Development of face

DEVELOPMENT OF FACE
Moderator: Dr. Chaitanya
By: Dr. Muhammad.Haneef
Post Graduate Trainee 1st year
OMFS

CONTENTS
 INTRODUCTION
 EARLY EMBRYONIC DEVELOPMENT
 DEVELOPMENT OF BRANCHIAL ARCHES
 DEVELOPMENT OF FACE
 DEVELOPMENT OF NOSE
 DEVELOPMENT OF PARA NASAL SINUSES
 DEVELOPMENT OF PALATE
 DEVELOPMENT OF JAWS
 DEVELOPMENT OF TMJ
 DEVELOPMENT OF TONGUE
 DEVELOPMENT OF EXTERNAL EAR
 DEVELOPMENT OF SALIVARY GLANDS
 DEVELOPMENT OF TOOTH
 TERATOLOGY
 CONGENITAL ANOMALIES
 SUMMARY
 REFERENCES

OUR FACE FROM FISH TO MAN
THE MOBILE MASK IN FRONT OF HUMAN BRAIN
BEGAN TO ATTRACT OUR ATTENTION WHEN
WE WERE BABIES AND CONTINUES TO
FASCINATE US AS LONG AS WE LIVE
W. K. GREGORY

INTRODUCTION
 An individual spends 9 months, 38 weeks,
266 days nearly 383040minutes of his life
his mothers womb. Human development is
continuous process and does not stop at
birth. Human brain triples its weight
between birth and 16 years.
 Anatomical structures are more diverse in
the mouth than in any other region.

DEVELOPMENT:
Todd “ Is progress towards maturity”.
Moyers “ All the naturally occurring
unidirectional changes in life of an individual
from its existence as a single cell to its
elaboration as a multifunctional unit
terminating in death”.
Development is growth + differentiation +
translocation.
Growth according to MOSS is change in morphological parameters which is measurtable.

SIGNIFICANCE
 Progress in surgery, especially in the pediatric age
group has made knowledge of human development
more clinically significant. The understanding and
correction of most congenital malformations (e.g.
Cleft palate) depend on the knowledge of normal
development and of the deviations that have
occurred.
 An understanding of common congenital
malformations and their causes also enable doctors,
dentists and others to explain the developmental
basis of abnormalities often dispelling parental
guilty feelings.

 In 40 to 60% of persons with birth defects, the
cause of congenital anomaly is unknown.
 Genetic factors, such as chromosome
abnormalities and mutant genes, account for
approximately 15% of abnormalities.
 Environmental factors produce approximately
10% of abnormalities.
 Multifactorial inheritance produces 20 to 25%;
 Twinning causes 0.5 to 1% of abnormalities.

EARLY EMBRYONIC DEVELOPMENT
1. PERIOD OF OVUM- From fertilization to 14th day.
2. PERIOD OF EMBRYO- From 14th day to 56th day.
3. PERIOD OF FETUS- From 56th day till birth.

FETAL PERIOD
 Last 7 months of fetal life are devoted to very
rapid growth and repositioning of body
components, with little further organogenesis
or tissue differentiation.
- 4 months human face is seen
- By 4th month sex of fetus is known
- Last 2 months of fetal life fat is deposited
subcutaneously.

CONTENTS
 INTRODUCTION
 DEVELOPMENT OF BRANCHIAL
ARCHES
 TERATOLOGY
 SUMMARY
 REFERENCES

DEVELOPMENT OF
BRANCHIAL/PHARENGIAL ARCHES
 APPEARS DURING THE 4th & 5th WEEK OF INTRA UTERINE
DEVELOPMENT.
 CONSISTS OF BARS OF MESENCHYMAL TISSUE SEPARATED BY DEEP
CLEFTS KNOWN AS PHARYNGEAL (BRANCHIAL) CLEFTS.
 ON DEVELOPMENT, A NO OF OUT POCKETING APPEARS, ALONG THE
LATERAL WALLS OF THE PHARYNGEAL GUT WHICH ARE THE
PHARYNGEAL POUCHES.
 CONTRIBUTE NOT ONLY TO THE FORMATION OF THE NECK BUT
ALSO PLAY AN IMPORTANT ROLE IN THE FORMATION OF THE FACE.
THOUGH DEVELOPMENT OF THESE ( ARCHES, CLEFTS & POUCHES )
RESEMBLES FORMATION OF GILLS IN FISHES & AMPHIBIA,IN THE HUMAN
EMBRYO REAL GILLS ARE NEVER FORMED. THEREFORE THE TERM
PHARYNGEAL ARCHES HAS BEEN ADOPTED.

