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Ortho > Growth And Development > Flashcards

Growth And Development Flashcards

1
Q

Growth

A

Increase in size

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2
Q

Development

A

Increase in complexity

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3
Q

Maturation

A

Combo of growth and development over time

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4
Q

What are patterns of growth determined by

A

The proportional relationships between structures

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5
Q

what relationships does ortho focus on for normal growth

A

Between structures to identify patterns of growth

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6
Q

What is a Norma growth pattern marked by ?

A

Changes in these proportional relationships over time

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7
Q

What do patterns imply?

A

Predictability

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8
Q

Cephalocaudal gradient of growth

A

Head to toe
2 month-fetus = head is 1/3 body and legs are 1/3 body
25 year old = head is 12% and legs are 1/2 body

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9
Q

What does the maxilla curve follow?

A

Neural growth curve

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10
Q

What does the mandible curve follow?

A

General growth curve

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11
Q

What grows more during the adolescent growth spurt?

A

The mandible grows more than the maxilla

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12
Q

Lymphoid growth curve- when is it at 200%?

A

Around age 10-11, huge tonsils then shrinks down

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13
Q

Completion of facial growth in 3 dimensions

A

1st - transverse (bilateral crossbite - address as soon as possible)
2nd- anterior-posterior (class II and class III)
3rd- vertical (overbite, open bite - wait to address, dont do implants in kids because last to finish growing)

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14
Q

Standard growth charts

A

Use to evaluate if a patients pattern of growth falls outside of the Normal range acceptable for a population.
Childs growth should plot along the same percentile at all ages

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15
Q

When does class II end to be treated?

A

Before the growth spurt

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16
Q

Variability in timing

A

Can be reduced by using developmental age rather than chronological age as an expression of an individuals growth status

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17
Q

Adolescent growth spurt

A

Period of rapid growth right before puberty
Coincident with sexual maturity

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18
Q

Females growth spurt

A

11-13 years
Begin breast development and height spurt
Breast development peak
Menarche (completion)

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19
Q

Males growth spurt

A

13-15 yrs
Fat spurt
Peach fuzz on the upper lip
Pigmented hair on lip (peak)
Hair on chin

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20
Q

Age determination

A

Chronological age
Dental age
Skeletal age

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21
Q

Chronological age

A

Measured in years

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22
Q

Dental age

A

Stage of dental development (what teeth are present/absent)

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23
Q

Skeletal age

A

Bone maturation -determines growth status

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24
Q

Factors affecting variability in timing

A

Gender
Racial/ethnic differences
Sickness
Nutrtion
Timing factor - late/early maturer
Problems with growth (hormones or genetics)
Trauma

