Development of face by revath

1. BY Dr. D.V.S. REVATH VYAS
1ST MDS
DEVELOPMENT OF FACE AND JAWS

2.  ORIGIN OF HUMAN EMBRYO
 GERM LAYERS
 BRANCHIAL ARCHES, CLEFTS AND
POUCHES AND THEIR DERIVATIVES
 STAGES OF CRANIOFACIAL GROWTH
 DEVELOPMENT OF LOWERTHIRD FACE
 DEVELOPMENT OF MIDDLE THIRD FACE
 DEVELOPMENT OF UPPER THIRD FACE
 DEVELOPMENTAL ANAMOLIES.
OUTLINE OF MY PRESENTATION

3.  “Development is a progress
towards maturity” –
Todd(1931)
 “Development connotes a
maturational process involving
progressive differentiation at
the cellular and tissue levels” –
Enlow.
DEFINITION

4.  Human prenatal development begins with process involving in
ovarian cycle and fertilization
 Fertilization occurs in fallopian tube
 Fertilized ovum undergoes cleavage to form series of divisions to
form blastocyte which further gives rise to tissues and organs.
ORIGIN OF HUMAN EMBRYO

8.  10 lunar months
 Three phases
 First – GERMINAL PHASE -- from fertilization 2 weeks
largely cellular proliferation, migration and some differentiation
 Second – EMBRYONIC PHASE – from 2nd week  2nd month
Largely the differentiation of all major internal and external organ
Morphogenesis
Very vulnerable stage
 Third – FETAL STAGE – from 2nd month to birth
Largely a matter of growth and maturation
Prenatal development

9. FORMATION OF GERM LAYERS
At a very early stage the embryo proper acquire
to form 3 layered disc called as embryonic disc.
3 layers are ectoderm ,mesoderm and the
endoderm.

10. • Blastocyst increases in size by proliferation
• A blastocoel or blastocyst cavity forms between the inner cell mass and
the trophoblast
• Differentiation of the inner cell mass begins
• Results in the formation of a bilaminar embryonic disc comprised of two
cell layers
• Two layers are called an upper epiblast (ectoderm, mesoderm, endoderm) and a
lower hypoblast (extraembryonic endoderm)
• Above this disk is an upper amniotic cavity and a lower yolk sac (primitive
hematopoietic organ for the embryo/fetus)
• Trophoblast also begins to differentiate to form a primitive placenta
• The embryo connects to the developing placenta through a stalk

11. • The bilaminar embryonic disk converts into a trilaminar Disk of ectoderm,
mesoderm, endoderm (gastrulation)
• Formation of the primitive streak within the embryonic Disc critical to this
formation
• Migration of epiblast cells through the primitive streak Towards the
hypoblast – eventually creates three tissue layers called the Germ layers
1. Ectoderm
2. Mesoderm
3. Endoderm

12. Primitive streak

13. DEVELOPMENT OF NEURAL CREST
CELLS
•At the time of neural tube closure
a unique population of cells
separate from
• the crest fold they are called as
neural crest cells.
These have great migrating
capacity.
They are ectodermal in origin but
they also exhibit property of
mesenchymal tissue so they are
also called as ectomesenchymal
cells.

14.  In the head and neck region the
cells give rise to facial process
,branchial arches and their
cartilages , bone cells, ganglia of
autonomic nervous system.
 Also contribute to the formation
of embryonic connective tissue
of facial origin includes dental
structures like dentin cementum
and pulp.
DERIVATIVES OF NEURAL CREST
CELLS

15. FATE OF GERM LAYERS
 Ectodermal cells will give rise to the nervous system; the epidermis
and its appendages (hair, nails, sebaceous and sweat glands); the
epithelium lining the oral cavity, nasal cavities and sinuses; a part
of the intraoral glands, and the enamel of the teeth.
 Endodermal cells will form the epithelial lining of the
gastrointestinal tract and all associated organs.
 The mesoderm will give rise to the muscles and all the structures
derived from the connective tissue(e.g., bone, cartilage, blood,
dentin, pulp, cementum and the periodontal ligament).
 The embryonic disc will soon become altered by bends and folds
necessary for further development.

16.  development of a head fold
 is critical to the formation of the
primitive oral cavity
 folding results in the formation of
the primitive oral cavity =
stomatodeum
 separated from the developing and
expanding gut by a
buccopharyngeal membrane
(or oropharyngeal membrane)

17. BRANCHIAL ARCHES
• 1,2, 3 and 4 arch are well developed in humans.
•1and 2 extend into the midline.
•Mandibular arch is 1 st to develop located just below the
stomodium.
•Hyoid arch is 2 nd to develop.
The tissue bordering the stomodium gets elongated due
to the series of mesodermal thickenings in the wall of the
cranial most part of foregut called as branchial arches.

