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Ortho > Growth And Development > Flashcards

Growth And Development Flashcards

1
Q

Growth

A

Increase in size

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2
Q

Development

A

Increase in complexity

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3
Q

Maturation

A

Combo of growth and development over time

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4
Q

What are patterns of growth determined by

A

The proportional relationships between structures

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5
Q

what relationships does ortho focus on for normal growth

A

Between structures to identify patterns of growth

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6
Q

What is a Norma growth pattern marked by ?

A

Changes in these proportional relationships over time

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7
Q

What do patterns imply?

A

Predictability

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8
Q

Cephalocaudal gradient of growth

A

Head to toe
2 month-fetus = head is 1/3 body and legs are 1/3 body
25 year old = head is 12% and legs are 1/2 body

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9
Q

What does the maxilla curve follow?

A

Neural growth curve

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10
Q

What does the mandible curve follow?

A

General growth curve

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11
Q

What grows more during the adolescent growth spurt?

A

The mandible grows more than the maxilla

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12
Q

Lymphoid growth curve- when is it at 200%?

A

Around age 10-11, huge tonsils then shrinks down

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13
Q

Completion of facial growth in 3 dimensions

A

1st - transverse (bilateral crossbite - address as soon as possible)
2nd- anterior-posterior (class II and class III)
3rd- vertical (overbite, open bite - wait to address, dont do implants in kids because last to finish growing)

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14
Q

Standard growth charts

A

Use to evaluate if a patients pattern of growth falls outside of the Normal range acceptable for a population.
Childs growth should plot along the same percentile at all ages

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15
Q

When does class II end to be treated?

A

Before the growth spurt

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16
Q

Variability in timing

A

Can be reduced by using developmental age rather than chronological age as an expression of an individuals growth status

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17
Q

Adolescent growth spurt

A

Period of rapid growth right before puberty
Coincident with sexual maturity

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18
Q

Females growth spurt

A

11-13 years
Begin breast development and height spurt
Breast development peak
Menarche (completion)

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19
Q

Males growth spurt

A

13-15 yrs
Fat spurt
Peach fuzz on the upper lip
Pigmented hair on lip (peak)
Hair on chin

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20
Q

Age determination

A

Chronological age
Dental age
Skeletal age

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21
Q

Chronological age

A

Measured in years

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22
Q

Dental age

A

Stage of dental development (what teeth are present/absent)

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23
Q

Skeletal age

A

Bone maturation -determines growth status

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24
Q

Factors affecting variability in timing

A

Gender
Racial/ethnic differences
Sickness
Nutrtion
Timing factor - late/early maturer
Problems with growth (hormones or genetics)
Trauma

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25
Q

Why do we monitor growth?

A

Determine if growth is normal vs abnormal
Determine the specific growth pattern of each patient
Assess amount of growth remaining
Determine treatment timing of orthodontics (can be modified? Can be camouflaged? Orthognathic surgery correct?)

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26
Q

Craniofacial growth

A

Changes in proportions of head and face during growth
At birth- face and jaws underdeveloped
Much more growth of facial than cranial structures postnatally

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27
Q

Craniofacial complex

A

Cranial vault
Cranial base
Maxilla - nasomaxillary complex
Mandible

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28
Q

Cranial vault

A

Flat bones, intramembranous bone formation - no cartilage
Major mechanism growth = a position of new bone at the sutures

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29
Q

What growth curve does the cranial vault follow?

A

Neural growth curve

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30
Q

Cranial base

A

Formed by endochondral ossification - formed initially in cartilage and transformed into bone
Bands of cartilage (synchondroses) remain between centers of ossification
Growth occurs at the synchondroses in both directions

31
Q

Nasomaxillary complex

A

Intramembranous ossification
Growth by - a position of bone at the sutures connecting the maxilla to the cranium and cranial base, surface remodeling

32
Q

How does the maxilla grow

A

Downward and forward
Growth of cranial base pushes maxilla
A position of bone at the sutures fills in the space

33
Q

Midpalatal suture

A

Fuses early (transverse growth is first)

34
Q

What accounts for space for the third molars?

