Growth and

Development
Theories
Growth site versus growth centre
BAUME:
Growth Centre- site of endochondral ossification with
tissue-separating force, contributing to the increase of
skeletal mass.
i.e. location at which independent (genetically
controlled) growth occurs.
Growth site: regions of periosteal or sutural bone
formation and modeling resorption adaptive to
environmental influences.
i.e. merely location at which growth occurs.
GENETIC theory
 This theory simply states that all growth is controlled
by genetic influence and is preplanned.
Sutural dominance theory
 SICHER – studies using vital dyes – sutures caused
much of growth
 “….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.”
 Connective tissue in sutures of nasomaxillary
complex & vault – separated bones like
synchondrosis & epiphyseal plate
Evidence against sutural theory
1. Subcutaneous autotransplants of the
zygomaticomaxillary suture area in the guinea pig
have not been found to grow – lack of innate growth
potential.
2. Growth of sutures – respond to external stimuli.
3. Extirpation of facial sutures - no appreciable effect on
growth of the skeleton.
4. Shape of sutures - depends on functional stimuli
5. Closure of sutures -extrinsically determined.
6. Sites of sutures - not predetermined .
CONCLUSION:
 Sutures are growth sites not centres.
 Adaptive, compensatory or secondary growth.
Cartilaginous theory
SCOTT’S HYPOTHESIS:
 Intrinsic growth-controlling factors in cartilage &
periosteum.
 Sutures are secondary & dependent on extrasutural
influences.
 Cartilaginous part of skull must be recognised as
primary centres of growth, with nasal septum being a
major contributor in maxillary growth, per se.
 Sutural growth – responsive to synchondrosis
proliferation & local environmental factors.
Cranial base synchondroses

 Removal of spheno-occipital synchondrosis - results in

an arrest of growth in length of the cranial base .
 Pressure & tension – little effect on cartilage.
 Intramembranous bone- immediate response.
 Endochondral ossification at the synchondroses-
only a response to external stimuli?
 Cartilage- lacks same amount of independent growth
potential as transplants of epiphyseal cartilage under
similar experimental conditions.
 Spheno-occipital synchondrosis appears to close
much earlier than is usually stated in the textbooks -
11 to 16 years of age
Nasal septal cartilage
 Scott- primary cartilage in nasal septum – primary
mechanism for growth of nasomaxillary complex.
 Experimental excision of the nasal septum affects the growth
of the upper face considerably - due to trauma.
 Nasal septum - central support for the upper facial area, and
its loss results in a predictable collapse in the area.
 Arrhinencephalic 9-month-old child (with the septum
missing) - resorption and apposition processes in the
bony palate normal.
 Height of the upper face not greatly affected,
although the sagittal development of the middle third
of the face was retarded
 In recent experiments – growth as well in culture as
epiphyseal plate cartilage.
Condylar cartilage
 Growth of the condylar cartilage is responsible for the
anteroposterior growth of the mandible- primary growth
centre.
 Scott- growth of the condylar cartilage enables the condyle "to
grow upwards and backwards so as to maintain the contact at
the temporomandibular joint as the mandible is carried
downwards and forwards by the growth of the upper facial
skeleton."
 If the condylar cartilage is transplanted to a relatively
nonfunctional site, such as the subcutaneous or brain tissue, it
does not maintain its structure and does not behave like the
condylar cartilage in situ.
 Bilateral condylectomy, congenital absence of the rami- no
appreciable effect on the growth of the rest of the mandible in
humans.
FUNCTIONAL
MATRIX
HYPOTHESIS
INTRODUCTION
 Given by MELVIN MOSS
 Worked on the concept put by VAN DER KLAUVW
–FUNCTIONAL CRANIAL COMPONENT
 Carried out various lab studies and experiments
 THE ORIGIN,GROWTH AND MAINTENANCE
OF ALL SKELETAL TISSUES AND ORGANS ARE
ALWAYS SECONDARY,COMPENSATORY AND
OBLIGATORY TO TEMPORALLY AND
OPERATIONAL PRIOR EVENTS OR PROCESSES
THAT OCCUR IN SPECIFICALLY RELATED
NON-SKELETAL TISSUES,ORGANS OR
FUNCTIONAL SPACES
 MOSS said that head and neck region consist of
number of functions