18. CLEFT --- ECTODERM
ARCH --- MESODERM
POUCH --- ENDODERM

19. First arch(mandibular arch)
derivatives
 Cartilage – meckel’s cartilage
 Muscles – muscles of mastication, mylohyoid, tensor tympani,
tensor palatini, anterior belly of digastric, part of temporal bone
 Bones – maxilla, mandible, malleus, palatine bone, part of
temporal bone
 Nerve supply – mandibular nerve
 Blood supply – maxillary artery
 Ligment – sphenomandibular ligament (remenent)

20.  Cartilage – reicherts cartilage
 Muscles –stapedius, stylohyoid, muscles of facial expression,
platysma, auricular muscle, occipito frontalis, posterior belly of
digastric
 Bones – smaller cornua and superior part of hyoid, styloid
process, stapes
 Nerve supply – facial (seventh) nerve
 Blood supply - stapedial artery
 Ligment – stylohyoid ligament (remenent)
Second arch (hyoid arch)
derivatives

21.  Muscles - stylopharyngeus
 Bones – greater cornua of hyoid and inferior part of it
 Nerve supply – glossopharyngeal (ix) nerve
 Blood supply - right and left common carotids
Third arch derivatives

22.  Muscles – all the Muscles of pharynx (except
stylopharyngeus), all the Muscles of soft palate
(except tensor palatini), cricothyroid
 Nerve supply - Cranial nerve X (vagus), External
branch of superior laryngeal nerve
 Blood supply -
Fourth arch derivatives

23. Sixth arch derivatives

25.  After the development of arches in the region of neck ,a series
of grooves are formed ,they are ectodermal clefts.
 Clefts of 1 and 2 arches - external acoustic meatus
 2 ,3,4 and 6th arch - cervical sinus
 Cervical sinus gives swelling in the region of neck along the
anterior border of the sternocledomastoid musle forming
branchial cyst
 Branchial cyst opening into surface forming branchial sinus.
 Rarely opens into the lumen of pharynx in the tonsillar region.
Fate of ectodermal clefts.

26.  1st pouch
I. Ventral part obliterated to form tongue
II. Dorsal part of 1st and 2nd pouch together form diverticulum called as tubo-
tympanic recess
III. Distal part gives rise to auditary tube
 2nd pouch
I. Ventral part - tonsil
II. Dorsal part -tubotympanic recess
 3rd pouch - inferior parathyroid gland and thymus
 4th pouch - superior parathyroid glands
 5th pouch (ultimobranchial pouch)
Is seen for brief period during development
Incorporated with 4th pouch forming caudal pharyngeal complex
Fate of endodermal pouches

28. CLINICAL COMMENT
• From the initial development each cranial arch has specific
cranial nerves associated with it.
• The nerve and musculature of each arch merge together
and follow defined pathway to their functional position.
• These events are closely regulated genetically during
development.

29. STAGES OF CRANIOFACIAL
DEVELOPMENT
• The prenatal craniofacial growth
develops in 3 stages.
• The period of ovum - fertilisation to 2weeks.
• The period of embryo - 2weeks to 8weeks.
• The period of foetus - 8weeks till birth.

31.  face and related structure begins to develop during 4
th week of iu life
 During this time the rapidly growing brain of embryo
bulges over the oropharanangial membrane and
developing heart
 Facial development depends on 5 process which surrounds
the primitive mouth .
They are
 The frontonasal process.
 Paired maxillary process
 Paired mandibular process
`

32.  The face is divided into
upper third
middle third
lower third

33.  Growth of mandibular arch
 Formation of lower soft tissues
 Formation of lower hard tissues.
DEVELOPMENT OF LOWER THIRD OF
FACE

34.  After formation of stomodeum 2 bulges appear
inferior to primitive mouth they are mandibular
process.
 Consist of core of mesenchymal cells formed from
neural crest cells.
 They migrates from facial region
 Covered by ectoderm externally and endoderm
internally.
GROWTH OF MANDIBULAR ARCH

35.  Development of body of mandible is continued ,bone
formation markedly increases the size of mandible with
development of alveolar process surrounding tooth germ.

