LAPORAN TUTORIAL SGD

7 SKENARIO 1

Dosen Pembimbing
Tutorial Drg. Hesti
Widyawati, MH Disusun
Oleh:
1. Rafhana fidalina 074 (Moderator)
2. M. Viras Abdillah 081 (Scribble)
Anggota :

1. Imelda Florencea 063

2. Uut Oktavia 064
3. Mauriska Nada Silmi Al Misky 065
4. Alifvia Ayu Salsabila 067
5. Tiesa Adila Shahrani 068
6. Aulia Nur Magfiroh 071
7. Nabila Husna Rizka 073
8. Malik Aqil Choiri 078

FAKULTAS KEDDOKTERAN GIGI

UNIVERSITAS MUHAMMADIYAH
SEMARANG 2023
 KATA PENGANTAR
Thank God we pray for the presence of Allah SWT because of His grace
and grace we can complete Scenario 1 BDS 1.

We have compiled this scenario report in order to 2ulfil the task that has
been given to us. On this occasion, we would like to thank those who have helped
in completing this scenario report, especially drg. Hesti Widyawati, MH as BDS 2
SGD 7 Tutorial Lecturer, who always helps and guides us, so that we can finish
this scenario report properly.

We have compiled this report to broaden and add to our insights as well as
share information, knowledge, insights from readers, especially students. We are
aware that there are many shortcomings in this tutorial report, therefore we expect
criticism and suggestions from readers for the perfection of our next report.
Hopefully this report can be useful for readers.

Semarang, 12 Mei 2023

Drafting Team
 BAB I
PENDAHULUAN
Latar Belakang
Marriage is a bond between a pair of human children to form a family that
unites the genetic material from the female and the male. The gametes carried by
the female are called eggs (ovum) while the gametes carried by the male are
called sperm. The meeting of the two gametes in the maternal uterine tube begins
the development of a zygote, which is the origin of an individual. Oogenesis is the
process of forming female gametes that involves meiosis to produce haploid egg
cells (gametes). Spermatogenesis is the process of formation of male gametes
which also involves meiosis to produce haploid spermatozoa (gametes). The union
of the haploid number of chromosomes from each gamete, as many as 23 pieces,
will produce diploid chromosomes, a total of 46 pieces in the zygote. All the
characteristics inherited from an individual will be formed and determined at the
meeting of the two gametes. Human growth and development is strongly
influenced by many factors, it can be influenced from the prenatal and postnatal
phases. Growth and development in humans has many complex processes.

The human body consists of four main tissues, namely neural, somatic
(including muscle and bone), lymphoid and genital/sexual. This aspect of
increasing in size occurs in general body growth. Head growth describes the
aspect of differential growth. The baby's head increases in size as it matures, but
when compared to the overall body size, the adult head will appear to be reduced
in size when compared to the baby's head. The growth of the maxilla and
mandible is important to walk in balance so that a cleft palate does not occur. The
process of forming the palate includes the primary palate and the secondary
palate. The structure formed by the two protrusions that come together is the
intermaxillary segment. This structure consists of a lip component, which forms
the philtrum of the upper lip, a maxillary component, and a palatal component,
which forms the primary palate. Although the primary palate originates from the
intermaxillary segments, the major part of the definitive palate is formed by two
blade-shaped outgrowths from the maxillary prominence.
 SKENARIO 1
Where do our jaws come from
Ahmad,a pre clinical dentistry student,was reading a book about facial growth and
development,later the found his curiosity on the picture below.

picture shows an illustration of a developing embryo. Ahmad was shocked

knowing the picture was the beginning of the jaws that he used for eating
and talking. Using this picture, he did some research thoroughly into the
embryological process of the jaw. It turned out that in addition to bones, soft
tissues also had undergone its growth during prenatal period of the embryo.

