maxilla, development and clinical corelation.pptx

basic anatomy of maxilla with all aspects and processes, attachment, development of bone
The prenatal life may arbitrarily divided into 3 periods:-
The period of ovum (fertilization to 2 weeks)
The period of embryo (2 weeks to 8 weeks)
The period of fetus (8 weeks to 9 months)

Developmental anomalies of the face
It has been seen that the formation of the various parts of the face involves fusion of diverse components.
This fusion is occasionally incomplete and give rise to various anomalies.
The anomalies are:-
Unilateral harelip- Failure of fusion of maxillary process with medial nasal process on one side.



Bilateral harelip- failure of fusion of both maxillary processes with the medial nasal process.
Midline cleft of upper lip- defective development of the lowermost part of the frontonasal process may give rise to a midline defect of the upper lip.
Oblique facial cleft- nonfusion of the maxillary and lateral nasal process give rise to a cleft running from the medial angle of the eye to the mouth
Inadequate fusion of the mandibular and the maxillary processes with each other may lead to an abnormally wide mouth(macrostomia).



Too much fusion may result in a small mouth (microstomia)
The entire first arch may remain undeveloped on one or both sides, affecting the lower eyelid (coloboma type effect), the maxilla, the mandible and the external ear.
The prominence of the cheek is absent and the ear may be displaced ventrally and caudally.
There may be presence of cleft palate and of faulty dentition.
This condition is called mandibulofacial dysostosis, Treacher Collins Syndrome or 1st arch syndrome.
alate is formed from 3 components:-
primary/primitive palate – develops from frontonasal process
Secondary palate/palatal processes – develop from maxillary processes.

At the later stage, the mesoderm in the palate undergoes intramembranous ossification to form the HARD PALATE.
However, ossification doesnot extend into the most posterior portion, which remains as the SOFT PALATE.
The definitive/permanent palate is formed by
Fusion of palatal processes of maxilla with primitive palate.
Fusion of both palatal process of maxilla
Fusion of palatal process with nasal septum
LEFT PALATE:- Defective fusion of the various components of the palate give rise to the cleft in the palate.
COMPLETE CLEFT PALATE
Bilateral complete cleft Unilateral complete cleft

Growth occurs primarily by intramembranous ossification since there is no cartilage displacement.
Growth of nasomaxillary complex is produced by
Displacement
Growth at sutures
Surface remodelling.
Displacement of maxilla takes place by translation and translocation.
Primary displacement(translation) of maxilla occurs due to its own growth.
The bone deposition occurs on its posterior surface.

However, due to the thrust created by the growing bone, the maxilla is displaced forward.
Secondary displacement of the maxilla is a passive translation brought about by the gro

1. MAXILLA – THE UPPER JAW DR. POOJA JAISWAL OMFS PG 1 st YEAR MGSDC

2. INTRODUCTION The maxilla is the second largest bone of the face. It has a central location and provides structural support to the viscerocranium .

3. It has functional and aesthetic significance as it has a fundamental role in facial architecture, separates the nasal and oral cavities, forms the upper jaw, and contains the maxillary sinus.

4. EMBRYOLOGY

5. PRENATAL DEVELOPMENT The prenatal life may arbitrarily divided into 3 periods:- The period of ovum (fertilization to 2 weeks) The period of embryo (2 weeks to 8 weeks) The period of fetus (8 weeks to 9 months)

6. Formation of branchial arches at 4 th week of IUL

7. Lateral view at 4 th week of IUL Frontonasal process

8. PRENATAL EMBRYOLOGY OF HUMAN FACE FRONTONASAL PROCESS MAXILLARY PROCESS MANDIBULAR PROCESS

9. 4 th week of developing stomodeum 4.5 week, mandibular arch approaching each other End of 4 th week, appearance of lens and nasal placodes 5 th week, appearance of nasal pit and maxillary processes

10. Maxillary process approaching each other Fusion of processes

11. CLINICAL CORRELATION Developmental anomalies of the face It has been seen that the formation of the various parts of the face involves fusion of diverse components. This fusion is occasionally incomplete and give rise to various anomalies.