36.  Paired mandibular process fuse to form
mandibular arch .
 Future mandibular arch give rise to lower
face ,lower lip and lower teeth.
 Mesoderm of this arch gives rise to
1. Muscles of mastication
2. Palatal musles
3. Supra hyoid muscles
4. tongue

37.  5-6 th week muscle cell begin to differentiate and orient
towards their origin and insertion
 7th week muscle cell enlarge and begins to
migrates ,gets differentiated into massetter
medial pterygoid ,lateral pterygoid and
temporalis..
 10 th week muscle mass becomes well organised
bilaterally nerves from 5th cranial nerve are
incorporated early in these muscles.

38.  Initially grows intramembranously but subsequent
growth is related to appearance of secondary
cartilage .
 It is preceded by appearance of rod of cartilage called
as meckels cartilage.
 It extends from cartilagenous otic capsule in the
region of developing ear to a midline symphysis.
GROWTH OF MANDIBLE

39. 1. Extends towards the midline lie in close relationship with
opposite side.
2. 2plates are separated by fibrous tissue to form
symphysis.

40.  When tooth reaches bell stage ,bone comes closely related
to form alveolus.
 Inner wall resorption occurs –indicated by howship lacunae
 Outer wall bone deposites-indicated by osteoblast lining
osteoid.
 Developing teeth lie in trough of bone.
 Later teeth are separated by interdental septa with
development of root.
 Interradicular bone develops in multirooted teeth.

41.  Mapped out as condensation of fibrocellular tissue that is
continued developing along with body of mandible.
 Further there is backward spread of ossification.

42. Appear on 10-14th week of iu.
 They are Condylar cartilage
 Coronoid cartilage and
 Symphyseal cartilage.

43.  Appear on 12th week iu
 Rapidly forms cone shaped occupies most of the developing
ramus
 Cartilage converted to bone by endocondrial ossification.
 By 20th week iu only thin layer of cartilage remain in the
condylar head
 Direction and amount of condylar growth is related to the
change in mandibular position.

44.  Appears 4th month iu
 Surrounds anterior border and top of coronoid process.
 They are transitory growth cartilage.
symphyseal cartilage
 2 in no
 Appear as connective tissue at 2 ends of meckles cartilage.
 Obliterates with in 1 year of life.

45.  Gives rise to incus and malleus
 Spine of spenoid.
 sphenomandibular ligament
 Anterior ligament of malleus.

46.  Develops at 12 th week iu .
 Develops intramembranously
 Forms mesenchymal lining between developing mandibular
condyle below and temporal bone above.
 Forming upper and lower joint cavities
 Intervening mesenchyme becomes interarticular disc.

47.  Joint capsule develops from condensation of mesenchyme
 At birth mandibular fossa is flat
 No articular eminence is seen
 Becomes prominent only after eruption of deciduous
dentition.

48.  During 4th week of iu frontonasal process forms as bulging
of tissue in the upper facial area at most cephalic end of the
embryo.
 It gives rise to fore head bridge of nose primary palate nasal
septum.

49.  They are rounded areas of specialised thickened ectoderm
on the outer surface of the embryo
 Found at developing sense organ
 2lens placode –on eiter side forming future eye
 2otic placode –on eiter side forming future inner ear
 2 nasal placodes on anterior portion of frontonasal process
forming olfactory cells.

51.  At 4th week iu
 Placode gets submerged forming depression called
as nasal pits
 Deepening of pits produces nasal sac
 Grows internally towards brain
 Oronasal membrane separates nasal and
stomodeum
 Its disintegration brings nasal and oral cavities in
communication in the primary conchae posterior to
primary palate
 At the same time superior middle and inferior
conchae also develop.

52.  Middle portion of tissue forms medial nasal process
 Fuse to form middle portion of nose root to apex
 Center portion of upper lip and philtrum
 Internal portion medial nasal process grows inferiorly
forming intermaxillary segment and premaxillary segment
 Involved in the formation of upper incisors primary palate
and nasal septum

53.  Outer portion of nasal pit are lateral nasal process ,give rise
to ala and side of nose.
 Fusion of lateral nasal and medial nasal and maxillary
process give rise to nares and nostrils.

54.  AT 4TH WEEK IU adjacent swelling forms from increased
growth of mandibular arch
 Grows superiorly and anteriorly on each side of stomodeum
 Maxillary process give rise to upper lip ,cheeks ,secondary
palate posterior portion of maxilla ,maxillary canines and
posterior teeth zygomatic bone and part of temporal bone.

