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Embryology of the Head

,
Face and Oral Cavity

Raj Gopalakrishnan B.D.S., Ph.D.
Oral and Maxillofacial Pathology
Dept. of Diagnostic and Biological Sciences
University of Minnesota School of Dentistry
Prenatal Development
Figure from Ten Cate’s Oral Histology, Ed., Antonio Nanci, 6
th
edition
Differentiation of the Morula into Blastocyst
Figure from Ten Cate’s Oral Histology, Ed., Antonio Nanci, 6
th
edition
Formation of Two-Layered Embryo (2
nd
week of gestation)
Figures obtained from “Before We Were Born; Moore and Persaud, 6
th
edition, 2003”.
Called bilaminar germ disk
Ectoderm
Endoderm
Pre/prochordal plate
Firm union between ectodermal and
endodermal cells occur at prechordal
plate
Formation of Three-Layered Embryo: Gastrulation (3
rd
week)
Figure from Ten Cate’s Oral Histology, Ed., Antonio Nanci, 6
th
edition
Triploblastic embryo
Formation of Three-Layered Embryo: Gastrulation (3
rd
week)
Figures obtained from “Before We Were Born; Moore and Persaud, 6
th
edition, 2003”.
First 3 weeks: Leads to formation of triploblastic embryo

Next 3-4 weeks: differentiation of major tissues and organs

includes head and face and tissues responsible
for teeth development

differentiation of nervous tissue from ectoderm

differentiation of neural crest cells (ectoderm)

differentiation of mesoderm

folding of the embryo (2 planes-rostrocaudal and lateral)
Neural tube undergoes massive expansion to form the forebrain,
midbrain and hindbrain
Formation of neural tube and neural groove
Figures obtained from “Before We Were Born; Moore and Persaud, 6
th
edition, 2003”.
Neural groove
Components of the mesoderm
Along the trunk paraxial mesoderm breaks up into segmented
blocks called somites

Each somite has: sclerotome- 2 adjacent vertebrae and disks
myotome-muscle
dermatome-connective tissue of the skin over the somite

In the head region the paraxial mesoderm only partially fragments to form a series
of numbered somatomeres which contribute to head and neck musculature

Intermediate mesoderm: urogenital system

Lateral plate mesoderm: connective tissue of muscle annd viscera; serous
membranes of the pleura; pericardium and peritoneum; blood and lymphatic cells;
cardiovascular and lympahtic systems, spleen and adrenal cortex.
Figure from Ten Cate’s Oral Histology, Ed., Antonio Nanci, 6
th
edition
In the head, the neural tube undergoes massive expansion to form
the forebrain, midbrain and hindbrain

The hindbrain segments into series of eight bulges called
rhombomeres which play an important role in development of the head
Folding of the Embryo
Head fold forms a primitive
stomatodeum or oral cavity; leading
to ectoderm lining the stomatodeum
and the stomatodeum separated from
the gut by buccopharyngeal membrane
Onset of folding is at 24 days and
continues till the end of week 4
Embryo just before folding (21 days)
Figure from Ten Cate’s Oral Histology, Ed., Antonio Nanci, 6
th
edition
Figure from Ten Cate’s Oral Histology, Ed., Antonio Nanci, 6
th
edition
Neural Crest Cells
Group of cells separate from the neuroectoderm, migrate and
differentiate extensively leading to formation of cranial sensory
ganglia and most of the connective tissue of the head

Embryonic connective tissue elsewhere is derived form mesoderm
and is known as mesenchyme

