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Garbha Upanishad From the conjugation of the blood and semen embryo comes into existence.during the period of conception, after the sexual inter course it becomes kalada (one day old embryo) after remaining seven nights it becomes a spherical mass, after two months the head is formed, after three months limb region is formed
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Aristotle of stagera Claudius Galen Talmud Leonardo da vinci To present sheep cloning in 1997 by Ian Wilmut
Definition of Growth
Growth refers to increase in size - Todd Growth usually refers to an increase in size
J.S.Huxley.
Definition of Development
Development is a progress towards
maturity Todd
levels - Enlow
terminating in death
Moyers
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Definitions
Morphogenesis A biologic process having an underlying control at the cellular and tissue levels Differentiation It is a change from generalized cells or tissues to a more specialized kinds during development
Translocation
It is a change in position
Maturation
It is the emergence of personal characteristics and behavioural phenomenon through growth processes
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c. Maturity
d .Old age
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Timing and sequential change Prenatal growth- rapid increase in cell no. Postnatal growth- 20 yrs- declining growthincreasing maturation
Maturity-period of stability
Old age
death
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Functional change
Maturational change
Compositional change
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Proportional change
Dropping of diaphragm
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environment
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Changing complexity
All level of organisation
- sub-cellular to
whole organism
Complexity
development
Orthodontics
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fixed.
levels of organisation.
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Increase in size
Development
Development=growth+differenciation+translocation
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PATTERN
Pattern in growth represents proportionality .It
refers not just to a set of proportional relationships at a point in time but to change in these proportional relationships over time
The physical arrangement of the body at any
DIFFERENTIAL GROWTH
Different organs grow at different rates amount and at different times.
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GENITAL
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It illustrates the change in overall body proportions during normal growth and development.
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Predictability
Predictability of growth pattern is a specific
kind of proportionality that exists at a particular time and progresses towards another, at the next time frame with slight variations.
Change in growth pattern indicates some
Variability
No two individuals with the exception of
normal or abnormal
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Normality
Normality refers to that which is usually
quantitative variability
This can be done by using growth charts
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TYPES OF NORMALITY
STATISTICAL EVOLUTIONARY FUNCTIONAL
ESTHETICAL
CLINICAL
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Growth chart
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can be established.
Can be used to follow a child over time and
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Timing of Growth
One of the factors for variablity in growth. Timing variations arise because biologic clock of
Height
Distance curve
Age
Velocity curve
Distance Curve (cumulative curve): In this curve growth can be plotted in height or weight recorded at various ages. Velocity Curve(incremental curve): In this by amount of change in any given interval that is growth increment is plotted.
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Growth spurts
Defined as periods of growth acceleration Sex-linked
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shoulders of giants
_ SIR ISAAC NEWTON , ENGLISH MATHEMATICIAN 1643- 1727
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Methods of studying bone growth Types of growth data Methods of gathering growth data
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RATING
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Direct data: measurements ,living persons or cadaver -measuring device. Indirect data: images or reproductions of actual person.
Derived data comparing at least two measurements.
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Longitudinal studies.
measurements of same person or groupregular intervals through time. Advantage: problems are smoothed with time, Variability,serial comparison makes study of specific developmental pattern of individual possible. Disadvantages: time consuming, expensive, sample loss or attrition,averaging.
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DISADVANTAGES
Variation amongst individuals cannot be studied
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The mathews implant collection The hixon oregon implant study Cleft palate study
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The dentofacial relationships of 3 normal facial types (long, average, short) from 5-25 yrs of age was described & compared.
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METHODS
OF STUDYING GROWTH
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-- Pattern Intelligence / Specific areas of Skull Specific Growth Perfection / Dumbness etc.....
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craniometry. anthropometry.
cephalometry.
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ANTHROPOMETRY:
soft tissue pts over bony landmarks- living individuals. variation in soft tissue thickness - different rslts individual growth directly measured
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CEPHALOMETRIC RADIOGRAPHY: direct measurement - bony skeletal dimensions follow up same individual over time .
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Mineralized sections.
less processing distortions , both organic and inorganic matrix- studied simultaneously. Cellular details , resolutions - enhanced reduce thickness of the sections. Special stains Thin sections- quench- rapidly
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Microradiography.
High resolution of images of bone sections Differential density btwn pri and seco bone. Bone strength -proportional to degree of mineralisation. seco bone more strength than pri bone. Seco mineralisation process- 8 months to form minimum retention : 6-8 months.
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THERMOGRAPHY
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Scintigraphy
Hot Spots.
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MRI
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Fluorescent labels.
in vivo calcium binding labels anabolic time markers of bone formation. Mechanism of bone growth determined by analysis of label incidence and interlabel distance. Sequential use of different colored labels assess bone growth,healing and functional adaptation. Tetracycline,calcein green,xylenol orange,alizarin complexone,demeclocycline and oxytetracycline
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Radioisotopes.
Radioisotopes of certain elements or compounds are often used as in vivo markers labeled material injected and located within the growing bone by autoradiographic techniques.
1. Technetium 99 2. Calcium 45 3. Potassium 32
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RADIOISOTOPES
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Autoradiography.
