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7/21/2019 2.Formarea fetei.ppt
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STOMATOGENESIS AND THESTOMATOGENESIS AND THE
ANOMALIES WHICH MAY APPEARANOMALIES WHICH MAY APPEAR
DURING THE INTRAUTERINEDURING THE INTRAUTERINE
DEVELOPMENT OF THE FACEDEVELOPMENT OF THE FACE
Discipline of Orthodontics and Dento-Facial OrthopedicsDiscipline of Orthodontics and Dento-Facial OrthopedicsFaculty of Dental MedicineFaculty of Dental Medicine
U.M.F. “Grigore T. Popa” IasiU.M.F. “Grigore T. Popa” Iasi
!!O!!O".". P#OFP#OF.. PhDPhD. G$O#G$T %$G&. G$O#G$T %$G&
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COURSE PLANCOURSE PLAN
1.1. Development of the facial processes and future faceDevelopment of the facial processes and future face2.2. Prenatal development of the palatePrenatal development of the palate3.3. Coalescence defects of the facial processesCoalescence defects of the facial processes
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DEFINITIONSDEFINITIONS
• OntogenesisOntogenesis represents the formation and the development ofrepresents the formation and the development ofthe human organism from the egg cell until the exitus and itthe human organism from the egg cell until the exitus and it
takes part intakes part in the intrauterine periodthe intrauterine period as well asas well as after irthafter irth..• OrganogenesisOrganogenesis represents the intrauterine stage in whichrepresents the intrauterine stage in which
organs appear and differentiate.organs appear and differentiate.• !n the "th week of intrauterine development#!n the "th week of intrauterine development# stomatogenesisstomatogenesis
egins $face formation and development%.egins $face formation and development%.• !n the &th week#!n the &th week# odontogenesisodontogenesis egins $teeth formation andegins $teeth formation anddevelopment%.development%.
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PHASES OF DEVELOPMENTPHASES OF DEVELOPMENT
• 'he prenatal ( intrauterine human period'he prenatal ( intrauterine human period includes)includes)
• *gg period*gg period) from fecundation until the 1"th da+ after) from fecundation until the 1"th da+ afterconception,conception,
• *mr+onic period $*mr+onic period $emr+ogenesisemr+ogenesis%) from the 1"th da+ until%) from the 1"th da+ untilthe -&th intrauterine da+,the -&th intrauterine da+,
• oetal period $oetal period $foetogenesisfoetogenesis%) from the -&th intrauterine%) from the -&th intrauterine
da+ until irth.da+ until irth.
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PERIODIZATIONPERIODIZATION
• 'he organogenesis period'he organogenesis period corresponds to the first three monthscorresponds to the first three monthsof intrauterine life $egg and emr+ogenesis period% in whichof intrauterine life $egg and emr+ogenesis period% in whichorgans appear and differentiate.organs appear and differentiate. *xposure of emr+os to*xposure of emr+os to
teratogens $viruses or drugs% during these periods ma+ resultteratogens $viruses or drugs% during these periods ma+ resultinin congenital anormalitiescongenital anormalities..
• 'he morphogenesis period'he morphogenesis period corresponds to the following monthscorresponds to the following monthsof intrauterine life and after irth# until maturit+# when morpho/of intrauterine life and after irth# until maturit+# when morpho/functional growth and perfectioning of organs and apparatusfunctional growth and perfectioning of organs and apparatustake place. 0irth is an event taking part in this period.take place. 0irth is an event taking part in this period.
