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30 yr man
CBCT 90300
3D visualmethods
Skull with cavitiestendinous
insertions; ligamentsprojection of thenerves and vessels; their arrangement
Topographicrelation betweenstructures
IK
mandibula
palato-quadratum
hyomandibulare
hyoidealeVI
23456
IIIIIIIVV
1
Capsula ethmoidea
Capsula opticaCapsula
otica
Vertebrae occipitales
Arcus branchialesIK
Neurocranium and Viscerocranium (splanchnocranium)
Formation of splanchnocranium from branchial archesIK
desmocranium chondrocranium
IK
Edwin Stephen Goodrich1868-1946
The evolution of living organisms
Studies on the Structure & Development of Vertebrates
Development of the skull basis
Week 6IK
Holoprosencephaliapříklad: Cyclopia
Acraniapříklad: AnencephaliaIK
otocephalia, otoencephalia, agnathiaIK
Postnatal growth finalized bone forms; later also arrangements of
the bone tissue
Skull vault (cap) ! ? !
maxilla
mandibulaIK
Brain growth; ossification of synchondrosis sphenooccipitalis; expanding of eye bulb, muscle drawing; nasal septum growth; teeth eruption
The main events determining skull form
Growth types:General – to 70% final size 6 yrCranial – to 80% final size 6 yrFacial – to 80% final size 6 yrIK
neonatus
27 years
1 year
juvenileExternal form changes
face width - starts to growth earlier face length – finish to growth later
IK
Growth of skull basis1 yr os frontale (sinus frontalis)4 yr cribriform lamina of ethmoidal bone7 yr spheno-ethmoid,-frontal; fronto-sphenoid
resorptive areae – around lacerum foramen, jugular fossa, medial lamina of pterygoid process
nazozygomaxillar complex – from sutures surroundingmaxilla
infrazygomatic crest –sutura palatina transversa after EnlowIK
see: www.lf1.cuni.czor: http://anat.lf1.cuni.cz/aindex.html
IK
http://www.lf1.cuni.cz/http://anat.lf1.cuni.cz/aindex.html
*IK
Jawsγνάθος
(gnathos)
MaxillaMandibulalower facesegment
FORMgenetic determination
INNER STRUCTUREpressure and tension of the musclec surrounding mandible; teeth
eruption
FORMATIONfunctional demands and fusion of the primordia developed before
REMODELLATION DUE TO AGEchanged functional conditions, hereditary influences
IK
maxilla growth eventsventrokaudallyunder influence of frontomaxillaris, zygomaticomaxillaris, pterygopalatina sutures
around axis crossing interalveolar septum between lateral deciduous incisor and caninus
(„opening bridge“)incisiva et intermaxillaris sutures
septum nasiinfluence to surrounding structures
postnatallysutura palatina mediana (7-19 yr about 5 mm)
IK
Crista infrazygomaticazygomaticoalveolarisIK
MaxillaCorpusProc. frontalisProc. zygomaticusProc. AlveolarisProcessus palatinus
Sinus maxillaris(antrum Highmori) –opened to skullnasal cavity as a hiatus maxillaris
Fossa lacrimalisFossacaninaIK
Musclesare not insertedto fossacanina !!IK
1
2
3
45
6
7 8
910
11
1215
16
13 14V2IK
V2
canalis sinuosus (Pardanaudi)IK
IK
A M Shelley, V E Rushton & K Horner: Canalis sinuosus mimicking a periapical inflammatory lesionBritish Dental Journal 186, 378 - 379 (1999) Published online: 24 April 1999
IK
Palatum durumIK
week 6.5 IK
Palatal processesare mutually fusedone week laterin women than men
week 10IK
IK
EruptionIK
IK
8 mm
Hrbolková linie Vzdálenost od řezákového bodu ke spojnici mezi hroty špičáků Tubercular line Distance between incisale point and line connecting tops of canini
