口腔骨质发育.ppt

Craniofacial Growth and Development in orthodonticsOrthodontic Department,Orthodontic Department,West China College of StomatologyWest China College of StomatologySichuan UniversitySichuan UniversityNing HuangNing Huang 黄宁黄宁黄宁黄宁MD,DDS MD,DDS 一、一、Concepts of growth and developmentvGrowthRefers to an increase in size or number,an anatomic quantitive phenomenon.vDevelopmentRefers to an increase in complexity,physiologic,qualitative and behavioral phenomenon.vGrowth pattern Refers to the changes in spatial proportions of the physical arrangement of the human body over time.Four main types of bodily growth pattern:neural,somatic,genital,and lymphoid.Craniofacial growth pattern:changes in spatial proportions of the head and face as time passes.Three types of Craniofacial growth pattern:vertical,horizontal,and average facial growth pattern.vGrowth site A location at which growth occurs,which can be affected by environmental factors.vGrowth center A location at which independent growth occurs,which is controlled genetically.All growth centers also are growth sites,whereas the reverse is not true.vGrowth rotation The phenomenon that the direction of facial growth is rotational,which has been demonstrated by Bjrk growth study.It is obviously happened in mandible,and is the result of the growth of many craniofacial structures.vGrowth prediction An estimate of the amount and direction of the bones of craniofacial skeleton and the overlying soft tissues.Due to the inter-individual variation,growth prediction is considered a low accuracy procedure.vPubertal growth spurt The increased velocity of physical growth of human body around puberty.Assessment of stature,weight,secondary sex characteristics(onset of menstruation in girls),and hand-wrist radiograph helps to judge whether the patient has entered the pubertal growth spurt.vGrowth variability The inter-individual variation of growth and development in human being.It is important to determine whether an individuals growth is in the range of normal variation or falls outsides the normal range.vGrowth timing The same kind of growth and development happens for different individuals at different times.Such as pubertal growth spurt,which occurs at different ages in different adolescents.vGrowth remodeling:A reshaping of the outline of a bone by selective resorption in some area of its surface and apposition in other areas.vGrowth translation The entire movement of a bone caused by adjacent bones growth.vPattern of ossification Formation and development of bone.Two types of ossification:pEndochondral ossification (mandibular condyle and cranial base synchondroses)pIntramembranous ossification(cranial vault,maxilla,and mandibular body).二、二、Embryonic stage1.Neural crest2.Pharyngeal arches(6 pairs)3.Facial development:frontonasal process,maxillary process,mandibular process,palate三、三、Maxillary complexvTypes of growth:1.Surface remodeling 2.Displacement by cranial base growth 3.Growth at the suturev3-dimensional growth:1.AP(anteroposterior)direction:2.Downward direction 3.Transverse directionvThe role of maxillary complex growth in orthodontics:1.Hyperplasia 2.Hypoplasia 四、四、MandiblevTypes of growth:1.Translation:downward and forward by the growth of cranial base 2.Endochondral bone formation 3.Surface remodeling v 3-dimensional growth:1.AP(anteroposterior)direction:2.Downward direction 3.Transverse directionvThe role of mandible growth in orthodontics:1.Hyperplasia 2.Hypoplasia五、五、Cranial base 1.Types of growth:Endochondral ossification 2.Important growth centers:the spheno-occipital synchondrosis,inter-sphenoid synchondrosis,sphenoid-ethmoid synchondrosis.v3.The role of cranial base growth in orthodontics:length and angulation Class or malocclusion 六、六、Soft tissue1.Not paralleling the growth of underling hard tissue,but according to their functions(suckling,mastication,facial expression,swallowing,speech)2.Lips:Height:grows at adolescent spurt,then slow down Thickness(grows at adolescent spurt,then decreases),Teeth support 3.Nose:become prominent(adolescent spurt,post-adolescent growth still)4.Chin:Along with the underling bone,becomes more prominent in male and changes little,but becomes retrusive in female during adulthood 七、七、DentitionvPrimary,mixed,and permanent dentition see chapter 八、八、velocity of completeness of craniofacial growth vCranial base Maxillary MandiblevFemale MalevWidth Length Height九、九、Theories of growth control vGenetic theory,vSuture,vNasal septum,vMoss hypothesis(Functional matrix),vPetrovics hypothesis(Servo system)十、十、The rule of craniofacial growth and development in orthodontics1.Growth prediction is useful for treatment planning:amount,direction,and timing.Because of growth variability,its still difficult.2.Estimation of pubertal growth spurt of craniofacial organs will help to choose treatment time and appliances.3.To study the pre-and post-treatment change of orthodontics by eliminating the effects of growth.4.To develop a strategy for retention.Referencel口腔正畸学口腔正畸学 第五版第五版 林久祥林久祥lContemporary Orthodontics Fourth Edition W.R.Proffit,H.W.Fields,D.M.Sarver lAn Introduction to Orthodontics Third edition L.MitchellMain points todayvConcepts of growth and developmentvMaxillary complexvMandiblevThe rule of craniofacial growth and development in orthodontics