Theories of growth

Resource faculty:
Dr. Prabhat Ranjan Pokherel Sunny Bhattarai
Dr. Rajesh Gyawali 549 / 2012
Dr. Jamal Giri
(Department of orthodontics and dentofacial orthopedics)
Contents

Introduction to Growth
Theories of growth
Genetic theory
Sutural theory
Cartilaginous theory
Functional matrix theory
Van limborghs theory
Other theories
Growth

The self multiplication of living substance

(J.S.Huxley)
An increase in size
(Todd)
Quantative aspect of biologic development per unit time
(Moyers)
Growth

Growth is generally referred as increase in size or

number

It is largely an anatomic phenomenon

Major theories explaining growth are:

Genetic theory
Sutural theory
Cartilaginous theory
Functional matrix theory
Van limborghs theory
Other theories related to craniofacial growth

Enlows expanding V principle

Enlows counterpart principle
Neurotrophic process in oro-facial growth
Q. Genetic theory was put forward by?

1. Sicher
2. Brodie
3. Moss
4. Limborgh
Genetic theory

By Brodie in 1941
One of the earliest theories put forward
growth contolled by genetic influence and is preplanned
Q. Genetic theory was put forward by ?

1. Sicher
2. Brodie
3. Moss
4. Limborgh

ans:2
Q. All are the points against the sutural theory
except

1. Failure in growth during transplant

2. Growth in absence of suture
3. Shape of suture have been found to depend upon functional
stimulus
4. Mechanical forces have no effect on growth
Sutural theory

Sicher and weinnman in 1947

Cranio-facial growth occurs at suture
Cranio -facial skeleton enlarges due to expansible forces
exerted by sutures as they separate
Sutural growth in cranial vaults
 Points in against:
1. Failure in growth during transplant
2. Growth in absence of suture
3. Shape of suture have been found to depend upon
functional stimulus
4. growth can be halted by mechanical forces
Q. All are the points against the sutural theory
except

1. Failure in growth during transplant

2. Growth in absence of suture
3. Shape of suture have been found to depend upon functional
stimulus
4. Mechanical forces have no effect on growth

Ans:D
Q. Pacemaker for development of naso-
maxillary complex?
Cartilaginous theory

By james scott
Aka scott hypothesis / nasal septum theory / naso-capsular theory
Primary site of growth cartilage
Suture play little or no role in cranio-facial development
 Nasal-septal cartilage pacemaker for growth of entire
naso-maxillary complex

Experimental excision of nasal septum affects growth of

mid face considerably

Mandible long bone with a horse-shoe shaped

diaphysis with condyle representing an epiphyseal
plate.
Points in favour:
1. In many bones, cartilage growth occurs ,while bone
merely replace it
2. Epiphyseal plate and Nasal septal cartilage innate
growth potential
3. In 15%-20% of Scandinavian children studied who
suffered from condylar fracture showed reduction in
growth after the injury
4. Experiments on rabbit involving removal of nasal septal
Points against:
mandibular condyle showed significantly less growth than other
cartilage
It can be urged that the surgery itself and accompaning interference
with blood supply to the area can cause the growth changes.
Growth reduction seen in scandinavian children can be related to the
amount of trauma and the resultant scarring in the area.
Lund demonstrated that there was an excellent chance that the
condylar process would regenerate to its original size after fractures
Q. Pacemaker for development of naso-
maxillary complex?

