DEVELOPMENT OF JAW AND

PALATE

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 Pharyngeal arches(review)
Mesodermal thickenings in the side wall of pharynx(most cranial part of
foregut), cover by ectoderm & lined by endoderm. They grow ventrally &
fuse with the corresponding arch of opposite side in the floor of
developing pharynx.
Arches appear in the 4th and 5th week of development.
There are 6 arches but 5th disappears soon.
Inside they are separated by endodermal depressions called pharyngeal
pouches
Outside they are separated by ectodermal depressions pharyngeal
clefts.
Each arch has

Mesodermal core-gives rise to muscles

Nerve supplying the muscles derived from that arch.
Skeletal element-cartilage that give rise to bone.
Artery-aortic arch arterycontribute to adult arterial system
 Primitive pharynx

Pharynegeal
cleft

Proliferation of mesenchyme of primitive pharynx

gives rise to 6 pairs of pharyngeal or branchial arches.
 Primitive pharynx

Mesenchyme for head region derived from

Parexial mesoderm(somites and somitomeres)
Lateral plate mesoderm
Neural crest cells(originating from
neuroectoderm) form the midfacial and
pharengeal arch skeletal structure
Ectodermal placode

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 The face develops from five primordia that appear in the 4th week:
the frontonasal prominence, the two maxillary prominences, and the two mandibular
prominences. The oropharyngeal membrane breaks down in the 5th week to form
the opening to the oral cavity. A, C, ventral views; B, oblique view.

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JAW DEVELOPMENT
 Maxillary processes
Two maxillary processes that are derived from dorsal portion
of the first pharyngeal arch form the following parts of face:

1. the upper parts of the cheeks( premaxilla, maxilla,zygomatic

bone, part of temporal bones)
2. the upper lip except the philtrum
3. the maxilla(upper jaw) and
4. the secondary palate.

Maxillary processes of either side grow medially push the

median nasal prominences

Between lateral nasal process and maxillary prominence

develops nasolacrimal duct.
 Mandibular processes
Two mandibular processes which are derived from
ventral portion the first pharyngeal arch contain
Meckels cartilage

The mandibular processes form the lower part of the

face including the lower parts of the cheeks and the
lower lip as well as the mandible(lower jaw).

Each half of Mandible/lower jaw is formed by

membranous ossification(6th wk of intra-uterine life) of
mesenchyme tissue, surrounding the Meckels cartilage,
which unit by fibrous joint at symphysis menti.
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PALATE DEVELOPMENT

Fig: Hard palate and upper jaw

 PALATE DEVELOPMENT
The palate is derived from two embryonic parts:
1. The primary palate
2. The secondary palate
Primary palate- It is the posterior extension of the intermaxillary
process( fused medial nasal processes). The primary palate forms
between the 5th and 6th weeks. In the adult, it forms the anterior part
of the maxillary alveolus which carries the four incisors and the most
anterior triangular part of the hard palate.
Secondary palate- derived from the maxillary processes and in the
adult it forms the major part of the hard palate, the soft palate and the
uvula. Palatal shelves start to grow medially from the inner
aspects of the maxillary processes between the 7th and 8th weeks of
intrauterine life and fuse with each other as well as with the primary
palate.
Palate formation is completed by the third month(12th week) of
intrauterine life. Failure of fusion of the palatal embryonic components
results in a cleft palate which could be partial or complete.
 Development of palate
Primary palate or median palatine process

By 6th week,
mesenchymal
proliferation of
inner portion of
inter maxillary
segment gives
rise to primary
palate.
 Development of palate
Secondary palate
or Lateral palatine process:

mesenchymal
proliferation of inner
portion of maxillary
process fuse with
each other, then
fuse with the
triangular primary
palate to form
secondary palate.
 Development of palate
Incisive foramen: the midline
landmark between the
primary and secondary
palates.
Hard palate:
intramembranous
mesenchymal
condensations/ ossification
of anterior portion of
secondary palate.
Soft palate: myogenic
mesenchyme condensation
of posterior portion of
secondary palate, gives rise
to the musculature of the
soft palate.
 Development of palate
While the secondary palate is
forming, ectoderm and
mesoderm of the frontonasal
prominence and the medial
nasal processes proliferate to
form a midline nasal septum
that grows down from the roof
of the nasal cavity to fuse with
the upper surface of the
primary and secondary palates
along the midline.

