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Dr. Nabil Al-Zubair
PRE-NATAL FACIAL GROWTH
Introduction
Growth & development
of an individual
can be divided into TWO periods:
1. Pre-natal period 2. Post-natal period
can be Arbitrarily
Divided into three periods:
1. Period of ovum
2. Period of embryo
3. Period of fetus
1. Period of ovum
Extends
Time of Fertilization Two weeks
During this period
The Cleavage of the Ovum
The Attachment of the Ovum to the Intra-uterine Wall
Occurs
1-7 wks2. Period of embryo
Extends
Fourteen day Fifty sixth day
of intra-uterine life
The major part of the development of the facial &
cranial region occurs
During this period
3. Period of fetus
Extends
Till birthFifty sixth day
During this period
Accelerated growth of the cranio-facial structures
resulting in an increase in their size
Change in proportion b/w the various structures also occurs
In addition
CRANIAL VAULT
OR CALVARIUM
CRANIAL BASE FACIAL SKELETON
MAXILLA MANDIBLE
Pre-natal growth of the head
Prenatal growth of Cranial Base
The earliest evidence
seen in
post or late somitic period
(4th – 8th week of intra-uterine life)
• Thus a capsule is formed
around the brain called
Ectomenix or
Ectomeningeal capsule
Mesenchymal tissue condense
around the developing brain
CARTILAGE
40th day
BONE
Chondro-ossification
Flexure of the cranial base‫التواء‬
During the embryonic & early fetal period
in the region
b/w
Pituitary fossa
&
Spheno-occipital junction
cranial base flexed
Flexure of the cranial base
accompanied by a corresponding
Flexure of the developing Brain Stem
cranial base flexed
Spinal chord & Foramen magnum
directed
downwards
during the early stages of development
directed backwards
Flexure of the cranial base
• Downwards directed foramen
magnum is an adaptation seen
in man who, unlike animals,
(1) Stand erect
• Another consequence of the
flexure is
(2) The predominant downward
rather than forward
displacement of the face
during its growth from the cranial
base
PRENATAL GROWTH OF FACIAL SKELETON
– PRENATAL GROWTH OF MAXILLA
– PRENATAL GROWTH OF MANDIBLE
on the ventral aspect of the embryo
Ventral aspect Dorsal aspect
About the 4th week of intra-uterine life
(1) the developing brain
Two prominent
BULGES ‫انتفاخ‬
(2)
BUCCO-PHARYNGEAL
MEMBRANE
STOMODEUM
BRAIN
I
II
BULGES
separated by
Primitive oral cavity
which separates it from the foregut
formed byThe floor
FOREGUT
STOMODEUM
BRAIN
I
II
ESOPHAGEOUS
PHARYNGEAL ARCHES
FOREGUT
Laid down on the lateral & ventral aspects
cranialmost
Lies in close approximation
with
STOMODEUM
PHARYNGEAL ARCHESInitially six
Fifth one disappears as soon as it is formed
Separated
BRANCHIAL GROOVES
Mid-sagittal section
BRAIN
HEART
I
II
CORD
CARDIAC
BULGE
Full-face view 4-w embryo
form in the region of the future head & neck
I
II
Branchial arches
By around
five
4th week of intra-uterine life
Mid-sagittal section
BRAIN
HEART
I II
CORD
CARDIAC
BULGE
Full-face view 4-w embryo
Each of these arches contain:
1. A central cartilage rod that forms the skeleton of the arch
2. A muscular component termed as branchiomere
3. A vascular component
4. A neural element
I
II
Branchial arches
Mid-sagittal section
BRAIN
HEART
I II
CORD
CARDIAC
BULGE
Full-face view 4-w embryo
The other arches do not have any specific names
I
II
Branchial arches
first arch
MANDIBULAR ARCH
Development of
the naso-maxillary
region
Plays an
important role in
Second arch,
HYOID ARCH.