Histological sections are coated with a nuclear track emulsion to detect radiographic precursor for structural and metabolic material. Specific radioactive labels for protein carbohydrates or nucleic acids are injected.
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Quantitative and qualitative assessment of the label uptake is a physiologic index of cell activity. Commonly used autoradiographic labels are: A. 3 H thymidine. B. 3 H proline. C. Bromodeoxyuridine.
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Polarized light.
indicates the orientation of collagen fibers within the bone matrix. Most lamellar bone consists of collagen fibers oriented at right angles. However 2 other configurations can also be noted:longitudinally aligned(L osteons).
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And mixed fiber pattern. Loading condition at the time of bone formation dictate the orientation of collagen fibers . Thus bone formation can adapt to different loading conditions by changing the internal lamellar organization of bone tissue.
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Teleradiology.
Introduced in 1982 at international conference
of PACS. Universal method of storing and transporting digital images . Currently American college of radiology have developed DICOM to allow the transmisssion of images over the internet.
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Vital staining
reported by Belchier in 1796 John Hunter- alizarin dye Other dyes : tetracyline trypon blue lead acetate procion
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Natural markers.
developmental features - serial radiography. trabaculae,nutrient canals, lines of arrested growth cephalometric landmarks.
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Implant markers.
Bjork- tantalum or biologically inert alloys into growing bone radiographic reference markers for serial cephalometric study. The method allows precise orientation of serial cephalograms and information on the amount and sites of bone growth.
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B O N E :-
L : ost
Gr : osteon
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Osteoprogenitor Cells
-- Stem cells of mesenchymal origin.
Osteoblast cells
-- Bone forming cells. -- varied shape - oval - triangular - cuboidal -- increased RER, golgi apparatus -- Lay down organic matrix and calcification.
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Osteocytes
-- imprisoned osteoblast --keep intact lacunae & canaliculli
Osteoclasts
-- Bone removing cells -- resorption bay or Howships lacunae -- 2-100 um -- nuclei-20 or more -- acid phosphatase and lizosomes
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Periosteum
-- outer layer-fibrous -- inner layer-cellular
Function nutritive -- supportive-sharpeys fibers -- reparative-protective-osteoprogenitor cells -- protective-limiting membrane -oldage exostosis due to tear of periosteum
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Ossification Intramembraneous
endochondral
Intramembranous Ossification
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Endochondral ossification
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cartilage
bone
Calcified Vascular Essential Sensitive Inflexible Appositional
Non calcified Vascularity Avascular Surface membrane Nonessential Pressure resistance Tolerant Rigidity Flexible Modes of growth Interstitial and appositional
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TYPE OF BONES
Lamellar bone Non lamellar bone Fine cancellous bone
Clinical significance
Full strength of lamellar bone supporting an
orthodontically moved tooth is not attained for upto a year after completion of active treatment.
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Woven bone
Type of non lamellar bone Weak , disorganised, poorly mineralised Not found in adult human skeleton under
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Bundle bone
Present adjacent to periodontal ligament Presence of perpendicular striations called
sharpeys fibres. Formed on depository side of socket, laid dowm in the direction toward the moving tooth root.
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Composite bone
Predominant bone type during early retention
phase Most rapid means of producing strong bone Formed by deposition of lamellar bone within a woven bone lattice.
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drift displacement
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direction of growth are subject to deposition (+) and those opposite to it undergo resorption(-) surface principal
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covering membraneperiosteal bone comprises about half of the cortical bone tissue: bone laid down by the lining membrane-endosteal bone makes up the other half.
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Transverse histologic section of bone: A.Periosteal surface reorptive,endosteal surface depository. B.New endosteal bone addedon inner surface. C.Endosteal layer produced covered by periosteal layer following outward reversal. D.Cortex made entirely of periosteal bone.outer surface depository and inner surface resorptive.
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Growth fields
Inside and outside of
every bone is covered by growth fields which control the bone growth. They are both resorptive and depository types..
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About one half of the bone is periosteal and the other half endosteal.If endosteal surface is resorptive then periosteal surface would be depository. Provides two growth functions: Enlargement of any given bone Remodelling of any given bone
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Growth sites
Growth
fields having
special role in the growth of the particular bone are called growth sites e.g. mandibular condyle, maxillary tuberosity, synchondrosis of the basicranium, sutures and the alveolar process.
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Growth sites
Such
special sites do not out the entire carry growth process but the entire bone takes part
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Growth centers
Special areas which are
believed to control the overall growth of the bone e.g.mandibular condyle. Force, energy or motor for a bone resides primarily within its growth centre. Now believed that these centers do not control the whole growth process.
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MODELING
Bone modeling involves independent sites of resorption and formation that change the size and
shape of a bone.
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Endocrine.
1. 2. 3.
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Remodelling
Required differential growth activity required for bone shaping. It involves deposition and resorption occuring on opposite ends Four types Biochemical remodelling Haversian remodelling Pathologic remodelling Growth remodelling
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posteriorly by the combination of deposition and resorption. so the anterior part of the ramus gets remodeled into a new addition for the mandibular corpus.