55.  Develops from connective tissue around the oral
cavity of embryo.
 Appears during 2nd month of iu.
 Formed from the centers which are not preceeded by
cartilage.
Development of maxilla

56.  5 centers are
 External/malar - forms bone outside the infra orbital
canal and zygomatic process
 Inner/orbitonasal - forms inner part of the floor of the
orbit the frontal process and wall of the antrum.
 Palatine center - forms posterior3/4th of palate .

57.  Nasal center – situated between frontal process and
canine tooth .
 Incisive center – added to form premaxilla which
forms front part of alveolus which carries incisor
teeth .
 By 10th week bone consist of 2 portion ,maxilla proper
and premaxilla.

61.  The term palate refers to tissue interposed between oral
cavity and nasal cavity
 Develops from 1medial palatine process
2lateral palatine process
 Formed from 2 different embryonic structures.
Primary palate and secondary palate.
 Hard and soft tissue of palate are formed between 5th -12th
week

62. 1. Formation of primary palate
2. Formation of secondary palate
3. Completion of palate

64.  Formation of intermaxillary segment
 Arised as a result of fusion of 2 medial nasal processes
 IMS Is a wedge shaped mass,extends deep into nasal pits on
stomodeum , develops into floor of nasal septum
 IMS gives rise to primary palate
 Serves as partial separation between nasal and oral cavities

65. IMS gives rise to
I. Premaxillary portion of maxilla
II. Anterior 1/3rd of final and definate palate
III. Small portion of hard palate anterior to incisive foramen

66.  6th week iu bilateral maxillary process gives rise to 2 palatal
shelves /lateral palatine processes
 Grows inferiorly deep inside the stomodeum in a vertical
direction on both sides of developing tongue.
 Unknown shelf elevating force shifts direction of palatal
shelves from vertical to superior direction .Thus shelves
move horizontally.

68.  2 palatal sheves elongates move towards each other to
form secondary palate.
Secondary palate gives rise to
I. Posterior 2/3rd of hard palate maxillary canines and posterior
teeth
II.Soft palate and uvula

69.  Secondary palate meets posterior portion of primary palate
 Fuse to form hard and soft palate

70.  Starts rapidly during 8th week
 Primary center is near infraorbital foramen
 Posterior of hard palate ossifies from single ossification
center of palatine bone
 Completes at 12th week iu
 In posterior most region ossification does not occur forming
soft palate
 Mesenchyme from 1 n 2nd branchial arches migrate to form
palatal muscles.

73.  A small paired nasopalatine canal persist near median plane
of mature hard palate at the site of junction of primary and
secondary palate this canal is represented by incisive
foramen in mature palate

74. Development of tongue

75. 

76.  paranasal sinuses
 some develop during late fetal life
 frontal and sphenoid not present at birth
 at 2 years the two most anterior ethmoid sinuses grow into the frontal
bone – visible on X-rays by age 7
 two most posterior ethmoid sinuses grow into the sphenoid bone
 sinuses are important in the size and shape of the face during infancy and
the resonance of the voice
 the rest develop after birth
 form as outgrowths of the wall of the nasal cavity
 become air-filled extensions in the adjacent bones
 the original openings of these outgrowths persist as the
orifices of the adult sinuses
Development of Sinuses and
Nasal cavity

77.  Nasal cavity lined with a respiratory mucosa like the rest of the respiratory system
 Pseudostratified columnar epithelium with cilia
 Interspersed are goblet cells which rest on the basement membrane
 Very vascular lamina propria – warms the air
 Roof of the nasal cavity is a specialized area that contains the olfactory epithelium
 On the medial wall are the three nasal conchae
 Paranasal sinuses
 Frontal, sphenoid, maxillary and ethmoid sinuses
 Provide mucus for the nasal cavity
 Respiratory mucosa of ciliated pseudostratified columnar epithelium
 But is thinner than the nasal mucosa – also has fewer goblet cells
 No erectile tissue
Nasal and Paranasal tissues

79. 1.MICROGLOSSIA

80. 2.AGLOSSIA

81. 3.MACROGLOSSIA

83. 4.ANKYLOGLOSSIA

84. 5.BIFID TONGUE

85. Median rhombhoid glossitis

88. CLEFT LIP

89. CLEFT PALATE

90. Bifid uvula

91.  JAMES .K.AVERY
 MOOR PERSAUD
 B.K.BERKOVITZ
 MARY BATH BELOGH
 INDERBIR SINGH
REFERANCE

92. .