Transcript of "Prenatal and postnatal development of mandible /certified fixed

orthodontic courses by Indian dental academy "

1. 1. PRENATAL AND POSTNATAL DEVELOPMENT OF MANDIBLE INDIAN DENTAL
ACADEMY Leader in continuing dental education www.indiandentalacademy.com
www.indiandentalacademy.com
2. 2. PRENATAL DEVELOPMENT OF MANDIBLE www.indiandentalacademy.com
3. 3. CONTENTS 1. Period of Ovum 2. Period of Embryo 3. Period of Fetus 4. Meckels
cartilage 5. Neonatal mandible www.indiandentalacademy.com
4. 4. Period of Ovum 2 weeks 1.5 mm in length Cephalad differentiation not begun
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5. 5. Embryonal Period 14th to 56th day 3rd week- 3 mm 4th week- 5mm
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6. 6. 4 week embryo www.indiandentalacademy.com
7. 7. Contents of Mandibular Arch 1. Meckels cartilage 2. Musculature 3. Mandibular nerve 4.
Maxillary and External Carotid Artery www.indiandentalacademy.com
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9. 9. Fetal period 8th week till birth Tremendous acceleration is the theme Meckels
cartilage- precursor of mandibular mesenchyme www.indiandentalacademy.com
10. 10. Mandibular changes STUDY OF HUMAN FETAL MANDIBLE Ingham, J. Dent. Res,
1932 Observations:1. The alveolar plate lengthens more rapidly than ramus 2. The ratio of
alveolar plate length to total mandibular length is reasonably constant
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11. 11. 3. The width of the alveolar plate shows a more rapid increase than does total width 4.
The ratio of the width between the mandibular angle to the total width is relatively constant
during fetal life www.indiandentalacademy.com
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13. 13. Meckels Cartilage 41st 45th day of IUL Template Otic capsule - Symphysis
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14. 14. Ossification of Meckels cartilage Mandibular nerve Neurotrophic factor Osteogenesis
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15. 15. Ossification of Meckels cartilage Ectomesenchymal condensation at 36-38 days
Osteogenic membrane Primary ossification Intramembraneous bone lateral to cartilage
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16. 16. Ossification of Meckels cartilage Begins during 7th week Woven bone Lamellar bone
www.indiandentalacademy.com Haversian system 5th month
17. 17. Fate of Meckels Cartilage 1. Disappears by 24th week 2. Sphenomandibular ligament 3.
Resorbs on lateral surface dorsal to mental foramen 4. Ventrally- Accessory Endochondral
www.indiandentalacademy.com Ossicles
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19. 19. Fate of Meckels Cartilage 10th & 14th week Sec. accessory cartilages appear
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20. 20. Condylar Cartilage Growth rate increases at puberty(12 1/2-- 14 yrs) and ceases by 20
yrs www.indiandentalacademy.com
21. 21. Types of Ossification 1st one to ossify- 6th week of I.U.L Two types of ossification:- 1.
INTRAMEMBRANEOUS 2. ENDOCHONDRAL www.indiandentalacademy.com
22. 22. Parts of Mandible derived from INTRAMEMBRANEOUS Ossification 1. Whole of body
except anterior part 2. Ramus as far as mandibular foramen 1. 2. 3. 4. ENDOCHONDRAL
Ossification Anterior part of mandible Ramus above mandibular foramen Coronoid process
www.indiandentalacademy.com Condylar process
23. 23. NEONATAL MANDIBLE Low and wide ascending ramus Coronoid process is large
Body- open shell Mandibular canal runs low www.indiandentalacademy.com
24. 24. NEONATAL MANDIBLE www.indiandentalacademy.com
25. 25. Differential Growth At Birth Fetal life 8 weeks mandible>maxilla Mandible retrognathic
11 weeks mandible=maxilla Early post natal life Becomes orthognathic 13-20 weeks
maxilla>mandible www.indiandentalacademy.com
26. 26. POST NATAL GROWTH OF MANDIBLE www.indiandentalacademy.com
27. 27. Contents 1. 2. 3. 4. 5. 6. 7. Theories of growth Mechanisms of bone growth Skeletal units
of mandible Main sites of growth of mandible Condyle and great puzzle Current concept Age
changes in mandible www.indiandentalacademy.com
28. 28. Theories of Growth 1. Genetic theory- Brodie,1941 2. Scotts hypothesis, 1953 3. Sutural
dominance theory- Sicher, 1955 4. Functional matrix theory- Moss, 1962
www.indiandentalacademy.com 5. Van limborgh theory- 1970
29. 29. Mechanisms of Bone Growth 1. REMODELING 2. DISPLACEMENT: Primary
displacement Secondary displacement www.indiandentalacademy.com
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31. 31. Enlows V Principle Growth movement and enlargement of many facial and cranial
bones or parts of bones occur towards the wide ends of V www.indiandentalacademy.com
32. 32. Enlows Counterpart Principle Growth of any given facial or cranial part relates
specifically to other structural and geometric counterparts in the face and cranium Regional
part Counter part Balanced growth www.indiandentalacademy.com
33. 33. Growth Timings Overall growth of mandible takes place at different stages 1. 2. 3. First
there is increase in its Width Length Height www.indiandentalacademy.com
34. 34. Skeletal Units of Mandible www.indiandentalacademy.com
35. 35. Main sites of growth of Mandible Mandible undergoes largest amount of growth
postnatally and exhibits largest variability in morphology Principal growth sites are:1.
Posterior surface of ramus 2. Condylar process 3. Coronoid process/ alveolar process
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37. 37. Symphysis Menti 4-12th month after birth, syndesmosis is converted to synostosis No
widening after fusion www.indiandentalacademy.com
38. 38. Mental Foramen www.indiandentalacademy.com