Keywords: embryology, jaws, palate

RUMUSAN MASALAH

1. Facial development
2. The process of maxillary embryology
3. The process of mandibular embryology
4. Growth and The development of the palate
5. Ayat Al-Quran dan Hadits
TUJUAN

1. Students are able to explain facial development

2. Students are able to explain the process of maxillary embryology
3. Students are able to explain the process of mandibular embryology
4. Students are able to explain the growth and development of the palate

MANFAAT

1. Students can understand the process of facial development

2. Students are able to understand the process of maxillary embryology
3. Students are able to understand the process of mandibular embryology
4. Students are able to explain the growth and development of the palate
 BAB II
PEMBAHASAN

1. FACIAL DEVELOPMENT
Facial Embryology Facial embryology begins with the development of the
head and neck. When the head begins to form, the embryo consists of three layers
of tissue, namely the ectoderm, mesoderm, and endoderm. The development of
the head and neck has a distinctive picture located in the pharyngeal arch or called
the brankial arch. The arch develops in weeks 4 and 5. Pharyngeal arch plays a
role in the process of head formation but does not play a role in shaping the neck.
At the end of the 4th week, the pharyngeal arch surrounds the central part of the
face formed from the stomodeum. The three mudigahs aged 32 days or 41/2
weeks, there are five pharyngeal arches, namely a). The first pharyngeal arch
(mandibular protrusions), next to the caudal stomodeum. b).The second
pharyngeal arch (maxillary protrusions), located on the lateral side of the
stomodeum c). Third pharyngeal arch (frontonasal protrusions), a spherical
protrusion next to the caudal stomodeum. d. The fourth and fifth pharyngeal
arches whose cartilage unites to form the thyroides, cricoidea, corniculata, and
cuneiforme cartilage of the larynx.

The protrusion above the stomodeum, called frontonasal processes,

contributes to the development of the nose and upper lip. Two mandibular
processes
are located in the lower and lateral stomodeums that contribute to the
development of the lower jaw and lips. Maxillary processes are above the
mandibular processes that contribute to the mand in the development of the upper
jaw and lips In week 5, two protrusions grow, namely lateral processes (maxillary
swelling) and frontonasal processes (median nasal swelling). Over the next 2
weeks maxillary processes will continue to expand progressively to the medial
and press frontonasal processes towards the midline. The union of these two
protrusions will form the lips. From the maxillary processes will grow 2 shelfike
called palatine shelves which will form primary, secondary and foramen incisivus
palate in week 7.

There is a maxillary protrusion that will continue to increase in size and

will also grow towards the medial, thus forcing the nasal protrusion to the medial
towards the midline in the next two weeks. The medial nasal protrusion and
maxillary protrusion will disappear because the two protrusions come
together.The maxillary protrusion will disappear because the two protrusions are
united.The upper lip is formed by the medial nasal protrusion and both maxillary
protrusions while the lateral nasal protrusion does not participate in the formation
process. The lower lip and lower jaw are fused at the midline. The maxillary
protrusion and lateral nasal protrusion are separated by a deep groove called the
nasolacrimal groove. The ectoderm in this groove forms a dense epithelial cord
that breaks away from the ectoderm below. It is this rope that forms the
nasolacrimalis duct whose upper end will form the lacrimalis sacus after
canalization. The maxillary protrusion and lateral nasal protrusion will merge after
the strap is released. Then the lacrimal duct will run along the medial edge to the
inferior meatus of the nasal cavity. The
cheekbones are the articulation of the zygomatic bone and the zygomatic process
of the temporal bone. The repetition center originates in the lateral membrane and
follows the development of the eye by the end of the second month. The shape of
the face of adults is affected by the development of paranasale sinuses, conchae
nasales and dentition.

