development of face

2. DEVELOPMENT OF
FACE
Guided by-
Dr. SEEMA CHAUDHARY
Dr. NAVEEN MANUJA
Dr. CHAITRA T.R.
Dr. ASHISH AMIT SINHA
Prepared by-
Dr. Priyanka Biswas
M.D.S. 1st YEAR

3. All the naturally occurring unidirectional changes in
the life of an individual from its existence as a single cell
to its elaboration as a multifunctional unit terminating
in death.

4. In the hindbrain, crest cells originate from segmented regions known as
rhombomeres (R1 to R8).
R1 and R2 - first arch.
R4- second arch
R6 and 7- third arch
R8- fourth and sixth arches.
First arch receives crest cells originating in midbrain.
Patterning of pharyngeal arches (except first arch) is regulated by HOX
genes.
OTX2 participate in morphogenesis of the first arch.

8. Processes Developmental
Primordia
Relation to
stomatodeum
Parts of face formed Trigeminal
nerve division
innervating
Frontonasal
(Unpaired)
Mesenchyme
ventral to
developing
forebrain
Middle part of
upper border
Forehead,External
nose,Nasal
cavity,Nasal
septum,Philtrum of
upper lip
Ophthalmic
Except
philtrum
(maxillary)
Maxillary
(Paired)
Mesoderm of
dorsal part of 1st
arch
Lateral part of
upper border
Lateral parts of
upper lip,Upper
parts cheeks
Maxillary
Mandibular
(Paired)
Mesoderm of
ventral part of
1st arch
Lower border Chin,Lower lip,Lower
parts of cheeks
Mandibular

9.  Upper Lip
Each maxillary process
grows medially below the
developing eye and fuses
with the lateral nasal
process and then with the
medial nasal process.

10.  Lower Lip
The mandibular processes
of the two sides grow
toward each other and
fuse in the midline.

11.  Cheeks
The maxillary process fuses with
the lateral nasal process, region of
lip and extends from
stomatodeum to medial angle of
developing eye.
This line of fusion is marked by
the nasooptic furrow or
nasolacrimal sulcus.

12. Eyes

13. Nose

14. – Frontonasal process forms the bridge of
the nose.
– Fused medial nasal processes form the
dorsum and tip of nose.
– Lateral nasal processes form the alae of
of the nose
Mesoderm: Heaped up in median plane
forming prominence of nose.
External nares: Fusion of maxillary process
& medial nasal process.

15.  Palate
Components of Palate-
1. Primary/primitive palate: develops
from frontonasal process
2. Secondary palate/palatal processes:
develop from maxillary process.
Definitive/permanent palate: fusion of
these three parts as follows:
• Palatal processes + primitive palate.
• Both palatal processes of maxilla.
• Palatal processes + nasal septum

16. Age Developmental events
4th week Frontonasal, maxillary and mandibular processes can be identified
Lens and nasal placodes are present
5th week Nasal pits are established
6th week Tubercles for the development of pinna begin to be formed
On each side, palatal process arises from the maxillary process
7th week Eyelids are established
Maxillary process fuses with the medial nasal process
8th week Eyes shift from a lateral to a frontal position, Bucconasal membrane
ruptures
10th week Palatal processes and nasal septum fuse with each other

17. Tongue

18. Embryonic
Precursor
Intermediate
Structure
Adult Structure Innervation
Pharyngeal arch 1 Median tongue
bud
Lateral lingual
swellings
Overgrown by
lateral lingual
swellings
Mucosa of anterior
two thirds of
tongue
Lingual branch (sensory)
of mandibular division
of trigeminal nerve
Chorda tympani from
facial nerve (innervates
all taste buds except
vallate papillae)
Pharyngeal arch 2 Copula Overgrown by
other structures

19. Embryonic
Precursor
Intermediate
Structure
Adult Structure Innervation
Pharyngeal arch 3 Large, ventral part
of hypopharyngeal
eminence
Mucosa of most of
posterior one third
of tongue
Sensory branch of
glossopharyngeal nerve
(supplies vallate papillae)
Pharyngeal arch 4 Small, dorsal part of
of hypopharyngeal
eminence
Mucosa of small
region on dorsal side
side of posterior one
third of tongue
Sensory fibers of
superior laryngeal
branch of vagus nerve
Occipital somites Myoblasts Intrinsic muscles of
tongue
Hypoglossal nerve
Head mesoderm Myoblasts Palatoglossus muscle
muscle
Pharyngeal plexus of
vagus nerve

20.  Paranasal sinuses
The maxillary sinus- Forms during third fetal month, invaginations from
nasal sac within maxillary bones.
The sphenoid and frontal sinuses- Forms during fourth fetal month and
undergo secondary pneumatization during infancy.
The ethmoid sinuses- forms during fifth fetal month, invaginations from
middle meatus of nasal passages deep into ethmoid bone postnatally.

