SUBMITTED TO:- SUBMITTED BY:-

DR. RITU JINDAL NEHA

HEAD OF DEPARTMENT OF ROLL NO-38
PEDODONTICS B.D.S. IV TH PROF


INDEX
DEFINITIONS
GROWTH
DEVELOPMENT
DIFFERENCE BETWEEN GROWTH AND
DEVELOPMENT
PRENATAL PERIOD
* Development of FACE
* Development of FACE in LATERAL ASPECT
* Derivation of Part of face
* Development Anomalies of FACE
* Development of PALATE
* Anomalies of PALATE
* Classification of CLEFT PALATE
POST NATAL GROWTH OF MAXILLA AND
MANDIBLE




`
GROWTH
It is defined as developmental increase in mass In other
words, it is a process that leads to an increase in the
physical size of cells, tissues,organism as whole
(Stewart 1982)

It refers to an increase in size or number(Proffit 1986)

It is defines as normal changes in the amount of living
substance(Moyer 1988)

It is an increase in size of a living being or any of its parts
occuring in process of development(Stedman 1990)

It signifies an increase ,expansion or extension of any
given tissue(Pinkham 1994)

Development
An increase in complexity(Todd 1931)

An increase in skill and complexity of
functions(Lowrey 1951)

It addresses the progressive evolution of a
tisssue(Pinkham 1994)

It refers to all the naturally occuring unidirectional
changes in the life of an individual from its existence
as a single cell to its elaboration as a multifunctional
unit terminating in death (Moyer 1988)
Difference between
Growth and Development
Therefore ,Growth is a dynamic process with a stable
pattern of changes resulting in the increase in physical
size and mass during its course of development this
can be predicted with reasonable certainty

Therefore Development comprises all the normal
sequential series of events which result in the
increased complexity or maturity in the course of
natural progression from a single cell to the
multifunctional organism ending at death.
Prenatal Period
TOTAL PERIOD OF
PRENATAL LIFE :-
It consist of 40 weeks and
after 28 week the fetus
is consider viable

It classified into 3 phases

Period of ovum(from
fertilization to 14
th
day)

Period of embryo(from 14
th
to
56
th
day)

Period of foetus(56
th
day to
birth)
Development of Face
It includes following parts
Upper face
1. Lower lip
2. Upper lip
3. Nose
4. Cheeks
5. Eye
6. External ear
Lower face
1. Mandible














Development
Face is derived from
following structures that lie
around stomodeum:-
1. The frontonasal process
2. The first pharyngeal
/mandibular arch of each
side
The mandibular arch divides
into :-
1. Maxillary process
2. Mandibular process



The ectoderm overlying the
frontonasal process soon
shows bilateral localized
thickening that are situated
little above the stomodeum.
These are called nasal
placodes
These placodes soon sink
below the surface to form
nasal pits


The Edge of each pit are raised above the
surface
1. The Medial raised edge is called the
MEDIAL NASAL PROCESS
2. The lateral raised edge is called the
LATERAL NASAL PROCESS
Upper lip:-
Each maxillary process now grows medially and fuses with
lateral nasal process and then with medial nasal process
The medial and lateral nasal processes also fuses with each
other
In this way the nasal pits are cut off from the stomodeum
and called external nares
The Mesodermal lateral part of lip is formed from
maxillary process
The overlying skin derived from ectoderm covering this
process

The Mesodermal median part of lip called Philtrum
formed from the medial nasal process
Lower lip:-
1. The mandibular processes
of two sides grow towards
each other and fuse in
midline

2. They now form the lower
margin of stomodeum

3. Thus these mandibular
process fusion in midline
result in formation of lower
lip and lower jaw.
Cheeks
After formation of upper and
lower lip,the stomodeum is
very broad

In its lateral part , it is
bounded above by maxillary
process and below by
mandibular process.

The medial nasal process
fuses with maxillary process
to form cheek
Nose
The NOSE develop
from:-
1. The frontonasal
process
2. The medial and
lateral nasal process
The medial nasal
process fuses to form
crest and tip of nose
The lateral nasal
process fuses to form
Ala ,lateral wall of
nose
EYE
The region of eye is first seen
as an ectodermal thickening ,

The lensplacode which
appears on the ventro-lateral
side of the developing
forebrain lateral to nasal
placode

The lens placode sinks and
produce bulging represent
future eyeball are directed
laterally

It lie in angle between maxillary processes and
lateral nasal processes

With narrowing of frontonasal process they come
to face forward

Ear
It is formed around
dorsal part of the first
ectodermal cleft

A series of mesodermal
thickening appear on
mandibular and hyoid
arch where they adjoin
this cleft

