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147 Cards in this Set
- Front
- Back
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sheldons classification
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somatotypes
1.endomorphic 2.mesomorphic 3.ectomorphic |
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Endomorphy
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relative predominance of soft roundness
digestive viscera are massive derived from endodermal embryonic layer |
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Mesomorphy
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relative predominance of muscle,bone, and connective tissue
physique is heavy,hard, and rectangular skin is thick derived from mesoderm embryonic layer |
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Ectomorphy
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relative predominance of linearity(narrow and elongated form) and fragile
greatest sensory exposure largest brain and central nervous system derived from ectodermal embryonic layer |
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When are facial disharmonies and malocculusions most likely to occur?
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when there is a mixture of somatotypic features
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at what age is somatype determined?
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at age 20-25 y/o and remains constant
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How is somatotypes ranked?
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on a scale from 1 to 7 for each component
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2 head forms
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1.dolichocephalic
2.brachycephalic |
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dolichocephalic
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long and narrow
facial type: -leptoprosocpic -mandible retrusion |
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Brachycephalic
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wide and short head
face type: -euryprosopic -prominent lower jaw -large facial angle small Y axis |
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T/F growth disposition is same for all health individuals
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True
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What is the difference between males and females and puberty time?
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boys and girls reach pubertal growth spurt at different times
boys are two years behind girls |
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what is overall potential for growth primarly determined by?
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intrinsic factors
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what is individual maximum potential for growth effected by/
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environment
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do all body parts grow at the same time?
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no different body parts increase in size at different times and at different rates
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types of bone growth and morphogenesis
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epiphyseal
sutural remodeling cortical drift differential growth area relocation tranlatory growth expanding V principle |
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when is growth of neural tissue nearly complete?
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by age 6-7
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describe growth pattern of general body tissue like muscle, bone, and viscera
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S shaped curve w/ difinite slowing of rate of growht during childhood and an acceleration at puberty
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Describe growth curve of lymphoid tissue
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lymph tissue proliferates excessively in late childhood and then undergoes involution (decreases) at the same time that genital tissues are accelerating rapidly
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growth pattern of genital tissue
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increase in puberty
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5 theories of facial growth
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1.functional matrix
2.hunter-enlow growth equiv. 3.scotts cartilaginous theory 4.sichers sutural dom. theory 5.expanding V principle |
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Weinmann-Sicher Theory of of facial growth
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believed that sutural expansion was responsible for the downward and forward translation of the mandible
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JH Scott and the cartilage theory of facial growth
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proposed that cartilage can be considered to be a growth center
bc nasal cartilage, if transplanted, can continue to grow but condylar cartilage does not grow outside of its orginal location |
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Melvin moss and the the functionial matrix theory of facial growth
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said that neither cartilage now condylar cartilage are determinants of facial growth
growth of the craniofacial complex is in response to the soft tissues aroung them eg:brain, muscles of mastication,and sinuses examples: -hydrocephaly -anecephally -mastoid air cell infection |
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How does melvin moss functional matrix work?
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periosteal matrices act upon skeletal units in a direct fashion
by deposition and resorption causes changes in shape and size capsular matrices act upon functional cranial components as a whole in a secondary and indirect manner. by altering the volume of the capsules this causes passive translation |
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hunter enlow growth equivalent theory
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mandible,middle face, and cranial base are directly contiguous w/each other
growth events that occur in one affect the other two growth occurs at sutures, periosteal and endosteal surfaces, and synchrondroses |
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who believes that growth is a combination of complex remodeling and translation?
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hunter enlow
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to hunter enlow what equivalents does the face consist of?
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horizontal and vertical equivalents
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what are the horizontal growth equivalents in the hunter enlow growth equivalent theory
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anterior cranial base
maxilla body of mandible |
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how does mandible growth?
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expanding V princple
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male and female comparisons of mandibular growth during adulthood
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in men, the mandible appears to move downward and forward
in women, the mandible appears to moved downward and backward |
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indicators of physical maturity
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secondary sex characteristics
dental age chronilogical age skeletal age hand wrist |
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what growth curve does facial skeletal growth follow?
