Development of the Face Oral Histology Ass. Prof. Dr/ Baleegh A.

Alkadasi
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Development of the Face

-The development of the face occurs mainly between 4 – 8 weeks I.U.L.

A- Early in the 4th week, five primordial swellings consisting primarily of neural crest-
derived mesenchyme appear around the stomodeum and play an important role in the
development of face.

-The 5 primordia (process) include:

- 1 frontonasal prominence ventral to the

forebrain.

- 2 maxillary prominences develop from the

cranial part of first pharyngeal arch.

- 2 mandibular prominences develop from the caudal part of first pharyngeal arch.

B- By the end of 4th week, bilateral oval-shaped ectodermal thickenings called ‘nasal
placodes’ appear on each side of the lower part of the frontonasal prominence.

- Nasal placodes are primordia of the nose and nasal cavities.

C- Mesenchymal cells proliferate at the margin of the placodes and produce horse-shoe
shaped swellings around these.

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Development of the Face Oral Histology Ass. Prof. Dr/ Baleegh A. Alkadasi
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-The sides of these swellings are called ‘medial’

and ‘lateral’ nasal prominences

-The placodes now lie in the floor of a depression

called ‘nasal pits’

-Each lateral nasal prominence is separated from

the maxillary swelling by nasolacrimal groove.

D- The maxillary prominences continue to

increase in size and:

*Laterally, merge with the mandibular

prominences to form the cheek

*Medially, compress the medial nasal

prominences toward the midline and finally fuses
with these to form the upper lip.

The upper lip is formed by the two medial nasal prominences & the two maxillary
prominences

E- The medial nasal swellings enlarge, grow

medially and merge with each other in the midline to
form the intermaxillary segment.

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Development of the Face Oral Histology Ass. Prof. Dr/ Baleegh A. Alkadasi
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Intermaxillary Segment:

Gives rise to the:

1- Philtrum of lip (median part of the upper lip).

2- Premaxillary part of the maxilla, that bears the
upper 4 incisors and the associated gums
3- Primary palate (region of hard palate just
posterior to the upper incisors)

F-The mesenchyme from the 1st & 2nd pairs of

pharyngeal arches invade the facial prominences and
give rise to the muscles of mastication and muscles
of facial expression respectively.

Derivatives of Facial Components:

1*The frontonasal prominence forms the:

-Forehead and the bridge of the nose

-Frontal and nasal bones

2*The maxillary prominences form the:

-Upper cheek regions and most of the upper lip

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Development of the Face Oral Histology Ass. Prof. Dr/ Baleegh A. Alkadasi
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-Maxilla, zygomatic bone, secondary palate

3* The mandibular prominences fuse and form the:

- Chin, lower lip, and lower cheek regions

- Mandible

4* The lateral nasal prominences form the:

-alae of the nose

5* The medial nasal prominences fuse and form the intermaxillary segment

Development of Palate (Palatogenesis)

-Begins at the end of the 5th week. Gets completed by the end of the 12th week.

-The most critical period for the development of palate is from the end of 6th week to
the beginning of 9th week.

-The palate develops from two stages:

 Primary palate

 Secondary palate

1-The Primary Palate:

- Begins to develop early in the 6th
week from the deep part of the
intermaxillary segment, as
median palatine process.

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Development of the Face Oral Histology Ass. Prof. Dr/ Baleegh A. Alkadasi
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- Initially this segment is formed by merging of the medial nasal prominences (2

Medial nasal prominences intermaxillary segment -primary palate).
- Lies behind the premaxillary part of the maxilla.
- Fuses with the developing secondary palate

2) Secondary palate:
-The secondary palate is the primordium of the hard and soft
palate.

1- It begins to develop early in the sixth week from two

mesenchymal projections that extend from the internal
aspects of the maxillary prominences

2- Initially the lateral palatine processes or palatal shelves

project inferomedially on each side of the developing
tongue.

3- With the development of the jaws, the tongue moves

inferiorly.

4-During 7th & 8th weeks, the lateral palatine processes

elongate and ascend to a horizontal position above the
tongue.

5-Gradually the lateral palatine processes grow medially and

fuse in the median plane and fuse with the Posterior part of
the primary palate & nasal septum.

