Good Morning

Basic Concepts Of
Growth & Development

By
Monojit Dutta
PG 1st Yr.
D.J.C.D.S.R
 Contents

Introduction
Basic Terminologies
Growth Pattern
Growth Movements
Enlow Counterpart Principle
Conclusion
References
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 Introduction

Physical growth should be assessed for the following reasons:

The Recognition And Diagnosis Of Significant Deviations From
Normal Growth.
The Identification Of Grossly Abnormal Pathologic Growth.
The Planning Of Therapy.
The Determination Of The Efficacy Of Therapy.
Unless the clinician has a clear and quantitative assessment
Of growth at the start of treatment, it will be impossible to evaluate
Later how well any treatment has progressed.
Handbook Of Orthodontics 4th Ed Moyers 4
 GROWTH
QUETELET was the first to present detailed analysis of human growth
in 1842.

TODD An increase in size

KROGMAN Increase in size , change in proportion and progressive

complexity.

MOSS- Change in any morphological parameter which is

measureable.
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 GROWTH

MOYERS- Quantitative aspect of biologic development

per unit time.

PROFFIT : Growth is An Anatomic Phenomenon

Units : Inches/Year Grams/Day

Handbook Of Orthodontics 4th Ed Moyers 6

 Development

MOSS- Continuum of casually related events from

fertilization of ovum and onwards

TODD Progress towards maturity.

PROFIT- Physiological and Behavioral Phenomenon

Textbook Of Craniofacial Growth Sridhar Premkumar 7

 MOYERS- All the naturally occurring unidirectional changes
in the life of an individual from its existence as a single cell
to its elaboration as a multi functional unit terminating in
death

Fertilized
Embryo Neonate Child Adult
Egg

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Degeneration & Death
Handbook Of Orthodontics 4th Ed Moyers
 GROWTH DEVELOPMENT
Increase in Size Increase in Degree of Organization

Anatomic Phenomenon Physiologic & Behavioral Phenomenon

Quantitative Qualitative

Inches/Year Gram/Day ---

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 Development Growth + Differentiation + Translocation

Handbook Of Orthodontics 4th Ed Moyers 10

 MEREDITH : Entire Series of Anatomic And Physiologic changes taking
place between the beginning of prenatal life and close to senility

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Differentiation & Differential Growth

Differentiation : change from generalized cells to more

specialized kinds during development

Differential Growth : Different organs grow at different

rates to a different amount and at different times

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 Cephalocaudal Growth

Increased axis of growth in the

caudal direction
3rd month IUL head takes about
50% of total body length
At birth , head as decreased to
about 30%
In Adult , head is reduced to
about 12%

Orthodontics - Current Principles and Techniques - Graber 6th edition 13

 Disproportions Of Head And Face In Adults

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Contemporary Orthodontics Profitt,5th Edition

 Scammons Growth Curve
Richard Scammon
4 major tissues : Lymphoid, Neural,
General & Genital
Not all tissue system grow at same
rate
Lymphoid tissue attains a peak
growth of 200% during late
childhood and regress at puberty
Neural tissue completes by 6-7
years
General tissue follows the S
shaped curve
Genital tissue peaks at puberty 15

Orthodontics - Current Principles and Techniques - Graber 6th edition

 Normality & Variability

Normality : Thought Of As The Central Tendency For The Group.

Explained In Following Ways
Statistics : Mean, Median, Mode And Standard Deviation
Evolutionary
Functional
Esthetic
Clinical
Concept Of Normality Must Not Be Equated With The Ideal Or The Desired, Nor Is It
Appropriate As A Goal Of Treatment For An Individual. Rather, It Should Be Thought
Of As The Central Tendency For The Group.

Handbook Of Orthodontics 4th Ed Moyers 16

Proffit 5th 17
Proffit 5th 18
 Variability : Gross variation from the central tendency may also be
indicative of a pathologic condition
Timing :
The periods during which growth processes are turned on are called
growth spurts
When dental and facial skeletal growth are not synchronized, some
malocclusions are produced and others aggravated.