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EGG PERIODEGG PERIOD
• *gg period*gg period) from fecundation until the 1"th da+ after) from fecundation until the 1"th da+ afterconceptionconception
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STOMATOGENESISSTOMATOGENESIS
• *mr+o period $emr+ogenesis%) from the 1"th da+ until the-&th intrauterine da+
• appear neural plate
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STOMATOGENESISSTOMATOGENESIS
• fromfrom neural planeural plattee appearappear neuralneural tutuee • third germ cell la+er)
• eendodermndoderm• mmeessodermoderm• eectodermctoderm
ttwowo primitive cavities)cavities)• anterioranterior regionregion closed fromclosed from
uccouccophpharar++ngngeealal memranememrane• caudalcaudal regionregion // closed fromclosed from
cloacacloacall memranememrane
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STOMATOGENESISSTOMATOGENESIS
• neural tuneural tuee anterioranterior regionregion rapid growthrapid growth organisation rachialorganisation rachial
2- da+2- da+ 2& da+2& da+ - week- week & week& week
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ORGANISATION BRANCHIALORGANISATION BRANCHIAL
weekweek weekweek
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BRANBRANCCHIALHIAL APAPPPARATUARATUSS
• Phar+ngeal $Phar+ngeal $ranchial%ranchial% aapparatuspparatus egin "- week i.u. egin "- week i.u.• arch 1 rachial $mandiular%arch 1 rachial $mandiular%• arch 2 rachial $h+oid%arch 2 rachial $h+oid%• arch 3 rachial $th+roid%arch 3 rachial $th+roid%
• arch " rachialarch " rachial• arch - rachialarch - rachial
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BRANBRANCCHIALHIAL APAPPPARATUARATUSS
• 4rc4rchh 1 rachial $mandiular%1 rachial $mandiular% is a ma5or contriutor to is a ma5or contriutor todevelopment of the facedevelopment of the face $$maxillar+ and mandiularmaxillar+ and mandiular pprocessesrocesses%.%.• 'he'he trigeminal nervetrigeminal nerve $cranial nerve 6% is the$cranial nerve 6% is the nerve for the firstnerve for the first
arch.arch.• 'he cartilage of the first arch is'he cartilage of the first arch is 7eckel8s cartilage7eckel8s cartilage.. 'he dorsal end'he dorsal end
form two of theform two of the middle ear ossicles/the malleus and incus. 'hemiddle ear ossicles/the malleus and incus. 'hemiddlemiddle portionportion // cartilage regresses# ut itscartilage regresses# ut its perichondrium formsperichondrium formsthethe sphenomandiular ligamentsphenomandiular ligament.. 'he ventral part forms a'he ventral part forms a horseshoe/shaped structurehorseshoe/shaped structure in the shape of thein the shape of the futurefuture mandilemandile..
'he mesench+mal tissue lateral produce'he mesench+mal tissue lateral produce the mandile as thethe mandile as theoriginal 7eckel8s cartilageoriginal 7eckel8s cartilage disappearsdisappears..• ''he importanthe important musclesmuscles of masticationof mastication)) masseter# temporalis#masseter# temporalis#
medialmedial pter+goid# and lateral pter+goid.pter+goid# and lateral pter+goid. Other muscular derivativesOther muscular derivativesare the anterior ell+are the anterior ell+ ofof the digastric# m+loh+oid# tensor velithe digastric# m+loh+oid# tensor velipalatini#palatini# and tensor t+mpaniand tensor t+mpani..
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BRANBRANCCHIALHIAL APAPPPARATUARATUSS
• 4rc4rchh 2 rachial $h+oid%2 rachial $h+oid% form anterior region of the neckform anterior region of the neck 'he'he facial nervefacial nerve $cranial nerve 6!!% is the$cranial nerve 6!!% is the second arch nerve.second arch nerve.
'he cartilage of arch !! is known as'he cartilage of arch !! is known as 9eichert8s cartilage9eichert8s cartilage.. !ts dorsal!ts dorsalend produce the other middleend produce the other middle ear ossicle# the stapes# andear ossicle# the stapes# and thethest+loid process of the temporal onest+loid process of the temporal one. 4 portion of the. 4 portion of theerichondriumerichondrium forms theforms the st+loh+oid ligamentst+loh+oid ligament.. !!ts contriution tots contriution to development of thedevelopment of the h+oid oneh+oid one# specificall+# the lesser# specificall+# the lesser horn andhorn andthe superior portion of the od+.the superior portion of the od+.
'he'he muscles of facialmuscles of facial // the frontalis#the frontalis# oricularis oris# oricularisoricularis oris# oricularisoculi# :+gomaticus#oculi# :+gomaticus# and plat+smaand plat+sma. !. !nclude the stapedius#nclude the stapedius# st+loh+oid muscle# and posterior ell+ of thest+loh+oid muscle# and posterior ell+ of the digastric muscle.digastric muscle.
