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The Cranial Vault
Pre-natal and Post-natal
Development

INDIAN DENTAL ACADEMY
Leader in continuing dental education
www.indiandentalacademy.com

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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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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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Anatomy – in Brief
Synonyms:Calvaria not calvarium
Cranial vault
Desmocranium
Calva

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Anatomy – in Brief
Norma
Norma
Norma
Norma
Norma

Verticalis – Above
Basalis – Below
Lateralis – Side
Occipitalis – Back
Frontalis - Front

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Anatomy – in Brief
Span –
Superciliary ridges & glabella or frontal
bone
Squamous occipital bone
Part of Squamous temporal bone.

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Anatomy – in Brief
When viewed from above:a. Ellipsoidal (roughly)
b. Bones –
Frontal
Parietal
Occipital
Temporal
Greater wing of sphenoid
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c.

Anatomy – in Brief
Sutures
Frontal (metopic)
Coronal
Sagittal
Lambdoid
Parietal with Sphenoid
Parietal with Temporal
Bregma
Lambda
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Anatomy – in Brief
SCALP

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Pre-Natal Growth
Derivative of Mesenchyme and Mesoderm
Capsular membraneEndomeninx – Neural crest origin
Ectomeninx – Neural crest and
paraxial mesoderm.

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Pre-Natal Growth
Ectomeninx

Duramater

Superficial membrane

Vault

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Base
Pre-Natal Growth
Endomeninx

Piamater

Arachanoid

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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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Pre-Natal Growth
Site

site of future bones

Ossification

Intra membranous

Controlling factor

Brain growth

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Pre-Natal Growth

Ectomeninx:

Mesoderm –
Frontal, Parietal, sphenoid, petrous
temporal & occipital.
Neural crest –
Lacrimal, nasal, squamous temporal,
zygomatic, maxilla & mandible
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Pre-Natal Growth
Frontal Bone
Primary centre

Super ciliary arch

Secondary centers

zygomatic process,
nasal spine,
trochlear fossa

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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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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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Pre-Natal Growth
Ossification centers appear around 8th
week IU.
Fontanelles
Close at various times- 2 months to 2 years

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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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Pre-Natal Growth
-Control
Intrinsic genetic factors
Epigenetic factors
Environmental factors

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Intrinsic Genetic control

Local epigenetic factors

Cranial
differentiation

General epigenetic factors
Local Environmental factors
General Environmental factors

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Pre-Natal Growth
-Control
Shift of belief:Genetic influence
Examples- Primordia of eye.
- Brain.

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Epigenetics
Intrinsic Genetic control

Local epigenetic factors

Cranial
differentiation

General epigenetic factors
Local Environmental factors
General Environmental factors

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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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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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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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Post-Natal Growth
Scott’s theoryInherent growth potential of Cartilages
Sutures respond secondarily

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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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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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Post-Natal Growth

Ultimate Result

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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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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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Post-Natal Growth
Moss’ explanation for brain growth
controlling growth of the cranium…
Hydrocephalus, synostosis

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Post-Natal Growth
V A U L T

Brain
B A S E
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Post-Natal Growth
Cranial base

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Normal
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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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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Intrinsic Genetic control

Chondrocranial
Growth

Local epigenetic factors
General epigenetic factors

Desmocranial
Growth

Local Environmental factors
General Environmental factors

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Post-Natal Growth
Growth of the cranial vault – direct
influence of Neurocranial capsule

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Post-Natal Growth
Also – Periosteal growth – increase in
thickness - Growth of Diploë

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Post-Natal Growth
Thickening not uniform:Inner table
Brain
Outer table

mechanical influences
and functional stresses
(Benninghoff)
Growth of the frontal sinus

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Post-Natal Growth

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Post-Natal Growth

Periosteal bone formation

Change of shape of the bones

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Clinical Implications

Distortion of head during birth –
Fontanelles

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Clinical Implications
Development of the outer
superstructure of the skull – especially
at mastoid, temporal and nuchal lines.

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Clinical Implications

Synostosis syndromes
Courzon’s syndrome
Apert’s syndrome

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Clinical Implications
Other conditions – Hydrocephalus,
Anencephaly, Microcephaly

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Clinical Implications
Various conditions – cretinism, progeria,
trisomy 21, cleidocranial dysostosis, Anterior fontanelles remain open
Bossing of forehead
Brachycephalic skull

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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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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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Clinical Implications
Abnormal external forces applied to the
cranial vault, as by headboards, by
primitive tribes.

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References

Orthodontics – Principles and practice
T.M. Graber

Contemporary Orthodontics
W.Proffit

Craniofacial embryology
G.Sperber

Essentials of Facial growth
D. Enlow

Gray’s Anatomy
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Thank you
For more details please visit
www.indiandentalacademy.com

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