1.Digestion
2.Respiration
3.Speech
4.Olfaction
5.Balance
6.Vision
 Each of these function is completely carried out by
FUNCTIONAL CRANIAL COMPONENT
Each functional cranial component consists of all the
tissues ,organs,spaces and skeletal parts necessary to
carry out a given function.
The functional cranial component is divided into
1.functional matrix
2.skeletal unit.
Skeletal unit
 Composed of –bone, cartilage and tendinous tissue

MACROSKELETAL UNIT-
adjoining portions of number of neighbouring bones
carrying out a single function
eg-endocrainal surface of calvaria
Macro skeletal unit
 MICROSKELETAL UNIT
bones consisting of number of small skeletal units
MAXILLA-orbital
-pneumatic
-palatal
-basal
MANDIBLE-coronoid
-angular
-alveolar
-basal
FUNCTIONAL MATRICES
 This consist of soft tissue-
muscle,gland,nerve,vessels,fat and teeth as well as
non skeletal cartilages
DIVIDE INTO TWO TYPES-
 Periosteal matrices
 Capsular matrices
PERIOSTEAL MATRICES
 All non skeletal functional units adjacent to skeletal unit form
the periostel matrices
 They act by bringing transformation of the related skeletal
units
 Best explanation – coronoid process and temporalis muscle
 Removal,denervation,postinfectively-
decrease in the size or total disappearance
 Functional hypertrophy/hyperactivity-

increase in size and change in shape

 Hence in simple terms it can be stated-
Coronoid process does not grow itself first and thus
provide a platform upon which the temporalis muscle
can alter its function but it is the opposite which is
true
CAPSULAR MATRICES
FOUR CAPSULES ARE PRESENT-
• NEURO CRANIAL
• ORO FACIAL
• OTIC
• ORBITAL
 Each of these capsules is an envelop containing
functional cranial component
 Sandwitched between two covering layers
 Capsules expands due to volumetric increase of
capsular matrix
 This results in the translative movement of the
embedded bones
 NEUROCRAINAL CAPSULE
 Sandwiched between-skin and dura mater
 Consists of-5 layers of scalp

-bone
-two layer dura mater
TWO IMPORTANT POINTS
1.Volume of the neural mass is important whether or not
it contains “normal” amount brain tissue.
2.Expansion of this closed capsular matrix volume is
primary event in expansion of the capsule.
 The volumetric increase cause compensatory
expansion of surrounding capsule which is brought
about by mitotic activity.
 Later the calvarial functional cranial component as a
whole are passively and secondarily translated
 In hydrocephaly-passive,nonperiosteal translative
growth is produced.
 ORO FACIAL MATRIX
 Surround and protect oronasopharyngeal space.
 Surrounded by skin and mucous membrane on either
side.
 Originates by process of enclosure.
 Volumetric growth of these spaces is the primary
morphogenetic event in facial skull growth
Orofacial Capsule
 Primary function is maintaining airway this is
accomplished by “AIRWAY MAINTENANCE
SYSTEM”
 Growth of functional spaces-increase in the size of
capsule
 Followed by passive movement of functional cranial
component
 Cybernetic Theory
of
Craniofacial Growth-
PETROVIC 1977
Cybernetics Transfer of Information

•
Input Process Output

Cybernetic
Input Output
System
Transfer Function
 Regulation Type of Closed Loop

Input is constant
Any change of the input will initiate a “regulatory
process”

Input Comparator Transfer function

Regulation of input
 The Face as a Servosystem

Release of Hormones Position of Maxillary

Hormones (Command) Dental arch (Ref Input)

LPM & RDP Growth at condyle OCCLUSION

(Comparator)
(Coupling system) (Controlled System) Output
Periodontium,
Actuating Teeth
signal
Musculature
Actuator (Motor Cortex) Joint

Brain Mastication
(sensory engram) Deviation Signal (Performance)
 Components of a Servosystem

Reference Input Elements

COMMAND Reference Input

Actuator, Coupling System, COMPARATOR

Controlled System Output
(Controlled Variable) Performance
Analyzing
Elements

Central Comparator Performance

(sensory engram) Deviation Signal
 The Face as a Servosystem

Input – Maxillary dental arch

Output – Adjustment of the position of mandibular

dental arch
 Relationship Between Lateral Pterygoid,
Retrodiscal Pad and Condyle

MENISCUS
LPM
RDP
Methods of gathering growth data.

