Growth Patterns in

Dentofacial
Complex
Zari Danielle Torres
 Dimensional Changes
01 02 03
Growth of Nasomaxillary Mandibular Growth Timing of Growth in Width,
Complex Length, and Height

04 05
Rotation of Jaws during Interaction between Jaw
Growth Rotation and Tooth Eruption
 Growth of
Nasomaxillary
Complex
Two Basic Mechanism in Growth of
Nasomaxillary Complex
1. Passive displacement 2. Active component of
- growth in the the maxillary structures
cranial base that pushes and nose
the maxillary forward - push from behind
decreases greatly as
the cranial base
synchondroses close at
about age 7
 Two Basic Mechanism in Growth of
Nasomaxillary Complex
Because the push from behind
1. Passive Displacement decreases greatly as the
2. Active Growth of the cranial base synchondroses
Maxillary Structures and close at about age 7, most of
Nose the growth after that is due to
active growth at the maxillary
sutures and surfaces.
 Two Basic Mechanism in Growth of
Nasomaxillary Complex
- Maxilla grows
DOWNWARD and
FORWARD ● Amount of forward movement of
anterior surfaces is less than the
- Bone is added at the amount of displacement
SUTURES, TUBEROSITY, ● Total downward movement of the
ROOF OF THE MOUTH palatal vault is greater than the
amount of displacement
- Bone is removed from
ANTERIOR SURFACES
(except for a small area at
ANS), FLOOR OF
NOSE
 Two Basic Mechanism in
Growth of Nasomaxillary
- Complex
Nasal structures undergo same
displacement as maxilla and grows
more rapidly than the rest of the
Nasal dimensions increase at
face
25% greater than maxillary
- Nasal Growth:
growth during adolescence
- increase in size of
cartilaginous nasal septum
- Proliferation of the lateral
cartilages alters the
shape of the nose
Two Basic Mechanism in
Growth of Nasomaxillary
Complex
Mandibular Growth
Mandibular Growth
● steady rate before puberty
● Ramus height: ↑ 1-2mm/ year
● Body Length: ↑ 2-3mm/ year
● One feature is an accentuation of the
chin prominence
○ Change in chin contour because
the area just above the chin,
between it and the base of
alveolar process, is a resorptive
area
● The increase in chin prominence
results from a combination of
forward translation of the chin
Mandibular Growth
Extent of growth changes at
the glenoid fossa
● If the area moved forward relative to
the cranial base during growth, this
would translate the mandible forward
in the same way that cranial base
growth translates the maxilla.

● Usually, the attachment point moves

straight down, so that
there is no anteroposterior
displacement of the mandible
Timing of Growth in
Width, Length, and
Height
 Timing of Growth

● Growth in width -> length ->

height
● Growth in width tends to be
completed before adolescent
growth spurt
● Intercanine width is more likely to
decrease with age
○ As the jaws grow in length
posteriorly, they also grow
wider
 Timing of Growth
● maxilla grows slowly downward and
forward to age 14-15 then tends to
grow slightly more almost straight
forward

● growth in vertical height of the face

continues with the late vertical
growth in the mandible.

● Increases in facial height and

concomitant eruption of teeth
continue throughout life
Rotation of Jaws
during Growth
 Jaw Rotation during
Growth

- the rotation that occurs in the core of each jaw (INTERNAL ROTATION) tends to
be masked by surface changes and alterations in the rate of tooth eruption.
- The surface changes produce external rotation.
- the overall change in the orientation of each jaw, as judged by the palatal plane and
mandibular plane, results from a combination of internal and external rotation.
Jaw Rotation during Growth

Core of the mandible is the bone that surrounds that IAN

Jaw Rotation during Growth

Core of the mandible is the bone that surrounds that IAN

Jaw Rotation during
Growth

Internal rotation
ranging from 10-
15 degrees
 Jaw Rotation during
Growth
LOWER BORDER
The reason that OF MANDIBLE
internal rotation is not
expressed in jaw Posterior part – area
orientation is that of resorption
surface changes tend
to compensate Anterior aspect -
slight apposition
 Jaw Rotation during
Growth
it is less easy to divide the maxilla
into a core of bone and a series of
functional processes.

A small amount of forward

rotation is the more usual pattern
in maxilla, but backward rotation
occurs frequently
Jaw Rotation during Growth

For most patients, the external rotation is opposite in direction and equal in magnitude
to the internal rotation, so that the two rotations cancel and the net change in jaw is zero
Jaw Rotation during Growth

Vertical growth increases the space between the jaws, and the
maxillary and mandibular teeth normally divide this space equally.
Jaw Rotation during
Growth
SHORT-FACE TYPE
• Short anterior lower face height
• Excessive forward rotation of Md during growth
• Increase in normal internal rotation
• Decrease in external compensation
• Nearly horizontal palatal plane
• Low mandibular plane angle
• Large gonial angle
• Deep bite malocclusion
• Crowded incisors
Jaw Rotation during Growth
LONG-FACE INDIVIDUALS
• Excessive lower anterior face height
• Palatal plane rotates down posteriorly
• Negative inclination
• Md shows opposite, backward rotation
• Increase in mandibular plane angle
• Anterior open bite malocclusion
• Mandibular deficiency
• Chin rotates back and down
Interaction between
Jaw Rotation and
Tooth Eruption
Interaction between Jaw Rotation and
Tooth Eruption
Forward rotation of maxilla -
tend to tip the incisors forward,
increasing their prominence

Backward rotation directs

anterior teeth more posteriorly,
relatively uprighting them and
decreasing their prominence.
 Interaction between Jaw Rotation and
Tooth Eruption
patient with the short-face
pattern of growth.

As the mandible rotates

The eruption path of upward and forward, anterior
mandibular teeth is movement of the incisors is
upward and somewhat impeded and the bite
forward. deepens, creating a deep bite
malocclusion that usually
includes crowded incisors
 Uprighting of maxillary incisors in short-face ->
decreases arch length and contributes to progressive
crowding

When excessive rotation occurs in the short-face,

incisors tend to be carried into an overlapping
position even if they erupt very little = strong tendency
for deep bite malocclusion

In long-face growth pattern, an anterior open bite will

develop as anterior face height increases unless the
incisors erupt for an extreme distance. The rotation of
the jaws also carries the incisors forward, creating
dental protrusion.

Interaction between Jaw Rotation and

Tooth Eruption
Thank You
Reference:
Proffit WR Fields HW Larson BE Sarver
DM. Contemporary Orthodontics. Sixth ed.
Philadelphia PA: Elsevier; 2019.