But in the head it is known as ectomesenchyme because of its
origin from neuroectoderm
Look up Fig 2-12 in text book for derivative of the germ layers
and neural crest
Figure from Ten Cate’s Oral Histology, Ed., Antonio Nanci, 6
th
edition
Avian neural crest cells
Head Formation
Figure from Ten Cate’s Oral Histology, Ed., Antonio Nanci, 6
th
edition
Rhombomeres
(one of the first are the
occipital somites)
Neural Crest Cell Migration
Figure from Ten Cate’s Oral Histology, Ed., Antonio Nanci, 6
th
edition
Pharyngeal arches expand by proliferation of
neural crest cells
Couly et al., 2002
Forebrain
(prosencephalon)
Midbrain
(mesencephalon)
Hindbrain
(rhombencephalon)
r3
r5
Migration of cranial neural crest cells
Anterior midbrain
Posterior midbrain
Anterior hindbrain
Imai et al., 1996
E
E
E
FNM
TG
TG
TG
Md
Md
Clinical Correlation
Treacher Collins Syndrome is characterized by defects of
structures that are derived form the 1
st
and 2
nd
branchial arches and
is due to failure of neural crest cells to migrate properly to the
facial region
Sagittal section through a 25-day embryo
Figure from Ten Cate’s Oral Histology, Ed., Antonio Nanci, 6
th
edition
Buccopharyngeal membrane ruptures at 24 to 26 days
Internal View of the Oral Pit at 3.5 weeks
26-day embryo
Figure from Ten Cate’s Oral Histology, Ed., Antonio Nanci, 6
th
edition
The Developing Human by Moore & Persaud
groove/cleft
pouch
arch
membrane
esophagus
The pharyngeal apparatus
1
2
3
4
Branchial arches form in the pharyngeal wall (which has lateral plate mesoderm sandwiched
between ectoderm and endoderm) as a result of lateral plate mesoderm proliferation and
subsequent migration by neural crest cells
3 weeks
Sagittal view of the branchial arches with corresponding grooves between each arch.
Pharyngeal pouches are seen in the wall of the pharynx. The aortic arch vasculature
leads from the heart dorsally through the arches to the face
Fate of the Pharyngeal Grooves and Pouches
First groove and pouch: external auditory meatus
tympanic membrane
tympanic antrum
mastoid antrum
pharyngotympanic or eustachian tube

2
nd
, 3
rd
and 4
th
grooves are obliterated by overgrowth of the second
arch forming a cervical sinus – if persists forms the branchial fistula
that opens into the side of the neck extending form the tonsillar sinus

2
nd
pouch is obliterated by development of palatine tonsil

3
rd
pouch: dorsally forms inferior parathyroid gland
ventrally forms the thymus gland by fusing with the
counterpart from opposite side
4
th
pouch: dorsal gives rise to the superior parathyroid gland
ventral gives rise to the ultimobranchial body (which
gives rise to the parafollicular cells of the thyroid gland)

5
th
pouch in humans is incorporated with the 4
th
pouch
(A) Tissue from arch II and V growing towards each other (arrows) to make branchial
arches and grooves disappear
(B) Resulting appearance following overgrowth
(C) Contribution of each pharyngeal pouch
Anatomy of the Branchial Arches
Cartilage of 1
st
arch: Meckel’s
Cartilage of 2
nd
arch: Reichert’s
Other arches not named

Some mesenchyme around cartilage
gives rise to striated muscle

Each arch also has an artery and nerve

Nerve: two components (motor and
sensory)

Sensory nerve divides into 2 branches:
1. Posttrematic branch: covers the anterior
half of the arch epithelium
2. Prettrematic: covers the posterior half
of the arch epithelium
Figures obtained from “Before We Were Born; Moore and Persaud, 6
th
edition, 2003”.
Meckel’s cartilage: Has a close relationship with the
developing mandible BUT DOES NOT CONTRIBUTE TO IT
Indicates the position of the future mandible.
The mandible develops by intramembranous ossification.
The malleus and the incus develop by endochondral ossification of
the dorsal aspect of this cartilage.
Innervation: V cranial nerve

Reichert’s: Dorsal end: stapes and styloid process
Ventral end: lesser horns of hyoid bone and superior
part of the body of the hyoid bone
Innervation: VII cranial nerve

Cartilage of the 3
rd
arch: inferior part of the body and greater
horns of the hyoid bone

Cartilage of 4
th
and 6
th
arches: fuse to form the laryngeal cartilage
Table obtained from “Before We Were Born; Moore and Persaud, 6
th
edition, 2003”.
Aortic Vasculature Development
(A) At 4 weeks the anterior vessels have passed through each branchial arch tissue
and have disappeared. The pouches project laterally between each arch.

(B) At 5 weeks the 3
rd
branchial arch vessel becomes the common carotid, which
supplies the face by means of the internal carotid and stapedial arteries.

