Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
84 Cards in this Set
- Front
- Back
hierarchy of alterations in adult facial growth (from most to least)
|
soft tissues, frontal sinus, facial bones, cranial base bones
|
|
direction in which adult growth predominates, but is more characteristic for ______
|
vertical
female |
|
decreases/ increases with age
bone water content apatite crystal size volume of skeleton weight of skeleton cortex width |
decrease
increase increase decrease decrease |
|
adult growth--> mandibular rotation is _______ for males, and _____ for females
|
counterclockwise/forward
clockwise/ backward |
|
in adult growth, the palate region continues to move ____ and ______ in the posterior region, and in the anterior region in moves _______ and ______
|
inferiorly and posteriorly in the posterior region
anterior region it moves forward and downward |
|
for adult growth, the anterior midface shows a greater development _______ than ______
nasal bone region continues to develop ________ alveolus increases in size ________ |
more anteriorly than vertically
anteriorly vertically |
|
in adult growth, the lips tend to grow ____ resulting in ____ upper incisor display
overall there is a ______ and ______ of the profile teeth begin to incline ________ |
downward --> less upper incisor display
straightening and elongation of profile incline lingually- lip area is flattened |
|
face profile changes begin 10 years ______ for men than for women
women greater changes from ____ to ____ decades men greater changes from ____ to ____ decades |
later
2nd to 3rd 3rd to 4th |
|
max and mand arch width and arch depth _______ with age
|
decrease
|
|
in adult growth, maxillary central incisors ____ and become more ________
lower anterior have a tendency to _______ in females and _____ in males _______ teeth respond to the altered position of the mandible |
extrude and become more vertically upright (both sexes)
procline in females, remain stable in males posterior |
|
in adult growth, male maxillary incisors _______
therefore, mandibular molars have to move ____ to keep class I occlusion |
upright, crown moves lingually, would create class III malocclusion
mandibular molar teeth move backwards to keep occlusion |
|
in adult growth, female maxillary incisors _______ but also ______
therefore, mandibular molars have to move ______ to keep class I occlusion |
upright, but also have more forward extrusion
forward |
|
examples of growth centers
growth sites |
centers= sites of endochondral bone formation that exert pressure: synchondroses, nasal septum
sites= sutures, tuberosities, alveolar bone, periosteal/endosteal surfaces, condyles |
|
2 criteria for a growth center
|
1. endochondral bone formation
2. interstitial growth capable of generating a separating force |
|
wolff's law
mechanostat theory |
law: bone in a healthy person will adapt to the loads it's placed under
mechanostat: needs STRAIN to keep bone |
|
reversal line:
|
when you tip a tooth backwards it exerts pressure on the periodontal space and in turn remodels the alveolar bone
|
|
primary vs secondary displacement
|
primary- limited, only when bone itself is growing ONLY at primary cartilage
secondary- most bone growth caused by growth form brain, eyes, etc. |
|
expanding V principle. where is resorption vs deposition?
|
resorption on the outer surface, deposition on the inenr surface
palate and mandible |
|
dolichocephalic:
brachycephalic: euryprosopic: leptoprosopic: |
long skull
short skull wide face long face |
|
_____ major growth mechanism for growth of cranial vault
______ adapted sutural membranes are triggered by ____________ of bones on either side of the suture |
sutural growth major (also growth on surface)
tension adapted triggered by secondary displacement |
|
growth at cranial sutures initated by _______ --> ______ ---> _________ --> ______ --> bone apposition
|
brain growth ---> secondary displacement of cranial bones --> sutural separation --> tension (in fibers) ---> bone apposition
|
|
in cranial growth & remodeling:
_____ of anterior wall of middle cranial fossa _______ on sphenoid ____ displacement of anterior cranial fossa petrous ________ spheno-occipital _______ |
resorption of anterior wall
deposition on sphe forward displacement petrous enlargement spheno-occipital growth |
|
this maintains the relative placement of the spinal cord
|
differential remodeling
|
|
creates frontal sinus and when
|
after brain stops growing, outer cortex of skull bone continues to grow and make space
|
|
sutural growth of cranium _____ as you move inferiorly
endocranial fossa enlarges by: major synchondroses growth for cranium |
decreases
cortical remodeling spheno-occipital |
|
oxycephaly
plagiocephaly scaphocephaly |
oxy: fusion of lambdoid or coronal suture (makes up by extra lateral growth)
plagio: unilateral fusion of either lambdoid or coronal suture scaph: fusion of sagittal suture (makes up by extra a&p growth) |
|