39. 39. Alveolar Process Adds to height of mandible Tooth absent- process fails to develop
After tooth extraction, alveolar process resorbs www.indiandentalacademy.com
40. 40. Alveolar Process Buffer zone Adaptive remodeling makes orthodontic tooth movement
possible www.indiandentalacademy.com
41. 41. Ramus Bridges pharyngeal compartment Mandible in occlusion with maxilla
Remodeled in a posterosuperior manner www.indiandentalacademy.com
42. 42. Ramus to Corpus Remodeling Bicondylar dimension established early in childhood
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43. 43. Ramus to Corpus Remodeling Making room for molars www.indiandentalacademy.com
44. 44. Ramus and Middle Cranial Fossa Provides developmental potential for adaptations
required to place the corpus in a continuously functional position because of variations
elsewhere in the face and neurocranium. www.indiandentalacademy.com
45. 45. Antegonial notch Single field of resorption Mandibular foramen Relocates backward
and upwards Sustains midway location www.indiandentalacademy.com
46. 46. Size of notch depends On angle www.indiandentalacademy.com
47. 47. Lingual tuberosity Anatomic equivalent of maxillary tuberosity Boundary between
ramus and corpus Remodels in posterior and medial direction Resorptive field below
forms Lingual www.indiandentalacademy.com Fossa
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50. 50. Coronoid Process Propeller like twist www.indiandentalacademy.com
51. 51. Vertical V Horizontal V www.indiandentalacademy.com
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53. 53. The Mandibular Condyle Historically- regarded as kind of cornucopia No longer
believed as a pacesetting master centre Functions as regional field growth
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54. 54. The Mandibular Condyle Dual function1. Articular 2. Growth Not a primary center of
growth but rather 1. Secondary in Evolution 2. Secondary in Embryonic origin 3. Secondary
in Adaptive responses www.indiandentalacademy.com
55. 55. Condylar Growth Mechanism Special non vascular tissue Firm hydrophillic intercellular
matrix Endochondral growth mechanism- specific response to particular local circumstance
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56. 56. Histology of Condyle Capsular layerpoorly vascularised Proliferative
layerprechondroblasts closely packed with scanty matrix Zone of Deposition and
Resorption www.indiandentalacademy.com
57. 57. Proliferative process produces upward and backward growth movement
Multidirectional proliferative capacity www.indiandentalacademy.com
58. 58. Neck of the Condyle Lingual and buccal surfaces resorptive Condyle becomes neck
after remodeling Endosteal surfaces faces growth direction Periosteal surface points away
from it V principle www.indiandentalacademy.com
59. 59. The Condylar Question? Mandibles totally lacking condyles exist in nature Occupy
normal anatomic position and proper occlusion 2 conclusions1. Not the master center 2.
Displaced Anteriorly and Inferiorly without a push www.indiandentalacademy.com

