development, growth, clinical significance

1. SAIRA ELIZABETH DENNY
I MDS
DEPT. OF ORAL AND MAXILLOFACIAL PATHOLOGY

2. 
INTRODUCTION
 Mandible is the largest
and strongest bone of the
face, serves for the
reception of the lower
teeth. It consists of a
curved, horizontal
portion, the body;and two
perpendicular portions,
the rami, which unite with
the ends of the body
nearly at right angles.

3.  About the fourth
week of intrauterine
life, the
pharyngeal arches are
laid down
 The first arch is
called the mandibular
arch.
Courtesy:Human Embryology,I.B.Singh

4. 
 The first branchial arch, also called the first pharyngeal
arch and mandibular arch, is the first of six pharyngeal
arches. This arch divides into a maxillary process and
a mandibular process, giving rise to structures including
the bones of the lower two-thirds of the face and the jaw.
The maxillary process becomes the maxilla (or upper
jaw), and palate while the mandibular process becomes
the lower jaw. This arch also gives rise to the muscles of
mastication.

5. The first structure to
develop in the
primodium of the
lower jaw is the
mandibular division
of trigeminal nerve.
Courtesy:Google

6. 
 Meckel’s cartilage has a close, relationship to the
mandibular nerve, at the junction between posterior
and middle thirds, where the mandibular nerve
divides into the lingual and inferior dental nerve.
The lingual nerve passes forward, on the medial side
of the cartilage, while the inferior dental lies lateral
to its upper margins & runs forward parallel to it
and terminates by dividing into the mental and
incisive branches.
Courtesy:Google

7. 
Development of
 Body of mandible
 Rami of mandible
 Condylar process
 Coronoid process
 Alveolar process
DEVELOPMENT OF
MANDILLE
Courtesy:Google

8. 
The cartilage of the first arch, Meckel’s cartilage, has a
close, relationship to the developing mandible.
At 6 weeks of development, this cartilage extends as a
solid hyaline cartilagenous rod surrounded by a
fibrocellular capsule.
Body of mandible
Courtesy:Google

9. Their proximal or cranial ends are connected with
the ear capsules, and their distal extremities are
joined to one another at the symphysis by
mesodermal tissue.
Courtesy:Google

10. 
On the lateral aspect of Meckel’s cartilage, during the 6th
week of embryonic development, a condensation of
mesenchyme occurs in the angle formed by the division of
inferior alveolar nerve and its incisor and mental branches.
7th week-ossification begins in this condensation
+
Courtesy: Ten Cate

11. 
 From this centre of ossification, bone formation spreads
rapidly anteriorly to the midline and posteriorly to the
point where the mandibular nerve divides into lingual
and inferior alveolar branch.
Courtesy: Ten Cate

12. 
 The new bone forms a trough that consist of medial
and lateral plates that unite beneath the nerve. The
trough is soon converted into a canal as bone forms
over the nerve, joining the lateral and medial plates.

13. 
Relationship between Meckel’s cartilage and
mandible in human embryo
H&E tained section - human embryo
Courtesy: . Prenatal Development of the Human Mandible. THE ANATOMICAL RECORD 263:314–325 (2001)

14. THE RAMI OF THE
MANDIBLE

15. The ramus of the mandible develops by a rapid spread of
ossification backwards into the mesenchyme of the first
branchial arch diverging away from Meckel’s cartilage.
This point of divergence is marked by the lingula in adult
mandible, where the inferior alveolar nerve enters
mandibular foramen.
Courtesy:Google

16. 
 Thus by 10 weeks of development, the rudimentary
mandible is formed almost entirely by
intramembranous ossification.

17. 
Meckel’s cartilage has the following fate:
 Its posterior end forms the malleus and incus of the
inner ear and the sphenomalleolar ligament; but its
fibrocellular capsule persists to form the
sphenomandibular ligament .
 From the lingula forward to the devision of the
alveolar nerve into its incisor and mental branches,
Meckel’s cartilage degenerates.
H & E stained section-Meckel’s cartilage
Prenatal Development of the Human Mandible. THE ANATOMICAL RECORD 263:314–325 (2001)

18. 
 The further growth of mandible is influenced by the
appearance of 3 secondary cartilages:
1) Condylar cartilage
2) Coronoid cartilage
3) Symphyseal cartilage
Courtesy:Google

19. 
Carrot shaped cartilage appears (at 12 weeks of
development)in the region of the condyle and occupies
most of the developing ramus.
It is rapidly converted to bone by endochondral ossification
it gives rise to:
 Condyle head and neck of the mandible.
 The posterior half of the ramus to the level of inferior
dental foramen
At 20 weeks- a thin layer of cartilage remains in the
condylar head.
Remnants of cartilage persists until the end of 2nd decade of
life.
The condylar cartilage:

20. The coronoid cartilage:
It is relatively transient growth cartilage center ( 4th MIU). it gives rise to:
•Coronoid process.
•The anterior half of the ramus to the level of inferior dental foramen
Disappears long before birth
Courtesy:Google

21. 
 2 in number, appear in the connective tissue between
the 2 end of Meckel’s cartilage
 They are obliterated within the 1st year after birth.
Symphyseal cartilage

22. The alveolar process

23. It starts when the deciduous tooth germs reach the early
bell stage. The bone of the mandible begins to grow on
each side of the tooth germ. By this growth the tooth
germs come to be in a trough or groove of bone, which
also includes the alveolar nerves and blood vessels.
Later on, septa of bone between the adjacent tooth germs
develop, keeping each tooth separate in its bony crept.
The mandibular canal is separated from the bony crypts
by a horizontal plate of bone. The alveolar processes
grow at a rapid rate during the periods of tooth eruption.