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follows a growth curve similar to that of the general skeleton
undergoes a puberal spurt |
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What does orthodontic treatment depend on?
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developmental timing
amount of growth remaining |
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what should ortho tx take advantage of?
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pattern of facial growth
puberal growth period |
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what is an unreliable guide of sexual maturation/
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chrono age
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secondary sex characteristics in boys
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facial and axillary hair
larynx enlarges and voice low growth of penis near complete |
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secondary sex characteristics of girls
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breast buds appear at age 10
menarche usually occurs after the peak growth spurt around age 12.5 y/o |
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what does absence of sesamoid bone mean?
prescence? |
sesamoid bone is an ossification center
absence of sesamoid bone means pt is prepuberty prescence of sesamoid bone means that pt is in pubertal spurt or passed puberty |
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what to look at in hand wrist xray to determine if pt is passed puberty
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absence of precence of ossification centers
-sesamoid bone -epiphyseal plate closure |
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what if epiphyseal plate is closed?
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growth is complete
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summary of facial change from yound child to old
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goes from a concave to convex nasal dorsum, downward rotation of lobule, and shortening of upper lip
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endochondral vs intramembranous growth
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endochondral is when bone replaces cartilage
intramembranous is not associated w/cartilage. forms most of bones in skull |
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what type of growth does mandible undergo?
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intramembranous growth
man has 2 halves and makes one bone by the second year of life |
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translatroy growth
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put growth in one area and it is being manifested in another area
growth of sphenoid area/ cranium is going to affect the bone structure of the face |
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first body part to reach max growth
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brain
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1st tissue to reach maturity
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neural tissue by age 6
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what in oral cavity follow neural growth curve?
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the toneue bc happens same time thyroid drops
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what growth curve does maxilla/face follow?
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general body growth curve
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problem w/weinman sicher theory of facial growth
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sutures allow movement but do not push the bones apart
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last suture to close in craniofacial area
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midpalatal suture
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growth center
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where growth occurs indirectly to whats going on in environment
ex: transplant tissue anywhere and it still grows |
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growth site
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like sutures. some growth occurs in this area but they are not responsible for growth
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describe mandibular growth
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imposition of mental and posterior ramus
condyles go up and the posterior ramus is impositional and the anterior ramus is resorbtive expanding V-growth on mandible occurs posteriorly and mental grows down and forward |
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how does shape and angle of mandible tell you how pt will grow?
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L shape and flat pt is horizontal grower
C shape w/deep notch pt is vertical grower |
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what is shape of manibular condyle determined by?
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condyle is vertical when pt is young as you age the shape changes and it is determined by alveolar process
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as pt gets older, why does ANB change?
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SNA stays the same but SNB gets large bc the chin comes forward so ANB decreases
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what reaches max growth first, max or man?
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maxilla
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when do girls have growth spurt of maxilla?
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2 years before first period
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can you predict growth by chrono age?
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no need to take ht/wt
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site of growth in long bones
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epiphyseal plate
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endochondral vs intramembranous ossification
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endochondral bones form from cartilage matrix
intramembranous osteoblasts arise from undifferentiated cells and make their ouwn ostoid matrix |
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growth remodeling
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progressive adjustment that functions to maintain the shape and proportions of the bone throughout its growth period
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cortical drift
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concurrent resorption and deposition of bone on opposite sides of cortical bone is the endostial or peristial direction so that the bone appears to drift in one direction
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differential growth
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certain parts of bone and certain areas of body grow faster than others
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area relocation
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the new bone is added to a surface of the existing old bone is shifted to a new position. this is a result of remodeling and differential growth during bone growth
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translatory growth
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appearance of growth/displacement in one area do to actual growth in another area
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identify the growth theory which considers bones as the single driving force behind craniofacial dev
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sicher and sutural dominence concept states that the CT produces actural force which is the driving force behind craniofacial growth. The primary event in sutrual growth is the proliferation of CT between the two bones
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t/f there is a big corrleation between height age and skeltal age
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TRUE
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major center of growth in mandiblee
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condyle
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what is primary stimulus for growth of mandible?