Face, Neck and Brain are supplied by the common carotid through internal carotid.
But by 7 weeks the circulation of face and neck shifts from the internal carotid to
external carotid. The internal carotid continues to supply the brain.
Details of the aortic arch changes during early development. Aortic arch vessels numbers
1,2 and 5 disappear . Arch 3 becomes the common carotid artery. Arch 4 becomes the
dorsal aorta and enlarges so that the common carotid arises from the aorta. Arch 6 becomes
the right and left pulmonary arteries
Shift in the vascular supply to the face
(A) Face and brain are supplied first by the internal carotid artery

(B) Facial vessels detach from the internal carotid and attach to the
external carotid
Muscle cells in the first arch become apparent
during the 5
th
week and begin to spread within
the mandibular arch into each muscle site’s
origin in the 6
th
and 7
th
week. These form the
muscles of mastication – masseter, medial
pterygoid, lateral pterygoid and temporalis
muscle. They all relate to the developing mandible

By 7 weeks the muscles of 2
nd
arch grow
upward to form the muscles of face.
As these muscles grow and expand they
forms sheet over the face and forms the
muscles of facial expression

Facial muscles grow from
the 2
nd
branchial arch to cover
the face, scalp and posterior
to the ear
Masticatory muscles of the mandibular arch
Cranial Nerves growing into Branchial Arches
Cartilages derived from the
branchial arches

Arch 1: Meckels cartilage and incus
Arch 2: Stapes, stylohyoid and lesser
hyoid
Arch 3: Greater hyoid
Arch 4 and 6 thyroid and
laryngeal cartilage
•Congenital auricular sinuses and cysts

•Branchial cysts

•Branchial sinuses

•Branchial fistula

•Branchial vestiges
(cartilaginous or bony remnants)

•Branchial cysts

Anomalies of the head and neck
Dermatlas
Dermatlas
Apparent fusion of facial processes by
elimination of furrows
True fusion of facial processes by
breakdown of surface epithelium
Figure from Ten Cate’s Oral Histology, Ed., Antonio Nanci, 6
th
edition
Development of the Face
The face develops between the 24th and 38th days of gestation

On 24
th
day, the 1
st
branchial arch divides into maxillary and
mandibular arches
Figures obtained from “Before We Were Born; Moore and Persaud, 6
th
edition, 2003”.
Frontonasal process
Figures obtained from “Before We Were Born; Moore and Persaud, 6
th
edition, 2003”.
Figures obtained from “Before We Were Born; Moore and Persaud, 6
th
edition, 2003”.
Figures obtained from “Before We Were Born; Moore and Persaud, 6
th
edition, 2003”.
Middle portion of the upper lip: Formed by the fusion of the medial
nasal process of both sides along with the frontonasal process

Lateral portion of the upper lip: Fusion of the maxillary processes
of each side and medial nasal process

Lower lip: Formed by the fusion of the two mandibular processes
Formation of the Lips
Unusual fusion between maxillary process and lateral nasal process
leading to canalization and formation of the nasolacrimal duct

Human embryo at 7 weeks
Figure from Ten Cate’s Oral Histology, Ed., Antonio Nanci, 6
th
edition
Cleft Lip
Pituitary Gland Development
Ectodermal in origin and develops from 2 sources:

1. An upgrowth from the ectodermal roof of the stomatodeum
called hypophysial diverticulum (Rathke’s Pouch) - adenohypophysis

2. A downgrowth from the neuroectoderm of the diencephalon
called the neurohypophysial diverticulum – neurohypophysis

During the 4
th
week of development, a hypophysial diverticulum
(Rathke’s pouch) projects from the roof of the stomatodeum and lies
adjacent to the floor (ventral wall) of the diencephalon. By the 5
th
week, this pouch has elongated and has become constricted
at its attachment to the oral epithelium and is in contact with the
infundibulum (derived from the neurohypophysis)
Figures obtained from “Before We Were Born; Moore and Persaud, 6
th
edition, 2003”.
Figures obtained from “Before We Were Born; Moore and Persaud, 6
th
edition, 2003”.
Derivation and Terminology of the Pituitary Gland
Oral Ectoderm Adenohypophysis Pars distalis
(hypophysial diverticulum (glandular portion) Pars tuberalis
from roof of stomodeum) Pars intermedia


