BASIC CONCEPTS OF

GROWTH & DEVELOPMENT

Presented by
Dr. Sharmin Sultana
BDS, FCPS Part II Trainee
Dept of Orthodontics and Dentofacial
Orthopedics
Dhaka Dental College and Hospital
A thorough background in craniofacial growth and
development is necessary for every dentist. Scince
dentists and orthodontists are heavily involved in the
development of not just the dentition but the entire
dentofacial complex, a conscientious practitioner may
be able to manipulate facial growth for the benefit of
the patient.
SOME DEFINITIONS RELATED TO GROWTH
As is the nature of growth, where in the concepts keep changing with new
research findings, there has been no single definition associated with it.
Different researchers have defined growth in various ways-

 Growth refers to increase in size - Todd

 The self multiplication of living substance -JX Huxley.
 Increase in size, change in proportion and progressive complexity-
Krogman.
 Entire series of sequential anatomic and physiological changes taking
place from the beginning of prenatal life to senility -Meredith.
 Growth is the quantitative aspect of biologic development and is
measured in units of increase per units of time, for instance, inches per
year or grams per day -Moyers.
 Growth usually refers to an increase in size and number – Proffit
 Change in any morphological parameter which is measurable - Moss.
Some Definition Related to Development
 Development refers to all the naturally occurring unidirectional changes
in the life of an individual from its existence as a single cell to its
elaboration as a multi functional unit terminating in death - Moyers
 Development is a progress towards maturity – Todd
 Development connotes a maturational process involving
progressive differentiation at the cellular and tissue levels –
Enlow
Some Definition
 Differentiation:
Differentiation is the change from generalized cells or tissues to more
specialized kinds during development. Differentiation is change in quality
or kind.

 Translocation:
Translocation is change in position. The chin point is translocated (moved)
downward and forward far more than any growth at the chin itself. Indeed,
most of the growth is taking place at the condyle and ramus while the
entire mandible is translocated ventrally.

 Maturation:
The term maturation is sometimes used to express the qualitative changes
which occur with ripening or aging. We speak, for example, of the ripening
of the ovum and we think of pubescence as a period of rapid maturation
as well as accelerated physical growth.
METHODS OF STUDYING PHYSICAL GROWTH
The data collection for the evaluation of physical growth is done in two
ways:
1. Measurement approach: It is based on the techniques for measuring
living animals (including humans), with the implication that measurement
itself will do not harm and that the animal will be available for additional
measurements at another time.
2. Experimental approach: This approach uses experiments in which
growth is manipulated in some way. This implies that the subject will be
available for some detailed study that may be destructive. For this reason,
such experimental studies are restricted to non-human species.
Measurement Approaches:
1. Craniometry
2. Anthropometry
3. Cephalometric radiography
4. Three-Dimensional Imaging