DEVELOPMENT OF FACE
Development of face depends upon the
inductive activities of organizing centres
Procencephalic Rhombencephalic
Induces the inner
ear apparatus and
upper third of face
Induces the middle and
external ear apparatus
and the middle and
lower third of face

 Face develops from 5 prominences that
surround the stomatodeum
- Frontonasal
- Paired maxillary processes.
- Paired mandibular processes.

 Frontonasal prominence formed by
proliferation of mesenchyme ventral to the
forebrain. It forms
- Lateral optic diverticula  eyes
- Forehead (between the eyes)
- Nasal placodes

 Mesenchyme proliferates around the placodes
producing medial and lateral nasal
prominences
Lateral nasal prominence separated from
maxillary process by nasolacrimal groove

 Fusion of medial nasal prominences and the maxillary
and lateral nasal prominences requires disintegration
of nasal fin.
 Failure of normal disintegration of nasal fin cause
cleft of upper lip and anterior palate.

Midline merging of medial nasal process
Forms:
- Philtrum of upper lip.
- Tip of the nose.
- Primary palate.
Merging of medial nasal and maxillary process
Continuity of the upper jaw and lip.
Causes separation of nasal pits from stomodeum

Merging of mandibular process in midline
Forms lower jaws and lips

DEVELOPMENT OF NOSE
 The nose is a complex of
contributions from:
- Frontal prominence 
The bridge.
- Medial nasal prominence
 Median ridge and tip
- Lateral nasal prominence
 The alae
- The cartilage of nasal
capsule  the septum
and nasal conchae

CONTENTS
 INTRODUCTION
 DEVELOPMENT OF PARA NASAL
SINUSES
 TERATOLOGY
 SUMMARY
 REFERENCES

Paranasal Sinuses
 Paranasal sinuses develop during late fetal life the
remainder develops after birth.
 They form as outgrowths or diverticula of the
walls of the nasal cavities and become air filled
extensions of the nasal cavities in the adjacent
bone.
 Frontal
 Ethmoidal
 Maxillary
 Sphenoidal

 Expand in nasal fossae
by growth of mucous
membrane sacs-
primary pneumatization
 Enlarged by secondary
pneumatization
 Retain communication
with nasal fossae
through ostia

DEVELOPMENT OF PALATE
 Palatogenesis begins towards the end of 5th
week and is completed by about 12th week.
 The palate develops from two primordia.
 Primary palate
 Secondary palate

 EACH OF THE FIVE ARCHES CONTAIN
1. A CENTRAL CARTILAGE THAT FORMS SKELETON OF
ARCH
2. MUSCULAR COMPONENT OR BRANCHIOMERE
3. VASCULAR COMPONENT
4. NEURAL ELEMENT
 MANDIBLE IS THE DERIVATIVE OF THE FIRST
PHARYNGEALARCH
 DORSAL PORTION IS KNOWN AS MAXILLARY PROCESS
 VENTRAL PORTION KNOWN AS MANDIBULAR PROCESS
OR MECKEL’S CARTILAGE
 DEVELOPMENT OF MANDIBLE STARTS AT 4TH WEEK I.U.L
 CENTER OF FACE FORMED BY STOMODEUM,
SURROUNDED BY FIRST PAIR OF PHARYNGEALARCHES