Handbook Of Orthodontics 4th Ed Moyers 19

Growth Spurts
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1. Prenatal
Period of Ovum : conception to 2 weeks
Period of Embryo : 2- 8 weeks
Period of Fetus : 2 10 Intrauterine months
2. Postnatal
Infant : One year after birth.
Mixed dentition growth spurt
Females : 7- 9 years.
Males : 8-11 years.
Pre Pubertal growth spurt
Females: 11-13 years.
Males: 14-16 years.
Pubertal period
Females : 18 20 yrs 21

Males : till 25 yrs

 Distance & Velocity Curve

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Contemporary Orthodontics Profitt,5th Edition

 Distance Curve :
Gueneau de Montebeillard
Obtained by joining successive points from birth to adulthood
Measured At set intervals

Due to Growth Variability this can be best explained by Velocity Curve

Velocity Curve : Amount of increment in height per year

More informative about accelerations and decelerations in growth rate
More revealing
Unit : mm/year 23

Textbook Of Craniofacial Growth Sridhar Premkumar

 Growth Site and Centre

Coined by Baume

Growth Centre : Places of endochondral ossification with tissue

separating force contributing to increased skeletal mass like cranial
and facial sutures, condyles, nasal septal cartilage synchondrosis

Growth sites : Region of periosteal bone formation and modeling

resorption adaptive to environmental influences like condyle

Proffit considered growth centers as genetically controlled

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Textbook Of Craniofacial Growth Sridhar Premkumar
 Remodelling

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Textbook Of Craniofacial Growth Sridhar Premkumar
 Remodeling is a process of reshaping and resizing as a consequence of
progressive continuous relocation
Types
Biochemical : Mineral Homeostasis
Growth : constant replacement of bone during
Haversian : cortical reconstruction
Pathological

Handbook Of Orthodontics 4th Ed Moyers 26

 Drift & Displacement
Drift
Termed by Enlow
Combinations of deposition and resorption result in growth movement
toward the depository surface

Handbook Of Orthodontics 4th Ed Moyers 27

 Displacement
Movement of whole bone as a unit

Handbook Of Orthodontics 4th Ed Moyers 28

Primary displacement, that is, Secondary displacement is
displacement associated with the movement of a bone related to
bone's own enlargement. enlargement of other bones.

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Textbook Of Craniofacial Growth Sridhar Premkumar
 V principle

Bone deposition on the inner

surface due to concept of surface
growth depending on growth
direction
Resorption on outer surface of V
The V moves away from the tip ,
enlarging simultaneously
Increase in size and growth in a
unified process
Thus called Expanding V Principle

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Textbook Of Craniofacial Growth Sridhar Premkumar
 31

Textbook Of Craniofacial Growth Sridhar Premkumar

 Surface principle

Sides of bone facing the

direction of the growth
are subject to deposition
and those opposed to it
undergo resorption

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Textbook Of Craniofacial Growth Sridhar Premkumar
Posterior Growth & Anterior Displacement

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Contemporary Orthodontics Profitt,5th Edition
Textbook Of Craniofacial Growth Sridhar Premkumar
Overall growth pattern of maxilla and mandible can be explained in 2
different ways

Cranium as reference area Maxilla and Mandible moves downward and

forward
Vital studies shows Posterior surface of Ramus, the condyle & the
coronoid are the principal sites of growth with little changes along the
anterior part of mandible

Therefore, it is correct to view the Mandible being translated downward

and forward while it grows upward and backward 34

Textbook Of Craniofacial Growth Sridhar Premkumar

 Enlow Counterpart Principle

Donald H Enlow
The growth activity in one region is invariably
accompanied by complementary growth in other region
Both dimensions and alignment of craniofacial
components are important in determining the overall
facial balance

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Textbook Of Craniofacial Growth Sridhar Premkumar
 Conclusion
Growth patterns
Cephalocaudal Growth
Scammon Growth Curve
Normality & Variabilty
Timing , Distance & velocity curve
Mechanism of bone growth
Remodeling
Growth movements
Drift & Displacement
V principle
Surface Principle
Posterior Growth & Ant Displacement
Enlow Counterpart principle
Handbook Of Orthodontics 4th Ed Moyers 37
 Those Who Are Enamored Of Practice Without Science Are Like A Pilot Who
Goes Into A Ship Without Rudder Or Compass And Never Has Any Certainty
Where He Is Going. Practice Should Always Be Based Upon A Sound Knowledge
Of Theory.
-Leonardo Da Vinci.

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 References

Textbook Of Craniofacial Growth Sridhar Premkumar

Essentials Of Facial Growth - Donald H Enlow , Mark G Hans
Handbook Of Orthodontics 4th Ed Moyers
Contemporary Orthodontics Profitt,5th Edition
Orthodontics - Principles & Practice Graber, 6th Edition
Thank You

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