Growth and Development of Mandible / Orthodontic Courses by Indian Dental Academy

GROWTH AND
DEVELOPMENT OF
MANDIBLE

INDIAN DENTAL ACADEMY

Leader in continuing dental education
www.indiandentalacademy.com

INTRODUCTION
The human mandible has no one design for
life. Rather it adapts & remodels through the
seven stages of life, from the slim arbiter of
things to come in infant, through a powerful
dentate machine & even weapon in the full
flesh of maturity, to the pencil thin, porcelain
like problem that we struggle to repair in the
adversity of old age.

prenatal growth of mandible
PRENATAL GROWTH OF
MANDIBLE

Nerveosteogenesis(Neurotrophic
factors)

Ectomesenchyme

interacts(36-38days iul)

Epi of 1
st
Arch

Osteogenic Memberane
1 centre of ossification(6
th
week)

Inferior Alv Nerve
Incisive branch
around
below
Trough for acc dev Tooth buds
spread of IM ossification
dorsally and ventrally
body and ramus of the
mandible

presence of neuromuscular
bundleMandibular
foramen and canal and
mental foramen

Fate of Meckel`s cartilage
PRENATAL GROWTH OF
MANDIBLE
SECONDARY ACC CARTILAGES
(10
TH
-14
TH
WEEK I U L)

-condylar cartilage

-coronoid cartilage

-Mental ossicle cartilage
PRENATAL GROWTH OF MANDIBLE
Secondary cartilage of coronoid process

Develop within temporalis muscle

Incorporated into IMB of ramus

Disappear before birth

PRENATAL GROWTH OF
MANDIBLE
1/2 Cartilages

Mental ossicles
Intramembranous bone
syndesmosis

synostosis
Ossify (7
th
month of IUL)
PRENATAL GROWTH OF
MANDIBLE
CONDYLAR CARTILAGE(10
TH
WEEK IUL)

Grow interstitially and oppositionally

CONDYLAR CARTILAGE

1
ST
Evidence of endochondral bone (14
th
week iul)

Much of cartilage replaced with Bone by middle of fetal life

Upper end Growth cartilage and Articular cartilage

Changes Mand position and form

Growth at puberty peak b/n 12 -14yrs

Ceases 2o yrs of life

NEONATAL MANDIBLE
RamusLow & wide

coronoidlarge & above
the condyle
Bodyopen shell
containing tooth buds

Mand canallow in the
body
DIFFERENTIAL GROWTH
During fetal life
8weeks - MANDIBLE> MAXILLA
11weeks -MANDIBLE= MAXILLA
13-20weeks-MAXILLA>MANDIBLE

AT BIRTH
Mandible tends to be retrognathic
Early postnatal life -orthognathic
POST NATAL GROWTH &
DEVELOPMENT OF
MANDIBLE

MECHANISMS OF GROWTH

Growth Of The Mandible Primarily Involve

Bone remodeling
Process Of Bone Deposition And Resorption

Cortical drift
Combination of bone deposition and resorption resulting in
growth movement towards deposition surface

Displacement
Movement of whole bone as a unit
I) Primary displacement
II) Secondary displacement

THEORIES OF GROWTH
GENETIC THEORY

Bone primary determinent

Cartilage primary determinent

The soft tissue matrix
SUTURAL THEORY
Craniofacial growthsutures

Suture transplanted

Sutures pulled apart

Sutures compressed

Sutures are sites that react not primary
dereminants

CARTILAGINOUS THEORY
Growth of maxilla Nasalseptum cartilage
Transplantation
Epiphyseal plate
Nasalseptal cartilage
Condylar cartilage

Removal of condyle

FUNCTIONAL MATRIX THEORY OF
GROWTH

Skeletal growth occur as a response to
functional needs & mediated by the soft
tissue in which it is embedded