ROLE OF MECKEL’S CARTILAGE
DERIVED FROM FIRST PHARYNGEAL ARCH AROUND
41TH – 45TH DAY I.U.L
EXTENDS FROM OTIC CAPSULE -THE MIDLINE OR SYMPHYSIS
FIRST OSSIFICATION CENTER ARISES AT 6TH WEEK I.U.L IN
THE REGION OF BIFURCATION OF THE INFERIOR ALVEOLAR
NERVE
THE CENTER IS LOCATED LATERAL TO THE MECKEL’S
CARTILAGE
FROM THIS “PRIMARY CENTER”- OSSIFICATION SPREADS
“BELOW AND AROUND” THE INFERIOR ALVEOLAR NERVE
AND THEN MOVES “UPWARDS”
OSSIFICATION THEN SPREADS “DORSALLY AND VENTRALLY”
TO FORM RAMUS AND THE BODY OF MANDIBLE
AS OSSIFICATION CONTINUES MECKEL’S CARTILAGE BECOMES
SURROUNDED BY BONE

REMANANTS OF MECKEL’S CARTILAGE:
MAJOR PART OF THE MECKEL’S CARTILAGE DISAPPEARS
DURING GROWTH
1. MENTAL OSSICLES
2. INCUS AND MALLEUS
3. SPINE OF SPHENOID
4. ANTERIOR LIGAMENT OF MALLEUS
5. SPHENOMANDIBULAR LIGAMENT

TYPES OF OSSIFICATION:
MANDIBLE IS THE SECOND BONE IN THE BODY TO BE
OSSIFIED
THERE ARE TWO TYPES OF OSSIFICATION :
1. INTRAMEMBRANOUS TYPE :
FORMATION OF BONE IS NOT PRECEDED BY FORMATION
OF CARTILAGENOUS MODEL
BONE IS DIRECTLY LAID INTO FIBROUS MEMBRANE
THERE IS CONDENSATION OF MESENCHYMAL CELLS
SOME CELLS FORM OSTEOBLAST AND SECRETE OSTEIOD
DEPOSITION OF CALCIUM SALTS INTO THE OSTEOID
LEADS TO CONVERSION OF OSTEOID INTO LAMELLA

2. CARTILAGENOUS TYPE:
FORMATION OF BONE IS PRECEDED BY FORMATION OF
CARTILAGENOUS MODEL
CONDENSATION OF MESENCHYMAL CELLS TO FORM
CHONDROBLASTS-- LAY DOWN HYALINE CARTILAGE
CARTILAGE IS SURROUNDED BY PERICHONDRIUM —
VASCULAR AND CONTAINS OSTEOGENIC CELLS
INTERCELLULAR CELLS SURROUNDING CARTILAGE CELLS
CALCIFY DUE TO THE ACTION OF ALKALINE PHOSPHATASE
NUTRITION TO THE CELLS IS CUT– LEADING TO DEATH---
FORMATION OF EMPTY SPACES— PRIMARYAREOLAE
BLOOD VESSELS AND OSTEOGENIC CELLS INVADE THE
CALCIFIED CARTILAGENOUS MATRIX WHICH IS NOW
REDUCED TO BARS OR WALLS– FORMATION OF LARGER
SPACES----SECONDARYAREOLAE

PARTS OF MANDIBLE DERIVED FROM
1. INTRAMEMBRANOUS OSSIFICATION
i) WHOLE BODY OF MANDIBLE EXCEPT THE ANTERIOR PART
Ii) RAMUS OF MANDIBLE AS FAR AS MANDIBULAR FORAMEN
2. ENDOCHONDRAL OSSIFICATION
i) ANTERIOR PORTION OF THE MANDIBLE (SYMPHYSIS)
ii) PART OF RAMUS ABOVE THE MANDIBULAR FORAMEN
Iii) CORONOID PROCESS
iv) CONDYLAR PROCESS

SUMMARY
MANDIBLE DEVELOPS FROM FIRST PHARYNGEAL ARCH
SEVERAL CHANGES OCCUR IN THE MANDIBLE DURING THE
DEVELOPMENTAL PERIOD
ANY DISTURBANCE DURING THE NORMAL GROWTH OF THE
MANDIBLE REFLECTS AS A ANOMALY

Associated with the formation of ear ossicles,
a new jaw joint
TMJ made its first appearance in mammals.
Secondary joint / Squamosodentary joint
[As it is present between squamous part of temporal bone
and the mandible (dentary)].
- One can imagine this evolutionary transmission
occurring by means of a bony process which appeared
on the mandibular anterior to quadratoarticular joint
which at one time became large enough to contact the
skull.