Pinna formed by fusion
of these thickenings.
Derivation of Parts of Face
1) Mandibular prominences Lower jaw and lip

2) Frontonasal prominence


Upper part :- Forehead
Lower part :- Nasal Placodes
Medial Nasal process
Nasal Pits
Lateral Nasal process

3) Lateral nasal process Ala of nose
Lateral wall of nose

4) Medial nasal process Tip of nose

5) Maxillary process Nasolacrimal duct

6) Stomodeum Oral cavity

7) Nasal pits Nasal cavity


Development Anomalies of Face
Hare lip
Oblique facial cleft
Macrostomia
Microstomia
Proboscis
Mandibulo facial dysostosis
Retrognathia
Hypertelorism
Congenital lip pits
Anomalies of face
Development of Palate
(weeks 5-12)
From each maxillary
process, a plate like like
shelf
grows medially this is
called palatine process
The palate will be
formed from:-
1. The two palatal
process
2. A primitive palate
formed from
frontonasal process
The fusion begins anteriorly and proceed backwards

At later stage,the mesoderm in the palate undergoes
intramembranous ossification to form Hard palate

However ossification does not extend to posterior portion
which remain as soft palate.
The part of palate derived from frontonasal process form
Premaxilla which carries incisor teeth.


Anomalies of Palate
Cleft palate
it result in anomalous communications between the mouth
and the nose


Classification of Cleft Palate
Davis and Ritchie
Classification
Veau Classification
Kernahan Classification



Davies and Ritchie Classification

Group 1: Cleft anterior to
alveolus
Group 2: Post alveolar
clefts


Group I : Defect of soft palate
only

Group II: Defect involving
hard palate and soft palate

Group III: Defect involving
soft palate to alveolus,usually
involving the lip

GroupIV: Complete bilateral
clefts
Veau Classification
Kernahans striped Yclassification
Also called symbolic
and computergraphic
presentation.

It used a striped Y
having numbered
block to represent a
specific area of the
oral cavity.


Block 1 and 4 Lip

Block 2 and 5 Alveolus

Block 3 and 6 Hard palate
anterior to the incisive foramen

Block 7 and 8 Hard palate
posterior to the incisive foramen

Block 9 Soft palate
H
Types of Cleft Palate Deformity
PRENATAL DEVELOPMENT OF
MANDIBLE
The lower part of face accompnied by a rod
shaped bar called meckels cartilage
Sutural Growth
There are system of sutures
that unites bone of upper
part of face to the cranium
include
Frontonasal suture,
Frontomaxillary suture
Zygomatico-temporal
Zygomatico-maxillary
Pterygo-palatine
The growth in these areas
serve to move maxilla in
forward and downward
direction
Surface Apposition and
Resorption
This takes place on most of
facial and anterior surface of
maxilla
Apposition takes place on
outersurface of supraorbital
region of frontal bone
Similarly resorption on
lateral surface of orbital rim
lead to lateral movement of
eye ball
Bone resorption occur on
lateral wall of nose leading to
an increase in size of nasal
cavity

Bone resorption seen on floor
of nasal cavity to compensate
there is bone deposition on
palatal side

Anterior nasal spine
prominence increase due to
bone deposition
Bone deposition along
posterior margin of
maxillary tuberosity
causes lengthening of
dental arch and
enlargement of antero-
post. Dimension of
maxillary body
It help to accommodate
erupting molar.and
causing an deepning to
palate
Growth of Palate
Summarize of Maxillary Growth
Length increases
by:-
1. Sutural growth
2. Surface apposition
at maxillary
tuberosity
Width increases
by:-
1. Growth at median
palatine suture
2. Apposition at
zygomatic bone
Height
increases
by:-
1. Sutural
growth
2. Surface
apposition
3. Alveolar
growth
POST NATAL Growth Of Lower Face
/Mandible
At birth mandible is
little more curved
bar of bone
The coronoid and
angular and alveolar
processes are not
formed

Coronoid process grows
by addition to its
posterior surface and
resorption at the anterior
border
Angle of mandible is
augmented by addition of
bone to the posterior
border of ramus
The alveolar process
grows upwards and
outwards and forwards

Summary Of Mandibular Growth
Length increases by:-

Surface apposition at
posterior border of ramus
and resorption at anterior
border

Deposition at chin

Growth at condylar cartilage

Height increases by:-

Surface apposition at alveolar border
Apposition at lower border of
mandible
Growth at condylar cartilage

Width increased by:-

Sutural growth upto ist year
postnatally
Later surface apposition at outer
surface
Mandibular Growth
REFERENCE
Text book of Pedodontics 2
nd
edition Shobha Tandon
Textbook of Orthodontics 3
rd
edition M.S.Rani
Textbook of Orthodontics S.I.Bhalaji