顱面生長(zhǎng)發(fā)育

1、1Timing of growth第一快速期 出生5、6歲1st period of speediness Birth5、6yrs第二快速期 青春快速期2nd period of speedi：puberty Girl: 10 14、16yrsBoy: 1216、18yrsCompletion: Girl: 1014、16yrs Boy: 1216、18yrsScammons curves frowth the four major tie systems of the body.第I型：一般型typeI: General body ties第II型：神經(jīng)系型typeII: Neural ti

2、es第III型：型typeIII: genital ties第IV型：淋巴型typeIV: Lymphoid tiesPattern of growth生長(zhǎng)發(fā)育的方式錯(cuò)合畸形發(fā)育畸形Maloccluand dentofal deformity arise through variationshe normmental pro sA guide to diagnosis, treatment-plan and prognosis.Craniofal grownd development顱面部的24-k embryobranchial apparatus4-k embryobranchial ap

3、paratusGrowth of skull and face-before birth來(lái)源 第一鰓弓；發(fā)育方式 突起融合胚胎期顱面部的發(fā)育顱面部發(fā)育與全身的關(guān)系Relationship ben the growth of craniofal and body頜面部增長(zhǎng)的四個(gè)快速期第一快速期 3周7個(gè)月 乳牙萌出第二快速期 47歲 第一恒磨牙萌出第三快速期 1113歲 第二恒磨牙萌出第四快速期 1619歲 第三恒磨牙萌出全身生長(zhǎng)發(fā)育的快速期第一快速期 出生5、6歲第二快速期 青春快速期女性10歲14、16歲 12歲16、18歲312-k embryo8-k embryo腭（hard palat

4、e）的發(fā)育腭（hard palate）的發(fā)育6-k embryo4Unilateral cleft involving lip and jawextending to insicive foramenUnilateral cleft lip extendingo the noseNormal胚胎期發(fā)育異常的表現(xiàn)5面橫裂各種類型的唇裂Cleft palate combined witilateral anterior cleftIsolated cleft palateBilateral cleft involving lip and jaw6三維關(guān)系顏面外型的生長(zhǎng)Cleft jawandfac

5、e面斜裂面斜裂7面深度的發(fā)育3歲5-14歲面上部80%+15%面中部77%+18%面下部 69%+22%面部的生長(zhǎng)發(fā)育面高度的發(fā)育前面高（鼻根頦前）后面高（髁突下頜角） 3歲：73% 10歲：85%90%后/全：7歲42%20歲 46%面寬度的發(fā)育出生時(shí)已大部完成上面寬（顴弓間距） 2歲 70% 10歲 90%下面寬（下頜角間距） 6歲 85%面寬-牙弓間寬度面部的生長(zhǎng)發(fā)育891011121314分界顱底平面面橫平面-Bolton-Na-FrfortNB顱、面生長(zhǎng)的比例變化及特征Change in proportion and characteristic比例變化出生8：1 6歲 5：1成人2

6、：16歲顱部與面部不同步生長(zhǎng)卻相互制約15Nasomaxillary ComplexGrowth of the Nasomaxillary ComplexFor the pures of comparison, the skulls of other species, notably hominids and primates may be studiedhe Ffurt plane, but it is not considered to be the anatomicalition for other species.It was decidedt a plane passing thro

7、ugh the inferior margin of the left orbit (the pocalled the left orbitale) and the upper margin of each earc(the pocalled the porion) was most nearly parallel to the surface of the earth, and also close to theition the head is normally carriedhe living subject.The Frfurt plane (also called the auric

8、ulo-orbital plane) was established at the World Congress on Anthropology inFfurt, Germany in 1884, and decreed as the anatomical ition of the human skull.16The present conceptBone and cartilagond to soft te growth determined by functional needs.(the so called “functional matrix”theory)The present co

9、nceptBone is the determinant of its own growthCartilage is the determinant of bone growthSoft tie matrix is the determinant of growthAll are conttrolled genetically5 factors in coming ol typeChangehe angleGrowth of the Mandible functional matrix theory牙槽肌附麗髁突Orion17口周肌群的動(dòng)力平衡Treacher-Collins syndrome

10、Treacher-Collins syndrome鳥(niǎo)面綜合癥:又稱頜面骨發(fā)育不全及耳聾綜合征.是由于胚胎7 8周以前第一、二腮弓發(fā)育異常所致畸形。為常顯性遺傳特殊面貌表現(xiàn)為下頜骨發(fā)育不 良，耳廓處僅用一肉贅，上眼瞼下垂，不能支持眼睛。呈鳥(niǎo)臉，小眼、鉤鼻。Downs syndrome唐氏綜合征：由專攻此癥的J L H Down醫(yī)師而得名。異常，涉及許多 ，表現(xiàn)為多 、系統(tǒng)異常，故稱為“綜合征”。是人類最常見(jiàn)的一種 病，也是人類第一個(gè)被確認(rèn)的 病，不論國(guó)家、種族和 是否相同，患者的面部特點(diǎn)都非常相似，具有特殊的呆傻面容；智力發(fā)育不全生長(zhǎng)發(fā)育遲緩是唐氏綜合征最突出最嚴(yán)重的表現(xiàn)。身材矮小，頭圍小于正常

11、，骨齡常落后于 ，出牙延遲且常錯(cuò)位。表現(xiàn)為顱面發(fā)育異常的“綜合征”18生長(zhǎng)發(fā)育與生理齡實(shí)足(chronological age)生理(physiological age)骨齡(skeletal age)牙齡(dental age)第二性征齡(secondary sexual character age)形態(tài)學(xué)(morphological age)A12yr-oldgirlwitmusculardystrophyThewhiteoutlineindicatestheaverageoutlineforherage19Growth prediction到目前為止，對(duì)于發(fā)育的尚未取得可靠的結(jié)果。只能使用某一段群體測(cè)量的平均值來(lái)進(jìn)行分析。方法：假設(shè)下頜的生長(zhǎng)方向維持不變頭影測(cè)量描記比較同一不同發(fā)育階段比較與群體平均值How to assess growth clinicallyHand wrist x-raychanges and fal hair in boyslateral cephalogram tracings: superimitionsAsk parents how much the child grew last year (height and shoe size)look at parents