Download Orthodontic Tooth Movement

Oral Biology 5301
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Bone growth and development
Bone biology
Educational objectives
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Exposure to basic concepts of bone biology
Correlation of basic bone biology to clinical
treatment
Special considerations / implications of
bone biology to dentistry
Clinical Correlates of Bone Growth
and Development
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Facial skeletal development
Maxillary development
Mandibular development
Clinical Correlates of Bone Growth
and Development
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Effect of congenital anomalies on facial
growth and development
Effect of surgical correction of
congenital anomalies on facial growth
and development
Tooth development and retention
influence on alveolar bone levels
Clincal Correlates of Bone Growth
and Development
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Orthodontic tooth movement
Bone healing following tooth extraction
Bone response to alloplastic materials
Bone healing in approximation of dental
implants
Clinical Correlates of Bone Growth
and Development
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Bone grafting to treat dentoalveolar
defects
Bone grafting to treat discontinuity
defects
Fracture healing
Cellular Growth
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Hypertrophy
Hyperplasia
Secretion of extracellular material
Interstitial growth
Embryologic Type of Bone
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Endochondral
Intramembranous
Functional Matrix Theory of
Growth
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“Growth of the face occurs as a
response to the functional need and is
mediated by the soft tissue in which the
bone is embedded”
Soft tissues grow, bone and cartilage
react
Growth Control
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Bone is the determinant of its own
growth
Cartilage is the determinant of bone
growth
Soft tissue matrix is the determinant of
growth
All are controlled genetically
Orthodontic Tooth Movement
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Bone apposition and resorption
Effects on the pulp
Effects on the PDL
Effects on the tooth root
Effects of Periosteum
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Provision of undifferentiated
mesechymal cells
Envelope to limit/regulate bone
apposition
Introduction
10 y.o. female 12/98
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CC:
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Noticed swelling in
face on left side for
two weeks
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HPI:
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Facial swelling
Left lower lip
“tingles”
No pain or change in
bite
Examination
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Left lower facial swelling, without
thrill/bruit
Lower vestibular swelling, L>R
No abnormal tooth mobility
Teeth 19-28 vital with EPT
CN II-XII grossly intact
Assessment
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Problem list:
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Multilocular
radiolucent lesion
Teeth vital without
resorption,
displacement, or
mobility
Apparent cortical
expansion
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Diff. Dx:
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Central Giant Cell
Lesion
Ameloblastomic
Fibroodontoma
Ameloblastoma
Treatment Plan
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Impressions for splint fabrication
Screening labs Ca, alk phos, PTH
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CT of mandible:
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All WNL
Multilocular radiolucents, from infer border to
encompass tooth roots superiorly
Buccal and lingual cortices intact, although
expansion present
Incisional bx
Facial Growth and
Development
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15 year old man
Congenital cleft lip and palate
29 surgeries to nose and lip
Significant malocclusion
Status post facial skeletal growth
Masticatory insufficiency
Facial Growth and
Development
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4 year old boy with jaw immobility
Mother concerned about failure to
thrive and ability to receive dental care
Anterior open bite
Etiology unknown
Facial Growth and
Development
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7 year old boy
Condylar neoplasm resected as infant
(age 2) and recurrence treated age 4
Concerns about facial growth and
development