1.Craniometry: The first of the measurement approaches for studying

growth, with which the science of physical anthropology began, is
craniometry, based on measurements of skulls found among human
skeletal remains. Craniometry was originally used to study the Neanderthal
and Cro-Magnon peoples whose skulls were found in European caves in the
eighteenth and nineteenth centuries. Craniometry has the advantage that
rather precise measurements can be made on dry skulls; it has the
important disadvantage for growth studies that, by necessity, all these
growth data must be cross-sectional. cross-sectional means that although
different ages are represented in the population, the same individual can
be measured at only one point in time.
2.Anthropometry : It is also possible to measure skeletal dimensions on
living individuals. In this technique, called anthropometry, various
landmarks established in studies of dry skulls are measured in living
individuals simply by using soft tissue points overlying these bony
landmarks. For example, it is possible to measure the length of the cranium
from a point at the bridge of the nose to a point at the greatest convexity of
the rear of the skull. This measurement can be made on either a dried skull
or a living individual, but results would be different because of the soft
tissue thickness overlying both landmarks. Although the soft tissue
introduces variation, anthropometry does make it possible to follow the
growth of an individual directly, making the same measurements repeatedly
at different times. This produces longitudinal data- repeated measures of
the same individual. In recent years, Farkas‘ anthropometric studies have
provided valuable new data for human facial proportions and their changes
over time.
3.Cephalometric Radiology: The third measurement technique,
cephalometric radiology, is of considerable importance not only in the study
of growth but also in clinical evaluation of orthodontic patients. The
technique depends on precisely orienting the head before making a
radiograph, with equally precise control of magnification. This approach can
combine the advantages of craniometry and anthropometry. The
introduction of radiographic cephalometrics in 1934 by Hofrath in Germany
and Broadbent in the United States provided both a research and a clinical
tool for the study of malocclusion and underlying skeletal disproportions. It
allows a direct measurement of bony skeletal dimensions, since the bone
can be seen through the soft tissue covering in a radiograph, but it also
allows the same individual to be followed over time. Growth studies are
done by superimposing a tracing or digital model of a later cephalogram on
an earlier one, so that the changes can be measure.
The disadvantage of a standard cephalometric radiograph is that it
produces a two-dimensional representation of a three-dimensional
structure, and so, even with precise head positioning, not all measurements
are possible.
4. Three-Dimensional Imaging : New information now is being
obtained with the application of three-dimensional imaging techniques.
Computed axial tomography (CAT or iust CT) allows 3-D reconstructions of
the cranium and face, and this method has been applied for several years to
plan surgical treatment for patients with facial deformities. Recently, cone
beam rather than spiral CT has been applied to facial scans, signiflcantly
reducing the radiation dose and allowing scans of patients with radiation
exposuret hat is much closer to the dose from cephalograms.
Superimposition of 3-D images is much more difficult than the
superimpositions used with 2-D cephalometric radiographs, but methods
developed recently are overcoming this difficulty. Magnetic resonance
imaging (MRI) also provides 3-D images that can be useful in studies of
growth, with the advantage that there is no radiation exposure with this
technique. This method already has been applied to analysis of the growth
changes produced by functional appliance.
Experimental approach:
1. Vital staining
2. Autoradiography
3. Radioisotopes
4. Implant radiography

1.Vital Staining
Vital staining, introduced first by John Hunter in the eighteenth century.
Here growth is studied by observing the pattern of stained mineralized
tissues after the injection of dyes into the animal. These dyes remain in the
bones and the teeth, and can be detected later after sacrificing the animal.
Alizarin was found to be the active agent and is still used for vital staining
studies. Such studies are however not possible in the humans. With the
development of radio isotropic tracers, it is now possible to replace alizarin.
The gamma emitting isotope 99m Tc can be used to detect areas of rapid
bone growth in humans but these images are more useful in diagnosis of
localized growth problems than for studying growth patterns.
2. Autoradiography
Autoradiography is a technique in which a film emulsion is placed over a
thin section of tissue containing radioactive isotope and then is exposed in
the dark by radiation. After the film is developed, the location of radiation
indicates where growth is occurring.

3. Radioisotopes
These elements when injected into tissues get incorporated in the
developing bone and act as in vivo markers and can then be located by
means of a Geiger counter, e.g. 99mTc,Ca-45 labeled component of
protein, e.g. proline.

4. Implant Radiography
Implant radiography, used extensively by Arne Bjork and co-workers, is one
of the techniques that can also be used in human subjects. Here in, inert
metal pins (generally made of titanium) are inserted anywhere in the bony
skeleton including face and jaws. These pins are biocompatible.
Superimposing radiographs (cephalograms in case of face) on the implants
allow precise observation of both changes in the position of one bone
relative to another and changes in external contour of the individual bone.
Growth: Pattern, Variability, Timing
In studies of growth and development, the concept of pattern is an important one. Pattern in
general terms indicates the proportionality of the given object in relation to its various sizes.
However, in the concept of growth, it refers not only to the proportionality at a point of time but
also to changes in this proportionality over a period of time. The fourth dimension "time" is of
immense importance here. This can be clearly understood in the following illustration (Fig. 2.1),
which depicts the change in overall body proportions over a period of time-from fetus to
adulthood. The figure illustrates the changes in overall body proportions that occurs during
normal growth and development. In fetal life, at about the third month of intrauterine
development, the head takes up almost 50 percent of the total body length. At this stage, the
cranium is large relative to the face and represents more than half the total head. In contrast,
the limbs are still rudimentary and the trunk is underdeveloped. By the time of birth, the trunk
and limbs have grown faster than the head and face, so that the proportion of the entire body
devoted to the head has decreased to about 30 percent. The overall pattern of growth thereafter
follows this course, with a progressive reduction of the relative size of the head to about 12
percent in the adult.
Growth: Pattern, Variability, Timing cont…..

