DEVELOPMENT OF PALATE.ppt

DEVELOPMENT OF PALATE

1. DEVELOPMENT OF
PALATE
DR.VARDENDRA.M
DEPT. OF ORAL PATHOLOGY

2. CONTENTS:
INTRODUCTION
DEVELOPMENT OF PALATE
PALATAL SHELVES ELEVATION
FUSION OF PALATAL SHELVES
APPLIED ASPECTS
CONCLUSION
REFERENCES

3. DEVELOPMENT OF PALATE

4. INTRODUCTION
•Thethreeelementsthatmakeupthepalateare:(6
th
-
9
th
wk)
i)Twolateralmaxillarypalatalshelves
ii)Primarypalateofthefrontonasalprominence

5. PRIMARY PALATE FORMATION:
-2 medial nasal process merge at the deeper levels to
form the intermaxillary segment.
-INTERMAXILLARY SEGMENT HAS
Labial component-philtrum
Maxilla component-alveolus
Palatal component –primary palate

6. PRIMARY PALATE FORMATION:

7. PRIMARY PALATE

9. SECONDARY PALATE FORMATION:
-The maxillary processes give rise to two
palatal shelves.(6
th
week)

10. 6
th
wk
12
th
wk
Fusion of
palatal
shelves
8-9
th
wk
(Elevation of
Palatal shelves)
7
th
wk
(Tongue)

11. HISTOLOGIC PRESENTATION

12. SCHEMATIC PRESENTATION

13. Palatal shelf elevation
Extrinsic force concept--jaw
tongue
head position
intrinsic force concept--hydration of ground substance
mesenchymal cell activity
collagen

14. Fusion of Palatal Shelves
Thesiteofjunctionbetweenthe3palatal
componentsismarkedbytheincisive
papillaoverlyingtheincisivecanal

15. SOFT PALATE:
Posterior 1/4
th
of secondary palate–soft palate.
Soft palate—bilaminar fold of mucous membrane.
It contains-palatine aponeurisis
-five pairs of muscles
levator veli palatini
tensor veli palatini
musculus uvulae
palatopharyngeus
palatoglossus
-nerves and vessels
-palatine glands

16. COMPLETION OF PALATE:
The secondary palate & posterior portion of
the primary palate fuses together forming the
final palate. (12
th
week).

17. CLINICAL CONSIDERATIONS:
-Cleft lip & cleft palates are common defects.
-Those anterior to incisive foramen –
lateral cleft lip,
cleft upper jaw &
cleft between primary & secondary palates.

18. -Clefts posterior to the incisive foramen
include cleft palate & cleft uvula.
-Third category -combination of clefts lying
anterior & posterior to the incisive foramen

19. INCOMPLETE CLEFT LIP

20. BILATERAL CLEFT LIP

21. CLEFT LIP &PALATE AND JAW

22. OBLIQUE FACIAL CLEFT:

23. MEDIAN CLEFT

24. SUBMUCOSAL CLEFT:

25. CLEFT UVULA

26. CYST FORMATION

27. CLASSIFICATION OF CLEFTS
VARIOUS TYPES:
1.Davis & Ritchie classification.
2.Veaus classification.
3.Kernahan &stark symbolic classification.
4.International confederation of plastic and
reconstructive surgery classification.

28. VEAU’S CLASSIFICATION OF CLEFT PALATE
GROUP1 :Defects of the softpalate only.
GROUP2 :Defects involving the hard palate
and soft palate
GROUP3 :Defects involving the soft palate to
the alveolus, usually involving the lip
GROUP4 :Complete bilateral clefts.

30. ETIOLOGY:
1.HERIDITORY FACTORS
2.ENVIRONMENTAL FACTORS:
Infections–measles
radiation—x-rays
hormones—cortisone
nutritional deficiencies—B-complex, vit-A,
folate metabolism,

31. Drugs : Ethyl alcohol
- diphenylhydantoin
Trimethadione
Retinoids
Aminopterin & methotrexate
Pr ednisolone

32. TRANSITION OF
BLOOD SUPPLY
Causes of cleft
lip/ palate
Deficient jaw
Growth –tongue
Occupies superior
position
Failure of
mesenchymal
cell consolidation
Lack of degeneration
of medial epithelial
seam
Failure of
elevation
Delayed shelf
elevation
Defective palatal
shelf growth

33. EXOSTOSIS-TORUS PALATINUS

34. TORUS PALATINUS

35. CLEFT PALATE-SYNDROMES

36. GOLDENHAR SYNDROME
-> Ocular, auricular,
vertebral abnormalities.

37. PIERRE ROBIN’S SYNDROME
->Cleft palate.
->Glossoptosis.
->Micrognathia.

38. MEDIAN CLEFT FACE SYNDROME
->Hypertelorism.
->Median cleft of premaxilla,
palate

39. ORO FACIAL DIGITAL SYNDROME
->Cleft tongue.
->Cleft of mandibular
alveolar process.

40. APERTS SYNDROME
->Prognathicmandible.
->Hypoplasticmaxilla.
->High arched palate.
->Parrot beak appearance.
->Hypertelorism.

41. TREACHER-COLLINS SYNDROME
->Hypoplasiaof mandible
and malarbones.
->Macrostomia.
->Malformation of external ear.
->High arched palate.
->Bird or fish appearance.

42. CROUZON SYNDROME
->Prognathicmandible.
->Hypoplasticmaxilla.
->High arched palate.
->Parrot beak appearance.
->Hypertelorism.

43. MARFANS SYNDROME
->Long extremities
->Hyperextensibilityof joints
->Spidery fingers
->Bifid uvula
->Cvscomplications

44. DOWNS SYNDROME
->Macroglossia.
->Flat face ,flat occipit.
->Large anterior fontanelle.
->Broad short neck
->Outward slanting of
palpebralfissures

45. CONCLUSION

46. REFERENCES
T.w.sadler , ed8,langman’s medical embryology, pg
no.s 272-278
Marybathbalogh, ed2, illustrated, dental embryology,
histology&anatomy.
James avery,ed3,oral histology and embryology,pg
no.s 45-49,51-61.
Tencate’s,ed7,oral histology, development, structure,
and function pg no.s 39-56.

47. Berkovitz, ed3,oral anatomy histology and
embryology,pgno.s-8-12,269-283.
Shafer’s,ed6,textbook of oral pathology, pg no.s-22-25.
Neville ,damm,allen,bouquot,ed3,oral and maxillofacial
pathology,pgno.s-1-5,21-22.
orban’s,ed12,textbook of oral histology,embryologypg
no.s-9&10.
Moore persaud,ed7,the development of human,pgno.s-
230-235
Profit,ed4,contemporary orthodontics,pgno.s-44-47.

48. THANK YOU..