Elias
- Joined
- Nov 26, 2019
- Posts
- 7,146
- Reputation
- 15,219
The period from age 6 through 12 years represent a continuous progression of the growth in the head and neck. From age 5 to 10 years (approximately the age range of interest here), neural and cranial growth are found to be almost entirely complete. During this same age span, the jaws (maxilla = A = 2 and mandible = B = 3, grow at a faster rate than the cranium.
Differential growth center rates of craniofacial components. Using the Bolton standards for illustrative purposes, nasal projection and increased mandibular prominence are demonstrated. The nasal cartilage and mandibular condyle continue to grow by endochondral bone formation for some time, although the female mandibular growth spurt is most likely completed during this time period, and the male’s is yet to come. Growth modification can therefore be performed in this age group. Changes in cranial base length caused by endochondral bone formation at the sphenooccipital synchondrosis cease in early adolescence, but some appositional changes continue to occur at the basion and nasion. Vertically, there is a continued lowering of the palatal vault with sutural growth and apposition on the oral side of the palate and resorption on the nasal side as the intramembranous process of bone formation continues. Vertical facial growth is also complemented by dentoalveolar growth as the permanent teeth erupt and the alveolar ridges develop.
This anterior cranial base superimposition of the Bolton standard for 6- and 12-year-olds (solid line and dashed line, respectively) demonstrates the magnitude of anteroposterior and vertical skeletal growth during this period as well as the soft tissue change.
In the transverse plane, there is continued growth at the midpalatal suture. Most transverse palatal sutural growth in completed for females during this period when the first bridging of the suture occurs. Transverse appositional widening of the alveolar ridge occurs with eruption of the permanent teeth. Widening of the anterior arch accompanies lateral incisor eruption and is followed by width increases in the canines and premolars.
This anterior cranial base superimposition of the Bolton Standard for 6- and 12-year-olds (solid line and dashed line, respectively) demonstrates the magnitude of transverse and vertical skeletal growth during this period.
The implications of these changes are that anteroposterior growth modification for class III problems should be attempted during this time. For class II problems, growth modification can be attempted now or during early adolescence with equivalent results. Transverse changes should have been made using lingual arch type appliances unless rapid palatal expansion is going to be used with greater forces to interrupt the stable midpalatal suture. Vertical growth will continue in the face until much later.
Differential growth center rates of craniofacial components. Using the Bolton standards for illustrative purposes, nasal projection and increased mandibular prominence are demonstrated. The nasal cartilage and mandibular condyle continue to grow by endochondral bone formation for some time, although the female mandibular growth spurt is most likely completed during this time period, and the male’s is yet to come. Growth modification can therefore be performed in this age group. Changes in cranial base length caused by endochondral bone formation at the sphenooccipital synchondrosis cease in early adolescence, but some appositional changes continue to occur at the basion and nasion. Vertically, there is a continued lowering of the palatal vault with sutural growth and apposition on the oral side of the palate and resorption on the nasal side as the intramembranous process of bone formation continues. Vertical facial growth is also complemented by dentoalveolar growth as the permanent teeth erupt and the alveolar ridges develop.
This anterior cranial base superimposition of the Bolton standard for 6- and 12-year-olds (solid line and dashed line, respectively) demonstrates the magnitude of anteroposterior and vertical skeletal growth during this period as well as the soft tissue change.
In the transverse plane, there is continued growth at the midpalatal suture. Most transverse palatal sutural growth in completed for females during this period when the first bridging of the suture occurs. Transverse appositional widening of the alveolar ridge occurs with eruption of the permanent teeth. Widening of the anterior arch accompanies lateral incisor eruption and is followed by width increases in the canines and premolars.
This anterior cranial base superimposition of the Bolton Standard for 6- and 12-year-olds (solid line and dashed line, respectively) demonstrates the magnitude of transverse and vertical skeletal growth during this period.
The implications of these changes are that anteroposterior growth modification for class III problems should be attempted during this time. For class II problems, growth modification can be attempted now or during early adolescence with equivalent results. Transverse changes should have been made using lingual arch type appliances unless rapid palatal expansion is going to be used with greater forces to interrupt the stable midpalatal suture. Vertical growth will continue in the face until much later.