1. Longitudinal studies .
2. Cross sectional studies.
3. Semi-longitudinal studies.
1. LONGITUDINAL STUDIES
• Measurements made of the same person or group over a long
period of time.
• Long term studies – same sample studied by follow-up

Advantages:
1. Developmental pattern of individual studied and compared
2. Variation in development among individuals within sample
can be studied
Disadvantages:
1. Long periods of time – years , decades
2. Data storage and personnel required for long time
3. Expensive
4. Attrition – sample size reduction, unforeseen problems
5. Cannot be repeated for verification in same sample
2. CROSS-SECTIONAL STUDIES

 Different samples studied at different points in time.

Advantages:
1. Short duration
2. Less expensive, since completed fast
3. Large samples possible
4. Possible to repeat study
Disadvantages:
1. Cross sectional group averages tend to obscure individual
variations.
3. SEMI-LONGITUDINAL
STUDIES
Combo of longitudinal and cross-sectional – advantages of both
TYPES OF GROWTH DATA

1. DIRECT – measurement of living or cadavers by scales,

tapes, callipers

2. INDIRECT - measurement of photos, radiographs, casts

3. DERIVED – data derived after comparing two

measurements
METHODS OF COLLECTING
GROWTH
1. OPINION – crudest
DATA
- opinion / guess of experienced person
- not scientific, needs verification
2. OBSERVATIONS
3. RATINGS & RANKINGS –
Assigning numerical value for quantification of data
Rating – use of standard scales for classification
Ranking – assign rank to data based on value
4. MEASUREMENTS
 METHODS OF STUDYING
GROWTH
m easurem ent approaches. experim ental approaches.

craniom etry. at m icroscopic level. at m acroscopic level. at both levels.

anthropom etry. m ineralised sections. im plant m arkers vital staining.

cephalom etry. m icroradiography. finite elem ent m odeling. com parative anatom y.

fluorescent labels. natural m arkers.

polarised light.

radioisotopes.

nuclear volum e m orphom etry.

autoradiography.
 1. CRANIOMETRY

 Measurement of human skulls

 Information of races, extinct
population, growth pattern

Advantages: Precise measurement

Disadvantages: Data is cross-sectional

 2. ANTHROPOMETRY
 Measurements using soft tissue
points overlying bony landmarks in
living individuals.

Advantages : Follow growth of

individual
Disadvantages:
a. Underlying structures cannot be
studied
b. Soft-tissue – highly variable
 3. CEPHALOMETRIC
RADIOGRAPHY

Advantages :
a. Hard-tissue + underlying soft-tissue measurement
b. Longitudinal follow-up
Disadvantages:
1. Radiation exposure
2. Expensive equipment
3. Magnification
4. 2D representation of 3D structures

 HAND-WRIST RADIOGRAPHY
4. BIMETRIC TESTS

 Physical characteristics – weight, height, skeletal maturation,

ossification – measured and compared with standards
1. VITAL STAINING

 Belchier (1936) – animals eating madder plants – bones

stained red
 Dye Alizarin – bone research
 Administer dye to animal, sacrifice after time, gets
incorporated in bone.
 Sites, pattern, rate, amount, direction of bone deposition
 Alizarin red 5, Tetracycline, Lead acetate
2. RADIO-ISOTOPES

 Radioactive isotopes injected – incorporated in developing

bone
 In vivo markers – detected by tracking radioactivity they emit
 Patients
 Technetium33, Calcium45, Potassium35
3. Implants

• Bjork - implanting tiny bits of tantalum or biologically inert

alloys into growing bone

• Radiographic reference markers for serial cephalometric study.

• Precise orientation of serial cephalograms and information on

the amount and sites of bone growth.
4. NATURAL MARKERS

 Some natural landmarks remain constant / unchanged with

time – used as stable reference points for studying growth

 Ex: trabeculae, nutrient canals, lines of arrested growth -

references to study deposition, resorption and remodeling

 Anterior cranial fossa, mandibular canal in cephalometry