Prenatal Growth of Naso-maxillary Cpomlex
Maxilla
Nose
Palate
Mid-sagittal section of 1-m embryo
FRONTONASAL
PROCESS
STOMODEUM
BRAIN
PHARYNGEAL ARCHES
I II
The Mesoderm covering the developing forebrain Proliferates & forms a
downward projection that Overlaps the upper part of STOMODEUM.
This downward projection is called
FRONTO-NASAL PROCESS
MAXILLARY PROCESS
STOMODEUM
with perforating membrane
CARDIAC
BULGE
MANDIBULAR ARCH
HYOID ARCH
4-w/3.5mm EMBRYO
• The mandibular arch
gives off a bud from its
dorsal end called the
maxillary process
MAXILLARY PROCESS
MANDIBULAR PROCESS
CARDIAC
BULGE
HYOID ARCH
STOMODEUM
with perforating membrane
4-w/3.5mm EMBRYO
• The Maxillary Process
GROWS
Ventro-medio-cranial
to the main part of
the Mandibular Arch
which is now called
the Mandibular Process
FRONTONASAL PROCESS
MAXILLARY PROCESS
MANDIBULAR PROCESS
CARDIAC
BULGE
HYOID ARCH
STOMODEUM
with perforating membrane
4-w/3.5mm EMBRYO
At this stage the Primitive Mouth or
Stomodeum
OVERLAPPED
from above
from below
on either side
MAXILLARY PROCESS
OPTIC PLACODE
CARDIAC BULGE
Bilateral localized thickenings
above the stomodeum
4-w/3.5mm EMBRYO
NASAL PLACODES
soon sink & form
NASAL PITS
The ectoderm overlying the
fronto-nasal process
shows
CARDIAC BULGE
The formation of these NASAL PITS
divides the fronto-nasal process
into two parts:
a. The medial nasal process &
b. The lateral nasal process
Lateral processes will
become Alae of Nose
Medial processes form midline nose &
contribute to lip, central upper jaw
& primary palate
4-w/3.5mm EMBRYO
5.5-w/9mm EMBRYO
MAXILLARY PROCESS
As the Maxillary Process
undergoes Growth,
The fronto-nasal process
becomes narrow
so that the two NASAL PITS
come closer
Fronto-nasal process
Development of Palate
NARIS
Development of palate
• The palate is formed by
contribution of the :
a. Fronto-nasal process
b. Maxillary process
c. Palatal shelves given off
by the maxillary process
NARIS
INTER-MAXILLARY
SEGMENT
PRIMARY PALATE/ Median palatine process
NARIS
Gives rise to the premaxillary
region
Form the rest of the palate
Development of palate
• As the PALATAL SHELVES
grow medially,
Their union is prevented by the
presence of the TONGUE
TONGUE
Development of palate
• Initially the developing
PALATAL SHELVES grow
vertically downward towards
the floor of the mouth
• During the seventh week of
intra-uterine life,
a transformation in the position of
the palatal shelves occurs
EYE
BRAIN
MECKEL’S CARTILAGE
TONGUE
*
Site for meeting and fusion of nasal septum
& palatal shelves
EYE
TOOTH BUD
BRAIN
TONGUE
*
They change from a VERTICAL to HORIZONTAL
position
MECKEL’S CARTILAGE
mandibular bone
TONGUE
LATERAL PALATINE SHELF
Maxillary bone
This transformation is
believed to take place
within hours
Reasons to explain how this transformation occurs
a. Alteration in biochemical &
physical consistency of the
connective tissue of the palatal
shelves
b. Alteration in vasculature & blood
supply of the palatal shelves
c. Appearance of intrinsic shelf
force
d. Rapid differential mitotic activity
e. Muscular movements
f. Withdrawal of the embryonic face from
against the heart prominence results in
slight jaw opening. This results in
withdrawal of the tongue from b/w the
palatal shelves from a vertical to a
horizontal position
PALATE
PROXIMITY
Epithelial disintegration
& conversion
Mesenchymal continuity
FUSION
Epithelial & Mesenchymal
differentiation
STEPS IN PALATAL-NASAL FUSION
by 8 ½ weeks of intra-uterine life
The connective tissue intermingle
separates the two
nasal cavities from
each other & the oral
cavity
The mesial edges of the
palatal processes fuse with
the free lower end of nasal
septum
Prenatal Growth of Mandible
• The Meckel’s cartilage is derived
from the first branchial arch around
the 41st – 45th day of intra-uterine
life
• It extends from the cartilaginous
otic capsule to the midline or
symphysis & provides a template
for guiding the growth of the
mandible
TONGUE
Meckel’s cartilage
TONGUE
Meckel’s cartilage
• A major portion of the Meckel’s
cartilage DISAPPEARS during
growth &
the remaining part develops into the
following structures:
1. The mental ossicles
2. Incus & Malleus
3. Anterior ligament of malleus
4. Spheno-mandibular ligament
TONGUE
Meckel’s cartilage
• The first structures to develop in the
PRIMORDIUM of the lower jaw is
THE MANDIBULAR DIVISION of the
trigeminal nerve.