the cranial base is made up of _________ bone, with relative growth pattern:
|
endochondral bone
growth between the neural and somatic patterns |
|
cranial base bones seen:
plays role in this kind of displacement closely related to this anatomy |
1st- provide framework for facial development
primary and secondary displacement soft-tissue anatomy of upper respiratory system |
|
cranial base flexion locates foramen magnum more ____ and in more ___ orientation
flexes most rapidly _____ and during ________ years |
anterior and rostral (underneath skull) orientation
before birth and during 1st 2 postnatal years |
|
anterior cranial base is measured from _____ to _____
related synchondrosis: posterior cranial base is measured from _____ to _____ related synchondrosis: |
nasion to sella turcica- sphenoethmoidal synchondrosis
sella turcica to basion- spheno-occipital synchondrosis |
|
as you age, the cranial base angle:
|
decreases (most changes during childhood)
|
|
synchondroses of the cranial base and when they fuse
|
intersphenoid: fuses at birth
anterior and posterior occipital (3-5 years) spheno-ethmoidal (7-8 years) spheno-occipital (15-20 years) |
|
synchondroses of the cranial base displaces maxilla ______ and glenoid fossa ________ and _________
|
forward
backwards and downwards |
|
symptoms of achondroplasia
_____ posterior base ______ cranial base angle ________ calvaria _______ sinuses ______ and _____ midface ________ mandible |
problems making cartilage causes more acute base angle
- short posterior base - small cranial base angle - enlarges calvaria - large sinuses - short recessive midface - prognathic mandible |
|
malocclusions caused by large anterior and posterior cranial base lengths
malocclusion caused by a large cranial base angle (nasion-sella-basion) |
class II
class II (mainly div I) |
|
relationship between cranial base and maxillomandibular relationships
smaller angle = larger angle= |
smaller angle- midface is pushed back and up
larger angle- midface is forward/larger, more forward rotation |
|
cranial shape that has a higher likelihood of class III malocclusion
|
brachiocephalic
|
|
2 types of malocclusion with genetic components
|
class III (1/3 have major gene component)
class II div II- due to smaller toth size which is genetic |
|
3 components of mechanical/functional hypotheses for changes in occlusion
|
1. habits
2. interferences with normal breathing 3. decreases in muscle strength and activity |
|
lingual pressures greater during _____ and _____
resting pressure greater on the ____ aspect of _________ incisors |
postural rest and deglutition
labial aspect of mandibular incisors |
|
frequency of abnormal sucking habits lead to which malocclusions (most frequently to least frequently)
|
open bite
class II div I cross bite III I class II div 2 |
|
2 malocclusions associated with finger-sucking and why
|
1. bilateral narrowing of maxillary arch
- lowered resting tongue posture - raised buccal pressures 2. unilateral crossbites due to "convenience swing" of mandible to one side |
|
lip-sucking
lower lip to _____ aspect of ____ incisors hyperactive ___ muscle prevents normal ________ |
lingual aspect of maxillary incisors
mentalis muscle normal deglutition |
|
swallowing habit that can lead to anterior open bite
|
pushing tongue forward when swallowing to create seal when swallowing
|
|
potential airway problems
upper: middle: lower: |
upper: nares, turbinates, polyps
middle: adenoids lower: tonsils |
|
complications caused by complete blockage of airway by enlarged adenoid tonsils
eruption? gonial angle? condylar growth? mandible rotation? malocclusion? face height? |
mouth breathing!
- decrease maxillary transverse width - supereruption of teeth - larger gonial angle (steeper mandibular plane) - condlye grow posterior - rotate mandible down/ retrognathic - class II malocclusion - longer face height |
|
malocclusion caused by muscular dystrophies
|
class II (most have vertical problems, no muscle strength to pull mandible up)
|
|
development of nasomaxillary complex postnatally occurs almost entirely by ____________ (the exception is __________)
growth of nasomaxillary complex occurs primarily by: |
intramembranous ossifcation (septum is endochondral)
apposition of bone at sutures surface remodeling |
|
2 types of maxillary sutures where growth occurs
in response to: |
circummaxillary (attaches midface to cranium) and intermaxillary sutures (midpalatal/transverse)
in response to primary and secondary displacements |
|
displacement of the midface leads to:
do sutures displace the midface? |
GROWTH of facial sutures.
NO- displaced due to growth of cranial and cranial base, nasal septum and expansion of oronasal capsule |
|
the nasal septum plays a role in ____ and ____ displacement of the maxilla
shows limited growth potential after _____ years |
vertical and horizontal displacement
limited after 7-8 years |
|
which has more growth potential? vertical or a/p growth of maxilla?