24. GROWTH OF THE MANDIBLE

25. Growth of the mandible
I. Growth by
secondary cartilage
II. Development of
the alveolar
process
III. Subperiosteal
bone
appositionand
bone resorption

26. I. Growth by
secondary cartilage
( mainly condylar
cartilage )
Increase in height
of the mandibular
ramus
Increase in the over
all length
of the mandible
Increase of the inter
condylar
distance

27. II. Development of the alveolar process:
Due to the increase in the space between the upper and
lower jaws a space is created between the opposing teeth to
erupt.
At the same time bone apposition occurs at the crest of the
alveolar process and the fundus of the alveolus.
This means that bone deposition contributes to the growth
of the body of the mandible in height.

28. III. Subperiosteal bone apposition and bone
resorption:
Bone deposition Bone resorption Result in
External surface of
the mandible
Inner surface of the
mandible
Increase the
transeverse
dimension
Posterior border of
the remus
Anterior border of
the ramus
Adjust the thickness
of the ramus
Anterior border of
the coronoid
process
Posterior border of
the coronoid
process
Displacement of the
coronoid process
Chin region ‫ــــــــــــــــــــــــ‬ Modeling of the
lower face

29. 
Age changes in the
mandible
At birth
 The body of the bone is a mere shell, containing the
sockets of the two incisor, the canine, and the two
deciduous molar teeth, imperfectly partitioned off from
one another.
 The mandibular canal is of large size, and runs near the
lower border of the bone;
 the mental foramen opens beneath the socket of the first
deciduous molar tooth.
 The angle is obtuse (175°), and the condyloid portion is
nearly in line with the body. The coronoid process is of
comparatively large size, and projects above the level of
the condyle.

30. 
Childhood
 The two segments of the bone become joined at the symphysis,
from below upward, in the first year; but a trace of separation may
be visible in the beginning of the second year, near the alveolar
margin.
 The body becomes elongated in its whole length, but more
especially behind the mental foramen, to provide space for the
three additional teeth developed in this part.
 The depth of the body increases owing to increased growth of the
alveolar part, to afford room for the roots of the teeth, and by
thickening of the subdental portion which enables the jaw to
withstand the powerful action of the masticatory muscles; but the
alveolar portion is the deeper of the two, and, consequently, the
chief part of the body lies above the oblique line.

31. 
 The mandibular canal, after the second dentition, is
situated just above the level of the mylohyoid line;
and the mental foramen occupies the position usual
to it in the adult. The angle becomes less obtuse,
owing to the separation of the jaws by the teeth;
about the fourth year it is 140°.

32. 
Adulhood
 The alveolar and subdental portions of the body are
usually of equal depth. The mental foramen opens
midway between the upper and lower borders of the
bone, and the mandibular canal runs nearly parallel
with the mylohyoid line.
 The ramus is almost vertical in direction, the angle
measuring from 110° to 120°.

33. 
Old age
 The bone becomes greatly reduced in size, for with the
loss of the teeth the alveolar process is absorbed, and the
chief part of the bone is below the oblique line.
 The mandibular canal, with the mental foramen opening
from it, is close to the alveolar border.
 The ramus is oblique in direction, the angle measures
about 140°, and the neck of the condyle is more or less
bent backward.

34. 

35. 
-Developmental disturbances:
 Agnathia
 Micrognathia
 Macrognathia
 Facial hemihypertrophy
 Facial hemiatrophy
 Abnormalities of dental arch relation
-Developmental cyst
 Median mandibular cyst
 Alveolar cyst of newborn
Clinical consideration

36. 
-Hypoplasia or absence of mandible
-The entire mandible or one side may
be missing or only the condyle or the
entire ramus.
Agnathia
Courtesy:Google

37. 
Micrognathia
- Means small jaw
- Maxilla or mandible
may be affected
- Can be due to small jaw
or to an abnormal
positioning or
abnormal relation of
one jaw to another.
Courtesy:Google

38. 
-abnormally large jaws
Factors that favor mandibular prognathism:
- Increased height of ramus
- Increased mandibular body length
- Increased gonial angle
Macrognathia
Courtesy:Google

39. 
-exhibit an enlargement which is confined to one side of
the body, unilateral macroglossia, and premature
development, and eruption as well as increased size of
dentition.
Facial hemihypertrophy
Courtesy:Google

40. 
-progressive wasting of subcutaneous fat accompanied
by atrophy of skin,cartilage , bone and muscle.
Facial hemiatrophy
Courtesy:Google

41. 
 Class I
 Class II
 Class III
Abnormalities of dental
arch relations

42. 
Median mandibular cyst
- Originate from proliferation of epithelial remnants
entrapped in the median mandibular fissure during
fusion of the bilateral mandibular arches.
- Primodial cyst originating from a supernumerary
enamel organ in the anterior mandibular segment.
Developmental cyst

43. 
 Alveolar cyst of newborn
- Arise from epithelial remnants of deeply budding
dental lamina during tooth development

44. 
All the events taking place during development of
mandible play an important role in dermining the final
structure of mandible, any deviation of which can give
rise to various abnormalities in the oro facial region.
CONCLUSION

45. 
1.Ten Cate’s Oral Histology, Development, Structure
And Function-Seven Edition .
2. Oral Anatomy, Histology And Embryology-
Berkovitz,4th Edition
3. Orban's Oral Histology And Embryology-12th Edition
4. Histology and embryology-James Avery
5. Prenatal Development of the Human Mandible. THE
ANATOMICAL RECORD 263:314–325 (2001)
Reference

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