• This is followed by the mesenchymal
condensation forming The first
branchial arch
TONGUETONGUE
TONGUE
Neurotrophic factors
OSTEOGENESIS
Ossification centers
induce
Nerve
single
6th week of intra-uterine life
BIFURCATION of the inferior alveolar nerve
into mental & incisive branches
TONGUE
Neurotrophic factors
OSTEOGENESIS
Ossification centers
induce
Nerve
single
6th week of intra-uterine life
BIFURCATION of the inferior alveolar
nerve into mental & incisive branches
Intramembranous ossification spreads:
(1) Below & around the inferior alveolar nerve & its
incisive branch & upwards
Trough
TONGUE
Neurotrophic factors
OSTEOGENESIS
Ossification centers
induce
Nerve
single
6th week of intra-uterine life
BIFURCATION of the inferior
alveolar nerve into mental &
incisive branches
Intramembranous ossification spreads:
(1) Below & around the inferior alveolar
nerve & its incisive branch & upwards
Trough
(2) Dorsally & ventrally froms the body & ramus of the
mandible
7-w/19mm EMBRYO
EYE
FOREHEAD
MOUTH
LOWER JAW
HYOID BONE
MAXILLARY PROCESS
LARYNGEAL CARTILAGES
FACE
The two mandibular
processes grow medially
& fuse to form the lower
lip & lower jaw
Thank you for listening!

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Pre-natal facial growth Dr. Nabil Al-Zubair

  • 2. Introduction Growth & development of an individual can be divided into TWO periods: 1. Pre-natal period 2. Post-natal period
  • 3. can be Arbitrarily Divided into three periods: 1. Period of ovum 2. Period of embryo 3. Period of fetus
  • 4. 1. Period of ovum Extends Time of Fertilization Two weeks During this period The Cleavage of the Ovum The Attachment of the Ovum to the Intra-uterine Wall Occurs
  • 5. 1-7 wks2. Period of embryo Extends Fourteen day Fifty sixth day of intra-uterine life The major part of the development of the facial & cranial region occurs During this period
  • 6. 3. Period of fetus Extends Till birthFifty sixth day During this period Accelerated growth of the cranio-facial structures resulting in an increase in their size Change in proportion b/w the various structures also occurs In addition
  • 7. CRANIAL VAULT OR CALVARIUM CRANIAL BASE FACIAL SKELETON MAXILLA MANDIBLE Pre-natal growth of the head
  • 8. Prenatal growth of Cranial Base
  • 9. The earliest evidence seen in post or late somitic period (4th – 8th week of intra-uterine life)
  • 10. • Thus a capsule is formed around the brain called Ectomenix or Ectomeningeal capsule Mesenchymal tissue condense around the developing brain CARTILAGE 40th day BONE Chondro-ossification
  • 11. Flexure of the cranial base‫التواء‬ During the embryonic & early fetal period in the region b/w Pituitary fossa & Spheno-occipital junction cranial base flexed
  • 12. Flexure of the cranial base accompanied by a corresponding Flexure of the developing Brain Stem cranial base flexed Spinal chord & Foramen magnum directed downwards during the early stages of development directed backwards
  • 13. Flexure of the cranial base • Downwards directed foramen magnum is an adaptation seen in man who, unlike animals, (1) Stand erect • Another consequence of the flexure is (2) The predominant downward rather than forward displacement of the face during its growth from the cranial base
  • 14. PRENATAL GROWTH OF FACIAL SKELETON – PRENATAL GROWTH OF MAXILLA – PRENATAL GROWTH OF MANDIBLE
  • 15. on the ventral aspect of the embryo Ventral aspect Dorsal aspect About the 4th week of intra-uterine life (1) the developing brain Two prominent BULGES ‫انتفاخ‬ (2)