At week 5 of IUL, proliferation of mesenchyme frontonasalis around the opening

of the nostrils produces the medial and lateral nasal processes. Processus
maxillary grows in a medial direction from a lateral position to form the lateral
aspect of the maxilla. On the 6th week of IUL, from maxillary process will form
two shelflike, so-called palate blades. These three elements (a processus nasalis
which fused and the two maxillary processes) play a role in shaping upper lip,
upper alveolar, and primary palate which occur approx 6th week of IUL. In the
7th week of IUL the palate blades will be rise to a horizontal position above the
tongue and fuse with each other form the secondary palate. The part of the palate
that originates from maxillary process is called the secondary palate. On the front
union of these two blades with the triangular primary palate will form the incisive
foramen. Development of a face humans have seen. The upper lip has fused, and
has
Figure 1

Embryo at 6 weeks IUL. A. Formation of the upper lip and below, B. and C.
sagittal sections of the head showing development of the intermaxillary segments
of the fusion processes medial nasal cavity on the inside of the stomodeum.

Figure 2.

Formation of the branchial

arches at 3 weeks of IUL.

The first branchial arch is also called the arch mandible, which is composed of
functioning Meckel's cartilage as the mandibular developmental framework, then
almost all Cartilage substance disappears, mandible mostly undergo
intramembranous ossification except mental ossicles,condyle, and coronoid
Figure 2 Facial development at 4th and 8th week of IUL

2. THE PROCESS OF MAXILLARY EMBRIOLOGY

Facial development occurs between the 4th week and the 10th IUL. A hole
develops in the center between the brains and a heart that will become the oral
cavity (stomodeum).Beneath this opening is the I branchial arch (arch
mandibularis). The maxillae that form the cheekbones develop from the first arc.
The second branchial arch is called the hyoid.This overall arch is important in
facial development and neck.

The head still looks folded, part of the brain is developing into the forebrain,
midbrain, and subbrain behind. Migration of neural crest cells will complete
embryonic connective tissue (mesenchyme) needed for craniofacial development.
During the 4th week of IUL, cavity the mouth (stomodeum) is bordered by a large
face. At stage Early in development, the oropharyngeal membrane separates the
cavity mouth of the developing pharynx. On the 5th week IUL, proliferation of the
surrounding frontonasal mesenchyme the opening of the nostrils which gives rise
to the nasal processes medially and laterally. At 6th week of IUL, from the upper
corner of the mouth the maxillary process develops into the lateral nasal process
to medial. In the 7th week IUL was visible development of a human face. The
upper lips have fused,and a philtrum has formed.
The maxilla develops within the maxillary process is a derivative of the first
branchial arch (arch mandibularis), and is composed as a whole by tissue
fibrocellular (mesenchymal up to approx. 6 weeks IUL). The maxilla undergoes
intramembranous ossification. Maxillary ossification begins in the 7th week,
slightly later than the mandible. From some center that appears as a band of
fibrocellular tissue in the outer part of the nasal capsule, near a point where the
ramus alveolar superior anterior is a branch of the nerve infraorbitalis, and slightly
above the enamel of the dental lamina canine.

The maxilla that forms the cheekbones develops from the first arch of the brankial
arch to II called hyhoid. The maxilla develops in the maxillary processus which is
a derivative of the branchial arch ( mandibullar arch ),and is composed enteroly of
fibrocelllular tissue.

The maxilla is fussed with the base of the cranium.The cranial base enlarges
endochondrially,but maxillary growth is intramembranous at the suture aposis on
the surface.maxillary growth moves forward and dawnword thereby shifting the
cranium back and up.Endochondral growth from the base of the cranium to the
nasal septum is important of the movement of the maxillary union forward and
downword.Maxilla undergone intramembranous ossification Maxillary
ossification begins at 7th week.Slightly later than mandiable.From a center appears
as a band fibrocellular tissue on the outside of the nasal capsule,near a point where
the anterior superior alveolar ramus bifurcates from the infoorbital nerve.and
slightly above the enamel of the the canines.Ossification center in five directions
main,as follow :

1. Up to form the frontal procces of the maxillary bone

2. To the back from the zygomatic procces of the maxillary bone
3. Inward to from the palatine processus of the maxillary bone
4. Downword to from the alveolar processus of the maxillary bone
5. To the front to form the midlane to form facies facialis

