GROWTH AND DEVELOPMENT OF FACE in Dental

Growth and development of face

1. GROWTH AND DEVELOPMENT OF FACE PRESENTOR - DR. SUNIDHI CHAUDHARY PERCEPTOR - DR. MANVI MALIK

2. CONTENTS Introduction. Head and Neck development. Development of Face. Development of Upper and Lower Lip. Development of Nose. Development of Palate. Development of Tongue. Craniofacial Anomalies. Conclusion. References.

3. INTRODUCTION

4. GROWTH Growth may be defined as the normal changes in the amount of a living substance . - MOYER Growth refers to an increase in size or number . – PROFFIT Growth may be defined as a developmental increase in mass i.e , it is a process that leads to an increase in the physical size of cells, tissues, organs or organisms as a whole – STEWART (1982) “ Growth signifies an increase, expansion or extension of any given tissues ” – PINKHAM (1994)

5. DEVELOPMENT Development refers to all the naturally occurring, progressive, unidirectional changes in the life of an individual from its existence as a single cell to its elaboration as a multifunctional unit terminating in death . – MOYERS (1988) Development is a progress towards maturity . – TODD (1931) Development addresses the progressive evolution of a tissue. – PINKHAM (1994)

6. EMBRYOLOGY : It is the study of the formation and development of the Embryo from the moment of its inception to the time when it is born as an infant. HUMAN EMBRYOLOGY - 1OTH EDITION INDERBIR SINGH, CRANIOFACIAL EMBRYOLOGY G.H SPERBER 2 ND EDITION

7. CRANIOFACIAL EMBRYOLOGY G.H SPERBER 2 ND EDITION

8. CRANIOFACIAL EMBRYOLOGY G.H SPERBER 2 ND EDITION

9. HEAD AND NECK DEVELOPMENT The most typical feature is formed by the Pharyngeal or Branchial apparatus. Pharyngeal arches : are rod-like thickening of mesoderm present in the wall of foregut. Appear in 4 th -5 th week of human development. Human embryology : Inderbir singh 10 th edition

10. Between any two arches, the endoderm lining of pharynx is pushed outward to form a series of pouches called ENDODERMAL or PHARYNGEAL POUCHES . Opposite each pouch the surface ectoderm dips inwards as an ENDODERMAL CLEFTS . Human embryology : Inderbir singh 10 th edition

11. Human embryology : Inderbir singh 10 th edition

12. CRANIOFACIAL EMBRYOLOGY G.H SPERBER 2 ND EDITION

13. DEVELOPMENT OF FACE : The development of Human face occurs between the 4 th and 8 th week of embryonic life. After the formation of Headfold The Developing Forebrain and the Pericardium form 2 prominent bulgings. These bulgings are separated by a depression called STOMATODAEUM present in the ventral aspect of the embryo. Baylis A. Head and Neck Embryology: An Overview of Development, Growth and Defect in the Human Fetus.

14. STOMATODAEUM ( future mouth)   is the primordial mouth region and a surface central depression lying between the forebrain bulge (cranially) and the heart bulge (caudally) . It’s floor is formed by the BUCCOPHARYNGEAL MEMBRANE which separates it from the foregut. Mesoderm covering developing forebrain proliferates and form downward projection called FRONTONASAL PROCESS . Human embryology : Inderbir singh 10 th edition

15. Each mandibular arch forms the lateral wall of stomatodaeum, this arch gives off a bud from its dorsal end called MAXILLARY PROCESS and grows ventro-medially cranial to main part of the arch called MANDIBULAR PROCESS . Human embryology : Inderbir singh 10 th edition

16. R and L Mandibular process fuse and form boundary of future mouth . Nasal placodes appear over Frontonasal process. Nasal placodes is converted in to nasal pit , the nasal pits enlarge to form nasal cavity . Elevations of pit form the Medial and Lateral nasal process . 5 th week IUL H uman embryology : Inderbir singh 10 th edition, CRANIOFACIAL EMBRYOLOGY G.H SPERBER 2 ND edition

17. DEVELOPMENT OF UPPER AND LOWER LIP : Fusion of Frontonasal process with R and L Maxillary process . 6th week IUL Human embryology : Inderbir singh 10 th edition

18. The Maxillary and Mandibular processes partly fuse to form the cheek , with growth of the maxillary processes the nasal pits come closer to each other. Frontonasal Prominence (white) Frontonasal Prominence - Lateral nasa l (purple) Frontonasal Prominence - Medial nasal  (green) Pharyngeal Arch 1 - Maxillary prominence  (yellow) Pharyngeal Arch 1 - Mandibular prominence  (orange) Stomatodeum (black) Baylis A. Head and Neck Embryology: An Overview of Development, Growth and Defect in the Human Fetus. 6th week IUL

19. DEVELOPMENT OF NOSE : The nose is a complex of contribution from : Frontonasal prominence : the Bridge . Median nasal prominence : Median ridge and tip. Lateral nasal prominence : the Alae. The cartilage of nasal capsule : Septum and Nasal conchae. As the nose become prominent, external nares open up downward. Jankowski R, Márquez S. Embryology of the nose: the evo-devo concept. World Journal of Otorhinolaryngology. 2016 May 28;6(2):33-40. 6th week IUL

20. DEVELOPMENT OF PALATE : 8th week IUL

21. DEVELOPMENT OF TONGUE : Largest single muscular organ inside the oral cavity, which lies relatively free. Mucosa of tongue develops from endoderm in the floor of pharynx (first, second, third and fourth pharyngeal arches) It develops from two parts , they are: Formation of anterior 2/3rd of the tongue . Formation of posterior 1/3rd of the tongue . Human embryology : Inderbir singh 10 th edition