The nasal cavity is now divided

into two nasal passages that
open into the pharynx behind
the secondary palate through
openings called the definitive
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choanae.
 INTER-MAXILLARY PALATE FROM BELOW
SEGMENT

NARIS
PRIMARY PALATE/
Median palatine process

UPPER LIP

GUM
LATERAL PALATINE
PROCESS/SHELF

NASAL SEPTUM
(mostly from median
nasal processes)
 PALATE FROM BELOW a little later
Incisive foramen

PRIMARY PALATE/
Median palatine process
fuses with
LATERAL PALATINE
PROCESS/SHELF

Once the primary palate is

fused in place, the lateral
shelves meet & fuse zipper-
NASAL SEPTUM partly like towards the rear
hidden by palate
 PALATE FROM BELOW 12-w

GUM Frenulum of UPPER LIP

Developing 10 Incisors
not yet erupted
Incisive papilla
Raphe of
HARD PALATE

SOFT PALATE

Uvula last site to fuse

 Summary-Palate
Primary palate develops from the inner
portion of inter maxillary segment .

Secondary palate is formed from the

fusion of inner portion of maxillary process
with each other and then with the
triangular primary palate.
 Congenital malformations - Palate

Cleft palate

Cleft soft & hard

Unilateral cleft Bilateral cleft
palate
lip & palate lip & palate
 Congenital malformations - Palate

Fig: Ventral view of the palate, gum, lip, and nose. A. Normal. B. Unilateral
cleft lip extending into the nose. C. Unilateral cleft involving the lip and jaw and
extending to the incisive foramen. D. Bilateral cleft involving the lip and jaw. E.
Isolated cleft palate. F. Cleft palate combined with unilateral anterior cleft lip.
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 APPLIED ANATOMY
The face, jaw and palate is formed by the growth and fusion of five facial
swellings(processes). Complete or partial failure of fusion between any of
these processes results in a facial cleft, which may be unilateral or
bilateral, and is a component of more than 300 syndromes.

The two most common types of facial cleft are:

cleft lip - results from failure of the maxillary process(prominence) to
fuse with the intermaxillary process. The cleft may range in length from a
minor notch in the vermilion border of the lip (lies just lateral to the
philtrum) to a cleft that completely separates the lateral lip from the
philtrum and nasal cavity. The depth of clefting also varies: involve just
the soft tissue of the lip; or divide the lateral portion of the maxillary bone
from the premaxillary portion (the portion bearing the incisors) and from
the primary palate. Clefts of this type often result in deformed, absent, or
supernumerary teeth.
cleft palate- which results from the failure of the two palatine shelves to
fuse with each other along the midline during the 7th to 10th weeks.

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 Applied anatomy-cleft palate
Cleft palate (failure of the fusion of palatine shelves) may result from a
variety of causes which include: inadequate growth of the palatine
shelves (neural crest cell migration, proliferation, or excess apoptosis),
failure of the shelves to elevate at the correct time, an excessively wide
head, and secondary rupture after fusion.

Cleft palate may also occur as a secondary consequence of

mandibular dysplasias. During normal development, the mandibular
primordium grows, thereby lowering the tongue relative to the palatal
shelves and allowing them to elevate. If the first pharyngeal arch does
not develop appropriately, the tongue will not be lowered and will
physically obstruct palatal shelf elevation. This secondary cleft palate
resulting from a smaller lower jaw (microagnathia) and occurring with
backward displacement of the tongue(glossoptosis) is referred to as
Pierre Robin sequence .It can also be part of syndromes like Stickler
and Treacher Collins syndromes.

Most cases of cleft palate are multifactorial in etiology involving both

genetic susceptibility and environmental factors. Teratogens such as
phenytoin, vitamin A and its analogs, and some corticosteroid anti-
inflammatory drugs also can cause cleft palate. 24
A. Incomplete cleft lip. B. Bilateral cleft lip. C. Cleft lip, cleft jaw, and cleft
palate

D. Isolated cleft palate. E. Oblique facial cleft. F. Midline cleft lip 25

OROFACIAL MALFORMATIONS : Agents

MEDICINES Vitamin A/Retinoids, Cortisone

DIETARY DEFICIENCIES Folic acid

TOXINS ethanol/alcohol, fluoride

INFECTIONS Rubella/German measles

FEBRILE ILLNESS

GENETICS

CHEMOTHERAPY
EXCESS RADIATION
Thank You

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