3. THE PROCCES OF MANDIBULLAR EMBRYOLOGY

Growth and development of the face and oral cavity starting at week 3 of IUL. At
first it was still in the form of a tube and consists of 3 elements namely
ectodermal, mesodermal and endodermal. On growth and development
oromaxillofacial is greatly influenced by the growth and development of branchial
apparatus. This section makes a contribution significant impact on head and neck
structures. This section consists of 4 components namely the branchial arches or
arches pharyngeal (branchial arches), branchial pouch (branchial pouches),
branchial slits or pharyngeal slits (branchial grooves) and branchial
membrane.The main component of this group is the arch branchial which is the
most characteristic feature in development of the head and neck, as well as its
temporary structures will form the major muscles, nerves, blood vessels and
elements skeletal.
First Branchial Arch (I)

The first branchial arch (I)

Consists of a dorsal, maxillary processes that extend forward under the eye area
and the ventral portion, containing the mandibular process Meckel's cartilage.
During further development, bones Meckel's cartilage is missing except for two
small patches at its dorsal end persists and forms the incus and malleus.
Mesenchyme maxillary processes form the premaxilla, maxilla, os. zygomaticum
and part of os. temporalis through os. membranous.The mandible is also formed
by ossification of the membranous tissues mesenchyme surrounding Meckel's
cartilage. Besides that,The first arch helps form the bones of the middle ear.

Second Branchial Arch (II)

The cartilage of the second arch or hyoid arch (Cartilage Reichert) forms the
stapes, styloid process os. temporalis,stylohyoid ligament and ventral to the cormu
minus and the top of the corpus os. hyoideum. The hyoid arch muscle is
m.stapedius, m. stilohioideus, venter posterior m. disgatricus, m.auricularis and
facial expression muscles. Facial nerve, nerve second arch, innervates all of these
muscles.

Third Branch (III) Arch

The third branchial arch cartilage produces the lower part of the body and the
greater horn of the hyoid bone. Arrangement the muscles are limited to m.
stylopharyngeus. This muscle is innervated by glossopharyngeal nerve, third arch
nerve.

Fourth to Sixth Branchial Arches (IV - VI)

Cartilaginous components of the fourth branchial arch and all six fuse to form
laryngeal cartilages: cartilages thyroidea, crikoidea, arytenoidea, corniculates and
cuneiform. Muscle fourth arch (m. cricothyroideus, m. levator veli palatini and m.
constrictor pharyngeal) is innervated by the superior laryngeal nerve(branch of the
vagus nerve), fourth arch nerve. Intrinsic muscle The larynx is innervated by the
recurrent laryngeal nerve (a branch of the vagus), sixth arch nerve.
Prenatal Growth and Development

The cartilage of the first branchial arch viz Meckel's cartilage forms the lower
jaw. During the week the 6th IUL, the development of this cartilage bone extends
as rods of hyaline cartilage, covered by a fibrocellular capsule, from where the
development of the ear (otic capsule) to the midline in where is the mandible
located? Bone growth and development Meckel's cartilage is close to the
formation
of n.mandibularis. At n. mandibularis is formed to reach 1/3 Meckel's cartilage
dorsal, n. mandibularis is then branching into n. alveolaris inferior and n. alveolar
lingualis and will cross in the cartilage. Next n. alveolar inferior running anteriorly
and branching into n.mentalist and n. incisors. In this lateral branching place
Fibrous connective tissue ossifies in the 7th week of IUL. In the 7th week of IUL
intramembranous ossification begins within These condensations, form the first
bone of the mandible. From At this ossification center, bone formation spreads
rapidly anteriorly toward the midline and posteriorly to the point where the nerve
The mandible is divided into lingual and inferior alveolar branches. The
ossification center is around the mandibular foramen. Then Growth and
development progress in an anterior direction reaches the mandibular symphysis
posteriorly to form the ramus mandible to form a complete, moderate mandible
Meckel's cartilage disappears. The mandible is a solid form there are n. incisors
that have been branched from n. inferior alveoli. This sturdy form though the end
will become the canal and after birth, the two halves of the mandible will fuse at
the midline.