Difference in
Mammalian jaw-joint Non mammalian jaw-joint
A) Concavo-Convex joint surface Concave
B) Intra-articular disk Absent

EMBRYOLOGY
-Develops late in embryonic life.
-Compared with large joints of extremities.
-Associated with its late evolutionary development.
-During the 7th prenatal week, the jaw joint lacks:
-Condylar growth cartilage.
-Joint cavities.
-Synovial tissues
-Articular capsule.
2 skeletal elements : mandible and temporal bone are
not yet in contact with each other.

7 week old embryo
-Meckel’s cartilage extends all the way from chin to base of the
skull.
-Serves as a scaffolding or strutt against which the mandible
develops.
-Provides a temporary articulation between mandible and base of
the skull until TMJ takes over.
-Near end of fetal life Meckel’s cartilage completes its
transformation:
-Incus
-Malleus
-Anterior ligament of malleus
-Sphenomandibular ligament
Meckel’s cartilage plays an a basic role in setting the evolutionary
stage for the emergence of this joint.

Articular Disc:
-Earliest appearance in 6 week old embryo.
-Muscular derivative of 1st branchial arch.
-Disc analge- vague layer of mesenchyme
stretching across upper end of mandibular ramus.
-No capsule.
-No condyle.

Articular Disc:
-At its anterior end, mesenchymal analge extends laterally
from superior border of Lateral pterygoid muscle, to
medial side of masseter muscle.
-At the end of 6th week, lateral pterygoid inserts not on
the mandibular but on the posterior end of Meckel’s
cartilage.
-During 7th week – (lateral pterygoid) joins upper end of
mandibular ramus; also continues posteriorly beyond this
point with mesenchyme analge des abv; these 2 structures
insert in common part of Meckel’s cartilage which
becomes the malleus.

At 7 weeks: the future condyle is still only a condensation of
mesenchyme resting on osseous lamella, which forms the mandibular
ramus.
12 week – condylar growth cartilage makes its 1st appearance and
begins to develop a hemi-spherical articular surface.
By 13th week – condyle and articular disc having moved up into
contact with temporal bone.
Only when such articular contact has been made do the joint cavities
develop.
Inferior space appearing first.
Disc begins to get compressed.
When central portion of disc is compressed this part becomes
avascular.

The articular capsule:
-Becomes recognizable during twelth week as a faint cellular
condensation along the medial and lateral sides of joint connecting
mandible with temporal bone.
-Articular disc merges peripherally with these condensations.
-Formation of capsule posterior to joint does not occur until
twenty-second week; when the Glaserian fissure; becomes narrow;
encroaching upon Meckel’s cartilage as it passes into middle ear.
-Articular disc becomes intercepted at the Glaserian fissure, loses
its continuity with malleus and develops definitive attachment to
anterior lip of GF.
-Joint cavities are now lined by synovial tissue and according to
Symons (1952), temporal bone now shows area of secondary
cartilage in medial part of the joint.

By 26th week:
All components of TMJ present except articular eminence.
Meckel’s cartilage still extends through GF, but by thirty-
first week is transformed into sphenomandibular ligament.
By 39th week:
Ossification of bones in this region has proceeded to the
point where; ligament gains its apparent attachment to
spine of sphenoid.

 Tongue appears to begin to form in 4th week
of intra uterine life from 1st pharangeal arch
 Second swelling, copula/hypobronchial
eminence is formed second third and partly
fourth mesoderm arches.
 Part of fourth arch forms the epiglottis.
Behind this there is laryngeal inlet flanked
arytenoid swelling.

Introduction
 The oral cavity is kept moist by a film of fluid
called saliva, this complex salivary fluid is
secreted by the salivary gland which is exocrine
in nature . Saliva’s important function is to
maintain the well being of mouth hence any
Individuals with a deficiency of salivary
secretion experience difficulty eating, speaking,
swallowing and prone to mucosal infections .