ENLOWS EXPANDING V
PRINCIPLE
The growth movement &
enlargement of these Bones
occur towards the wide ends
of the V as a result of
differential deposition &
selective resorption
ENLOWS COUNTERPART
PRINCIPLE
The growth of any given facial /cranial part
relates specifically to other structural &
geometric counterparts in the face &
cranium
Diff parts & counter parts
Maxillary & Mandibular arches
Middle cranial fossa breadth of Ramus
Parts of Mandible derived From

1. INTRAMEMBRANOUS OSSIFICATION
* Whole body of mandible except the anterior part
* Ramus of mandible as far as mandibular foramen

2 . ENDOCHONDRAL OSSIFICATION
* Anterior portion of the mandible (symphysis)
* Part of ramus above the mandibular foramen
* Coronoid process
* Condylar process

Timing of growth
Growth in width is completed 1
st
then
growth in length finally growth in height
Growth in width
Intercanine width does not much after 12yrs

Both molar & bicondylar width show small
until the end of growth in length

Ant width stabilize earlier
Growth in length
Continues through the period of puberty
Girls 14 -15 yrs
Boys 18 yrs
POST NATAL GROWTH OF
MANDIBLE
Mandible Developmentally & Functionally
divisible into skeletal subunits

Mandible undergoes largest amt of growth
postnatally and exhibits largest variability in
morphology

The main sites of postnatal growth
At condylar cartilages
Posterior border of rami
Alveolar ridges

THE RAMUS

Key role of ramus in placing the corpus &
dental arch into ever changing fit with
growing maxilla & the faces limitless strl
variations

By Remodeling adjustments in Ramus
length & Ant post width.

THE RAMUS
Relocates postly Deposition posteriorly

Resorption anteriorly
LINGUAL TUBEROSITY
Direct Anatomic equivalent of Max tuberosity

Inaccessible to cephalometric studies

Major Growth & Remodeling site

Effective boundary b/n Ramus & corps

LINGUAL TUBEROSITY
Deposition Postly & Medially
Resorption Below (Lingual fossa )
Lingual Tuberosity
Remodels in post direction with
slight lateral shift

Lingual shift of Ant part of Ramus

Length of corpus

Ramus to carpus Remodeling
Making room last
Molar
Ramus to carpus Remodeling
Coronoid process
Propellar like twist
Lingual side faces
posteriorly
superiorly
medially
Coronoid process
Fallows V PRINCIPLE

V oriented vertically
Coronoid process
v PRINCIPLE

VOriented horizontally
Coronoid process
Coronoid process medially
to become post part of carpus
Buccal side Resorptive
Ramus
Superior part of
ramus the area below
sigmoid
notch
Ramus
Antigonial notch
Size of the notch ed
downward rotation
Of carpus relative to the
Ramus
The size of the notch depends upon Ramus Carpus junction
Post edge Ramus is a major
growth site

Condyle grows obliquely upward &
backward

The angle of growth is variable

The gonial region is Anatomically
variable
Mand Foramen midway b/n
Ant & post borders of Ramus
The Mandibular condyle
Secondary cartilage

not a primary center of growth, but rather
* Secondary in Evolution
* Secondary in Embryonic origin
* Secondary in adaptive responses
condyle
Cartilage is special nonvascular tissue

firm matrix unyielding to the pressure

Endochondral growth mechanism

Provides pressure tolerant articular
contact

Multidimensional growth capacity in
response to ever changing developmental
conditions & variations
Capsular layer of poorly
vascularised connective
tissue highly cellular

Chondroblasts cellular
proliferation

Chondroblasts
hypertrophy

Zone of resorptive &
Bone deposition
Proliferative process
produces upward &
backward growth
movement

Multidirectional
proliferative capacity-
the arrangement of
daughter cells does
not reflect direction of
growth
The cortical layer of IMB
continues on to the
condylar neck

Ant margin of condylar
neck depository
grows supely

post margin - depository
grows on to post barder
of ramus
Lingual & Buccal
sides - Resorptive

