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Published byRolf Heath Modified over 9 years ago
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Oral Biology 5301 Bone growth and development Bone biology
Educational objectives Exposure to basic concepts of bone biology Correlation of basic bone biology to clinical treatment Special considerations / implications of bone biology to dentistry
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Clinical Correlates of Bone Growth and Development
Facial skeletal development Maxillary development Mandibular development
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Clinical Correlates of Bone Growth and Development
Effect of congenital anomalies on facial growth and development Effect of surgical correction of congenital anomalies on facial growth and development Tooth development and retention influence on alveolar bone levels
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Clincal Correlates of Bone Growth and Development
Orthodontic tooth movement Bone healing following tooth extraction Bone response to alloplastic materials Bone healing in approximation of dental implants
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Clinical Correlates of Bone Growth and Development
Bone grafting to treat dentoalveolar defects Bone grafting to treat discontinuity defects Fracture healing
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Cellular Growth Hypertrophy Hyperplasia
Secretion of extracellular material Interstitial growth
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Embryologic Type of Bone
Endochondral Intramembranous
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Functional Matrix Theory of Growth
“Growth of the face occurs as a response to the functional need and is mediated by the soft tissue in which the bone is embedded” Soft tissues grow, bone and cartilage react
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Growth Control Bone is the determinant of its own growth
Cartilage is the determinant of bone growth Soft tissue matrix is the determinant of growth All are controlled genetically
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Orthodontic Tooth Movement
Bone apposition and resorption Effects on the pulp Effects on the PDL Effects on the tooth root
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Effects of Periosteum Provision of undifferentiated mesechymal cells
Envelope to limit/regulate bone apposition
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Introduction 10 y.o. female 12/98
CC: Noticed swelling in face on left side for two weeks HPI: Facial swelling Left lower lip “tingles” No pain or change in bite
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Examination Left lower facial swelling, without thrill/bruit
Lower vestibular swelling, L>R No abnormal tooth mobility Teeth vital with EPT CN II-XII grossly intact
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Assessment Problem list: Diff. Dx: Multilocular radiolucent lesion
Teeth vital without resorption, displacement, or mobility Apparent cortical expansion Diff. Dx: Central Giant Cell Lesion Ameloblastomic Fibroodontoma Ameloblastoma
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Treatment Plan Impressions for splint fabrication
Screening labs Ca, alk phos, PTH All WNL CT of mandible: Multilocular radiolucents, from infer border to encompass tooth roots superiorly Buccal and lingual cortices intact, although expansion present Incisional bx
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Facial Growth and Development
15 year old man Congenital cleft lip and palate 29 surgeries to nose and lip Significant malocclusion Status post facial skeletal growth Masticatory insufficiency
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Facial Growth and Development
4 year old boy with jaw immobility Mother concerned about failure to thrive and ability to receive dental care Anterior open bite Etiology unknown
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Facial Growth and Development
7 year old boy Condylar neoplasm resected as infant (age 2) and recurrence treated age 4 Concerns about facial growth and development
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