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Development of the Face Oral Histology Ass. Prof. Dr/ Baleegh A. Alkadasi
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**Fusion with the nasal septum begins anteriorly during 9th week, extends posteriorly and
is completed by 12th week

**Bone develops in the anterior part to form the hard palate. The posterior part develops
as muscular soft palate.

Development of the nose

At the 5th week IUL , the 2 nasal placodes develop on the lower part of the front nasal
processes , "mesenchymal" proliferation occurs producing the medial and lateral nasal
processes , which form a horse – shoe shape which transform nasal placodes into nasal pits
(nostrils) at the 6th week IUL.

The medial nasal process is that part medial to the pit and the lateral nasal processes , is
that tissue in close contact to the maxillary process .

The two medial nasal processes develops to:

1- The center and tip of the nose.

2- The inward growth gives the nasal septum.

The two lateral nasal processes forms the lateral sides of the nose.

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Development of the Face Oral Histology Ass. Prof. Dr/ Baleegh A. Alkadasi
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Nasolacrimal groove

It separates the lateral nasal processes from maxillary processes.

The Nasolacrimal duct develops from a rod-like thickening of the ectoderm in the floor
of the nasolacrimal groove. This solid cord of cells separates from the surface ectoderm
and lies in the underlying mesenchyme .The cord gets canalized to form the nasolacrimal
duct

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Development of the Face Oral Histology Ass. Prof. Dr/ Baleegh A. Alkadasi
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Development of the tongue

- The tongue begins to appear at about 4 week IUL in the floor of the stomodeum.

-The tongue is composed of 2 parts:

1) Anterior 2/3, the body of the tongue.

2) Posterior 1/3, the base.

- The two parts separated by shallow groove or median sulcus in the body as a V- shape
sulcus called terminal sulcus.

1. Anterior 2\3 (body of the tongue ) is developed from the first bronchial arch by 2
lateral lingual swellings and 1 median tuberculun impar .

-These lateral lingual swellings quickly enlarge and merge with each other and overgrow
the tuberculum impare to form the mucous membrane of the anterior 2\3.

2- The base of the tongue is developed from midline swellings of The 2 nd , 3 rd and 4 th

branchial arches .

-The second arch gives copula.

- The 3 rd and 4 th arches give hypo-branchial eminence.

- The hypo-branchial eminence over grows the copula which disappears.

- The tongue separates from the floor of the mouth and gives the tongue mobility except in
the anterior part where lingual frenum still attach the tongue to the floor of the mouth)

- The muscles of the tongue arise from the occipital somites which have migrated forward
into the tongue area, carrying with them their nerve supply the 12th cranial nerve
(hypoglossal) nerve.

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Development of the Face Oral Histology Ass. Prof. Dr/ Baleegh A. Alkadasi
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• - The dorsum of the tongue bears

papillae:

1- Circumvallate papilla- 2-5

months
2- Fungiform - 11 weeks
3- Filliform – after birth

• Gustatory(taste) cells starts 7th

week

• All taste bud present at birth

except- taste bud
(circumvallate papilla)

Innervation of the tongue:-

Anterior 2\3:

- General sensation: Lingual nerve branch of mandibular n. which is branch of trigeminal

n.

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- Special sensation (taste sensation): chorda tympani of the facial nerve.

Posterior 1\3: is innervated by glassopharyngeal n. (9th cranial n.) for general and taste
sensation.

-Hypoglossal n.: supplies the muscles. (Motor nerve)

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Development of the Face Oral Histology Ass. Prof. Dr/ Baleegh A. Alkadasi
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Developmental Anomalies related to Face & Palate

Facial clefts:
Failure of the embryonic facial prominences to fuse properly.

-May be unilateral or bilateral

-May involve:

*Lips only: Cleft lip

*Palate only: Cleft palate

*Lip & palate: Cleft lip & palate

*Region of nasolacrimal groove: Facial clefts

1) Cleft lip:-

- Unilateral C.L

- Bilateral C.L

- Median cleft lip.

Clefts vary from another to a cleft extending into the floor of the nostrils results from failure
of fusion of maxillary process with the median nasal process on one side (unilateral), on
the both sides (bilateral)

Median cleft (hare lip) results from failure of merging of the two median nasal processes.

processes.