|
vertical has more growth potential
a&p growth happens more quickly, maturation reached sooner |
|
growth of the maxillary complex is greatest _________, at these 2 places
|
posteriorly at the maxillary tuberosities and pterygoid plate
|
|
in the nasomaxillary complex the amount of forward movement of anterior surfaces is ______(greater/less) than amount of displacement
|
forward movement is less than amount of displacement
|
|
_____________ result in differential remodeling of the maxillary skeleton
_______ on orbital floor _______ on nasal floor _____ of alveolar bone w/ dental eruption |
growth fields
apposition resorption apposition |
|
adolescent spurt in maxillary growth is restricted to:
|
vertical growth
|
|
in midfacial remodeling
The ANS grows _____ and slightly _______ the PNS drifts _______ an d______ with bone added to the _________(back or front) orbitale drifts _____ and ______ |
ANS grows inferiorly and slightly anteriorly
posteriorly and inferiorly bone added to the back superiorly and posteriorly |
|
components of mid-facial growth include these 5 things (area and direction)
|
orbit remodeling (up and back)
sutural growth (downward) apposition at infrazygomatic crest (downward) resorption at nasal floor (only can resorb/displace downwards) alveolar bone deposition (eruption of teeth is greater htan growth displacement downward) |
|
when the maxilla rotates forward, where does resorption vs deposition occur?
|
resorption occurs in the front
deposition occurs in the back overall appears to move downward in a parallel fashion |
|
transverse growth in the midface occurs mainly due to ________ and in part due to _________
|
growth at the mid-saggital suture
minority due to addition of bone to the buccal surface of teeth (cortical drift outward) |
|
in normal transverse rotation the (front/back)____ separates more
when separated by an appliance the transverse rotation is more in the _______ |
at back of suture
front of suture (no resistance) |
|
postnatal mandibular growth is influenced by ____ and ________ growth
follows ________ pattern spurts lead to growth in this direction: sex differenced due to |
maxillary and posterior cranial base growth
scammon's somatic pattern mid-childhood and adolescent growth VERTICAL only due to extra 2 years in male growth rate |
|
mandibular growth cannot occur ________ except for at the condyl
mandibles grow longer and wider by apposition on the ____ surfaces of the corpus and ______ surfaces of the ramus |
can't grow interstitial (except at condylar cartilage- secondary growth site)
buccal surfaces of corpus and posterior surfaces of the ramus |
|
the _____ is extensively remodeled as the mandible growths
displaced _____ & ______ grows _____ & _______ |
ramus
forward/downward grows up and back |
|
ramus growth and remodeling
____ and _____ condylar growth apposition along _______ ramus resportion along _______ & ________ |
superior and posterior condylar growth
apposition along posterior ramus resorption along anterior ramus and along lower border of ramus |
|
modeling of anterior corpus
______ drift of alveolar bone ______ & _______ drift of upper anterior border and posterior border ________ of lower anterior border _______ & ____ modeling of inferior border |
superior drift
superior & posterior drift relative stability inferior and posterior modeling of inferior border |
|
growth of condylar cartilage when transplanted
nasal septum? |
little or no growth; not a growth center
nasal septum acts like a synchondrosis and grows nearly as well |
|
how and why does the condyle respond to an altered environment?
|
by interstitial growth- proliferation zone cell layer isn't well protected from environmental insults
|
|
mandibular ankylosis can cause what
|
extreme class II- no translation upon opening = no growth
|
|
the glenoid fossa normally is translated _______ & ________ during growth, which ________ chin projection
|
down and back
reduces chin projection (not talking about rotation) |
|
true rotation is normally covered up by:
makes apparent rotation: |
angular remodeling changes
apparent rotation is then usually none |
|
forward rotation leads to _____ tipping of mandibular teeth
backward rotation leads to ______ tipping of mandibular teeth |
forward tipping
backward tipping |
|
rotation of maxilla is ______ than madnible
|
less than mandible
|
|
forward rotation leads to the condyle moving _____ an d______
backward rotation of mandible leads to the condyle moving ____ & _______ |
forward and upward
backward and upward |
|
excessive forward rotation in ______ face individuals progressive _____ the maxillary incisors, creating _____ bite and _____ malocclusion
|
short faced individuals
uprights the maxillary incisors creates deep-bite and crowded malocclusion (class II div I) |
|
long faced individuals tend to have ___ than average forward or backward rotation
why? |
less than average rotation
- steep mandibular angle - open-bite malocclusion - mandibular deficiency |
|
mandible has more or less transverse rotation than maxilla?
|
less! only 70% of max transverse rotation
|
|
why do you see more class II developments later in adolescence?
|
transverse and forward rotation occurs more during childhood than adolescents
|
|
how is the nasal floor remodeled?
resorption happens more in the ____ to cover up its forward growth |
resorption only- cannot add bone
more resorption in the front- apparently looks like it's moving down parallel |
|
bone with most potential for growth
|
mandible
|
|
only places where primary displacement occurs
|
spheno-occipital-ethmoid synchondroses and nasal septum
|
|
what is hyperdivergence?
|
steep mandibular angle - leads to class II, long face issues
hypodivergence - too flat of a mandibular angle |
|
excessive class II skeletal malocclusion is normally caused by
|
normal maxillary and deficient mandibular growth
|
|
determines anterior-posterior bony chin placement
|
true rotation
|