Postnatal Growth and Development

Mandibular growth occurs by the process of remodeling bone. Growth in the

length of the mandible occurs due to: presence of bone deposition on the posterior
surface (ramus) with balance of absorption on the anterior surface. This
mattercauses the mandible to elongate backwards.Growth in mandibular width
occurs because of this bone deposition on the outer surface of the mandible and
absorption on the inner surface. Although the mandible is the main bone (single
bone), but the mandible is a skeletal unit each of which is associated with subtle
networks around which are called functional matrices. Functional matrices are the
main determinant of skeletal unit growth.

There are two types of mandibular growth, namely:

1. First pattern, posterior portion of mandible and base the cranium is fixed,
while the chin moves down and forward.
2. The second pattern, the chin and body of the mandible only change
slightly while growth mostly occurs at the edges posterior ramus,
coronoid and condyle of the mandible.
 Mandibular growth is divided into five parts:

1. Growth of the articular condyles

2. Growth of muscle attachments

3. Growth of the mandibular ramus

4. Growth of the mandibular corpus

5. Alveolar bone growth

4. GROWTH AND THE DEVELOPMENT OF THE PALATE

Palatum as the overall shape of the two primordia which can be classified as
primary palate and palate secondary. At about the 6th week of IUL growth a
secondary palate begins to form, which arises from the processus medial nasal.
Composed of mesodermal, it forms eventually will expand the basic shape of the
nasal cavity.Growth and development of the palate occurs through some steps:

Primary Palate

During the 5th week of IUL, the primary palate begins to form by the
Intermaxillary Segment (fusion of the medial nasal processes)growing medially
and caudally. Segment intermaxillary is an internal wedge-shaped mass that
extends and inward inferior to the nasal pit, on the inside of the stomodeum,and
progresses to the base of the nostrils and the nasal septum.
Secondary Palate

During the 6th to 7th week of IUL, medial wall (oral surface) of the maxillary
process produces a pair a thin medial appendage called the palatine process (the
palate blade). These blades develop inferiorly and deeper than the stomodeum in
the vertical direction along either side of the developing tongue. At the beginning
of Embryology and Growth and Development of the Oral Cavity 60 the 8th week
of IUL, the tongue begins to contract and move away.In addition, the lower jaw
grows downward and forward.

At the end of the 8th week of IUL, the palatine process rotates quickly upwards to
a horizontal position over the tongue andfuse with each other by the primary
palate. process fusionThis palatal forms the secondary palate which is with the
palateprimary forms the definitive palate.

Around the 9th week of IUL, the secondary palate begins develops from the
lateral palatine process, but development this is not completed until the 3rd month
of IUL. Both of these processes grow vertically on either side of the tongue. First
the secondary palate develops downwards due to the presence of the tongue
embryonic. But after the lower jaw (os. mandibularis) develops, the space
increases in size, so
that the tongue descends lower. This results in growth and development The
secondary palate may develop toward the midline and fuse.In addition, the nasal
septum also held fusion with both secondary palate (left and right).

Development of the Secondary Palate

During weeks 7-8 of IUL, elevation of the lateral palate slats from vertical to
horizontal starting from the 7th week of IUL.This phenomenon is considered to be
the source of facial retraction attach to the forefoot: elevation of the face
facilitates mandibular growth, the volume of the oral cavity increases and the
tongue grows downward due to elevation of the palatine blades.Nasal septum
associated with secondary palatal It is an outgrowth of the frontonasalis process.
Fusion part the front (anterior) and posterior nasal passages occur in the 2nd week
8-12 IUL. The nasal septum fuses with the anterior palate.Disintegration of the
epithelium is apoptosis from the other side fusion, which later develops into the
midpalatal.Ossification occurs from the 8th week of IUL. In the 4th month of
palate grows wider along the midpalatal suture. Deepening Palatal
elevationPalatal blade approximation Symmetrical contact Attachment (increased
glycoprotein secreted by epithelium) Fusion to the nasal passages Epithelial
disintegration Invasion of mesenchymal cells of the palatal arches with apposition
to the alveolar margins occurs when postnatal.
5. AYAT DAN HADITS
Hadits