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BRANBRANCCHIALHIAL APAPPPARATUARATUSS
• 4rch 34rch 3 rachial $th+roid%rachial $th+roid% form anterior region of the neck form anterior region of the neck 'he'he glossophar+ngeal nerveglossophar+ngeal nerve $cranial nerve !;% is the nerve for arch$cranial nerve !;% is the nerve for arch
3.3. 'he st+lophar+ngeus muscle'he st+lophar+ngeus muscle
<+oid one<+oid one / greater horn and the inferior part of the od+ of the/ greater horn and the inferior part of the od+ of theh+oid oneh+oid one
• 4rches " & ranchial4rches " & ranchial form inferior region of the neck and form inferior region of the neck andsuperior of the thorax.superior of the thorax.• 'he vagus nerve $cranial nerve ;% is the nerve for the fused fourth
and sixth arches.• 'he muscles of the phar+nx and lar+nx.• 'he lar+ngeal cartilages / including the th+roids# cricoids# and
ar+tenoids cartilages# ut not the epiglottis.
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BRANBRANCCHIALHIAL APAPPPARATUARATUSS
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BRANBRANCCHIALHIAL APAPPPARATUARATUSS
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BRANBRANCCHIALHIAL APAPPPARATUARATUSS
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DEVELOPMENT OF THE FACEDEVELOPMENT OF THE FACE
• acial development takes place etween the forth and the eightacial development takes place etween the forth and the eightweek of development and consists in the enlargement and theweek of development and consists in the enlargement and the
shifting of the prominences of the first ranchial arch whichshifting of the prominences of the first ranchial arch whichsurrounds thesurrounds the primitive emrionar+ mouthprimitive emrionar+ mouth $stomodeum%.$stomodeum%.
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FACIAL PROCESSESFACIAL PROCESSES
• 4round the stomodeum# five prominences appear which are4round the stomodeum# five prominences appear which arecalledcalled facial processesfacial processes, the+ are masses of mesoderm covered, the+ are masses of mesoderm covered+ ectoderm)+ ectoderm) one frontal process# two maxillar+ process andone frontal process# two maxillar+ process and
two mandiular process.two mandiular process.
"" weekweek
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FACIAL PROCESSESFACIAL PROCESSES
• 'he frontal process'he frontal process will divide in the 3-th da+ intowill divide in the 3-th da+ into two internaltwo internalnasal processes $medial%nasal processes $medial% andand two external nasal processestwo external nasal processes
$lateral%.$lateral%.
" week & week
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FACIAL PROCESSESFACIAL PROCESSES
• appearappear nasal placodesnasal placodes• appearappear optic placodesoptic placodes
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FACIAL PROCESSESFACIAL PROCESSES
• acial processesacial processes will grow in median and anterior position +will grow in median and anterior position +cellular multiplication# getting closer together# and +cellular multiplication# getting closer together# and +mesodermi:ation the+ will unite forming themesodermi:ation the+ will unite forming the future facefuture face..
"/ week
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FUTURE FACEFUTURE FACE
• 'he internal nasal processes'he internal nasal processes will give irth to the upper lip=swill give irth to the upper lip=sphiltrum# the interincisive one $primar+ palate%# tip of the nosephiltrum# the interincisive one $primar+ palate%# tip of the nose$columella%# the perpendicular plate of the ethmoid and the$columella%# the perpendicular plate of the ethmoid and the
nasal septum.nasal septum.
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FUTURE FACEFUTURE FACE
• 'he external nasal processes'he external nasal processes will form the external part of thewill form the external part of thenose# the nostril floor and threshold and the upper and internalnose# the nostril floor and threshold and the upper and internalpart of the orit.part of the orit.
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FUTURE FACEFUTURE FACE
• 'he maxillar+ processes'he maxillar+ processes will form the maxillar+ onewill form the maxillar+ one$secondar+ palate%# 2(3 external of the upper lip and the palatal$secondar+ palate%# 2(3 external of the upper lip and the palatalapoph+ses of the maxillar+ one.apoph+ses of the maxillar+ one.
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FUTURE FACEFUTURE FACE
• 'he mandiular processes'he mandiular processes will form the mandiular one andwill form the mandiular one andthe lower lip.the lower lip.
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DEVELOPMENT OF THE PALATEDEVELOPMENT OF THE PALATE
• 'he palate develops from the sixth to the twelve week of the'he palate develops from the sixth to the twelve week of thedevelopment process# through adevelopment process# through a doule separation processdoule separation process $vertical and hori:ontal% of the primitive naso/oral chamer.$vertical and hori:ontal% of the primitive naso/oral chamer.
• 'he vertical separation'he vertical separation takes place through the nasal septumtakes place through the nasal septumwhich divides the two nasal cavities.which divides the two nasal cavities.