22. Human embryology : Inderbir singh 10 th edition

23. Summary of events : Permar’s Oral embryology and Microscopic anatomy 7 th Edition

24. CRANIOFACIAL ANOMALIES OF FACE : Craniofacial anomalies are a diverse group of deformities caused in the growth of the head and facial bones. They may be caused by some f actors which include the following : Combination of genes Environmental Shafer’s textbook of oral pathology 9 th edition

25. CLEFT LIP AND CLEFT PALATE : Cleft lip : The failure of fusion of the frontonasal and maxillary processes , resulting in a cleft of varying extent through the lip, alveolus, and nasal floor. Cleft palate : The failure of fusion of the palatal shelves of the maxillary processes , resulting in a cleft of the hard and/or soft palates. Overall incidence of cleft lip and palate is approx. 1 in 600 to 800 live births and isolated cleft palate occurs approximately in 1 in 2000 live births . Thus, the typical distribution of cleft types are: Cleft lip alone – 15% Cleft lip and palate – 45% Isolated cleft palate – 40% Semer NB, Adler- Lavan M. Practical plastic surgery for non surgeons. Philadelphia: Hanley & Belfus ; 2001 Feb.

26. It has been clearly established that two separate and distinct entities exist : Cleft lip with or without associated cleft palate Isolated cleft palate Shafer’s textbook of oral pathology

27. Human embryology : Inderbir singh 10 th edition

28. CLEFT LIP/ HARE LIP Human embryology : Inderbir singh 10 th edition

29. TREATMENT : Nahai FR, Williams JK, Burstein FD, Martin J, Thomas J. The management of cleft lip and palate: pathways for treatment and longitudinal assessment. InSeminars in Plastic Surgery 2005 Nov (Vol. 19, No. 04, pp. 275-285). Copyright© 2005 by Thieme Medical Publishers, Inc., 333 Seventh Avenue, New York, NY 10001, USA..

30. Vyas T, Gupta P, Kumar S, Gupta R, Gupta T, Singh HP. Cleft of lip and palate: A review. Journal of family medicine and primary care. 2020 Jun;9(6):2621.

31. Mandibulofacial dysostosis ( Treacher collins syndrome ) Facial hemihypertrophy Shafer’s textbook of oral pathology 9 TH edition

32. Craniosynostosis Hemifacial microsomia Deformational plagiocephaly Cummings C, Canadian Paediatric Society, Community Paediatrics Committee. Positional plagiocephaly. Paediatrics & child health. 2011 Oct 1;16(8):493-4. Kajdic N, Spazzapan P, Velnar T. Craniosynostosis-Recognition, clinical characteristics, and treatment. Bosnian journal of basic medical sciences. 2018 May;18(2):110. Birgfeld CB, Heike C. Craniofacial microsomia. InSeminars in plastic surgery 2012 May (Vol. 26, No. 02, pp. 091-104). Thieme Medical Publishers.

33. Developmental anomalies of Tongue : MICROGLOSSIA MACROGLOSSIA ANKYLOGLOSSIA FISSURED TONGUE Gupta OP. Congenital macroglossia. Archives of Otolaryngology. 1971 Apr 1;93(4):378-83 , Nepram SS, Jain P, Huidrom RD. Isolated microglossia : A case report. Journal of Medical Society. 2015 Sep 1;29(3):180.

34. CONCLUSION Understanding the sequelae of the development of face equips us with the knowledge of the factors responsible for any maldevelopment and thus assists us in treating them using a comprehensive and multidisciplinary approach.

35. REFERENCES HUMAN EMBRYOLOGY - 1OTH EDITION INDERBIR SINGH CRANIOFACIAL EMBRYOLOGY G.H SPERBER 2 ND EDITION Permar’s Oral embryology and Microscopic anatomy 7 th Edition Baylis A. Head and Neck Embryology: An Overview of Development, Growth and Defect in the Human Fetus. Jankowski R, Márquez S. Embryology of the nose: the evo-devo concept. World Journal of Otorhinolaryngology. 2016 May 28;6(2):33-40. Shafer’s textbook of oral pathology Kajdic N, Spazzapan P, Velnar T. Craniosynostosis-Recognition, clinical characteristics, and treatment. Bosnian journal of basic medical sciences. 2018 May;18(2):110. Birgfeld CB, Heike C. Craniofacial microsomia. InSeminars in plastic surgery 2012 May (Vol. 26, No. 02, pp. 091-104). Thieme Medical Publishers Cummings C, Canadian Paediatric Society, Community Paediatrics Committee. Positional plagiocephaly. Paediatrics & child health. 2011 Oct 1;16(8):493-4. Gupta OP. Congenital macroglossia. Archives of Otolaryngology. 1971 Apr 1;93(4):378-83 Nepram SS, Jain P, Huidrom RD. Isolated microglossia : A case report. Journal of Medical Society. 2015 Sep 1;29(3):180. Semer NB, Adler- Lavan M. Practical plastic surgery for non surgeons. Philadelphia: Hanley & Belfus ; 2001 Feb

36. Nahai FR, Williams JK, Burstein FD, Martin J, Thomas J. The management of cleft lip and palate: pathways for treatment and longitudinal assessment. InSeminars in Plastic Surgery 2005 Nov (Vol. 19, No. 04, pp. 275-285). Copyright© 2005 by Thieme Medical Publishers, Inc., 333 Seventh Avenue, New York, NY 10001, USA. Vyas T, Gupta P, Kumar S, Gupta R, Gupta T, Singh HP. Cleft of lip and palate: A review. Journal of family medicine and primary care. 2020 Jun;9(6):2621.

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