where more than 2 bones meet
6 fontanelles are present at birth and these close by the age of 18 months

when facial growth is complete, all of the sutures fuse

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20
Q

What are the two ways the cranial base grows

A

endochondral ossification

surface remodeling

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21
Q

When is half the growth of the cranial base finished

A

by age 3

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22
Q

When does the sphene-ethmoidal synchondrosis fuse

A

7 years old

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23
Q

When does the sphenoid-occipital synchondrosis close

A

at around 13-15 years in females and 15-17 years in males

24
Q

When does the sphenoid-occipital synchondroses fuses

A

at around 20 years

25
Q

What does growth of cranial base between 4-20 year result in

A

overall increase in length of the cranial base

26
Q

When does the anterior cranial base become stable

A

around 4 YO
has been used for superimposition in cephalometric analysis
this allows the orthodontist to assess skeletal changes due to growth and / or treatment

27
Q

Why is the cranial base so important for ortho

A

it plays a role a role in determining how the maxilla and mandible relate to each other
the shape or angle of the cranial base effects the jaw relationship

28
Q

What does a small angle of the cranial base result in

A

more likely to be associated w class III

29
Q

What does a large angle of the cranial base result in

A

more likely to be associated w class II

30
Q

What does the maxilla/nasomaxillary complex include

A

orbits
nasal cavity
upper jaw
zygomatic processes

31
Q

What is displacement

A

when a mass of bone is moved relative to its neighbor

is brought about by focus exerted by the soft tissues and by intrinsic growth of bone itself

32
Q

How is the mandible displaced

A

downwards and forwards relative to anterior cranial base

33
Q

What is rate of growth of maxilla

A

follows neural growth of brain

slows down at age 7

34
Q

What does forward displacement of maxillary complex create

A

space posteriorly for development of maxillary tuber-sixties and space for eruption of molar teeth

35
Q

Where does sutural growth take place

A

at zygomatic and frontal bones and mid palatine suture

36
Q

What is surface deposition and resorption in the maxilla

A

deposition on the lower border of the hard palate and alveolar processes and resorption on floor of nasal cavity and the floor of the orbits

37
Q

How do both the mandible and maxilla slow

A

width slows first
then length
then height

38
Q

What are differences in growth in length of mandible and maxilla

A

increase in length by 26mm in males and 20mm in females between ages 4-20 in MANDIBLE

increase in length by 8mm in males and 5.5mm in females between ages 4-20 in MAXILLA

39
Q

What is the difference in rate of growth in mandible and maxilla

A

growth accelerates significantly during pubertal growth spurt in mandible

at age 7 years, growth of maxilla proceeds very slowly

40
Q

What is the difference in growth slowing in mandible and maxilla

A

in mandible growth slows to adult level around age of 17 in F and 19 in M

in maxilla growth slots to adult levels at around 12

41
Q

What are the theories of craniofacial growth

A

remodeling theory
sutural theory
cartilaginous theory
functional matrix theory

42
Q

What is the remodeling theory

A

Everything just grows by a process of deposition and resorption

The sutures and cartilages do not exert an intrinsic force

43
Q

What is the sutural theory

A

growth occurs at the sutures and cartilages but the growth at the sutures is the prime factor

44
Q

What is the cartilaginous theory

A

the cartilages i.e nasal septal cartilages and synchondrosis generate the force to developmthe bones in a specific direction

45
Q

What is the functional matrix theory

A

growth occurs in response to individual units which are developed to provide a function

each unit (functional matrix) is composed of tissue organs and spaces
thus its the force exerted by the growing soft tissues that determines the direction and extent of growth
46
Q

What are the recent views on the control of growth

A

combo of genetic and environmental influences involved

growth in one part of skull influences anotehr

47
Q

What are the primary cartilage control on growth

A

primary cartilages of cranial base and nasal septum have intrinsic growth potential and exert a genetic influence over growth

48
Q

What are the condylar cartilage control on growth

A

it seems to act differently

controversy exists as to whether its a primary growth force or purely adaptive

49
Q

What is the impact of growth on malocclusion

A

can improve or worsen malocclusion

50
Q

How can growth be utilized by orthodontic for tx outcome

A

use of functional appliance
use of rapid maxillary expansion
use of protraction head gear

51
Q

If there is a continued unfoavourable growth pattern what is the impact on ortho tx

A

relapse can occur

52
Q

What is adult facial growth like

A

continues through life
growth in length of face continues into early 20s in males, late teens in females

tendency to increased overall length and prominence of nose and chin (and forehead in men)

lips become thinner and more recursive (soft tissue changes)

53
Q

What is a growth rotation

A

due to imbalance in growth of anterior and posterior face heights

54
Q

What does forward growth rotation lead to

A

short face

can lead to development of deep bite

55
Q

What does backward growth rotation lead to

A

long face

can lead to anterior open bite

56
Q

What is adverse growth

A

continued growth when there is a significant growth rotation that can make malocclusion worse

BDS3 CLINICAL Ortho (11 decks)

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