21. Ankyloglossia- tongue is not freed from
floor of the mouth.
The most common form- frenulum
extends to tip of tongue.

22. ◆ Paramedian lip pits
◆ Commissural lip pits
 Anomalies of lip

23.  Van der woude syndrome
Ascher syndrome

24. • Atresia can be seen- at the external nares, at posterior
nasal aperture or in cavity proper.
• Communication between cranial cavity and nose due to
congenital defects in the cribriform plate of ethmoid
bone.
• The nasal septum deflected to one side or may be
absent.
• Communication of nasal cavity with the mouth.

25. Clinical correlation
Cleft palate
Complete cleft palate:
• Bilateral complete cleft
• Unilateral complete cleft
Incomplete cleft palate:
• Cleft of hard and soft palate
palate
• Cleft of soft palate
• Bifid uvula
Anticonvulsant drugs
(phenobarbital,
diphenylhydantoin) given
during pregnancy increase risk
of cleft palate

26. nasal stent
Grayson et al. first described this
modification in 1993.
As soon as possible after birth, a custom-
made alveolar mold is worn full time, with
weekly or biweekly adjustments until
alveolar cleft is narrowed to 5 mm or less.
Goals:
• Bringing lip segments together
• Reducing alar base
• Relaxing tension on a splayed alar rim
NASO-ALVEOLAR MOULDING
Nasal stent

27. • Harelip:
– Unilateral harelip: Maxillary process & MNP
on one side.
– Bilateral harelip: Both maxillary processes &
MNP.
– Midline cleft of upper lip: Defective
development of lower most part of frontonasal
process, give rise to midline defect of upper lip.
• Cleft of lower lip:
When two mandibular processes do not fuse
with each other, lower lip shows a defect in
midline. The defect usually extends into jaw.

28. • Oblique facial cleft:
Non fusion of maxillary and LNP-
cleft running from medial angle of
eye to mouth.
Unilateral lack of fusion: leads to
formation of a lateral facial cleft.
Macrostomia-
Inadequate fusion of the
mandibular and maxillary
with each other.
Microstomia-
Too much fusion may result in a
small mouth.

29. Cyclops
 The nose forms a cylindrical
projection or proboscis jutting out
from below forehead.
 May affect only one half of nose
and is usually associated with
fusion of two eyes.

32. C/C- A 17-year-old woman reported
to department with a sensitivity to
hot and cold in her left lower back
tooth.
Extraoral findings-
narrow face with mandibular and
zygomatic hypoplasia along with
antimongoloid slant of eyes.
Malar hypoplasia resulted in a ‘sunk-
in’ appearance.
Partial absence of lower eyelashes
and coloboma of lower lateral eyelid.
Rudimentary pinna was present
bilaterally.

33. Intraoral examination- revealed
anterior open bite and carious
left lower 1st and 2nd molars.
Radiographic investigations-
PA skull view and lateral skull
view revealed mandibular
hypoplasia along with prominent
antigonial notch.
Treatment- The patient was
treated for her chief complaint
and motivated for orthodontic
treatment and prosthetic
reconstruction of the ears.

34. Pierre-Robin
Sequence
-Alters first-arch structures.
-Triad of micrognathia, cleft
palate, and glossoptosis.
Goldenhar Syndrome
craniofacial abnormalities-
involve maxillary, temporal, and
zygomatic bones. Ear, eye, and
vertebral defects observed.

35. DiGeorgeSequence
-Includes velocardiofacial syndrome and
conotruncal anomalies face syndrome.
- CATCH22
-Deletion of long arm of chromosome
22q11.
-Genetic causes, exposure to retinoids,
alcohol, and maternal diabetes can
produce the defects.

36. Loeys-Dietz Syndrome
The triad of arterial tortuosity and aneurysms, hypertelorism, and bifid uvula
or cleft palate.
Caused by heterozygous mutations in the genes encoding transforming
growth factor B receptors 1(chromosome 9q33– q34) and 2(chromosome
3p24).
1) LDS type 1: Craniofacial involvement consisting of cleft palate,
craniosynostosis, or hypertelorism.
2) LDS type 2: Isolated bifid uvula and no other craniofacial features,