"Allah Swt, mengutuskan Malaikat ke dalam rahim. Malaikat berkata: "Wahai

Tuhan! la masih berupa air mani". Setelah beberapa ketika Malaikat berkata lagi:
"Wahai Tuhan! Ia sudah berupa darah beku". Begitu juga setelah berlalu empat
puluh hari Malaikat berkata lagi: "Wahai Tuhan! Ia sudah berupa seketul daging".
Apabila Allah Swt, membuat keputusan untuk menciptakannya menjadi manusia,
maka Malaikat berkata: "Wahai Tuhan! Orang ini akan diciptakan lelaki
perempuan? atau Celaka atau bahagia? Bagaimana rezekinya?, serta bagaimana
pula ajalnya?" Segala-galanya dicatat semasa dalam perut ibunya".
Muslim). (H.R. Bukhari)

Ayat

Artinya:
Dan sungguh, Kami telah menciptakan manusia dari saripati (berasal) dari
tanah. Kemudian Kami menjadikannya air mani (yang disimpan) dalam tempat
yang kukuh (rahim). Kemudian, air mani itu Kami jadikan sesuatu yang melekat,
lalu sesuatu yang melekat itu Kami jadikan segumpal daging, dan segumpal
daging itu Kami jadikan tulang belulang, lalu tulang belulang itu Kami bungkus
dengan daging. Kemudian, Kami menjadikannya makhluk yang (berbentuk) lain.
Mahasuci Allah, Pencipta yang paling baik. (Q.S. al-Mukminun [23]: 12–14).
 MAAPING

Embryology

Frontonasal Maxillary Mandibular

Prominance Prominance Prominance
 BAB III
KESIMPULAN DAN SARAN
KESIMPULAN
Facial embryology begins with the development of the head and neck. At
the time the head begins to form, the embryo consists of three layers of tissue,
namely ectoderm, mesoderm, and endoderm which are located in the pharyngeal
arch or called the branchial arch. Facial development occurs between the 4th and
10th week of IUL.

The maxilla is one of the craniofacial parts where growth balance changes
most easily due to external influences. During the 4th week of the IUL, in the
early stages of development, the oropharyngeal membrane separates the oral
cavity from the developing pharynx. At week 5 of IUL, proliferation of the
frontonasalis mesenchyme. In the 6th week of IUL, from the upper corner of the
mouth the maxillary processes extend to the lateral to medial nasal processes. In
the 7th week of IUL, the development of a human face can already be seen.

The oromaxillofacial growth and development is greatly influenced by the

growth and development of the branchial apparatus. This section makes a
significant contribution to the structure of the head and neck. This section consists
of 4 components namely branchial arches or pharyngeal arches, branchial
pouches, branchial slits or pharyngeal slits (branchial grooves) and branchial
membranes.

SARAN

We hope to be even better to maintain and improve our activities during the
discussion. and we can be more active in the future.
 DAFTAR PUSTAKA
Primasari, A. (2018). Embriologi Dan Tumbuh Kembang Rongga Mulut.USU.
Press,. ISBN 978-602-465-029-2
Sadler,T.W.(2012). Langman Embriologi Kedokteran Edisi 12. Ebook.
Albery,E.H,Hathorn,I.S.& Pigott,R.W.,1986.Dalam: Cleft Lip and Palate: A Team
Approach Brisol: Wright,pp 17-19
Greene,N.D.& Copp,A.J.,2009.Development of The Vertebrate Central
Nervous System:Formation of The Netral Tube.Prenatal
Diagnosis.volume 29,