Facial Growth and

Development
Mary Noelyn Degoma
 INTRODUCTION

Growth can be defined as an increase in size

by natural development.
 INTRODUCTION

• Craniofacial growth, which includes the growth of

the cranium and facial bones, is still a mystery.
• However, the locations where cranial bone
growth occurs and how this modifies the structure
of the bones and the face are well documented.
 EARLY CRANIOFACIAL
DEVELOPMENT
• Craniofacial growth problems account for three-
quarters of all birth defects. Knowledge of early
formation of facial tissues can help us understand
how these problems occur.
• The fertilized egg divides rapidly into a ball of cells,
or blastocyst. During the fetal stage, development is
predominantly growth, without significant further
differentiation.
 NEURAL CREST
• Neural crest cells are responsible for
many specialized tissues of the
craniofacial region of the human body.
• They migrate to the facial area from the
tips of the neural crests, which join to
form a tube around the primitive spinal
cord in very early embryonic
development.
 NEURAL CREST
• Neural crest cells are responsible for
many specialized tissues of the
craniofacial region of the human body.
• They migrate to the facial area from the
tips of the neural crests, which join to
form a tube around the primitive spinal
cord in very early embryonic
development.
PHARYNGEAL ARCHES
• Pharyngeal arches form as part of the
preserved genetic segmental patterning
that occurs in many different species.
• Each arch contains cartilage, muscle,
blood supply, and a nerve. The first arch
structures also include some of the
bones of the middle ear and the
external ear.
FACIAL DEVELOPMENT
• Pharyngeal arches form as part of the
preserved genetic segmental patterning
that occurs in many different species.
• Each arch contains cartilage, muscle,
blood supply, and a nerve. The first arch
structures also include some of the
bones of the middle ear and the
external ear.
 FACIAL DEVELOPMENT

• The development of the face begins around

the end of the fourth week i.u. with the
appearance of five swellings, or processes,
around the stomodeum (primitive mouth).
Mechanisms of The process of new mineralized
bone formation bone formation is known as
ossification.
and growth This can occur in two ways:

• Intramembranous ossification—
formation of bone in a membrane.
• Endochondral ossification—
bony replacement of a cartilage
model.
Mechanisms of
Intramembranous ossification
bone formation
and growth • occurs during embryonic
development in sheet-like
osteogenic membranes. The bones
of the calvarium, facial bones, most
of the mandible, and the clavicle
are formed by intramembranous
ossification.
Mechanisms of Endochondral ossification
bone formation
and growth • Endochondral ossification occurs in
all other bones of the skeleton. It
begins in ossification centres in
cartilage models of the bones and
spreads out from these primary
ossification centres. Growth at
primary ossification centres causes
expansion.
CONTROL OF CRANIOFACIAL
GROWTH
• Some researchers believe that there is
tight genetic control of facial growth at
primary growth cartilages in the facial
skeleton, the nasal septal cartilage for
maxillary growth, and the condylar
cartilage formandibular growth. Although
these cartilages are necessary for facial
growth they do not appear to be primary
growth centres.
CONTROL OF CRANIOFACIAL
GROWTH
• Other researchers believe that growth
occurs due to growth of surrounding
soft tissues, the ‘functional matrix’
theory
Factors • GENETIC FACTORS
affecting • NUTRITION
• ILLNESS
growth and • HORMONES
development •
•
RACE
SOCIOECONOMIC FACTORS
• FAMILY SIZE AND BIRTH ORDER
• EXERCISE
• SECULAR TRENDS
• CLIMATE AND SEASONAL EFFECTS
• PSYCHOLOGICAL FACTORS
Pattern,
variability •

and timing of
growth
•
•
Pattern of
• In studies of growth and development,
the concept of pattern is an important
one. Pattern in general terms
growth indicates the proportionality of the
given object in relation to its various
sizes.
• However, in the concept of growth, it
refers not only to the proportionality
at a point of time but also to changes
in this proportionality over a period of
time
 • There is an axis of increased growth
Cephalocaudal extending from head towards the

gradient of feet
• In fetal life, about the third month of
growth intrauterine development (IUD), head
occupies 50 percent of the total body
length and within the head the
cranium is large relative to the face.
The trunk and limbs are rudimentary.
 • At birth: head-39 percent of total body
Cephalocaudal length , Legs-1/3rd of total body length
• ln adults: head-12 percent of total body
gradient of length , Legs- 1/2 of the total body length
Therefore, with growth, trunk and limbs grow
growth faster than the head and face
 • Even within the head and face, the
Cephalocaudal cephalocaudal growth gradient
strongly affects proportions and
gradient of growth leads to changes in proportion with
growth.

• When the skull of a newborn infant is

compared proportionally with that of
an adult, it is easy to see that the
infant has a relatively much larger
cranium and a much smaller face.
DIFFERENTIAL GROWTH-SCAMMON’S
CURVE OF GROWTH

• Another aspect of the normal growth pattern is that , not all

the tissue systems of the body grow at the same rate.
• Scammon's has classically described the growth of various
tissues. Obviously, the muscular and skeletal elements grow
faster than the brain and central nervous system, as reflected
in the relative decrease of head size. The overall pattern of
growth is a reflection of the growth of the various tissues
making up the whole organism.
DIFFERENTIAL GROWTH-SCAMMON’S
CURVE OF GROWTH

• To put it differently, one

reason for gradients of
growth is that different tissue
systems that grow at
different rates are
concentrated in various parts
of the body
•

• There is a rhythm seen in body stature or

height
• The first wave is seen 5th to 6th year.
• Then follows a slower increase terminating in
boys at 10 to 12 years and in girls no later
than 10 years.
• Then during the adolescence period there is
acceleration seen which ends in girls around
16 years and in boys around 18.
•

•
•

• Since everyone is not alike in the way

they grow, it is clinically very difficult to
decide and decipher the deviation of
growth pattern of an individual from the
normal.
•

• To evaluate the present growth status of

the individual
• To follow the child's growth over a period
of time using such charts.
•

•
▪Remodeling
▪Growth fields, sites, centers
▪Growth movement
 Remodeling
•

•
 Growth fields
• The outside and inside
surfaces of bone are
blanketed by mosaic-like
pattern of soft tissues,
cartilage or osteogenic
membrane called as
“growth field”

• These when altered are

capable of producing growth in
a particular bone.
Displacement Growth
Displacement is the movement of
whole bone as a unit.
It is of 2 types:
Movement
• primary displacement/
Translation
• secondary displacement/
Translocation

Drift
Cortical drift is the type of
growth movement occuring
towards the depository surface
by a combination of resorption
and deposition.
Displacement
•

• According to this theory, all growth in

a body is controlled by genetic
influence and is pre-planned.
• The role of genetic tissues in growth
is controlled by epigenetic influences
from other tissue groups and their
functional, structural and
developmental input signals.
•

• This theory postulated that all of the

craniofacial skeletal growth occurs only by
bone remodeling.
• It also stated that the cartilages of
craniofacial skeleton have little to no role in
growth of craniofacial skeleton.
•

• This theory also acknowledged the genetic

influence on growth
•

• This theory also acknowledged the genetic influence on growth

•
• According to Moss, bone growth within the craniofacial skeleton is influenced primarily by
function.
• This concepts attemps to establish a relationship between form and function.
• It stresses the dominance of non-osseous structures over skeletal components.
• Thus, the origin, form, growth, position and maintenance of all skeletal tissues is always
secondary, compensatory and mechanically obligatory to chronologically and morphologically
prior events that occur in specifically related non-skeletal tissues.
Enlow’s ‘V’ principle
of growth •
(area relocation
theory)
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Thank You!