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  • 7/27/2019 A to z Orthodontics Vol 2 Growth and Development

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    A to Z

    ORTHODONTICS

    Volume: 02

    Dr. Mohammad Khursheed AlamBDS, PGT, PhD (Japan)

    GROWTH

    ANDDEVELOPMENT

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    First Published August 2012

    Dr. Mohammad Khursheed Alam

    All rights reserved. No part of this publication may be reproduced stored in a retrieval system,

    or transmitted, in any form or by any means, electronic, mechanical, photocopying, recording orotherwise, without prior permission of author/s or publisher.

    ISBN: 978-967-5547-91-1

    Correspondance:

    Dr. Mohammad Khursheed Alam

    Senior Lecturer

    Orthodontic Unit

    School of Dental Science

    Health Campus, Universiti Sains Malaysia.

    Email:

    [email protected]

    [email protected]

    Published by:

    PPSP Publication

    Jabatan Pendidikan Perubatan, Pusat Pengajian Sains Perubatan,

    Universiti Sains Malaysia.

    Kubang Kerian, 16150. Kota Bharu, Kelatan.

    Published in Malaysia

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    Contents

    1. Some definition...................................................3

    2. Cephalocaudal gradient of growth........................3

    3. Scammons curve..4

    4. Bone of the skull..4-5

    5. Growth of the skull.. 6-7

    6. Period of development of dentition.......................7

    7. Primate space..........................................................8

    8. Incisor liability...............8

    9. Lee way space.8-9

    10.Flush terminal plane...9

    11.Ugly duckling stage........... 10-11

    12.Importance of 1st molar..11

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    Growth

    Growth is the increase in size (Todd). It may also be defined as the normal

    change in the amount of living substance. eg. Growth is the quantitative

    aspect and measures in units of increase per unit of time.

    Development

    It is the progress towards maturity (Todd). Development may be defined as

    natural sequential series of events between fertilization of ovum and adult

    stage.

    Maturation

    It is a period of stabilization brought by growth and development.

    CEPHALOCAUDAL GRADIENT OF GROWTH

    This simply means that there is an axis of increased growth extending from

    the head towards feet. At about 3rd month of intrauterine life the head

    takes up about 50% of total body length. At this stage cranium is larger

    relative to face. In contrast the limbs are underdeveloped.

    By the time of birth limbs and trunk have grown faster than head and the

    entire proportion of the body to the head has increased. These processes

    of growth continue till adult.

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    SCAMMONS CURVE

    In normal growth pattern all the tissue system of the body do not growth at

    the same rate. Scammons curve for growth shows 4 major tissue system

    of the body;

    Neural

    Lymphoid

    General: Bone, viscera, muscle.

    Genital

    The graph indicates the growth of the neural tissue is complete by 6-7 year

    of age. General body tissue show an S shaped curve with showing of rate

    during childhood and acceleration at puberty. Lymphoid tissues proliferate

    to its maximum in late childhood and undergo involution. At the same time

    growth of the genital tissue accelerate rapidly.

    Scammon`s curve for growth of the four major tissue systems of the body

    NEED TO KNOW ABOUT PHYSICAL GROWTH

    To see whether there is any gross abnormality present or not.

    To plan the therapy.

    To determine the efficiency of the treatment.

    BONES OF THE SKULL

    A) Bones of the cranial base:

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    A) Fontal (1)

    B) Ethmoid (1)

    C) Sphenoid (1)

    D) Occipital (1)

    B) Bones of the cranial vault:

    1. Parietal (2)

    2. Temporal (2)

    C) Bones of the face:

    Maxilla (2)

    Mandible (1)

    Nasal bone (2)

    Lacrimal bone (2)

    Zygomatic bone (2)

    Palatine bone(2)

    Infra nasal concha (2)

    FUSION BETWEEN BONES

    1. Syndesmosis: Membranous or ligamentus eg. Sutural point.

    2. Synostosis: Bony union eg. symphysis menti.

    3. Synchondrosis: Cartilaginous eg. sphenoccipital, spheno-ethmoidal.

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    GROWTH OF THE SKULL:

    A) Cranium: 1. Base 2. Vault

    B) Face: 1. Upper face 2.Lower face

    CRANIAL BASE:

    Cranial base grows at different cartilaginous suture. The cranial base may

    be divided into 3 areas.

    1. The posterior part which extends from the occiput to the salatercica. The

    most important growth site spheno-occipital synchondrosis is situated here.

    It is active throughout the growing period and does not close until early

    adult life.

    2. The middle portion extends from sella to foramen cecum and the sutural

    growth spheno-ethmoidal synchondrosis is situated here. The exact time of

    closing is not known but probably at the age of 7 years.

    3. The anterior part is from foramen cecum and grows by surface

    deposition of bone in the frontal region and simultaneous development of

    frontal sinus.

    CRANIAL VAULT:

    The cranial vault grows as the brain grows. It is accelerated at infant. The

    growth is complete by 90% by the end of 5th year. At birth the sutures are

    wide sufficiently and become approximated during the 1st 2 years of life.