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Functions of Remodeling
1.
whole bone
3. Progressively change the shape of the bone to
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Functions of Remodeling
1.
Progressively change the size of whole bone Sequentially relocate each component of the whole bone Progressively change the shape of the bone to accommodate its various functions
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2.
3.
4. Progressive fine tune fitting of all the separate bones to each other and to their contiguous ,growing, functioning soft tissues 5. Carry out continuous structural adjustments to
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Drift
It is remodeling process
and a combination of deposition and resorption. If an implant is placed on depository side it gets embedded.eventually marker becomes translocated from one side of cortex to other.
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Displacement
Displacement is a physical movement of the
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Primary displacement
It is a physical
movement of a whole bone and occurs while the bone grows and remodels by resorption deposition E.g. in maxilla
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Secondary displacement
It is the movement of a
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general functions
Positions each bone
Designs and constructs each bone
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Balloon Anology
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Hand Anology
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Rotation
According to Enlow,
growth rotation is due to diagonally placed areas of deposition and resorption Two types
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Horiz Verti
PTM
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Stage 2
Displacement. Amt of forward displacement equals the amt of post length. PTM returns to same line. Class 2 position of maxilla.
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Stage 3
What are counterparts of maxillary
arch. - NMC - ACF - Palate - Corpus of mandible. mandible described. - Corpus - Ramus Why separate bcoz has separate counterparts.
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max arch. Body of max arch cp of max arch. Corpus remodels, what was ramus at once becomes body. however still cl 2.
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Stage 4
remodelling and disp of
mandi. condyle and post part of ramus remodels. process not to increase width of ramus. but to relocate it postly for lengthening the corpus.
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stage 5
whole mandible displaced
ant by amt ramus has relocated. post- primary displ. ramus lengthening remains same. only corpus horizontal dimension change. cl 1 returned. separation of occlusion.
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stage 6
dimension of temporal
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stage 7
vertical line moves ant. forehead cheekbone ACF Palate Max arch all move in ant
direction.
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stage 8
Effect of MCf on mandi.-
secondry disp. less than max effect. bcoz MCF grows in front and between the condyle and maxi tuberosity. SOS lies between condyle and ant boundary of MCF.
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MCF counterpart ?
stage 9
space. skeletol function of ramus - bridge pharyngeal space and span of MCF. A-P breadth of ramus is critical. - too narrow- retrusive. wide- protrusive.
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stage 9
floor of ACF & forehead grow by endocranial
depostition & ectocranial resorption. nasal bone ant displaced. enlarging bone displaces calvaria by sutural growth. depositing new bone at contact edges. 1. frontal. 2. parietal. 3. occipital. 4. temporal.
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stage 10
NMC vertical
lengthening. remodelling depo and reso. prim disp. resorption of superior (nasal side). deposition of inferior (oral side).
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stage 11
Downward mvmt of
palate & max arch. 2-3 downward pri disp & suture grow 1-2 remodelling. 2-3 downward disp. 1-2 teeth own mvmnt ( vertical drift). can be clinically influenced by appliances.
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Stage 12
upward / superior drift
of each mandi tooth. max teeth drift more than mandi teeth. less growth to work with in mandi. curve of spee.
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stage 13
remodelling also
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stage 14
rationale of growth of
zygo process. zygo remodels post more deposition ant less resorption hence forward growth.
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Enlows V principal
Most useful and basic
concept in facial growth as many facial and cranial bones have a V- shaped configuration. Bone deposition(+) occurs on the inner side and resorption (-) occurs on the outer surface.
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lingual side of coronoid process,growth proceeds and this part of the ramus increases in vertical dimension.
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also bring about a posterior direction of growth movement. This produces a backward movement of coronoid processes even though deposit is on the lingual side.
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undergoes relocation into a more narrow part as the whole v moves towards the wide part (fig 2)
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REFERENCES:
Proffit:contemporary orthodontics. Moyers:handbook of orthodontics. An inventory of United states and Canadian
growth record sets.S.Hunter , Baumrind S AJO 1993. Craniofacial imaging in orthodontics :S Kapila et al AO 1999:69 Essays in honour of Robert moyers CFGS.monograph 24.
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References
Bone biodynamics in orthodontics:CFGS.27 Atlas of craniofacial growth in Americans
of African descent CFGS.26 Growth changes in the nasal profile from 78 yrs AJO 1988:94 Meng H ,R Nanda Longitudinal changes in 3 normal facial types .S Bishara,AJO1985:88 S Bishara,J R Peterson, changes in the facial dimensions & relationships between the ages 5-25yrs.AJO 1984:85
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References
Lewis A B, Roche AF pubertal spurts in
cranial base & mandible AJO 1985:55 Popovich.Thompson. Craniofacial templates for orthodontic case analysis. Baumrind S,Korn EL,quantitation of maxillary remodeling. AJO 1987:91 Atlas of craniofacial growth CFGS monograph 2. Moyers,Van Der Linden standards of human occlusal development CFGS:5 B Grayson 3D cephalogram theory,technique and clinical application.
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