All of these changes, which are a part of the normal growth pattern, reflect the
cephalocaudal gradient of growth (Table 2.1). This simply means that "there is an
axis of increased growth extending from the head toward the feet."

Table 2.1 Cephalocaudal gradient of growth

Cephalocaudal gradient of growth-Scammon’s: There is an axis of
increased growth extend ing from head towards the feet
• Tn fetal life, about the third month of intrauterine development (IUD), head
occupies 50 percent of the total body length and within the head the cranium is
large relative to tile face. The trunk and limbs are rudimentary
• At birth: head-39 percent of total body length , Legs-1/3rd of total body length
• ln adults: head-12 percent of total body length , Legs- 1/2 of the total body
length
Therefore, with growth, trunk and limbs grow faster than the head and face
Growth: Pattern, Variability, Timing cont…..
Another aspect of the normal growth pattern is that , not all the tissue systems of the body grow at
the same rate (Figure 2-2) and Table 2.2 Scammons has classically described the growth of
various tissues. Obviously, the muscular and skeletal elements grow faster than the brain and
central nervous system, as reflected in the relative decrease of head size. The overall pattern of
growth is a reflection of the growth of the various tissues making up the whole organism. To put it
differently, one reason for gradients of growth is that different tissue systems that grow at different
rates are concentrated in various parts of the body.

Table 2.2 differential Growth( scammons growth curve)

Different tissues in the body grow at different times and

different rates. Therefore, the amount of growth
accomplished at a particular age is variable. Scarnmon
divided the tissues in the body into:
a. Neural tissues
b. Lymphoid tissues
c. Somatic/general tissues (muscles, bone, viscera).
d. Genital tissues
• Neural tissues complete 90 percent of their growth by 6
years and 96 percent by 10 years of age
• Lymphoid tissues reach 100 percent adult size by 7
years: proliferate far beyond the adult size in late
childhood (200% by 14 years) and involute around the
onset of puberty
• Somatic tissues show an S-shape curve with definite
slowing of growth rate during childhood and acceleration
at puberty going on till age 20
• Growth of the genital tissues accelerate rapidly around
the onset of puberty.
Even within the head and face, the cephalocaudal growth gradient strongly affects
proportions and leads to changes in proportion with growth (Figure 2-3). When the
skull of a newborn infant is compared proportionally with that of an adult, it is easy to
see that the infant has a relatively much larger cranium and a much smaller face.This
change in proportionality, with an emphasis on growth of the face relative to the
cranium,is an important aspect of the pattern of facial growth. When the facial growth
pattern is viewed against the perspective of the cephalocaudal gradient, it is not
surprising that the mandible, being farther away from the brain, tends to grow more
and later than the maxilla, which is closer.

Figure 2-3
The second important concept in the study of growth and development is variability. It
indicates the degree of difference between two growing individuals in all four planes
of space including the all-important time. Since everyone is not alike in the way they
grow, it is clinically very difficult to decide and decipher the deviation of growth
pattern of an individual from the normal. One way to do this is to compare the growth
of a given child relative to person on a standard growth chart.
Although charts of such nature are commonly used for height and weight, the
growth of any part of the body can also be plotted this way. Such charts help us in
two ways.
1. To evaluate the present growth status of the individual, and
2. To follow the child's growth over a period of time using such charts.

A final major concept in physical growth and development is that of timing. All the
individuals do not grow at the same time or in other words possess a biologic clock
that is set differently for all individuals. This can be most aptly demonstrated by the
variation in timing of menarche (onset of menstruation) in girls. This also indicates
the arrival of sexual maturity. Similarly, some children grow rapidly and mature early
completing their growth quickly, thereby appearing on the high side of the
developmental charts until their growth ceases and their peer group begins to catch
up. Others grow and develop slowly and so appear to be behind even though in due
course of time they might catch up or even overtake others.
RHYTHM AND GROWTH SPURTS
Human growth is not a steady and uniform process of accretion in which all body
parts enlarge at the same rate and same increment per year. The rate of growth
is most rapid at the beginning of cellular differentiation, increases until birth and
decreases thereafter, e.g. in the prenatal period height increases 5000 times
from stage of ovum to birth whereas in the postnatal period increase is only 3 fold.
Similarly weight increases 6.5 billion fold from stage of ovum to birth whereas in the
postnatal period increase is only 20 fold. Postnatally growth does not occur in a
steady manner. There are periods of sudden rapid increases, which are termed as
growth spurts. Mainly 3 spurts are seen:

Name of spurt Female Male

1. Infantile/childhood growth spurt 3 yrs 3 yrs
2. Mixed dentition/Juvenile growth spurt 6-7 yrs 7-9 yrs
3. Prepubertal/adolescent growth spurt 11-12 yrs 14-15 yrs

CLINICAL SIGNIFICANCE OF THE GROWTH SPURTS

• To differentiate whether growth changes are normal or abnormal.
• Treatment of skeletal discrepancies (e.g. Class Ii) is more advantageous if carried out in the
mixed dentition period, especially during the growth spurt.
• Pubertal growth spurt offers the best time for majority of cases in terms of predictability,
treatment direction, management and treatment time.
• Orthognathic surgery should be carried out after growth ceases.
• Arch expansion is carried out during the maximum growth period.
VARIABLES AFFECTING PHYSICAL GROWTH
Variability may be seen in the rate, timing, or character of growth as well as the
achieved or ultimate size.
1. Heredity
There is genetic control of the size of parts to a great extent of the rate of growth,
and of the onset of growth events, for example, menarche, dental classification, the
eruption of teeth, ossification of bones, and the start of the adolescent growth spurt.
Not all the genes are active at birth. Some only express themselves in the
surroundings made possible by the physiologic growth of later years; such effects are
called "age limited." An important point for orthodontics: there is a considerable
degree of independence between growth before and growth during adolescence.

2. Nutrition
Malnutrition delays growth and may affect size of parts, body proportions, body
chemistry, and the quality and texture of some tissues (e.g., teeth and bones).
Malnutrition may also delay growth and the adolescent growth spurt, but children
have fine recuperative powers provided the adverse conditions have not been too
extreme. During rather short periods of malnutrition growth slows up and waits for
better times. With the return of good nutrition growth takes place unusually fast until
the genetically determined curve is neared once more and subsequently followed.
Though "catchup growth" is seen in both sexes, girls seem to be better buffered
against the effects of malnutrition and illness.
3. Illness
Systemic disease has an effect on child growth, but the plasticity of the
human organism during growth is so great that the clinician must
differentiate between minor illnesses and major illnesses. The usual minor
childhood illnesses ordinarily cannot be shown to have much effect on
physical growth. On the other hand, serious prolonged and debilitating
illnesses have a marked effect on growth. The pediatrician is concerned not
only with the diseases that may kill or maim the child but also with those
that affect the growth process as well.

4. Race
Anthropologists studying the racial aspects of growth have a problem in the
definition of race. Some so-called racial differences are clearly due to
climatic, nutritional, or socioeconomic differences. However, gene pool
differences account for the fact that North American blacks are ahead of
whites in skeletal maturity at birth and for at least the first 2 years of life.
This progress is associated with advanced motor behavior and earlier ability
to crawl and sit up. North American blacks also calcify and erupt their teeth
about 1 year earlier than whites.
5. Climate and Seasonal Effects on Growth
There is a general tendency for those living in cold climates to have a greater
proportion of adipose tissue, and much has been made of the skeletal variations
associated with variations in climate. There are seasonal variations in the growth
rates of children and in the weights of newborn babies. Contrary to popular belief,
climate has little direct effect on rate of growth.

6. Adult Physique
There are correlations between the adult physique and earlier development events.
For example, tall women tend to mature later and there are variations in the rate of
growth associated with differing somatotypes.

7. Socioeconomic Factors
Socioeconomic aspects obviously include some growth factors mentioned previously
(e.g., nutrition); yet, there are discrete differences. Children living in favorable
socioeconomic conditions tend to be larger, display different types of growth (e. g.,
height weight ratios), and show variation in the timing of growth, when compared with
disadvantaged children. Some of the causes of these differences are obvious and
some of the implications are puzzling.
8. Exercise
A strong case for the effects of exercise on linear growth has not been made in a
quantitative fashion. Although exercise may be useful for the development of motor
skills, for increase in the muscle mass, for fitness, and for general well-being, those
children who exercise strenuously and regularly have not been shown to grow more
favorably.

9. Family Size and Birth Order

There are differences in the sizes of individuals, in their maturational levels of
achievement, and in their intelligence that can be correlated with the size of the
family from which they came. First-born children tend to weigh less at birth and
ultimately achieve less stature and a higher I.Q.