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    The development and extension of frontal sinus takes place particularly at

    the age of puberty and there is deposition of bone on the surfaces of

    cranial bone.

    PERIOD OF DEVELOPMENT OF DENTITION

    A) From birth to complete eruption of deciduous teeth. From birth to 2

    year.

    B) From complete eruption of deciduous teeth to the eruption of first

    permanent molar. From 2 to 6 year.

    C) Mixed dentition period. From 6year to 12 year.

    D) Period from the eruption of the 2nd permanent. From 12 year to

    onward.

    SEQUENCE OF ERUPTION OF DECIDUOUS TEETH

    Upper/Lower A B D C E

    SEQUENCE OF ERUPTION OF PERMAMENT TEETH

    Upper: 6 1 2 4 3 5 7 Lower: 6 1 2 3 4 5 7

    or 6 1 2 4 5 3 7 or 6 1 2 4 3 5 7

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    ANTHROPOID SPACE / PRIMATE SPACE / SIMIENS SPACE

    The space mesial to upper deciduous canine and distal to lower deciduous

    canine is characteristically found in primates and hence it is called primate

    space.

    INCISOR LIABILITY

    When the permanent central incisor erupt, these teeth use up specially all

    the spaces found in the normal dentition. With the eruption of permanent

    lateral incisor the space situation becomes tight. In the maxillary arch it is

    just enough to accommodate but in mandibular arch there is an average

    1.6 mm less space available. This difference between the space present

    and space required is known as incisor liability.

    These conditions overcome by;

    1. This is a transient condition and extra space comes from slight

    increase in arch width.

    2. Slight labial positioning of central and lateral incisor.

    3. Distal shift of permanent canine.

    LEE WAY SPACE (OF NANCE)

    Definition:

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    The combined mesiodistal width of the permanent canines and pre molars

    is usually less that of the deciduous canines and molars. This space is

    called leeway space of Nance.

    Measurement of lee way space:

    Is greater in the mandibular arch than in the maxillary arch

    It is about 1.8mm [0.9mm on each side of the arch] in the maxillary arch.

    And about 3.4mm [1.7 mm on side of the arch] in the mandibular arch.

    Importance:

    This lee way space allows the mesial movement of lower molar there

    by correcting flush terminal plane.

    * LWS can be measure with the help of cephalometry.

    FLUSH TERMINAL PLANE (TERMINAL PLANE RELATIONSHIP)

    Mandibular 2nd deciduous molar is usually wider mesio-distally then the

    maxillary 2nd deciduous molar. This leads to the development of flush

    terminal plane which falls along the distal surface of upper and lower 2nd

    deciduous molar. This develops into class I molar relationship.

    Distal step relationship leads to class 2 relationship.

    Mesial step relationship mostly leads to class 3 relationship.

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    1

    FEATURE OF IDEAL OCCLUSION IN PRIMARY DENTITION

    1. Spacing of anterior teeth.

    2. Primate space is present.

    3. Flush terminal plane is found.

    4. Almost vertical inclination of anterior teeth.

    5. Overbite and overjet varies.

    UGLY DUCKLING STAGE

    Definition:

    Stage of a transient or self correcting malocclusion is seen sometimes is

    called ugly duck ling stage.

    Occurring site: Maxillary incisor region

    Occuring age: 8-9 years of age.

    Occuring due to: This situation is seen during the eruption of the

    permanent canines. As the developing p.c. they displace the roots of lateral

    incisor mesially this results is transmitting of the force on to the roots of the

    central incisors which also gets displaced mesially. A resultant distal

    divergence of the crowns of the two central incisors causes midline

    spacing.

    This portion of teeth at this stage is compared to that of ugly walk of the

    duckling and hence it is called Ugly Duckling Stage.

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    1

    Described by Broad bent. In this stage children tend to look ugly. Parents

    are often apprehensive during this stage and consult the dentist.

    Correction: Corrects by itself, when canines erupt and the pressure is

    transferred from the roots to the coronal area of the incisor.

    IMPORTANCE OF 1ST MOLAR

    1. It is the key tooth to occlusion.

    2. Angles classification is based on this tooth.

    3. It is the tooth of choice for anchorage.

    4. Supports occlusion in a vertical direction.

    5. Loss of this tooth leads to migration of other tooth.

    6. Helps in opening the bite.

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    1

    Bibilography:

    1. Bhalajhi SI. Orthodontics The art and science. 4th edition. 2009

    2. Gurkeerat Singh. Textbook of orthodontics. 2nd edition. Jaypee, 2007

    3. Houston S and Tulley, Textbook of Orthodontics. 2nd Edition. Wright, 1992.

    4. Iida J. Lecture/class notes. Professor and chairman, Dept. of Orthodontics, School of dental

    science, Hokkaido University, Japan.

    5. Lamiya C. Lecture/class notes. Ex Associate Professor and chairman, Dept. of Orthodontics,

    Sapporo Dental College.

