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1. The Cranial Vault
Pre-natal and Post-natal
Development
INDIAN DENTAL ACADEMY
Leader in continuing dental education
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2. Introduction
Four regions of the Craniofacial complex:The
o The
o The
o The
o
Cranial Vault
Cranial Base
Naso-maxillary complex
Mandible
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3. Introduction
Further –
Pre - natal and Post - natal growth
Attention to:i. Site and location of growth
ii. Type of growth occurring.
iii. Determinant or controlling factors.
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4. Anatomy – in Brief
Synonyms:Calvaria not calvarium
Cranial vault
Desmocranium
Calva
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5. Anatomy – in Brief
Norma
Norma
Norma
Norma
Norma
Verticalis – Above
Basalis – Below
Lateralis – Side
Occipitalis – Back
Frontalis - Front
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6. Anatomy – in Brief
Span –
Superciliary ridges & glabella or frontal
bone
Squamous occipital bone
Part of Squamous temporal bone.
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7. Anatomy – in Brief
When viewed from above:a. Ellipsoidal (roughly)
b. Bones –
Frontal
Parietal
Occipital
Temporal
Greater wing of sphenoid
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14. Pre-Natal Growth
Close relation between ectomeninx and
endomeninx except in areas of venous
sinuses.
Fibres of Falx cerebri, Falx cerebelli and
Tentorium cerebelli.
Shape of brain
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15. Pre-Natal Growth
Site
site of future bones
Ossification
Intra membranous
Controlling factor
Brain growth
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17. Pre-Natal Growth
Frontal Bone
Primary centre
Super ciliary arch
Secondary centers
zygomatic process,
nasal spine,
trochlear fossa
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18. Pre-Natal Growth
Parietal bone
Region of Parietal eminence
Occipital bone (Squamous part)
Just above superior nuchal line
Temporal bone (Squamous part)
Root of zygoma
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19. Pre-Natal Growth
Tympanic ring of temporal bone
4 centers in lateral wall of tympanum
Formation of Sutural/Incal bones
Unusual centers of ossification
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20. Pre-Natal Growth
Ossification centers appear around 8th
week IU.
Fontanelles
Close at various times- 2 months to 2 years
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22. Pre-Natal Growth
-Control
3 questions posed by Van Limborgh:Relationship between skull and
primordia of other organs?
Co-ordination of endochondral and
intramembranous ossification?
Co-ordination of growth of skull and
other organs?
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24. Intrinsic Genetic control
Local epigenetic factors
Cranial
differentiation
General epigenetic factors
Local Environmental factors
General Environmental factors
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25. Pre-Natal Growth
-Control
Shift of belief:Genetic influence
Examples- Primordia of eye.
- Brain.
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Epigenetics
26. Intrinsic Genetic control
Local epigenetic factors
Cranial
differentiation
General epigenetic factors
Local Environmental factors
General Environmental factors
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27. Post-Natal Growth
Related to Growth of the Brain
Maximum growth upto the 5th year of
life – (91% as shown by Davenport)
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28. Post-Natal Growth
Various Theories of Growth, and how
they relate to the cranial vault.
Sicher’s Sutural dominance theory
Scott’s Cartilaginous theory
Moss’ FMH
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29. Post-Natal Intrinsic Genetic control
Growth
Sicher’s Theory
Local epigenetic factors
Desmocranial
Growth
General epigenetic factors
Local Environmental factors
General Environmental factors
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31. Post-Natal Growth
Intrinsic Genetic control
Chondrocranial
Growth
Local epigenetic factors
General epigenetic factors
Desmo- Sutures
cranial
Periosteal
Growth growth
Local Environmental factors
General Environmental factors
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32. Post-Natal Growth
Moss’ FMH
Intrinsic Genetic control
Local epigenetic factors
Desmocranial
Growth
General epigenetic factors
Local Environmental factors
General Environmental factors
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34. Post-Natal Growth
Sicher – Intrinsic control
Hydrocephalus, anencephaly,
microcephaly
Scott – Cartilage not responsive to
pressure or tension, but intra
membranous bone is.
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36. Post-Natal Growth
Synchondrosis
Sutures
Sarnat, Burdi, Baume, Petrovic etc.
Also explains why growth of cranial base
is less influenced by brain growth than
growth of Cranial vault - Van Limborgh
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37. Post-Natal Growth
Moss’ explanation for brain growth
controlling growth of the cranium…
Hydrocephalus, synostosis
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40. Post-Natal Growth
Van Limborgh's Summarization:1. Intrinsic control of growth at
synchondroses
2. Intrinsic control of sutural growth is
less
3. Synchondroses
Growth centre
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41. Post-Natal Growth
4. Sutural growth controlled in part by
growth of cranial base
5. Periosteal bone growth (vault)
controlled epigenetically by adjacent
structures
6. Growth of cranial vault also controlled
by local environmental factors (muscle
forces inclusive)
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50. Clinical Implications
Development of the outer
superstructure of the skull – especially
at mastoid, temporal and nuchal lines.
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53. Clinical Implications
Various conditions – cretinism, progeria,
trisomy 21, cleidocranial dysostosis, Anterior fontanelles remain open
Bossing of forehead
Brachycephalic skull
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54. Clinical Implications
Herniation of dura mater into the nose
Dura remains in contact with the
ectoderm in the region of the anterior
neuropore.
Ventral bending of the fronto-nasal
process brings this junction close to the
future nose.
Nasal capsule forms around this, and the
junction sinks forming the foramen
caecum
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56. Clinical Implications
The dura then separates from the
ectoderm, and foramen caecum closes.
If this foramen fails to close, dura can
herniate in to the nose.
Also formation of dermoid cysts, sinus or
encephalocele.
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