[Development of dental occlusion (2)].
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The cranial base is of crucial importance in integrated craniofacial development. As distinct from facial bones, it is formed through endochondral ossification. The posterior and anterior cranial bases are derived from distinct embryologic origins and grow independently--the anterior cranial base solely from the neural crest, the posterior cranial base from the paraxial mesoderm. The anterior cranial base has more prolonged and active growth and exerts more influence on facial growth than does the posterior cranial base. Cranial base angulation is a unique feature in modern human beings. Cranial base anomalies have been identified in many genetic and developmental disorders. The molecular basis of cranial base development and growth is being clarified. In this review, these aspects of cranial base are discussed in detail, with a focus on developmental features, roles in craniofacial growth, anomalies, and the genetic basis of development.
Cephalometric radiographic evaluation needs to be supplemented with soft tissue analyses that assist in the proper mechanics. Radiographs remain prescriptive to alter therapy. Patient cooperation is directly related to understanding and applying learning principles that are essential for quality orthodontic care. Prescriptions and new wires continue to make treatment more efficient and exacting. The anomalies of the teeth profoundly affect tooth placement in the occlusion. The transverse plane is the first and most important plane of occlusion that needs early intervention. This plane is directly related to correction of the sagittal through vertical development. The scope of airway and function needs to supplement specific modalities of therapy. Functional appliances usually have significant dentoalveolar effects within the growth process. Individual variation remains the hallmark of human growth and development, with or without therapeutic intervention.
It has been known since the time of Claude Bernard that the "function makes the organ" and ensures its development. However, it took Planas to discover that the masticatory function is the principal factor related to the development of the jaw! Nonetheless, this function only attains its objective if it is physiologically normal, grinding of food taking place by alternative laterality, which can only occur according to Gysi with a balanced occlusion, in conformity with Hanau's rules: opening-closing type mastication as a result of another type of occlusion leads to maxillo-alveolar sub-development and lack of sufficient space. Neuro-Occlusal Rehabilitation (N.O.R.) attempts to detect the type of mastication and occlusion at an early age, to correct it as from the age of 3 years by selective grinding in order to establish alternative laterality: true prophylaxis. If the grinding function is not adequate because it has been corrected too late, Planas appliances are used. Post-orthodontic stability is remarkable as the treatment uses natural and normal means of development.
A cystostatic of group Vinca-alcaloides, Vincristine, is often used in chemotherapy. As a microtubular poison it reacts with microtubular molecules of cell cytoplasma and in response to dose administrated decelerates or stops cell division. Since the information about the effect of this drug on molar teeth has not been found in available literature the aim of this study was to investigate the effect of vincristine on tooth development and jaw growth in rats. The experiment was carried out on Wistar rats of both sexes. Vincristine (Oncovin, "Lilly") was injected to animals in the dose of 0.1 mg/kg b.w. seven or eight days following birth. Treated and control animals were sacrificed on the 24th postnatal day. Radiographs of the mandibule were used to study tooth development. The morphometric examination concerned the following parameters: in maxillar frontal and posterior arc width and height; vertical and sagital dimension as well as length of incisive crown in the mandibule. The results of the analysis suggested that the teeth of treated rats were retarded in development compared to the control animals. Morphometric investigations showed that in treated rats both jaws were decelerated in growth in comparison to the control group but with no statistical significance. It should be emphasized that a 16-day-period was too short that full efficet of Vincristine should be established in rats and lead to a result which could suggest a certain molar development and jaw growth.
In order to achieve palatal closure with the least possible impediment to maxillary growth, the two-stage repair seems to be the best procedure in our hands. The technique and timing of closure of soft and hard palate are described. For soft palate closure a modification of Widmaier's (1959) technique is used. Of the 216 cases operated upon this manner, usually at the age of 18 months (total and partial clefts included), the great majority show a soft palate of sufficient length and good elevation, a definite improvement in comparison with the one-stage procedure used formerly. Hard palate closure is postponed until between 5 and 8 years, the timing of surgery is chosen individually on the assessments of speech and dento-maxillary development.
Post-natal craniofacial growth in the miniature pig MIN-LEWE is influenced by the tongue in various ways. Periodic and locally differentiated intensive craniofacial growth explains why the tongue has a measurable effect on jaw growth only at certain times. This is the situation in animals glossectomized at an age of 12 weeks. Shortening of the tongue in miniature pigs aged six weeks resulted in no measurable changes in the jaw after a prolonged post-surgical interval (23 weeks), which indicates that the capacity of the orofacial system during post-natal development is considerable.
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