• 'he hori:ontal'he hori:ontal one separates the primar+ from the secondar+one separates the primar+ from the secondar+palate.palate.
• 'he palate consists in two structures) primar+ palate $'he palate consists in two structures) primar+ palate $premaxillapremaxilla oror incisive oneincisive one% and secondar+ palate $% and secondar+ palate $soft palatesoft palate andand hardhardpalatepalate%%
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DEVELOPMENT OF THE PALATEDEVELOPMENT OF THE PALATE
• 'he primar+ palate'he primar+ palate is formed from theis formed from the internal nasal processesinternal nasal processes which develop downwardswhich develop downwards and givesand gives))
• vertical median extension# calledvertical median extension# called mediamedial l tubercletubercle $the future$the futurenasal septum%,nasal septum%,
• two lateral extensions calledtwo lateral extensions called globular processesglobular processes $the future$the futureincisive one% which move one towards the other and fuse onincisive one% which move one towards the other and fuse onthe median line and form thethe median line and form the intermaxillar+ segmentintermaxillar+ segment..
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DEVELOPMENT OF THE PALATEDEVELOPMENT OF THE PALATE
• 'he secondar+ palate is formed from the maxillar+ processes whichdevelop from the mesench+ma two lateral palatine shelves in theupper/lower plan etween which the tongue is positioned.4fterwards# these shelves elongate# the tongue moves towards the
inferior which allows the shelves to orientate in hori:ontal position#to get closer together and then merge on the median line.
& week week
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DEVELOPMENT OF THE PALATEDEVELOPMENT OF THE PALATE
• 'he median palatine raphe is a relic from the fusion of thehori:ontal shelves and the incisive foramen lies at the unionetween the primar+ palate and the hard secondar+ palate.
• !n the ninth week of development# the hori:ontal shelves unite
with the nasal septum on antero/posterior direction.
1> week
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DEVELOPMENT OF THE TONGUEDEVELOPMENT OF THE TONGUE
• ormarea limiiormarea limii se reali:ea:? din arcul ! @i !!! ranhial)se reali:ea:? din arcul ! @i !!! ranhial)• mucoasa corpus/ului limii $ anterioare ale limii% se⅔mucoasa corpus/ului limii $ anterioare ale limii% se⅔
de:volt? din arcul ! ranhialde:volt? din arcul ! ranhial• mucoasa r?d?cinii limii $ posterioar? a limii% se de:volt?⅓mucoasa r?d?cinii limii $ posterioar? a limii% se de:volt?⅓
din arcul !!! ranhial.din arcul !!! ranhial.- s?pt.- s?pt. - luni- luni
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ANOMALII DIN PERIOADA DE DEZVOLTAREANOMALII DIN PERIOADA DE DEZVOLTARE
• *mriopatii*mriopatii / sunt malformaAiile congenitale care apar Bn/ sunt malformaAiile congenitale care apar Bnperioada de emrionperioada de emrion. *le afectea:? organele care au Bnceput s?. *le afectea:? organele care au Bnceput s?se forme:e @i astfel vor apare malformaAiile cranio/facialese forme:e @i astfel vor apare malformaAiile cranio/facialeasociate cu cele cardiace# datorate factorilor teratogeni.asociate cu cele cardiace# datorate factorilor teratogeni.
• etopatiietopatii / sunt malformaAii care apar Bn/ sunt malformaAii care apar Bn perioada de f?tperioada de f?t..• la na@terela na@tere
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EMBRIOPATIIEMBRIOPATII
• ntre a 1-/a @i a 2>/a :i i.u. $Bn perioada de gastrul?%# datorit?ntre a 1-/a @i a 2>/a :i i.u. $Bn perioada de gastrul?%# datorit?fenomenului de inducAie# pot apare)fenomenului de inducAie# pot apare)• diprosopiediprosopie / dedul?ri ale extremit?Aii cefalice/ dedul?ri ale extremit?Aii cefalice•
polignaAiepolignaAie / dedul?ri ale arcului mandiular/ dedul?ri ale arcului mandiular• trisomia 21 angdon Downtrisomia 21 angdon Down / aeraAii cromo:omiale/ aeraAii cromo:omiale
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EMBRIOPATIIEMBRIOPATII
• n s?pt?mEna 3 / " i.u. $Bnn s?pt?mEna 3 / " i.u. $Bn perioada form?rii mugurilor faciali%#perioada form?rii mugurilor faciali%#pot apare anomalii aparAinEnd primului arc ranhial prin)pot apare anomalii aparAinEnd primului arc ranhial prin) nede:voltarea mugurilor facialinede:voltarea mugurilor faciali))
ciclocefalieciclocefalie / lipsa mugurelui frontal/ lipsa mugurelui frontal arinencefaliaarinencefalia / lipsa mugurilor na:ali interni din/ lipsa mugurilor na:ali interni din
sindromul Patausindromul Patau ageniocefaliaageniocefalia
hipopla:ia mugurilor facialihipopla:ia mugurilor faciali))
sindromul Pierre 9oinsindromul Pierre 9oin $afectarea mugurilor mandiulari%$afectarea mugurilor mandiulari% sindromul ranceschettisindromul ranceschetti $afectarea mugurilor maxilari%.$afectarea mugurilor maxilari%.