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25
Why do we monitor growth?
Determine if growth is normal vs abnormal Determine the specific growth pattern of each patient Assess amount of growth remaining Determine treatment timing of orthodontics (can be modified? Can be camouflaged? Orthognathic surgery correct?)
26
Craniofacial growth
Changes in proportions of head and face during growth At birth- face and jaws underdeveloped Much more growth of facial than cranial structures postnatally
27
Craniofacial complex
Cranial vault Cranial base Maxilla - nasomaxillary complex Mandible
28
Cranial vault
Flat bones, intramembranous bone formation - no cartilage Major mechanism growth = a position of new bone at the sutures
29
What growth curve does the cranial vault follow?
Neural growth curve
30
Cranial base
Formed by endochondral ossification - formed initially in cartilage and transformed into bone Bands of cartilage (synchondroses) remain between centers of ossification Growth occurs at the synchondroses in both directions
31
Nasomaxillary complex
Intramembranous ossification Growth by - a position of bone at the sutures connecting the maxilla to the cranium and cranial base, surface remodeling
32
How does the maxilla grow
Downward and forward Growth of cranial base pushes maxilla A position of bone at the sutures fills in the space
33
Midpalatal suture
Fuses early (transverse growth is first)
34
What accounts for space for the third molars?
Apposition of bone in the molar area
35
Nasomaxillary complex remodeling
Maxilla goes down and forward, its anterior surface tends to resort through remodeling except small area around the anterior nasal spine
36
Remodeling of the palatal vault
Moves in the same direction as it is being translated Bone is removed from the floor of the nose and added to the roof of the mouth Ant surface maxilla - bone removed, cancelling the forward translation As palatal vault moves down, bone remodeling also widens it
37
Mandible translation vs growth
Translated - downward and forward Grows- upward and backwards Maintains contact with skull
38
Mandible site of growth
Site of growth - posterior surface of the ramus, condylar process, coronoid process
39
Mandibular remodeling
Ramus is extensively remodeled Apposition of new bone on the posterior surface of the mandible and resorption of bone from the anterior surface of the mandible
40
Skeletal problems Class II caused by
Maxillary excess (protrusion) Mandibular deficiency (Retrusion) Or combo of both
41
Skeletal problems class III caused by
Maxillary deficiency (Retrusion) Mandibular excess (protrusion) Or a combination of both
42
Class II tx early
Headgear
43
Headgear
Prevent maxillary growth and allow the mandible to catch up
44
Class II tx during late mixed/early perm dentition (during growth)
Growth modification During growth spurt Functional appliances
45
When do you treat earlier in class II during a growth spurt
Psychosocial issues
46
Class II tx after growth spurt
Camouflage Surgery
47
Camouflage
Extractions during perm. Dentition to hide a mild/moderate skeletal problem
48
Surgery
After all growth completed
49
Class III tx option early
Growth modification
50
Growth modification class III
Protraction face mask (reverse pull headgear) Before sutures fuse
51
What does treatment timing depend on ?
Degree of severity Amount of growth remaining Treatment objectives Facial profile
52
When is the ideal time for ortho treatment for most patients?
Adolescent growth spurt : maximize growth modification All permanent teeth erupted
53
What are the exceptions for early treatment ?
-When Sutural maturity is a concern - 7-6 year old in class III protraction facemask during early mixed dentists, post cross bite -ant cross bite of teeth being damaged -psychosocial reason
54
What are the exceptions for late treatment?
prolonged growth - in class III patients the mandible contours to grow after the adolescent growth spurt - severe long face (vertical dimension is last to finish growth)
55
What are the indications for extraction of permanent teeth as part of ortho treatment?
Not enough room for the teeth to be well position in either jaw Camouflage a skeletal discrepancy
56
What tooth is usually extracted in class II and class III?
Class II = max 1st premolars Class III= mand 2nd premolars
57
Patients with dental problems determination of time of treatment
Based on dentition (Dental development)
58
Patients with skeletal problems determination of time of treatment
Based on skeletal maturation/development
59
What growth does headgear affect
Maxilla Mandible - protraction facemask (reverse pull headgear) = class III
60
What growth does function appliances affect?
Mandible - herbst, Mara, twin block
61
Class I referral for evaluation
Just before loss of 2nd primary molars
62
Class I ideal treatment timing
Permanent teeth and adolescent growth spurt (during/after)
63
Class I treat early if
-severe crowding -early primary canine loss -psychosocial
64
Class II referral for evaluation
Just before adolescent growth spurt
65
Class II ideal treatment timing
Adolescent growth spurt
66
Class II treat early if
-extreme problems -social problems -tissue damage
67
Class III referral for evaluation
Early mixed dentition
68
Class III ideal treatment timing
-during early mixed dentition (Age 7-9) -prolonged growth of the mandible will require treatment later
69
Class III treat early if
-almost always -early diagnosis -maxillary deficiency
70
Transverse growth event to consider
Fusion of mid-palatal suture
71
Transverse implication for treatment
Earlier is better
72
Vertical growth event to consider
Vertical growth continue
73
Vertical implication for treatment
Retention of correction
74
What happens to the midpalatal suture as we age?
Becomes more interdigitated

Ortho (19 decks)

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