Ans. Nasal-septal cartilage

Functional matrix theory

Melvin moss in 1960s and reviewed by him in 1999

Function determines Form
origin ,form ,position ,growth and maintenance of all
skeletal tissues and organs are always secondary
,compensatory and necessary responses to
chronologically and morphologically prior events or
processes that occur in specifically related non-skeletal
tissue ,organs or functioning spaces
 Functions carried out by functional cranial components
Functional cranial components :
I. Functional matrix
II. Skeletal unit
I. Skeletal unit

. composed of bone ,cartilage and tendinous tissues

. Micro-skeletal unit : bone compromised of several small skeletal
units
.Maxilla orbital, pneumatic ,palatal ,basal
.Mandible alveolar ,angular ,condylar ,gonial ,mental ,coronoid
,basal
.Macro-skeletal units: adjoining portion of number of bones united to
function as a single cranial component
II. Functional matrix

Consists of soft tissues muscles ,glands ,nerves ,vessels ,

fats ,teeth and functioning spaces

Two types : periosteal matrices and capsular matrices

Periosteal matrices:

Acts directly and actively upon their related skeletal units

produce secondary compensatory transformation
Functional demand skeletal remodelingtransformation
Eg: blood vessels ,nerves ,muscles ,glands

Capsular matrices:
Acts indirectly and passively upon their related skeletal tissues
produce secondary compensatory translation
Skeletal units moved; no bone remodeling
Organization of functional matrix theory
 Drawbacks

Introduced vague terms that were confusing

So, functional matrix was re-explained in 1999 by Moss

himself
Van Limborghs theory

Van limborgh in 1970

Combined all the three existing theory
He believed following factors controlled growth:
I . Intrinsic genetic factor
II . Local epigenetic factor
III . General epigenetic factor
IV . Local environmental factor
V . General environmental factor
I. Intrinsic genetic factors
genetic expression in bones and cartilage

II. Local epigenetic factors

bone growth by genetic control from adjacent
structures like brain,eyes

III. General epigenetic factors

genetic factor determining growth from distant
structures.
eg. Sex hormones ,growth hormones
IV. Local environmental factors
nongenetic factors from local external environment
eg. Habits ,muscle force

V . General environmental factors

non genetic external influences
eg. Nutrition ,oxygen
Views expressed by Limborgh

Intrinsic genetic factor-controls chondrocranial and

desmocranial growth
Cartilaginous part of skull must be considered as
growth centers
Sutural growth is mainly controlled by skull cartilages
and other skull structures
Periosteal growth largely depends upon adjacent
structure
Sutural and periosteal growth are additionally governed
by local non-genetic environmental influences
Enlows expanding v principle

States about V shaped pattern of growth

Growth occur towards wide end of V: differential deposition and
selective resorption
Bone deposition on inner side and resorption on outer side
Deposition also at the 2 ends of arm
Occurs in base and body of mandible, palate , ends of long bones
etc
 Enlows counterpart principle

Growth of any facial or cranial part relates specifically to

other structural and geometric counterpart in face and
cranium

Balanced growth : Regional growth = counterpart growth

Imbalance occurs due to :

amount, direction and time
Parts and counterparts:

Naso -maxillary complex : anterior cranial fossa

Horizontal dimension of pharyngeal space : middle
cranial fossa
Middle cranial fossa : breadth of ramus
Maxillary arch : mandibular arch
Bony maxilla : corpus of mandible
Maxillary tuberosity : lingual tuberosity
Neurotrophic principle

Non- impulse transmitting neural function involving axoplasmic

transport and providing long-term interaction between neuron and
innervated tissues
Hemostatically regulates the morphological ,compositional and
functional integrity of tissue

3 neurotrophic mechanism:
- Neuro-epithelial trophism
- Neuro-visceral trophism
- Neuro-muscular trophism
Neuro-epithelial tropism
Epithelial mitosis and synthesis neurotropically
controlled
In absence: abnormal epithelial growth, oro-
facial hypoplasia and malformation occurs
Neuro-muscular
Eg. tastebuds tropism
Embryonic myogenesis independent of neurotropic
control
At myoblast stage, neural innervation occurs without
which further myogenesis cannot occur(Moss)
Neuro-visceral tropism
The salivary gland, fat tissues and other organs
are neurotropically regulated
References:

Contemporary orthodontics by William R. Proffit

Orthodontics: The art and science by S.L. Bhalajhi