IK
Sulcus palatinus major; its content
IK
born time:
biphasic growth
topography
month
yryr
yrIK
„Maxillary ductDuctus maxillaris“
Linie patra palatum (palatal line)
Wall ofrecessusfrontalis is thinIK
mandibula growth eventscondyle growth
ramus mandibulae relocation
dorsal margin of ramus appositionforamen mandibulae changes position: symphysis menti
canalis mentalisIK
Latr trias mammal
Jurassicmammal
platypusIK
Canalis alveolaris inferiorformation; formation of the
mandibular body
M.Doskočil: Chrupavka ve vývoji mandibuly. (cartilage in the development of the mandible) Cs.Stomatologie, 1:10-18, 1988 Klepáček, Mazánek et al. 2002
SecondarycartilageIK
Grey 1918IK
rovina okluze occlusal planeprotetická rovina Camper plane
xvodorovná rovinahorizontal plane
M.Doskočil: Chrupavka ve vývoji mandibuly. (cartilage in the development of themandible) Cs.Stomatologie, 1:10-18, 1988
Meckel´s cartilage and cartilaginous derivatives insidemandibular neckIK
ENDIK
aposice
Additions of jaw mass in women are between 9-18 year to less than half of menIK
V principle
IK
mandible growthcondylar growthremodelation (influenced by insertion of m. pterygoideus lat.)
Relocation ramus mandibulaeVertical growth, alveolar formation
Apposition on dorsal surface of ramus mandibulae
Foramen mandibulae ´chages´position: (from level of upperalveolar margine to occlusal plane of the last molar 3-15 yr)
Symphysis mentiVentrally is gradually missing - afer postnatal month 6 is not seen
Canalis mentalisinfluenced by interstitial bone growth and growth of the mandible to widthIK
Podle Čiháka 1997IK
Feature ´rotation´duringdevelopment:Around condyle axisAround imaginaryaxis which isparallel with body ofmandible
matrix rotation (matrix rotation, apparent rotation):
(´shift´ of the superficialjaw layer due to surrounding hard structures)Inner rotation of the
matrix (intramatrix rotation, angular remodelling)(´rotation´ of thespongiosa insidejaws)
Sc. Total rotation of thematrix -rearrangement of jaw IK
IK
red line lomená linka –
přibližný rozsah úponu
hluboké části masseterusupposed
extent of thedeep
masseterpart
IK
IK
Hmatné struktury
Palpable structuresIK
Foramenlinguale ? _ _
FETAL MONTH 3
FETAL MONTH 7
YEAR 1IK
IK
Eaglův syndrom –
osifikace vazu společně s
osifikací lig. stylohyoideum
dráždí n. IXIK
Eruptio dentorum
IK
0.1-0.4 mm
IK
En-En – šířka čelisti
mandible width
Co-Ii-Co –Bonvillův trojúhelník
Bonvill triangleIK
After Lang et al. 2002
Canalis retromolaris A,B,C)
Canalis (foramen) linguale
A
B CIK
The anterior loop (AL) of the mental nerve: length variations from the most anterior loop point to mental foramen. Colours: blue = MIC, red = mental canal (the anterior opening of the mandibular canal) yellow = mandibular canal. 1 = length of the AL (0.00 to 10 mm).
Panoramic radiograph showing extension of the mental nerve beyond the mental foramen boundary as an intraosseous anterior loop (arrows). Juodzbalys G, Wang HL, Sabalys G.: Anatomy of Mandibular Vital Structures. Part II: Mandibular
Incisive Canal, Mental Foramen and Associated Neurovascular Bundles in Relation with DentalImplantology.J Oral Maxillofac Res. 2010 Apr 1;1(1):e3. doi: 10.5037/jomr.2010.1103. eCollection 2010.