Types of salivary glands
I Based on anatomic location
 Parotid gland
 Sub mandibular gland
 Sub lingual gland
 Accessory glands (labial, lingual,
palatal buccal,glossopalatine and
retromolar)
III Based on size and amount of
secretion
Major salivary glands
Minor salivary glands
II Based on type of secretion
 Serous:parotid ,submandibular
and von ebners glands
 Mucous : sub lingual,labial
,buccal,palatine
,glossopalatine,posterir part of
tongue
 Mixed:sub mandibular, sub
lingual ,anterio labial buccal and
lingual minor glands

Anatomy
 Development :individual salivary glands arise as a proliferation of oral
epithelial cells,forming focal thickening that grows into underlying
ectomesenchyme
Parotid : 6 th week of I U : corners of stomatidium
Sub mandibular : end of 6 th week of I U : floor of mouth
Sub lingual : 8 th week of I U: lateral to primordium
Minor salivary gland : 12 th week of I U :buccal epithelium

FORMATION OF DENTAL LAMINA
 At about 21st day of embryonic life the embryo folds along two planes
rostocaudal and lateral.
 The head fold is critical for the formation of primitive stomatodeum or oral
cavity, lined by stratified squamous epithelium, oral ectoderm.
Neural Crest Cells: This is ectomesenchymal tissue, termed neural crest from
its site of origin, arises from crest of neural fold, where neutralizing and
epidermalizing influences the interact.
- Pleuripotential cells with great migratory propensities.
Primary Epithelial Band: Roughly horse shoe shaped epithelial bands
corresponding in position to future upper and lower jaws.
Formed as a result of change in orientation of mitotic spindle and cleavage plain
of dividing cells and gives rise to dental lamina and vestibular lamina.

 The band of epithelium that invades the underlying ectomysenchyme
along each of horse shoe shaped future dental arches called Dental
lamina at about 6th week of embryonic life.
Importance:
 Primordium for the ectodermal portion of deciduous teeth.
 Successional tooth buds .
 Buds for permanent molars from distal extension of dental lamina.
 Dental lamina degenerates at about 5th year of life.
 Remnants persist as epithelial pearls / islands.
Vestibular Lamina / Lip Furrowband:
 Epithelial thickening labial and buccal to dental lamina in each
dental arches.
 Forms oral vestibule.

STAGES IN TOOTH DEVELOPMENT
The stages are named after the shape of the epithelial part of the
tooth germ.
1) BUD STAGE:
a) The ectodermal cells along the dental lamina multiply rapidly
in to round or ovoid swellings at different points
corresponding to the position of future deciduous teeth.
b) These form the primordium for the enamel organs of the tooth
bud.
c) It consist of
i. low columnar cells at periphery and polygonal cells at the centre.
ii. Dental papilla.
iii. Dental sac.

2) CAP STAGE:
This stage is characterized by the shallow invagination on the deep
surface of the bud as a result of continued proliferation.
 In this stage cells of enamel organ can be histologically differentiated
as follows:
 Outer enamel epithelium (OEE). – peripheral cuboidal cells.
 Inner enamel epithelium (IEE) – columnar cells.
 Stellate reticulum
–polygonal cells located in the center.
–provides cushion like effect, thus supports
and protects delicate enamel forming cells
 Enamel knot – the densely packed cells in the center enamel organ.
 Enamel cord – a vertical extension of the enamel knot between inner
and outer enamel epithelium.
 Dental papilla – the ectomesenchymal cells proliferate and condense
under the influence of proliferating epithelium.
 Dental sac – the dense fibrous layer.

3) BELL STAGE:
 The epithelial invagination deepens and the margins continue to grow,
thus the enamel organ assumes bell shape.
 Stage consist of
 IEE – Single layer of tall columnar cells called ameloblasts.
 Stratum Intermedium – squamous cells present in between IEE and
stellate reticulum. Shows high degree of mitotic activity.
 Stellate reticulum – star shaped cells. Collapses before enamel
formation.
 OEE – flattens to low cuboidal form.
– surface laid in folds at the end of bell
stage prior to enamel formation begins.
 Dental lamina
 Dental papilla – odonto blasts differentiation.
 membrane performativa.
 Dental sac – circular arrangement of fibers and resembles capsular
structure.