  • 16. BUCCO-PHARYNGEAL MEMBRANE STOMODEUM BRAIN I II BULGES separated by Primitive oral cavity which separates it from the foregut formed byThe floor FOREGUT
  • 17. STOMODEUM BRAIN I II ESOPHAGEOUS PHARYNGEAL ARCHES FOREGUT Laid down on the lateral & ventral aspects cranialmost Lies in close approximation with STOMODEUM
  • 18. PHARYNGEAL ARCHESInitially six Fifth one disappears as soon as it is formed Separated BRANCHIAL GROOVES
  • 19. Mid-sagittal section BRAIN HEART I II CORD CARDIAC BULGE Full-face view 4-w embryo form in the region of the future head & neck I II Branchial arches By around five 4th week of intra-uterine life
  • 20. Mid-sagittal section BRAIN HEART I II CORD CARDIAC BULGE Full-face view 4-w embryo Each of these arches contain: 1. A central cartilage rod that forms the skeleton of the arch 2. A muscular component termed as branchiomere 3. A vascular component 4. A neural element I II Branchial arches
  • 21. Mid-sagittal section BRAIN HEART I II CORD CARDIAC BULGE Full-face view 4-w embryo The other arches do not have any specific names I II Branchial arches first arch MANDIBULAR ARCH Development of the naso-maxillary region Plays an important role in Second arch, HYOID ARCH.
  • 22. Prenatal Growth of Naso-maxillary Cpomlex Maxilla Nose Palate
  • 23. Mid-sagittal section of 1-m embryo FRONTONASAL PROCESS STOMODEUM BRAIN PHARYNGEAL ARCHES I II The Mesoderm covering the developing forebrain Proliferates & forms a downward projection that Overlaps the upper part of STOMODEUM. This downward projection is called FRONTO-NASAL PROCESS
  • 24. MAXILLARY PROCESS STOMODEUM with perforating membrane CARDIAC BULGE MANDIBULAR ARCH HYOID ARCH 4-w/3.5mm EMBRYO • The mandibular arch gives off a bud from its dorsal end called the maxillary process
  • 25. MAXILLARY PROCESS MANDIBULAR PROCESS CARDIAC BULGE HYOID ARCH STOMODEUM with perforating membrane 4-w/3.5mm EMBRYO • The Maxillary Process GROWS Ventro-medio-cranial to the main part of the Mandibular Arch which is now called the Mandibular Process
  • 26. FRONTONASAL PROCESS MAXILLARY PROCESS MANDIBULAR PROCESS CARDIAC BULGE HYOID ARCH STOMODEUM with perforating membrane 4-w/3.5mm EMBRYO At this stage the Primitive Mouth or Stomodeum OVERLAPPED from above from below on either side MAXILLARY PROCESS
  • 27. OPTIC PLACODE CARDIAC BULGE Bilateral localized thickenings above the stomodeum 4-w/3.5mm EMBRYO NASAL PLACODES soon sink & form NASAL PITS The ectoderm overlying the fronto-nasal process shows
  • 28. CARDIAC BULGE The formation of these NASAL PITS divides the fronto-nasal process into two parts: a. The medial nasal process & b. The lateral nasal process Lateral processes will become Alae of Nose Medial processes form midline nose & contribute to lip, central upper jaw & primary palate 4-w/3.5mm EMBRYO
  • 29. 5.5-w/9mm EMBRYO MAXILLARY PROCESS As the Maxillary Process undergoes Growth, The fronto-nasal process becomes narrow so that the two NASAL PITS come closer Fronto-nasal process
  • 31. NARIS Development of palate • The palate is formed by contribution of the : a. Fronto-nasal process b. Maxillary process c. Palatal shelves given off by the maxillary process NARIS INTER-MAXILLARY SEGMENT PRIMARY PALATE/ Median palatine process NARIS Gives rise to the premaxillary region Form the rest of the palate
  • 32. Development of palate • As the PALATAL SHELVES grow medially, Their union is prevented by the presence of the TONGUE TONGUE