60. 60. The Condylar Question? 1955- Weinmann and Sicher Major growth center
Explanation seems to be logical Charlier and Petrovic supported this theory If correct then
condyle would grow by 2 mechanisms1. Interstitial proliferation 2.
Appositionalwww.indiandentalacademy.com growth
61. 61. The Condylar Question? 1962- Moss, Functional matrix Hypothesis Questions the
primacy of Sicher theory Condyle is under influence of the growth of orofacial capsular
matrices Concept of dominance of epigenetic and www.indiandentalacademy.com
environmental factors is supported
62. 62. The Condylar Question? 1963- Koski et al Transplanted mandibular ramus of the
rat Recovered tissue was same as original Condyles with part of ramus
transplantedmeasurable growth 1968- Rankow and Moss Condylectomy in young
femaleimmediate downward and forward growth seen along with basal mandibular
www.indiandentalacademy.com translation and increase in vertical height
63. 63. Current concept Enlow Condyle does have intrinsic genetic programming but extra
condylar factors are needed Extra condylar factors are1. Intrinsic and extrinsic
biomechanical forces 2. Physiologic inductors www.indiandentalacademy.com
64. 64. More recent studies involve NerveMuscle-Connective tissue pathways Periodontal
membrane and soft tissue matrix--- sensory input higher centers motor input to muscles
repositions mandible affects growth and remodeling of condyle
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65. 65. Adaptive Role of Condyle Multidirectional growth potential If growth of mandible were
preprogrammed within condyle, mandible cannot fit into maxilla and basicranium
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66. 66. Chin Protrusive chin is characteristic of humans Males- more prominent Femalesless prominent www.indiandentalacademy.com
67. 67. Mental Protuberance Formed by mental ossicles Poorly developed in infants Forms
by osseous deposition Reversal line www.indiandentalacademy.com
68. 68. Factors affecting mandibular growth 1. 2. 3. 4. Systemic factors Genetic Hormonal
Nutritional Illness www.indiandentalacademy.com
69. 69. Factors affecting mandibular growth 1. 2. 3. 4. Local factors Ankylosis Trauma Birth
injury Ear infection www.indiandentalacademy.com
70. 70. Anomalies of mandible Syndromes associated with mandible 1. Pierrie robin syndrome
2. Treacher collins syndrome 3. Marfans syndrome www.indiandentalacademy.com
71. 71. Anomalies of mandible Congenital anomalies 1. Agnathia 2. Micrognathia 3.
Macrognathia www.indiandentalacademy.com
72. 72. Anomalies of mandible 1. 2. 3. 4. Developmental anomalies Torus mandiularis Stafnes
cyst Achondroplasia Odontogenic cyst www.indiandentalacademy.com
73. 73. Touras mandibularis Stafnes cyst www.indiandentalacademy.com
74. 74. Age changes of Mandible At birth Adult Old age 1 Mental foramen Near the lower border
Midway b/n upper & lower border Near the upper border 2 Angle of the mandible 3 coronoid
& condyloid processes Obtuse Right angle Obtuse Coronoid is larger & above condyle
Condyle is above the coronoid 4 Mandibular canal Runs little above the mylohyoid line
Present; two halves united fibrous tissue Runs parallel to the mylohyoid line Condyle is above

the coronoid but in extreme old age bent backwards Runs close to the upper border 5
Symphysis menti Represented by faint ridge only in the upper part
www.indiandentalacademy.com Not recognizable or absent
75. 75. References 1. Human anatomy- B.D. Chaurasia 2. Human Embryology- I.B Singh 3.
Craniofacial embryology SPERBER 4. CranioFacial growth ENLOW
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76. 76. 5. Contemporary orthodontics PROFFIT 6. Principles and practice of orthodontics
T.M GRABER 7. Study of human fetal mandible INGHAM, J Dent Resarch, 1932 8. Text
book of oral pathology- SHAFERS www.indiandentalacademy.com
77. 77. There is nothing new under the sun But there are lot of old Things we dont know Thank
You www.indiandentalacademy.com