Advanced bell stage
Bell stage with permanent tooth bud

4) ADVANCED BELL STAGE :
 Future dentino enamel junction.
 Cervical portion of enamel organ forms the hertwig’s
epithelial root sheath.
Hertwig’s Epithelial Root Sheath and Root formation:
 Root development starts after enamel and dentin
formation reaches future cemento enamel junction.
 Enamel organ forms hertwig’s epithelial root sheath
consisting of inner and outer enamel epithelium. It modes
the shape of roots and initiates radicular dentin formation.
 The sheath looses its continuity after radicular dentin
formation.

 Cementoblast form cementum over dentin.
 Epithelial diaphragm – the inner and outer enamel epithelium
bend at the future CEJ into horizontal plane narrowing wide
cervical opening. The cells proliferate along with adjacent
connective tissue cells of pulp.
 Apical foramen opening is narrowed by the deposition of dentin
and cementum at the apex of root.
 In multi rooted teeth the differential growth of epithelial
diaphragm causes division of root trunk in to two or three roots.
 The long tongue like extensions of the horizontal diaphragm
develops two in mandible, three maxilla. Before this the free
ends grow towards each other and fuse.
 The cervical opening of coronal enamel organ is divided in to
two or three openings and dentin formation starts on the
periphery of each opening.

Cervical loop
Heartwig’s epithelial root sheath and
forming root

Teratology
 Defnition: The sceince that studies birth
defects is teratology.
 The agents called as Teratogens.
 Maximum susceptibility in from 3rd to 8th
week of gestational period; The period of
embryogenesis.

Principles of Teratology
 Susceptibility depends on genotype of
conception and the manner of interaction
with the environment
 Developmental stage at the time of exposure
 Dose and duration of exposure
 Mechanisms of interaction of teratogens and
pathogenesis to anomaly
 Manifestations include death, retardation,
malformation and functional disorders,

6 general classes of congenital
abnormalities
1. Agenesis like absence of teeth.
2. Full/partial aplasia = incomplete development
like cleft palate
3. Hyperplasia = excessive development like
macrognathia, maxillary hyperplasia
4. Embryonic survival like thyroglossal cyst
5. Hemartoma, misplacement of normal tissue
like lingual thyroid
6. Blastoma like teratoma in which there is
atypical differentiation of embryonic tissue

Defects involving the pharyngeal region
 Involving the pharyngeal region
1. Ectopic thyroid and thymic tissue
2. Branchial fistulas

Neural crest cells and craniofacial
defects
1.Treacher collin syndrome/ first arch
syndrome/ mandibulofacial dystosis
syndrome
a) May be caused due to Vitamin A.
b) Arises as autosomal dominant trait.
c) May arise due to new mutations Due to retardation or
failure of differentiation of maxillary mesoderm at or
after 50mm stage of development of embryo.
-malar, zygomatic hypoplasia,
Mandibular hypoplasia.
-lower eyelid colobomas.
-malformed ears
-lower eyelid colobomas

2. Robin sequence – may occur independently
or in association with other syndromes.
 May occur in oligohydroaminos due to
compression of chin against chest
-micrognathia with mandible being affected severely.
-cleft palate.
-glossoptosis – posteriorly placed tongue.

3. Di george anomaly – it in includes
velocardiofacial syndrome or conotruncal anomlies of
face.
 Caused due to alcohol, maternal diabetes & retinoids.
 All part of spectrum called as CATCH22
 Due to deletion of long arm of chromosome 22 and the
following:
 Cardiac defects
 Abnormal facies
 Thymic hypoplasia
 Cleft palate
 Hypocalcemia

5. CROUZON’S SYNDROME/ CRANIOFACIAL
DYSTOSIS.
1.Associated with premature closure of the cranial sutures
leading to one of the following
a. Boat shaped skull
b. Tower shaped skull
c. Clover leaf shaped skull or Brachecephaly
d. Egg shaped skull
2. Maxillary hyperplasia with high arched palate maybe
associated with cleft
3.Increased interpupillary distance
4.Hypoplasia of the orbit
5. Congenital defects of the heart.