2) Cleft palate: -

- Cleft of primary palate.

- Cleft of secondary palate

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Development of the Face Oral Histology Ass. Prof. Dr/ Baleegh A. Alkadasi
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- Cleft of both primary and secondary.

1- Cleft of primary palate results from failure of the lateral palatine processes to fuse
withthe primary palate.

2- Cleft of the secondary palate, posterior to the incisive foramen, results from failure of
the lateral palatine processes to meet fuse and merge with each other and with nasal septum.

Since fusion of 2nd palate extend posteriorly the degree of the cleft may vary from the
results from the simplest form or “bifid uvula” to complete cleft involving both hard and
soft palate.

3- Cleft of both 1ry and 2ry palate:

Results from failure of fusion between the three palatine processes and with nasal septum

-Cleft of the palate problems is according to the extends of the cleft.

-A bified Uvula causes no discomfort.

Gnathochisis- failure of central fusion of mandibular prominences

Micrognathia-underdevelopment of lower jaw, incorrect positioning of ear.

Agnathia- total lack of development of lower jaw & incorrect positioning of ear.

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Development of the Face Oral Histology Ass. Prof. Dr/ Baleegh A. Alkadasi
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Failure of maxillary prominence to fuse with median nasal prominence results in unilateral
or bilateral cleft palate.

4-Developmental anomalies of the tongue.

-Ankyloglossia (tongue tie)
The tip of the tongure remains tied to the floor of the mouth.
-Macroglossia (large tongue)
In mangolism
-Bified tongue :
failure of merging of the 2 lateral lingual swellings.
-Median rhomboidal glassitis (central papillary atrophy) : due to failure of the lateral
lingual swellings to overgrow the tuberculum impar.

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Development of the Face Oral Histology Ass. Prof. Dr/ Baleegh A. Alkadasi
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Causes of congenital Malformation

(l) Hereditary causes.

(ll) Environmental causes.

I) Hereditary:

they may be due to (chromosomal – Genetic abnormalities)

a. Chromosomal causes:

* An increased number in one or more chromosome is teratogenic and result in a condition

known as '' Trisomy 21'' or Down's syndrome ( Mongolism ) . This malformation is

characterized

by :

1- Mental retardation

2- Flat nasal bridge

3- Fissured protruding tongue

4- Macroglossia (enlarged tongue)

5- Delayed tooth eruption

b. Genetic causes:

They are due to a disturbance in migration and distribution of the neural crest cells, so it
leades to a condition known as ''mandibalofacial dysostosis '' or Treacher Collins syndrome
which is characterized by:

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Development of the Face Oral Histology Ass. Prof. Dr/ Baleegh A. Alkadasi
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- Underdeveloped face

-Dentinogenesis imperfects (defect in dentin formation)

II) Environmeutal causes:

1- Infectious agents: viral infection (e-g. Rubella virus w causes German measles).

It leads to cleft palate and malformed teeth.

2- Radiation: The direct effect of x-ray on embryo may cause cleft palate (Should be
avoided during pregnancy)

3- Drugs:

- Thalidomides which are known to be self hypnotic cause partial or total absence of limbs)

- Tetracylins taken during 2nd or 3rd month of pregnancy cause permanent brownish
discoloration and hypoplasia of enamel.

- Chloropromazine (longacting antiemetic) may cause hypocalcification of teeth

&skeleton

4- Hormones: their action is not definite however, cortisone was to cause cleft lip and
palate in some escprimental animals.

5- Nutritional disorders, it is not considerd as teratogenic agent in human. However vitA

defeciency or hypervitaminosis is teratogenic in animals vit C ,D may cause in human

malformations.

6- Smoking, Alcohol and caffeine:

Heavy smoking mother has a higher incidence of cleft lip and palate of their infants.
Alcohol taking during pregnancy Leads to:

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Development of the Face Oral Histology Ass. Prof. Dr/ Baleegh A. Alkadasi
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(1) Mental retardation

(2) Growth deficiency

(3) Maxillary hypoplasia.

Also, caffeine may cause developmental defects.

Note :

* The embryonic period (2w - 8w ) is the most critical period because during this period ,
the differentiation of the major organs and systems take place.

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