IK
Anatomical variations of the mental foramen (MF) position in the horizontal plane in relation to the roots of teeth.Colours: blue = MIC, red = mental canal (the anterior opening of the mandibular canal) yellow = mandibular canal.1 = distance from MF to midline of the mandible (approximate distance 28 mm); 2 = distance from MF to the inferior border of the mandible (14 to 15 mm); 3 = possible MF location zone in the horizontal plane in relation to the roots of teeth; 4 = the shape of MF can be round or oval, the diameter is 1.68 to 3.5 mm; 5 = prevalence location of MF in the horizontal plane for Caucasian population; 6 = prevalence location of MF in the horizontal plane for Mongoloids and African people.
The appearance of the mental foramen on panoramic radiographs: classification by Yosueand Brooks. A = continuous; B = separated; C = diffuse; D = unidentified type.IK
Emergence patterns of the mental canal and mental foramen opening
Colours: blue = MIC, red = mental canal (the anterior opening of the mandibular canal) yellow = mandibular canal. A = superiorly, B = posterosuperiorly; C = labially; D = mesially (anteriorly); E = posteriorly.
Blue: karea betweenmental openingsinterforaminous regionIK
Rearrangement of the innerjaw structurerespectsmasticatingpressure
Hustota spogiosy
IK
Pressureand tensiontrajectories
in mandibleIK
Transfer of pressure
and loadin mandible
after Lang 1995
Trajectorium dentale(to proc. condylaris)
basilare(from corpus to neck as posticum)
marginale(in angulus)
praeceps(to linea mylohyoidea
and to linea obliqua externa)
copolans(incisura mandibulae)
transversum(from proc.coronoideus to angulus)
radiatum(below each alveolus) IK
Postnatal:Width of face isenlarged slowelyand is finishingthat earlyFace high isenlarged more and finish late
After year 40 resorption is up the aposition
Mandible growsvery long
Jaw growth: anteriorotation Physiologic(ventrocaudaly) Total (whole) influences also aktivity of the
surrounding structures(matrix rotation, apparent rotation)
rotation of the matrix: (intramatrix rotation, angularremodelling)IK
IK
cranial growth size about 90%very low pubertal spurt 5-7 year final size
facial growth 6 year cca 80%pubertal spurt is proportional final size
skeletal (general) growth about 6 yearpubertal spurt accelerate cca 70%
final sizeIK
IK
*IK
IK
posterorotation anterorotationIK
Gender differences
between male and female
skullsIK
ageHead
circumference
Born time 34 cm 6 month 43 cm 1 year 47 cm 3 year 50 cm 10 years 53 cm 18 years 56 cm
Proportional growth
•Relation between head/body: newborn 1/4, adult 1/8
•Relation between body/muscles: 22 % in month 3, 35 % after yr 3, 40 % adult man.
energy•newborn: 40 % energy on growth (110 kcal/kg daily); •toddler: 3 % energy on growth (60–90 kcal/kg daily).
IK
http://www.wikiskripta.eu/index.php/Kojenechttp://www.wikiskripta.eu/index.php/Batole
rovina okluze occlusal planeprotetická rovina Camper plane
xvodorovná rovinahorizontal plane
IK
after Deffez1985
Patrová deska
Palate plateIK
Transmitionof the
masticatorypress on
skullstructures
Three buttresses allow face to absorb force
Nasomaxillary(medial) buttress
Zymaticomaxillary(lateral) buttress
Pyterigomaxillary(posterior) buttress
Midfacebuttresses
vertical and horizontal
IK
• Three buttresses allow face to absorb force– Nasomaxillary
(medial) buttress
– Zymaticomaxillary (lateral) buttress
– Pterygomaxillary (posterior) buttress
Midface buttresses
IK
Tractionand tensionlines in skull
baseIK
Traction and tension lines and main fracture lines in skull basisIK
leFort fractures(René Le Fort 1902)
Location of the fracturelines :
• Medial orbit wall
• Lateral orbit wall to sutura frontozygomatica
• Processus pterygoideus
• Basal part of the nasalseptum - septum nasi
• arcus zygomaticus
IK
Le Fortfractures
Le Fort IGeren fractureSubzygomaticIK
Le Fort fractures
Le Fort IIPyramidal,
central, uppersubzygomaticIK
Le Fort fractures
Le Fort IIISuprazygomatic
fractureIK
CondyleUpper
Lower neck
Retromolar (angular)
Through canine, through
mental region
Fracture lines in the mandible
Traction and tension linesIK
TEETH
tooth dens lat.odoús (ὀδoύς), odóntos (ὀδόντος) gr.
