1. growth & development
- 2. General concepts of growth Growth Assessment Bone formation and growth control Growth of craniofacial complex
- 3. Growth Development Increase in size - increase in & number complexity Anatomical - increase in specialization - phsiological or behavioral
- 5. Reflects proportionality overtime Allows predictability Ex: changes in overall body proportions - cephalocaudal gradient of growth
- 6. Not all tissues grow at the same rate
- 7. Individuals are not alike in the way they grow It is important to know if an individual is at the extreme of a normal variation or outside the normal range
- 8. The same events happen to different individual at different times ( biologic clock) Some children grow quickly and mature early Chronological age Vs Development age CA is not a good indicator of growth status because of timing and variability
- 9. To determine optimum time for treatment(growth modification & surgery) To determine the amount of growth left To determine type of growth
- 10. “ Brachy”tends to grow horizantly “ Dolicho” tends to grow vertically Knowing the general pattern of growth and the expected direction can be helpful in orthodontics diagnosis and treatment planning . Vertical Growth Damages Faces (Dolicocephalic) Horizontal Growth Improves Faces (Brachycephalic)
- 11. Bone ,teeth,sometimes cartiladge Hyperplasia hypertrophy Mineralized ECM Interstitial growth is Impossible after calcification Direct or surface deposition Everything including some cartiladge except bone and teeth Hyperplasia Hypertrophy and secretion of ECM occur in the surface
- 12. The sites of growth Type of growth Control of growth
- 13. Flat bones –intermembranous bone Ossification center Apposition of new bones at the cranial sutures ,periosteal activity (remodelling)-pressure from the growing brain Bone resorption from the inner surface and bone deposition in the outer surface - remodelling
- 14. Bones of the base of the skull are formed by endochondreal ossification . Centers of ossification appears leaving some cartilage called synchondroses in between These are the growth sites . Sphino-occipital . Intersphenoid . Sphenoethmoidal
- 15. Cranial base grows by endochondreal ossification that occurs at both margins of the synchondrosis.
- 16. Intermembranous Growth occur by : . Apposition of bone at the sutures that connect the maxilla to the cranium . Surface remodelling Downward and forward – anterior maxilla is the area of resorption
- 17. Growth of the surrounding soft tissue translates the maxilla downward and forward ,opening spaces in the sutures where bone is added
- 18. Remodelling of the palatal vault moves it 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 On the anterior surface ,bone is removed ,partially cancelling the forward translation ,as the vault moves downward ,the same process of bone remodelling also widen it .
- 20. Intermembranous and endochondral Cartridge-condyle Growth sites : . Chin inactice .translated downward and forward by growth at the mandibular condyle along the posterior border of the ramus . The body grows longer by periosteal apposition of bone on its posterior surface . The ramus grows higher by endochondral replacement at the condyle accompanied by surface remodelling . growth is upward and backward
- 21. Remodelling is done by resorption in the anterior part of the ramus and deposition in the posterior part of the ramus
- 24. Overall growth direction results in a downward and forward displacement with most of growth occuring in the ramus .
- 26. Orthodontics alternative Official Site for Natural Growth Guidance.flv