4. Hemifacial Microsomia/ Goldenhar syndrome/
oculoauriculovertebral syndrome.
 Maxilla, zygomatic, temporal bone are tiny and flat
 Microtia/ anotia
 Tumours or dermoids in eyeball
 Fused hemivertebrae / spina bifida
 Assymmetry
 Cardiac abnormalities like
- teratology of fallot
- Venticulo-septal defects

Defects arising in tongue
 Tongue tie or ankyologlossia
 Aglossia
 Macroglossia
 Microglossia
 Lingual thyroid nodule
 Lymphoma of tongue
 Haemangioma of tongue
 Bifid tongue or scrotul or fissured tongue
 Lingual cyst
 Thyroglossal ductal cyst
 Ankyloglossum superiosum
 Lipoma of tongue
 Teratoma of tongue

Defects of thyroid
1.Aberrant thyroid tissue
2.Cyst or fistula

Defects of teeth
Size Related
 Microdontia
 Macrodontia
Shape related cusp
 Gemination
 Twinning
 Fusion
 Concrscense
 Dens in dente
 Talons cusp
 Dilaceration
 Dens evaginatus
 Taurodontism
Number related
 Anodontia
 Onligodontia
 Supernumary tooth
 Supernumary roots
Structure related
 Ameoleogenesis imperfecta
 Dentino genesis imperfecta
 Enamel hypoplasia
Related to growth and eruption
 Impected tooth
 Transposition and ectopic
eruption

Congenital anomalies related to
Salivary Glands
 Aberrancy/ ectopic salivary glands –
staffne’s cyst
 Aplasia
 Hypoplasia / hyperplasia
 Atresia- congenital occlusion or absence of
one or more major salivary gland ducts
 Accessory duct / accessory lobe

Congenital anomalies affecting
TMJ
 Hypoplasia of condyle – unilateral/ bilateral
 Hyperplasia of condyle – unilateral /
bilateral
 Double condyle
 Hyperplasia / hypoplasia of coronoid
process
 Malformed glenoid process or articular
tubercle

Defects in development of Eye and
External Ear
 Ear – preauricular pits and appendages
 Eye -
Cyclopia or synopthalmia with probescis
Absence of eye ie anopthalmia
Colobomas of eyelids
Congenital Ptosis
Fusion of eyelids-cryptophalmos
Epicanthal fold

SKELETAL SYSTEM
SKULL
NEURO CRANIUM
 THE MEMBRANOUS PART
 THE CARTILAGINOUS PART
OR CHONDROCRANIUM
VISCERO CRANIUM
 BONES OF THE FACE.
 FORMED FROM THE FIRST
TWO PHARYNGEALARCHES

CARTILAGINOUS NEUROCRANIUM OR
CHONDROCRANIUM

DEVELOPMENT OF FACIAL SKELETON
 THE FACE MAY BE CONVIENTLY,IF SOME WHAT
ARBITARILY DIVIDED INTO UPPER, MIDDLE & LOWER
THIRDS.
 THE THREE PARTS CORRESPOND GENERALLY TO THE
EMBRYONIC STRUCTURES NAMELY THE FRONTO
NASAL, MAXILLARY & MANDIBULAR PROCESS.

 UPPER THIRD OF FACE IS PREDOMINANTLY OF
NEUROCRANIAL COMPOSITION,WITH THE FRONTAL BONE OF
THE CALVARIA ,PRIMARILY RESPONSIBLE FOR THE FORE
HEAD.
 INTIALLY GROWS MOST RAPIDLY KEEPING PACE WITH ITS
NEUROCRANIAL ASSOCIATION & THE PRECOCIOUS
DEVELOPMENT OF THE FRONTAL LOBES OF THE BRAIN.
 ACHIEVES ITS ULTIMATE GROWTH POTENTIAL AT AN EARLY
AGE, PRACTICALLY CEASING THE GROWTH SIGNIFICANTLY
AFTER THE 12 YEARS OF LIFE.