    6. Laura M. An introduction to Orthodontics. 2nd edition. Oxford University Press, 2001

    7. McNamara JA, Brudon, WI. Orthodontics and Dentofacial Orthopedics. 1st edition, Needham

    Press, Ann Arbor, MI, USA, 2001

    8. Mitchel. L. An Introduction to Orthodontics. 3 editions. Oxford University Press. 2007

    9. Mohammad EH. Essentials of Orthodontics for dental students. 3rd edition, 2002

    10.Proffit WR, Fields HW, Sarver DM. Contemporary Orthodontics. 4th edition, Mosby Inc., St.Louis,

    MO, USA, 2007

    11.Sarver DM, Proffit WR. In TM Graber et al., eds., Orthodontics: Current Principles and

    Techniques, 4th ed., St. Louis: Elsevier Mosby, 2005

    12.Samir E. Bishara. Textbook of Orthodontics. Saunders 978-0721682891, 2002

    13.T. M. Graber, R.L. Vanarsdall, Orthodontics, Current Principles and Techniques, "Diagnosis and

    Treatment Planning in Orthodontics", D. M. Sarver, W.R. Proffit, J. L. Ackerman, Mosby, 2000

    14.Thomas M. Graber, Katherine W. L. Vig, Robert L. Vanarsdall Jr. Orthodontics: Current Principles

    and Techniques. Mosby 9780323026215, 2005

    15.William R. Proffit, Raymond P. White, David M. Sarver. Contemporary treatment of dentofacial

    deformity. Mosby 978-0323016971, 2002

    16.William R. Proffit, Henry W. Fields, and David M. Sarver. Contemporary Orthodontics. Mosby978-0323040464, 2006

    17.Yoshiaki S. Lecture/class notes. Associate Professor and chairman, Dept. of Orthodontics, School

    of dental science, Hokkaido University, Japan.

    18.Zakir H. Lecture/class notes. Professor and chairman, Dept. of Orthodontics, Dhaka Dental

    College and hospital.

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    1

    Dedicated To

    My Mom, Zubaida Shaheen

    My Dad, Md. Islam

    &

    My Only Son

    Mohammad Sharjil

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    1

    Acknowledgments

    I wish to acknowledge the expertise and efforts of the various

    teachers for their help and inspiration:

    1. Prof. Iida Junichiro Chairman, Dept. of Orthodontics,

    Hokkaido University, Japan.

    2. Asso. Prof. Sato yoshiaki Dept. of Orthodontics, Hokkaido

    University, Japan.

    3. Asst. Prof. Kajii Takashi Dept. of Orthodontics, Hokkaido

    University, Japan.

    4. Asst. Prof. Yamamoto Dept. of Orthodontics, Hokkaido

    University, Japan.

    5. Asst. Prof. Kaneko Dept. of Orthodontics, Hokkaido

    University, Japan.

    6. Asst. Prof. Kusakabe Dept. of Orthodontics, Hokkaido

    University, Japan.

    7. Asst. Prof. Yamagata Dept. of Orthodontics, Hokkaido

    University, Japan.

    8. Prof. Amirul Islam Principal, Bangladesh Dental college9. Prof. Emadul Haq Principal City Dental college

    10. Prof. Zakir Hossain Chairman, Dept. of Orthodontics,Dhaka Dental College.11. Asso. Prof. Lamiya Chowdhury Chairman, Dept. of

    Orthodontics, Sapporo Dental College, Dhaka.

    12. Late. Asso. Prof. Begum Rokeya Dhaka Dental College.13. Asso. Prof. MA Sikder Chairman, Dept. of Orthodontics,

    University Dental College, Dhaka.

    14. Asso. Prof. Md. Saifuddin Chinu Chairman, Dept. ofOrthodontics, Pioneer Dental College, Dhaka.

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    1

    Dr. Mohammad Khursheed Alamhas obtained his PhD degree in Orthodontics from Japan in 2008.

    He worked as Asst. Professor and Head, Orthodontics

    department, Bangladesh Dental College for 3 years. At the sametime he worked as consultant Orthodontist in the Dental office

    named Sapporo Dental square. Since then he has worked in

    several international projects in the field of Orthodontics. He is

    the author of more than 50 articles published in reputed journals.

    He is now working as Senior lecturer in Orthodontic unit, School

    of Dental Science, Universiti Sains Malaysia.

    Volume of this Book has been reviewed by:

    Dr. Kathiravan Purmal

    BDS (Malaya), DGDP (UK), MFDSRCS (London), MOrth

    (Malaya), MOrth RCS( Edin), FRACPS.

    School of Dental Science, Universiti Sains Malaysia.

    Dr Kathiravan Purmal graduated from University Malaya 1993.

    He has been in private practice for almost 20 years.

    He is the first locally trained orthodontist in Malaysia withinternational qualification. He has undergone extensive

    training in the field of oral and maxillofacial surgery and

    general dentistry.