DENTES
(incisor, canine, premolar, molar
(Y5 “dryopithec“ formula )IK
Gingival border of occlusal plane
Prominentia (swallen tubercle surface)determines direction of tubercle gliding during mastication
Sklovinná lišta spojuje hroty hrbolků a valy
M1IK
Utváření horní čelisti a zubního oblouku
materiál dentálního výběžku se musí spojit s výběžkem
faciálnímIK
after Ash and Ramfjord 1982
Hrbolková linie
Centrictubercle
Centrictubercle
Centralocclusion(points in contact appearto be stops (theyare in maximal
intercuspidation) (point centric)
Dynamicocclusion(tubercles are moved betweenICP and RCP and slightly alsoto sides) (free centric)
After Krause 1969
Lines betweeninner and outertubercles
Hrbolková linie
Occlusal contacts antagonistic teeth during intercuspidation
….jsou mezi opěrnými
a protilehlými hrbolky
acentrictubercle
acentrictubercleIK
Dentalarches
Conics
Closed eclipse(elipsoid form)
Opened eclipse(parabolic form)
Berkovitz a kol. 2002
Jaw forms
Schuenke a kol. 2006
IK
Usual occlusal relation between antagonistic teeth
Edward Hartley Angle (1855 – 1930) american dentist and orthodontist„father of modern orthodontia“Normoocclusio I. classIK
IK
I.
II.
III.
Bite enhancementand formation of the
relations between dentalarches during eruption
^ Ash, M. M. and Stanley J. Nelson, S. J.: Dental Anatomy, Physiology, and Occlusion. 8th edition. 2003
The distance between opposite alveolar margines is increasedyear
year
year
Bite enhancement
Bite enhancement
Bite enhancement
IK
http://en.wikipedia.org/wiki/Tooth_eruption
IK
IK
Berkowitz et al.: Oral Anatomy, Histology and Embryology. 3rd ed.. Mosby 2002Woelfel, Scheid: Dental Anatomy, 6th ed. Williams & Wilkins, 2002Feneis, Dauber: Pocket Atlas of Human Anatomy. Georg Thieme, 2007Weber: Memorix Zahnmedizin. 2nd. ed., Georg Thieme Verlag 2003Schuenke,Schulte,Schumacher: Head and Neuroanatomy. Thieme, 2006Fehrenbach,Herring: Anatomy of the Head and Neck. 3rd ed., Saunders Elsevier, 2007Snell: Clinical Anatomy for Medical Students. Williams and Wilkins, 2004 Moore, Agur: Essential Clinical Anatomy, Williams and Wilkins 2002Lang: Clinical Anatomy of the Masticatory Apparatus and Peripharyngeal Spaces. Stuttgart, Thieme, 1995White, Pharoah: Oral Radiology: Principles and Interpretation 5th ed., Mosby, 2003Bath-Balogh: Workbook for Illustrated Dental Embryology, Histology and Anatomy. 2nded. 2005, SaundersWhaites: Essentials of Dental Radiography and Radiology. 4th ed., 2006Churchill Livingstone Ivo Klepáček, J. Mazánek et al.: Klinická anatomie ve stomatologii. Grada 2002Own archive
see: www.lf1.cuni.czor: http://anat.lf1.cuni.cz/aindex.html
Sources
IK
http://www.lavoisier.fr/gb/livres/index.asp?togo=detail.asp?texte=506213&action=new&select=auteurhttp://www.lf1.cuni.cz/http://anat.lf1.cuni.cz/aindex.html