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COALESCENCE DEFECTSCOALESCENCE DEFECTS
• 0etween the fifth and the eight week of intrauterine existence#0etween the fifth and the eight week of intrauterine existence#the asence of facial processes or some of their coalescencethe asence of facial processes or some of their coalescencedefects are incompatile with life)defects are incompatile with life)• 4gnathia4gnathia the asence of maxillar+ processes, the asence of maxillar+ processes,• ateral cleft of the faceateral cleft of the face colooma $from the mouth colooma $from the mouth
commissure to the external angle of the e+e% commissure to the external angle of the e+e% failure offailure offusion offusion of the internal nasal processes and the external nasalthe internal nasal processes and the external nasal
processes withprocesses with thethe maxillar+ processes,maxillar+ processes,• 4gnathia4gnathia the asence of mandiular processes, the asence of mandiular processes,• 4stomia4stomia mandiular processes mandiular processes fusionfusion entirel+ withentirel+ with
maxillar+ processes.maxillar+ processes.
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COALESCENCE DEFECTSCOALESCENCE DEFECTS
• !n the same development period# other coalescence defects of!n the same development period# other coalescence defects offacial processes can appear as well)facial processes can appear as well)• 7edian cleft of the face7edian cleft of the face internal nasal processes do not internal nasal processes do not fusionfusion
etween them,etween them,• Paramedian cleft of the faceParamedian cleft of the face external nasal processes do not external nasal processes do not
fusionfusion with the internal nasal processes,with the internal nasal processes,• Cleft lip# alveolar and palateCleft lip# alveolar and palate maxillar+ processes do not maxillar+ processes do not fusionfusion with the internal nasal processes,with the internal nasal processes, Cleft palate result of failure ofCleft palate result of failure ofthe lateral palatine shelves to fuse with each other# with the nasalthe lateral palatine shelves to fuse with each other# with the nasalseptum# or with the primar+ palate.septum# or with the primar+ palate.
• !nferior median cleft of the face!nferior median cleft of the face mandiular processes do not mandiular processes do not
fusionfusion etween them,etween them,• 'ransversal cleft of the face'ransversal cleft of the face mandiular processes do not mandiular processes do not fusionfusion with maxillar+ processes,with maxillar+ processes,
• 7icrostomia7icrostomia / mandiular processes/ mandiular processes fusionfusion too much withtoo much withmaxillar+ processes,maxillar+ processes,
• 7acrostomia7acrostomia mandiular processes mandiular processes fusionfusion too little withtoo little with
maxillar+ processes.maxillar+ processes.
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CLEFTS LIP AND PALATECLEFTS LIP AND PALATE
cheilocheiloschi:isschi:is ilateralilateral
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CLEFTS LIP AND PALATECLEFTS LIP AND PALATE
cheilocheilo//gnatognatoschi:isschi:is unilateralunilateral
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CLEFTS LIP AND PALATECLEFTS LIP AND PALATE
cheilocheilo//gnatognatoschi:isschi:is ilateralilateral
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CLEFTS LIP AND PALATECLEFTS LIP AND PALATE
cheilocheilo//rinorino//gnatognato//palatopalatoschi:isschi:is totaltotal
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TRTREEATMENTATMENT CLEFTSCLEFTS
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TRTREEATMENTATMENT CLEFTSCLEFTS
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TRTREEATMENTATMENT CLEFTSCLEFTS