10. Secular Trends

Size and maturational changes in large populations can be shown to be occurring
with time that, as yet, have not been well explained. Fifteen-year-old boys are
approximately 5 inches taller than l5-year-old boys were 50 years ago. The average
age at onset of menarche has steadily become earlier throughout the entire world.
Both of these facts seem to be true when race, socioeconomic level, nutrition,
climate, and other differences have been carefully controlled in the samples. Such
changes are called secular trends in growth and, although thoroughly and
meticulously studied, have yielded no really satisfactory and generally accepted
explanation for such interesting findings.
11. Psychological Disturbance
It has been shown that children experiencing stressful conditions display an inhibition
of growth hormone. When the emotional stress is removed they begin again to
secrete growth hormone normally, and "catch-up" growth is seen.

Hypotheses of Craniofacial Growth

Through the years, a number of hypotheses of craniofacial development have been
formulated which are often encountered in textbooks and the periodical literature,
where they are sometimes called "theories." Theory requires a basis of sound
evidence; while hypothesis is thoughtful conjecture of the meaning of incomplete
evidence.
1. Genetic Theory
2. Sutural Dominance Theory (Sicher’s Hypothesis)
3. Scott's Hypothesis (Nasal Septum)
4. Moss' Hypothesis (Functional Matrix Hypothesis)
5. Petrovic's Hypothesis (Servosystem)
Sicher's Hypothesis (Sutural Dominance)
Sicher deduced from the many studies using vital dyes that the sutures were causing
most of the growth; in fact, he said" the primary event in sutural growth is the
proliferation of the connective tissue between the two bones. If the sutural connective
tissue proliferates it creates the space for oppositional growth at the borders of the
two bones." Replacement of the proliferating connective tissue was necessary for
functional maintenance of the bones. He felt that the connective tissue in sutures of
both the nasomaxillary complex and vault produced forces which separated the
bones, just as the synchondroses expanded the cranial base and the epiphyseal
plates lengthened long bones. Sicher‘ viewed the cartilage of the mandible
somewhat differently, stating that it grew both interstitially, as epiphyseal plates, and
appositionally, as bone grows under periosteum. His ideas came to be called the
"sutural dominance theory," but it would seem he held sutures, cartilage, and
periosteum all responsible for facial growth and assumed all were under tight intrinsic
genetic control.
Scott's Hypothesis (Nasal Septum)
Scott,85-87noting the prenatal importance of cartilaginous portions of the head, nasal
capsule, mandible, and cranial base, and feeling that this development was under
intrinsic genetic control, held that they continued to dominate facial growth
postnatally. He specifically emphasized how the cartilage of the nasal septum during
its growth paced the growth of the maxilla. He claimed that growth in the sutures was
secondary and entirely dependent on the growth of the cartilage and adjacent soft
tissues. Scotts hypothesis could explain the coordinated growth that had been
observed within the skull, and between the skull and the soft tissues. He introduced
the concept of cartilaginous 'growth centers'. The role of these growth centers was
explained in a contemporary summary of craniofacial skeletal growth (Scott 1955).
Several of Scott's basic tenets still hold credibility for researchers in the field of
growth. Van Limborgh supported the view that synchondroses of craniaI base have
some degree of intrinsic control. However, he felt that the periosteum should also be
considered as a secondary growth site because of its similarity to the suture.
Functional Matrix Theory of Growth
Melvin Moss introduced the functional matrix hypothesis in 1960. His theory holds
that neither the cartilage of the mandibular condyle nor the nasal septurn cartilage is
a deterrninant of jaw growth. Instead, he theorizes that growth of the face occurs as
a response to functional needs and neurotrophic influences and is mediated by the
softt issue in which the jaws are embedded. In this conceptual view, the soft tissue
grow, and both bone and cartilage react.
Melvin moss was inspired by the ideas of Van der Klaauw (1952) that 'bones'
were in reality, composed of several 'functional cranial components' the size, shape
and position of which were relatively independent of each other.