Neuroectoderm Neurohypophysis Pars nervosa
(neurohypophysial (nervous portion) Infundibular stem
diverticulum from Median eminence
floor of diencephalon)
Clinical Significance: Craniopharyngiomas develop from remnants
of stalk of hypophysial diverticulum (in pharynx of sphenoid bone)
Formation of the palate (weeks 7 to 9)
Palate develops from the primary palate and the secondary palate

The primary palate develops at about 28 days of gestation

Primary palate develops from the frontonasal and medial nasal
processes and eventually forms the premaxillary portion of the maxilla

The secondary palate develops between 7
th
and 8
th
week of gestation
and completes in the 3
rd
month

The critical period of palate development is from the end of 6
th
week
till the beginning of 9
th
week


Formation of the secondary palate
(starts between 7 to 8 weeks and completed around 3 months)
Figure from Ten Cate’s Oral Histology, Ed., Antonio Nanci, 6
th
edition
Figure from Ten Cate’s Oral Histology, Ed., Antonio Nanci, 6
th
edition
Cleft Palate
Formation of the Tongue
The tongue begins to develop at about 4 weeks. The oral part (anterior
two-thirds) develops from two distal tongue buds (lateral lingual
swellings) and a median tongue bud (tuberculum impar) [1st branchial
arch].
Innervation: V nerve
The pharyngeal part develops from the copula and the hypobranchial
eminence [2nd, 3rd and 4th branchial arches].
Innervation: IX cranial nerve
The line of fusion of the oral and pharyngeal parts of the tongue is
roughly indicated in the adult by a V-shaped line called the terminal
sulcus.
At the apex of the terminal sulcus is the foramen cecum.

Muscles of the tongue develop form the occipital somites and
innervated by hypoglossal nerve
Lingual swelling
Tuberculum impar
Figures obtained from “Before We Were Born; Moore and Persaud, 6
th
edition, 2003”.
The lingual papillae appear by the end of 8
th
week

Vallate and foliate papillae appear first, fungiform and
filiform (10-11 weeks) papillae appear later

Taste buds develop during the 11 to 13 weeks by inductive
interaction between epithelial cells of the tongue and invading
gustatory nerve cells from chorda tympani, glossopharyngeal
and vagus nerves
Thyroid gland development (4 to 7 weeks)
Figures obtained from “Before We Were Born; Moore and Persaud, 6
th
edition, 2003”.
Thyroglossal duct cyst
Lingual thyroid
Figure from Ten Cate’s Oral Histology, Ed., Antonio Nanci, 6
th
edition
Development of Jaw Bones
Figure from Ten Cate’s Oral Histology, Ed., Antonio Nanci, 6
th
edition
Development of Mandible
Figure from Ten Cate’s Oral Histology, Ed., Antonio Nanci, 6
th
edition
Figure from Ten Cate’s Oral Histology, Ed., Antonio Nanci, 6
th
edition
Fate of Meckel’s Cartilage
Posterior – malleus of the inner ear

Sphenomandibular ligament

Anteriorly, may contribute to mandible
by endochondral ossification (some evidence)

Rest are resorbed completely
Three secondary (growth) cartilages govern further growth of
mandible until birth

1. Condylar cartilage (most important)
2. Coronoid cartilage
3. Symphysial cartilage
Secondary Cartilages
Appears during 12
th
week and occupies most
of the ramus and is quickly ossified by
endochondral ossification, with a very thin
layer of cartilage present in the condylar head.
This remnant persists until 2
nd
decade of life
and is important for growth of mandible
Appears at 4 months and
disappears immediately
Figure from Ten Cate’s Oral Histology, Ed., Antonio Nanci, 6
th
edition
Development of Maxilla
Develops from one center of ossification in maxillary process of
the 1
st
branchial arch

Center of ossification is angle between the divisions where the
anterosuperior dental nerve is given off from inferior orbital nerve
from where it spreads posteriorly, anteriorly and superiorly

No arch cartilage is present, so maxilla develops in close
association with the nasal cartilage

One secondary cartilage also contributes to maxilla
development: zygomatic cartilage