 MIDDLE THIRD OF FACE IS SKELETALLY THE MOST
COMPLEX,BEING COMPOSED IN PART OF THE CRANIAL BASE &
INCORPORATING BOTH THE NASAL EXTENSIONS OF THE
UPPER THIRD PART OF THE MAXILLARY APPARATUS.
 GROWS MORE SLOWLY OVER A PROLONGED PERIOD, NOT
CEASING THE GROWTH UNTIL THE LATE ADOLESENCE.

 THE LOWER THIRD OF FACE COMPLETES THE MASTICATORY
APPARATUS, BEING COMPOSED OF THE SKELETON OF THE
MANDIBLE & ITS DENTITION.
 GROWS MORE SLOWLY , NOT CEASING THE GROWTH UNTIL
THE LATE ADOLESENCE.

 FACIAL BONES DEVELOP INTRA MEMBRANOUSLY FROM
OSSIFICATION CENTERS IN THE NEURAL CREST MESENCHYME OF
THE EMBRYONIC FACIAL PROCESS.
 IN THE FRONTONASAL PROCESS,INTRAMEMBRANOUS SINGLE
OSSIFICATION CENTER APPEARS IN THE 3RD MONTH.
 DURING 8TH WEEK A PRIMARY OSSIFICATION CENTER APPEARS FOR
EACH MAXILLAAT THE TERMINATION OF INFRA ORBITAL NERVE
JUST ABOVE THE CANINE TOOTH DENTAL LAMINA.
 FURTHER TWO INTRA MEMBRANOUS PREMAXILLARY CENTERS
APPEAR ANTERIORLY ON EACH SIDE IN THE 8TH WEEK & RAPIDLY
FUSE WITH THE PRIMARY MAXILLA.
 THE MANDIBULAR PROCESS DEVELOP BILATERALLY FROM A SINGLE
INTRA MEMBRANOUS CENTRE.

THE ATTACHEMENT OF THE FACIAL SKELETON ANTERO –
INFERIORLY TO THE CALVARIA DETERMINES THE CHONDRO
CRANIAL INFLUENCE ON FACIAL GROWTH.

CONTENTS
 INTRODUCTION
 TERATOLOGY
 CONGENITALANOMALIES
 SUMMARY
 CONCLUSION
 REFERENCES

CONCLUSION
JUST AS THE CLINICIAN NEEDS THE MEDICAL
HISTORY TO MAKE A LOGICAL DIAGNOSIS,
SO TOO THE GROWTH AND DEVELOPMENT
OF FACE IS ESSENTIAL FOR A LOGICAL
EXPLANATION OF ANY STRUCTURAL AND
FUNCTIONAL IMBALANCES IF IT DO OCCURS.

References
 T.W. Saddler “Langman’s Medical Embryology”. 5th
edition.
 G.H. Sperber “Craniofacial embryology”. 4th edition.
 W.R. Proffit “Contemporary orthodontics”. 3rd edition.
 S.I. Balaji “Orthodontics the art and science”. 2nd edition.
 A.R. Tencate “Oral histology”. 5th edition.
 Shafer “A textbook of Oral pathology”. 4th edition.
 B.D. Chaurasia “Human anatomy Head and neck”. 3rd
edition.
 Orban’s oral histology &embryology
 Textbook of Pedodontics –Shobha Tandon
 Text book of oral medicine – Ghoms
 Text book of embryology – Inderbere singh
 Craniofacial Development, Geoffrey H. Sperber.

Development of face

Empfohlen

Empfohlen

Weitere ähnliche Inhalte

Was ist angesagt?

Was ist angesagt? (20)

Andere mochten auch

Andere mochten auch (19)

Ähnlich wie Development of face

Ähnlich wie Development of face (20)

Mehr von Mohammed Haneef Farooq

Mehr von Mohammed Haneef Farooq (15)

Kürzlich hochgeladen

Kürzlich hochgeladen (20)

Development of face