The original version of the functional matrix hypothesis held that: the head is a
composite structure, operationally consisting of a number of relatively independent
functions; digestion, respiration, vision, olfaction, audition, equilibrium, speech,
neural integration, etc. Each function is carried out by a group of soft tissues which
are supported and/ or protected by related skeletal elements. Taken together, the soft
tissues and skeletal elements related to a single function are termed a functional
cranial component. The totality of all the skeletal elements associated with a single
function is termed a skeletal unit. The totality of the soft tissues associated with a
single function is termed as the functional matrix.
The growh of the cranium illustrates that, Pressure exerted by the growing brain
separates the cranial bones at the sutures, and new bone passively fills in at these
sites so that the brain case fits the brain. This phenomenon can be seen readily in
humans in two experiments of nature. First, when the brain is very small, the cranium
is also very small, and the condition of microcephaly results. In this case,the size of
the head is an accurate representation of the size of the brain. A second natural
experiment is the condition called hydrocephaly. In this case reabsorption of
cerebrospinal fluid is impeded, the fluid accumulates ,and intracranial pressure
builds up. The increased intracranial pressure impedes development of the brain, so
the hydrocephalic may have a small brain and be mentally retarded; but this
condition also leads to an enormous growth of the cranial vault. Uncontrolled
hydrocephaly may lead to a cranium two or three times its normal size, with
enormously enlarged frontal, parietal, and occipital bones. This is perhaps the
clearest example of a "functional matrix" in operation. Another excellent example is
the relationship between the size of the eye and the size of the orbit. An enlarged
eye or a small eye will cause a corresponding change in the size of the orbital cavity.
In this instance, the eye is the functional matrix.
Moss theorizes that the major determinant of growth of the maxilla and mandible is
the enlargement of the nasal and oral cavities, which grow in response to functional
needs. The theory does not make it clear how functional needs are transmitted to the
tissues around the mouth and nose, but it does predict that the cartilages of the nasal
septum and mandibular condyles are not important determinants of growth, and that
their loss would have little effect on growth if proper function could be obtained. From
the view of this theory, however, absence of normal function would have wide-
ranging effects.

It has been known for many years that mandibular growth is greatly impaired by
an ankylosis, defined as a fusion across the joint so that motion is prevented or
extremely limited. Mandibular ankylosis can develop in a number of ways. For
instance, one possible cause is a severe infection in the area of the
temporomandibular joint, leading to destruction of tissues and ultimate scarring.
Another cause, of course, is trauma, which can result in a growth deficiency if there
is enough soft tissue injury to lead to severe scarring as the injury heals. It appears
that the mechanical restriction caused by scar tissue in the vicinity of the
temporomandibular joint impedes translation of the mandible as the adjacent soft
tissues grow, and that this is the reason for growth deficiency in some children after
condylar fractures.
It is interesting, and potentially quite significant clinically, that under some
circumstances bone can be induced to grow at surgically created sites by the method
called distraction osteogenesis.The Russian surgeon Alizarov discovered in the
1950s that if cuts were made through the cortex of a long bone of the limbs, the arm
or leg then could be lengthened by tension to separate the bony segments. Current
research shows that the best results are obtained if this type of distraction starts after
a few days of initial healing and callus formation.

In summary, it appears that growth of the cranium occurs almost entirely in response
to growth of the brain. Growth of the cranial base is primarily the result of
endochondral growth and bony replacement at the synchondroses' which have
independent growth potential but perhaps are influenced by the growth of the brain.
Growth of the maxilla and its associated structures occurs from a combination of
growth at sutures and direct remodeling of the surfaces of the bone. The maxilla is
translated downward and forward as the face grows, and new bone fills in at the
sutures. The extent to which growth of cartilage of the nasal septum leads to
translation of the maxilla remains unknown, but both the surrounding soft tissues
and this cartilage probably contribute to the forward repositioning of the maxilla.
Growth of the mandible occurs by both endochondral proliferation at the condyle and
apposition and resorption of bone at surfaces. It seems clear that the mandible is
translated in space by the growth of muscles and other adjacent soft tissues and
that addition of new bone at the condyle is in response to the soft tissue changes.
Q. Functional matrix theory of growth -july 2007, jan 2011,

Reference
1. W.R.Proffit 27-58 pagr.
2. Robert E. Moyers 6-16 page, 42-50 pages.
3. Gurkeerat Singh 7-17 pages.
বসন্তে ভান্ত াবাসায় , ভাষা সসনিক দের স্মরন্তে,
অজস্র ফুন্ত র শুন্তভচ্ছা...

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