12. The anomalies are:- Unilateral harelip- Failure of fusion of maxillary process with medial nasal process on one side. Bilateral harelip- failure of fusion of both maxillary processes with the medial nasal process.

13. Midline cleft of upper lip- defective development of the lowermost part of the frontonasal process may give rise to a midline defect of the upper lip.

14. Oblique facial cleft- nonfusion of the maxillary and lateral nasal process give rise to a cleft running from the medial angle of the eye to the mouth.

15. Inadequate fusion of the mandibular and the maxillary processes with each other may lead to an abnormally wide mouth( macrostomia ). Too much fusion may result in a small mouth ( microstomia )

16. The entire first arch may remain undeveloped on one or both sides, affecting the lower eyelid ( coloboma type effect) , the maxilla, the mandible and the external ear. The prominence of the cheek is absent and the ear may be displaced ventrally and caudally. There may be presence of cleft palate and of faulty dentition. This condition is called mandibulofacial dysostosis , Treacher Collins Syndrome or 1 st arch syndrome.

17. DEVELOPMENT OF PALATE Palate is formed from 3 components:- primary/primitive palate – develops from frontonasal process Secondary palate/palatal processes – develop from maxillary processes.

18. FRONTAL VIEW VENTRAL VIEW

19. At the later stage, the mesoderm in the palate undergoes intramembranous ossification to form the HARD PALATE. However, ossification doesnot extend into the most posterior portion, which remains as the SOFT PALATE.

20. The definitive/permanent palate is formed by Fusion of palatal processes of maxilla with primitive palate. Fusion of both palatal process of maxilla Fusion of palatal process with nasal septum.

21. CLINICAL CORRELATION CLEFT PALATE:- Defective fusion of the various components of the palate give rise to the cleft in the palate. COMPLETE CLEFT PALATE Bilateral complete cleft Unilateral complete cleft

22. INCOMPLETE CLEFT PALATE Cleft of hard and soft palate Bifid uvula Cleft of soft palate

23. POSTNATAL GROWTH Growth occurs primarily by intramembranous ossification since there is no cartilage displacement. Growth of nasomaxillary complex is produced by Displacement Growth at sutures Surface remodelling.

24. DISPLACEMENT Displacement of maxilla takes place by translation and translocation. Primary displacement(translation) of maxilla occurs due to its own growth. The bone deposition occurs on its posterior surface.

25. However, due to the thrust created by the growing bone, the maxilla is displaced forward. Secondary displacement of the maxilla is a passive translation brought about by the growth of anterior cranial base. Growth of bone formation on both side of the suture takes place due to secondary displacement.

26. Secondary displacement forward downward

27. GROWTH OF SUTURE The maxilla is connected to the cranium and cranial base by a number of sutures. These sutures include:- Frontonasal suture Frontomaxillary suture Zygomaticotemporal suture Zygomaticomaxillary suture Pterygopalatine suture

28. These sutures are all oblique and more or less parallel to each other and they orient the direction of the facial growth downward and forward.

29. SURFACE REMODELLING VERTICAL GROWTH a) Alveolar process : its formation takes place by apposition of bone in 3 aspect( inferior, internal, external) in posterior region and on 2 aspect(inferior, internal) on anterior region. b) Palate : there will be resorption on superior aspect(nasal) and apposition on inferior aspect(oral), which will bring the palate downward.

30. ANTERO-POSTERIOR GROWTH Occurs by resorption in the vestibular part and apposition on the inferior and palatal part. There will be apposition on the posterior aspect of the horizontal part of the palate. There will be development of tuberosity .

31. Maxillary Sinus : As the sinus has the volume of small peas , the eruption of deciduous teeth will modify its volume and it increase in size with the eruption of upper six, about 8 years it has a pyramidal form that will lengthen after the eruption of the canine and the last molar .

32. Develops as an invagination from lateral nasal wall at 70 th day of gestation. At birth, it is 2cm long, 1cm broad and 1cm height At 12 years, it reaches its 2/3 rd of its size, sinus floor parallels the floor of the nasal cavity At 15-18 years adult size, sinus floor reaches below the level of floor of the nasal cavity. Pneumatization continues as age advances.

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