Oral Biology 5301

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Oral Biology 5301

• Bone growth and development
• Bone biology
• Educational objectives
• Exposure to basic concepts of bone biology
• Correlation of basic bone biology to clinical
  treatment
• Special considerations / implications of bone
  biology to dentistry

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Clinical Correlates of Bone Growth and Development

• Facial skeletal development
• Maxillary development
• Mandibular development

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Clinical Correlates of Bone Growth and Development

• 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

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Clincal Correlates of Bone Growth and Development

• Orthodontic tooth movement
• Bone healing following tooth extraction
• Bone response to alloplastic materials
• Bone healing in approximation of dental implants

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Clinical Correlates of Bone Growth and Development

• Bone grafting to treat dentoalveolar defects
• Bone grafting to treat discontinuity defects
• Fracture healing

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Cellular Growth

• Hypertrophy
• Hyperplasia
• Secretion of extracellular material
• Interstitial growth

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Embryologic Type of Bone

• Endochondral
• Intramembranous

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Functional Matrix Theory of Growth

• 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

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Growth Control

• 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

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Orthodontic Tooth Movement

• Bone apposition and resorption
• Effects on the pulp
• Effects on the PDL
• Effects on the tooth root

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Effects of Periosteum

• Provision of undifferentiated mesechymal cells
• Envelope to limit/regulate bone apposition

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Introduction10 y.o. female 12/98

• CC
• Noticed swelling in face on left side for two
  weeks

• HPI
• Facial swelling
• Left lower lip tingles
• No pain or change in bite

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Examination

• Left lower facial swelling, without thrill/bruit
• Lower vestibular swelling, LgtR
• No abnormal tooth mobility
• Teeth 19-28 vital with EPT
• CN II-XII grossly intact

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Assessment

• Problem list
• Multilocular radiolucent lesion
• Teeth vital without resorption, displacement, or
  mobility
• Apparent cortical expansion

• Diff. Dx
• Central Giant Cell Lesion
• Ameloblastomic Fibroodontoma
• Ameloblastoma

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Treatment Plan

• Impressions for splint fabrication
• Screening labs Ca, alk phos, PTH
• All WNL
• CT of mandible
• Multilocular radiolucents, from infer border to
  encompass tooth roots superiorly
• Buccal and lingual cortices intact, although
  expansion present
• Incisional bx

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Facial Growth and Development

• 15 year old man
• Congenital cleft lip and palate
• 29 surgeries to nose and lip
• Significant malocclusion
• Status post facial skeletal growth
• Masticatory insufficiency

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Facial Growth and Development

• 4 year old boy with jaw immobility
• Mother concerned about failure to thrive and
  ability to receive dental care
• Anterior open bite
• Etiology unknown

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Facial Growth and Development

• 7 year old boy
• Condylar neoplasm resected as infant (age 2) and
  recurrence treated age 4
• Concerns about facial growth and development

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