A

Apposition of bone in the molar area

35
Q

Nasomaxillary complex remodeling

A

Maxilla goes down and forward, its anterior surface tends to resort through remodeling except small area around the anterior nasal spine

36
Q

Remodeling of the palatal vault

A

Moves in the same direction as it is being translated
Bone is removed from the floor of the nose and added to the roof of the mouth
Ant surface maxilla - bone removed, cancelling the forward translation
As palatal vault moves down, bone remodeling also widens it

37
Q

Mandible translation vs growth

A

Translated - downward and forward
Grows- upward and backwards

Maintains contact with skull

38
Q

Mandible site of growth

A

Site of growth - posterior surface of the ramus, condylar process, coronoid process

39
Q

Mandibular remodeling

A

Ramus is extensively remodeled
Apposition of new bone on the posterior surface of the mandible and resorption of bone from the anterior surface of the mandible

40
Q

Skeletal problems Class II caused by

A

Maxillary excess (protrusion)
Mandibular deficiency (Retrusion)
Or combo of both

41
Q

Skeletal problems class III caused by

A

Maxillary deficiency (Retrusion)
Mandibular excess (protrusion)
Or a combination of both

42
Q

Class II tx early

A

Headgear

43
Q

Headgear

A

Prevent maxillary growth and allow the mandible to catch up

44
Q

Class II tx during late mixed/early perm dentition (during growth)

A

Growth modification
During growth spurt
Functional appliances

45
Q

When do you treat earlier in class II during a growth spurt

A

Psychosocial issues

46
Q

Class II tx after growth spurt

A

Camouflage
Surgery

47
Q

Camouflage

A

Extractions during perm. Dentition to hide a mild/moderate skeletal problem

48
Q

Surgery

A

After all growth completed

49
Q

Class III tx option early

A

Growth modification

50
Q

Growth modification class III

A

Protraction face mask (reverse pull headgear)
Before sutures fuse

51
Q

What does treatment timing depend on ?

A

Degree of severity
Amount of growth remaining
Treatment objectives
Facial profile

52
Q

When is the ideal time for ortho treatment for most patients?

A

Adolescent growth spurt : maximize growth modification
All permanent teeth erupted

53
Q

What are the exceptions for early treatment ?

A

-When Sutural maturity is a concern - 7-6 year old in class III protraction facemask during early mixed dentists, post cross bite
-ant cross bite of teeth being damaged
-psychosocial reason

54
Q

What are the exceptions for late treatment?

A

prolonged growth - in class III patients the mandible contours to grow after the adolescent growth spurt - severe long face (vertical dimension is last to finish growth)

55
Q

What are the indications for extraction of permanent teeth as part of ortho treatment?

A

Not enough room for the teeth to be well position in either jaw
Camouflage a skeletal discrepancy

56
Q

What tooth is usually extracted in class II and class III?

A

Class II = max 1st premolars
Class III= mand 2nd premolars

57
Q

Patients with dental problems determination of time of treatment

A

Based on dentition (Dental development)

58
Q

Patients with skeletal problems determination of time of treatment

A

Based on skeletal maturation/development

59
Q

What growth does headgear affect

A

Maxilla
Mandible - protraction facemask (reverse pull headgear) = class III

60
Q

What growth does function appliances affect?

A

Mandible - herbst, Mara, twin block

61
Q

Class I referral for evaluation

A

Just before loss of 2nd primary molars

62
Q

Class I ideal treatment timing

A

Permanent teeth and adolescent growth spurt (during/after)

63
Q

Class I treat early if

A

-severe crowding
-early primary canine loss
-psychosocial

64
Q

Class II referral for evaluation

A

Just before adolescent growth spurt

65
Q

Class II ideal treatment timing

A

Adolescent growth spurt

66
Q

Class II treat early if

A

-extreme problems
-social problems
-tissue damage

67
Q

Class III referral for evaluation

A

Early mixed dentition

68
Q

Class III ideal treatment timing

A

-during early mixed dentition (Age 7-9)
-prolonged growth of the mandible will require treatment later

69
Q

Class III treat early if

A

-almost always
-early diagnosis
-maxillary deficiency

70
Q

Transverse growth event to consider

A

Fusion of mid-palatal suture

71
Q

Transverse implication for treatment

A

Earlier is better

72
Q

Vertical growth event to consider

A

Vertical growth continue

73
Q

Vertical implication for treatment

A

Retention of correction

74
Q

What happens to the midpalatal suture as we age?

A

Becomes more interdigitated

Ortho (19 decks)

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