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functional matrix stimulus
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CVMS I(cervical vertebrate maturation)
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lower borders of all three vertibrate (C2,3,4) are f;at w/possible exception of concavity at lower border of C2. the bodies of both C3 and C4 are trapezoid in shape. the peak in mandibular growth will occur not earlier that one year after this stage
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CVMS II
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Concavities at tlower bodrder of Both C2 and C3 are present. The bodies of C3 and C4 may be either trapezoid or rectangular. the peak in mandibular growth will occur wi one year after this stage
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CVMS III
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concavities at lower borders of C2,3,4 are not present. the bodies of C3 and C4 are rectangular. the peak in mandibular growth has occured wi one or two years before this stage
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CVMS IV
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concavites at lower borders of C2,3,4 are still present. at least one of bodies of C3 or C4 is square. peak in man growth has occured not later that one year before this stage
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CVMS V
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Concavities at lower borders of C2,3,4 are still evident. at least on of bodies of C3 or C4 is rectangular or square. the peak in man gorwth hs occured not later that two years before this stage
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order of maturity(direction)
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transverse
saggittal vertical |
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growth
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an increase in anatomic size
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3 parameters of growth
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1.magnitude
2.direction 3.velocity |
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magnitude of growth
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linear dimension overall
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direction of growth
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vector of size increase in 3D system
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Velocity of growth
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amt of change per unit time
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2 manners in which size in growth can be documented
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1.cumulative or distance curve: when growth is measured periodically and measurements are plotted as percentages of total growth
2.incremental or velocity growth curve: plots growth increments as a function of time |
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what does growth imply?
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change
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most remarkable growth stage
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prenatal
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describe growth stages
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remarkable in prenatal growth
plateu during childhood increase in adolescence |
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what is overall potential for growth determined by?
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primarily by intrinic and genetic factors
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what is the extent to which an individual attains his/her potential for growth determined by?
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environment
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what does growth of primary cartilage and functioning spaces have a direct influence on?
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craniofacial pattern of change
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where is primary cartilage found? describe growth
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primary cartilage is in head and face and is identical to growth plates of long bones
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what dictates craniofacial growth?
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primary cartilage
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what 3 things faciliate pattern growth of the head and face?
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1.mandibular condylar cartilage
2.craniofacial sutures 3.appositional-resoptive bone change |
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what part of face matures first?
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anterior face
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2 ways to examine craniofacial pattern
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1.chair side
2.ceph |
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ideal frontal facial pattern of 7 year old
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right/left halves are symmetrical
glabella to subnasale=subnasale to menton subnasale to lower border of upper lip represents 1/3 distance from subnasale to menton upper central incisor edge is 2 mm inferior to lower border of upper lip |
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ideal facial profile pattern for 7 y/o
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chin 5 mm behind FHP
most anterior aspect of lower lip on FHP most anterior aspect of upper lip 5 mm ahead of FHP nasolabial angle of 10 degree no more than 2 mm lip seperation when relaxed |
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goal of treating facial imbalance in kids
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establish architectural balance and facial pattern
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what animal has nonpathological cleft?
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avions
therefore we study them |
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5 prominence which jaw develops from
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frontal/nasal (1)
nasal (2) mandibular (2) |
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formation of premaxilla
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by day 28, nasal placodes form from thickening of surface ectoderm from frontonasal prominence. neural crest cells around the placodes give rise to medial and lateral nasal prominences. plaodes invaginate forming nasal pits. the medial nasal prominences migrate and merge to form premaxilla
it is not the premaxilla untill both sides Fuse together |
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what does medial nasal prominence give rist to?
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philtrum
bridge of nose alar alveolar process w/incisors |
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how do palatal shelfs fuse?
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palatal shelves elevate, roll over tongue, and come together
there is medial edge epithelium on the 2 shelves. when the shelves come together they form a midline epithelial seam (MES) the MES under goes epithelia mesenchymal transformation. |
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what happens if when the Midline epithelial seam (MES) is made it does NOT undergo Epithelial mesenchymal transformation (EMT)?