V-shaped cone of condylar neck growing
towards its wider end
The condyle cant play king pin role of
Master center in pace-setting the growth

Bilaterally condyle-lacking mand occupy
normal Anatomic position

Condylar remodeling acts with displacement
as co-participants but not as driving force
Current concept
Condylar cartilage does have some intrinsic
genetic programming

But extracondylar factors are needed to sustain
this activity
1)Intrinsic & extrinsic biomechanical forces
2)physiologic inductors

ENLOW;
amt of pressure inhibit the growth
amt of pressure stimulate the growth
Mandible is less responsive to orthopedic
forces than maxilla

Mand orthopedics must modify growth
signals targeted at both ramus & condyle
to
be maximally effective
MENTAL FORAMEN
ALVEOLAR PROCESS
Adds ht & thickness to the
body of the Mand

Teeth absent fails to develop

Resorbs after tooth extraction
Alveolar process
Maintain occlusal relationship during differential
mandibular & midfacial growth buffer zones

Maintains vertical height

Adaptive remodeling makes orthodontic tooth
movement possible

Lingual movement of anteriors
Mental protuberance
Formed by mental ossicles from accessory
cartilage and ventral end of Meckels cartilage

Poorly developed in infants

Mental protuberance
Forms by osseous deposition
during childhood

Prominence is accentuated by
bone resorption above it

Reversal between 2 growth
fields

Concave convex

Reversal line could be High or
low
Chin
Protrusive chin is unique human trait

More prominent in male

Less prominent in female
Factors Affecting Growth
Systemic Factors
Genetic
Hormonal imbalance
Nutrition
Systemic illness or chronic illness
Localized alteration/ diseases of uterus
Systemic illness in mother
Drugs


1. Vascular abnormality
2. Lymphatic disturbance
3. Neurologic disease
4. Local infection
5. Ear infection or mastoiditis
6. Ankylosis
7. Trauma or fracture
8. Birth injury
9. Habits

B) Local factors
Anomalies of mandible
Some of the syndromes associated with
mandibular abnormality
1)Downs syndrome
2)Marfans syndrome
3)Turners syndrome
4)Kleinfelters syndrome
5) Pierre-robin syndrome
6) Treacher- collin syndrome

Congenital
Agnathia
Micrognathia
Macrognathia
Facial hemihypertrophy
Facial hemiatropy

Developmental

Infantile cortical hyperostosis

Achondroplasia

Torus mandibularis

Stafnes cyst

Odontogenic cyst

Odontogenic tumor
Age changes of Mandible
At birth
Adult
Old age
1 Mental
foramen

2 Angle of the
mandible
3 coronoid &
condyloid
processes

4 Mandibular
canal

5 Symphysis
menti
Near the lower
border

Obtuse (180)

Coronoid is
larger & above
condyle

Runs little
above the
mylohyoid line
Present;two
halves united
fibrous tissue
Midway b/n upper
& lower border

Right angle

Condyle is above
the coronoid

Runs parallel to
the mylohyoid line

Reprasented by
faint ridge only in
the upper part
Near the upper border

Obtuse (140)

Condyle is above the
coronoid but in
extreme old age bent
backwards
Runs close to the
upper border

Not recognisable or
absent
References
* Craniofacial embryology SPERBER
* Facial growth ENLOW
* Contemporary orthodontics PROFFIT
* Handbook of orthodontics MOYERS
* Principles and practice of orthodontics GRABER


Thank you

For more details please visit


Growth and Development of Mandible / Orthodontic Courses by Indian Dental Academy

Загружено:

Сведения о документе

Оригинальное название

Авторское право

Доступные форматы

Поделиться этим документом

Поделиться или встроить документ

Параметры публикации

Этот документ был вам полезен?

Это неприемлемый материал?

Авторское право:

Доступные форматы

Growth and Development of Mandible / Orthodontic Courses by Indian Dental Academy

Загружено:

Авторское право:

Доступные форматы

GROWTH AND

Вам также может понравиться