  • 33. Development of palate • Initially the developing PALATAL SHELVES grow vertically downward towards the floor of the mouth • During the seventh week of intra-uterine life, a transformation in the position of the palatal shelves occurs EYE BRAIN MECKEL’S CARTILAGE TONGUE
  • 34. * Site for meeting and fusion of nasal septum & palatal shelves EYE TOOTH BUD BRAIN TONGUE * They change from a VERTICAL to HORIZONTAL position MECKEL’S CARTILAGE mandibular bone TONGUE LATERAL PALATINE SHELF Maxillary bone This transformation is believed to take place within hours
  • 35. Reasons to explain how this transformation occurs a. Alteration in biochemical & physical consistency of the connective tissue of the palatal shelves b. Alteration in vasculature & blood supply of the palatal shelves c. Appearance of intrinsic shelf force d. Rapid differential mitotic activity e. Muscular movements f. Withdrawal of the embryonic face from against the heart prominence results in slight jaw opening. This results in withdrawal of the tongue from b/w the palatal shelves from a vertical to a horizontal position
  • 36. PALATE PROXIMITY Epithelial disintegration & conversion Mesenchymal continuity FUSION Epithelial & Mesenchymal differentiation STEPS IN PALATAL-NASAL FUSION by 8 ½ weeks of intra-uterine life The connective tissue intermingle separates the two nasal cavities from each other & the oral cavity The mesial edges of the palatal processes fuse with the free lower end of nasal septum
  • 37. Prenatal Growth of Mandible
  • 38. • The Meckel’s cartilage is derived from the first branchial arch around the 41st – 45th day of intra-uterine life • It extends from the cartilaginous otic capsule to the midline or symphysis & provides a template for guiding the growth of the mandible TONGUE Meckel’s cartilage
  • 39. TONGUE Meckel’s cartilage • A major portion of the Meckel’s cartilage DISAPPEARS during growth & the remaining part develops into the following structures: 1. The mental ossicles 2. Incus & Malleus 3. Anterior ligament of malleus 4. Spheno-mandibular ligament TONGUE
  • 40. Meckel’s cartilage • The first structures to develop in the PRIMORDIUM of the lower jaw is THE MANDIBULAR DIVISION of the trigeminal nerve. • This is followed by the mesenchymal condensation forming The first branchial arch TONGUETONGUE
  • 41. TONGUE Neurotrophic factors OSTEOGENESIS Ossification centers induce Nerve single 6th week of intra-uterine life BIFURCATION of the inferior alveolar nerve into mental & incisive branches
  • 42. TONGUE Neurotrophic factors OSTEOGENESIS Ossification centers induce Nerve single 6th week of intra-uterine life BIFURCATION of the inferior alveolar nerve into mental & incisive branches Intramembranous ossification spreads: (1) Below & around the inferior alveolar nerve & its incisive branch & upwards Trough
  • 43. TONGUE Neurotrophic factors OSTEOGENESIS Ossification centers induce Nerve single 6th week of intra-uterine life BIFURCATION of the inferior alveolar nerve into mental & incisive branches Intramembranous ossification spreads: (1) Below & around the inferior alveolar nerve & its incisive branch & upwards Trough (2) Dorsally & ventrally froms the body & ramus of the mandible
  • 44. 7-w/19mm EMBRYO EYE FOREHEAD MOUTH LOWER JAW HYOID BONE MAXILLARY PROCESS LARYNGEAL CARTILAGES FACE The two mandibular processes grow medially & fuse to form the lower lip & lower jaw
  • 45. Thank you for listening!