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a cleft will form bc the 2 sides will not come togehher bc the epithelium breaks down
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what is on anterior and posterior end of MES?
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Epithelial Triangles
premaxilla is above the upper epithelial triangle of the MES |
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what is the cause of clefts?
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env
genetics MULTIFACTORIAL |
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in which direction does palate close?
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from anterior to posterior
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problems that arise w/ cleft palate pts
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missing teeth (esp lat incisors)
supernumerary teeth (esp max lat incisors) crossbites |
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when should a bone graft be done on a cleft pt?
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during transition of dentition
before bone graft expand the palate to open the cleft |
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what class is most cleft pts?
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usually class III bc there is a lip/face defiency
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Classification of Cleft lips class I
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unilateral notching of vermillion not extending into the lip
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Classification of cleft lip CLASS II
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unilateral extending into lip but excluding the nasal floor
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Classification of cleft lip class III
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extends into nasal floor
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Classification of cleft lip class IV
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bilateral
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Classification of Cleft palate Class I
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soft palate only
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Classificaiton of Cleft palate Class II
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soft as well as hard but not including alveolar process
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Classification of cleft palate class III
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extends into the alveolar process
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what is the similiarty between Class I-III of cleft palate classification?
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they are all unilateral
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Classification of cleft palate class IV
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bilateral
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why does cleft pt get crossbite?
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bc there is a collapse of the posterior segment
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2 types of bone
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1.woven
2.lamellar |
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difference in tx of skeletal crossbite and dental crossbite
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skeltal crossbite Tx is bone expansion
dental crossbite Tx is tooth removal |
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woven bone
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not fully mineralized
no organization it is isotropic |
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2 examples of lamellar bone
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it is isotropic
1.trabecular 2.cortical |
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pagets disease
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woven bone that it somewhere it should not be
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what type of bone is anisotropic
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woven bone
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3 types of bone cells
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1.osteoblasts
2.osteocytes 3.osteoclasts |
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basic metabolic unit of bone
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osteon
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what is bone remodelling dependent on?
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age
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what age group has more flat cells and osteocytes in their bone?
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adults
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how much higher is trabecular remodeling than cortical?
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5-10 x higher
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what does cortical remodeling depend on?
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haversian and volkmanns' canals
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when does activation of bone (conversion from quiescence to active bone surface) occur?
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every 10 sec. in adults and sites may be active for as long as 8 mos
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osteoclast resorbtion rate
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20-40 micrmeter/day but resorbs a v.large area
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function of haversian canals in compact bone
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The Haversian canals surround bloods vessels and nerve cells throughout the bone and communicate with osteocytes
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volkmanns canals
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run perpendicular to haversian canals in compact bone and connect them together
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type of bone that is v. vascularized
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cortical bone
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describe relationship between osteoblasts and osteoclasts
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osteoclasts have a Rank steriod receptor and the osteoblasts has a Rank-L protein ligand. the osteoclasts Rank rec. binds to osteoblasts Rank L causing activation of the osteoclasts
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people w/ osteoporosis take OPG (Osteoprotegerin) . what is its purpose?
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OPG are receptors that bind to the RankL on the osteoblasts to that the Rank of the osteoclasts cannot bind. therefore, osteoclasts do not get activated
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2 types of bone formation
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endochondral
intramembranous |
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condylar growth type
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appositional
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long bones of limb growth type
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epiphyseal growth
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how does cartilage grow?
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interstitial
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most common CF anomaly
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cleft lip and palate
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what % of cases does cleft lip and palate together account for?
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50%
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what % of cases does isolated cleft lip and isolated cleft plate occur?
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25% each
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severe problems associated w/cleft pts
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natal teeth (max centrals)
absenst teeth (lat incisors) supernumerary teeth (lat) ectopic primary lat incisor and canines located palatally to cleft tooth anomalies(enamel hypoplasia,weird crown shape, etc) teeth adjacent to cleft, no alveolar bone so lost no alvolar bone to external forces from muscles cause crossbite in posterior |
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facial profile of cleft pt
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convex
class III |
