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GROWTH OF THE CRANIOFACIAL

SKELETON
Ferdinand Machibya
OPCD
Growth Pattern
• Normal growth pattern
Changes in overall body proportions
Overall body proportions changes during
normal growth and development:
•There is progressive reduction of the
relative size of the head
•From almost 30% of the total body lenght
at birth
•About 12% of the adult total body
•Faster growth of the trunk and limbs (lower
limbs grow more than upper limbs).
•At birth, the legs represent about one third
of the total body length, while in the adult,
they represent about half.
Pattern

Scammon’s Curve
Curves for growth of the four major tissue
systems of the body:
Neural tissues is nearly complete by 6 or 7 years
of age
General body tissues, including muscle, bone,
and viscera, show an S-shaped curve, with a
slowing of growth during childhood and an
acceleration at puberty
Lymphoid tissues proliferate far beyond the
adult amount in late childhood, and then
undergo involution
Genital tissues accelerates rapidly at
adolescence.
the rate of Craniofacia
growth
At infancy:
relatively much larger cranium and a much smaller
face

After the age of 6 years:


There is little growth of the cranium because the
brain has nearly reached its adult size

Facial skeleton
grows much longer and thus in the adult forms a
much larger proportion of the scull than in the
child.
Craniofacial skeleton growth pattern
Average growth pattern
Horizontal growth
pattern

Vertical growth pattern


2. Variability
Everyone is not alike in the way that
they grow as in everyting else.It can be
difficult but clinically very important to
decide whether an individual is merely at
the extreme of the normal variation or
falls outside the normal range.
Variability
• Racial and ethnic differences
• Gender
• Sickness
• nutrition
• Timing factor -Late/early maturers
• Problems with growth (hormones or genetics)
Growth site and Growth center
A site of growth is merely a location at
which growth occurs, whereas a center is a
location at which independent (genetically
controlled) growth occurs. All growth
centers also are growth sites, whereas the
reverse is not true.
Growth Center and Growth Site

For example, it is now known that the


sutures between the membranous
bones of the cranium and the maxilla
that previously were considered as
primary growth centers, actually are
mere sites of growth.
Maxilla (Nasomaxillary complex)

Postnatal growth occurs in two ways:


Surface remodeling at the sutures that
connect the maxilla to the cranium and cranial
base

By these mechanisms maxilla moves


downward and forward relative to the
cranium and cranial base.
Maxilla (Nasomaxillary complex)
• The surfaces are remodeled,
and bone is removed from
most of the anterior surface.
Only a small area around the
anterior nasal spine is an
exception.

• the bone is removed on the


nasal side and added on the
oral side of the palate, thus
creating an additional
downward and forward
movement of the palate.
Passive
displacement
The suture between
maxilla and cranium

the direction of
maxillary movement
The site of maxillary growth and
absorption

palatal vault
moves downward
Mandible

Growth occurs:
• In cartilage covering the mandibular condyle
as a growth site
• The chin is almost inactive
• All other areas of the mandible are formed
and grow by direct surface apposition and
remodeling
The body of the mandible grows
longer as the ramus moves away
from the chin.

This occurs by removal of bone from


the anterior surface of the ramus
and deposition of bone on the
posterior surface.
The site of growth and mechanisms:
height:condylar process、alveolar
bone growth

length: posterior margin bone


apposition ,anterior margin bone resorption

width:condylar process growth,


Lateral mandibular hyperplasia
characteristic:
Angle of mandible :it will be different
with age, growth and masticatory
function 。
newborn : 140 – 160 degree
Adults : 125 degree
the elderly : Obtuser
Masticatory: ?????
GROWTH ROTATION

Characteristic feature of facial development is


a rotation of both the maxilla and the
mandible.
This rotation can occur in either a forward (
anterior ) or backward (posterior) direction.
GROWTH ROTATION
Forward rotation is the more
common case :

• The ascending ramus is long


• Gonial angle is small
• Symphysis menti is tilted
backwards
• Chin is jutting out
• There is apposition under the
symphysis and resorption under
the gonion so the lower border
of mandible is S-shaped.
GROWTH ROTATION
Backward rotation
Increased anterior facial height
resulting from a marked
anterior lowering of the
mandible in particular
The following features are
typical:
• The ascending ramus is short
• Gonial angle is larger than
normal
• Symphysis menti is tilted
forwards
Sites versus centers of growth
A site of growth is merely a location at which
growth occurs, whereas
a center is a location at which independent
(genetically controlled) growth occurs

All centers of growth also are sites, but the reverse


is not true.
Thank you