DEVELOPMENT

OF
MAXILLA AND PALATE
CONTENTS:
PRE NATAL POST NATAL
DEVELOPMENTAL
DEVELOPMENT DEVELOPMENT
ANOMALIES

• CLEFT PALATE.
EMBRYONIC DISPLACEMENT • MICROGNATHIA. CLINICAL
DEVELOPMENT REMODELLING • MACROGNATHIA. IMPLICATIONS
GROWTH AT • TREACHER COLLINS
DEVELOPMENT OF SUTURES SYNDROME.
MAXILLA GROWTH IN • CLEIDOCRANIAL
HEIGHT, WIDTH & DYSOSTOSIS.
DEVELOPMENT OF LENGTH
• CRUZONS SYNDROME.
PALATE KEY RIDGES
• APERT SYNDROME.
MECHANISM OF MAXILLARY SINUS
PALATE ELEVATION • ACHONDROPLASIA.
PRE NATAL PERIOD

The pre-natal life can be arbitrarily divided into

three periods.

1. Period of the Ovum

2. Period of the Embryo

3. Period of the Fetus

PERIOD OF
OVUM
This period extends for a
period of approximately two
weeks from the time of
fertilization.
During this time the
cleavage of the ovum and
the attachment of the ovum
to the intra- uterine wall
occurs.
PERIOD OF
EMBRYO
This period extends from the
fourteenth day to the fifty
sixth day of intra-uterine
life.
During this period the major
part of the development of
the facial & the cranial
region occurs.
PERIOD OF
FETUS
• This phase extends
between the fifty sixth day
of intra-uterine life till
birth.
• In this period ,accelerated
growth of cranio-facial
structures occurs resulting
in an increase in their size.
• In addition, a change in
proportion between the
various structures also
occurs.
ANATOMY OF
MAXILLA
FEATURES OF MAXILLA
• It is SECOND largest bone of face
• 2 maxillae forms whole of upper jaw

Each maxilla contributes in formation of –

• 1. Face
• 2. Nose
• 3. Mouth
• 4. Orbit
• 5. Infratemporal fossa
• 6. Pterygopalatine fossa
PARTS OF MAXILLA:

• Each maxilla has –

• 1. A body
• 2. Four processes – Frontal, Zygomatic,
Alveolar, Palatine
• BODY OF MAXILLA
It has –1. Base – directed medially at nasal
surface
2. Apex - directed laterally at
zygomatic process
3. 4 surfaces
Anterior / facial
posterior / infratemporal
Medial / nasal
Superior / orbital
PRE NATAL DEVELOPMENT
OF MAXILLA
By around the 4th week of intra-
uterine life, five branchial arches form
in the region of the future head &
neck.

Each of these arches gives rise to

muscles, connective tissue,
vasculature, skeletal components &
neural components of the future face.
The first branchial arch is called the mandibular
arch & plays an important role in the
development of the naso- maxillary region.
The mesoderm covering the developing forebrain
proliferates & forms a downward projection that
overlaps the upper part of stomodeum .
This downward projection is called “FRONTO-
NASAL PROCESS”.
Around the FOURTH WEEK of intra-uterine life,
a prominent bulge appears corresponding to the
developing brain.
Below the bulge a depression primitive mouth
appears called “ STOMODEUM”.
The floor of the stomodeum is formed by the
BUCCOPHARYNGEAL MEMBRANE
• The stomodeum is thus overlapped
superiorly by the fronto-nasal process.
• The mandibular arches of both the sides
form the lateral walls of the stomodeum.
• The mandibular arch gives off a bud from
its dorsal end called the “MAXILLARY
PROCESS”
• The ectoderm overlying the fronto-nasal
process shows bilateral localized thickenings
above the stomodeum. These are called the
“NASAL PLACODES”.These placodes soon
sink and form the Nasal pits.
• The formation of these nasal pits divides the
fronto-nasal process into two parts:
• a)The medial nasal process
• b)The lateral nasal process
As the maxillary
processes become narrow
so that the two nasal pits
come closer. The line of
fusion of the maxillary
process & the medial
nasal process
corresponds to the naso-
lacrimal duct.
 OSSIFICATION OF
MAXILLA
• Ossification in mesenchyme of maxillary process of
1st arch.
• Center of ossification – close to the cartilage of nasal
capsule in angle between division of infraorbital
nerve
• From this center the bone formation spreads
• Bony trough for infraorbital canal is formed.
• Posteriorly – below the orbit toward the developing
maxilla
• Anteriorly – toward the future incisor region
• Superiorly – to form frontal process
• Medially – to form palate
• MAXILLA ossifies from 3 centers in the
membrane
1 center for maxilla proper – 6th week of IUL,
above the canine fossa
2 centers for premaxilla
Of two premaxillary centers
• Main center above the incisive fossa - 7th week of
IUL
• Second center – ventral margin of nasal septum -
10th week of IUL soon fuses with palatal process
of maxilla.

Premaxilla begin to fuse with alveolar process

almost immediately after the ossification begins.
 POST NATAL DEVELOPMENT OF MAXILLA
• Since, the maxillary complex is
attached to the cranial base,
there is a strong influence of the
latter on the former.
• Although there is no sharp line of
demarcation between the
cranium & maxillary growth
gradients yet the position of the
maxilla is dependent upon the
growth at spheno-occipital &
spheno-ethmoid synchondroses.
• Hence, while discussing the growth of naso-
maxillary complex, we have to look into three
aspects.
1)The displacement in the position of the maxillary
complex
2) Growth at sutures
3)Surface Remodeling
 DISPLACEMENT:

It is the movement of the whole bone as a unit.

Displacement can be of two types.

• PRIMARY DISPLACEMENT: If a bone gets displaced as a result of its own growth, it is called “Primary
displacement”.

e.g.. Growth of the maxilla at the tuberosity region results in pushing of the maxilla against the cranial base which
results in pushing of the maxilla against the cranial base which results in the displacement of the maxilla in a
forward & downward direction.
• SECONDARY DISPLACEMENT: If the bone gets displaced as a result of growth &enlargement of an
adjacent
• bone, it is called “Secondary displacement.”

e.g.. The growth of the cranial base causes the forward &downward displacement of the maxilla
PRIMARY DISPLACEMENT:

• Occurs in a forward direction.

• This occurs by growth of the maxillary
tuberosity in a posterior direction .
• This results in the whole maxilla being
carried anteriorly.
 SECONDARY
DISPLACEMENT
• Expansion of Middle Cranial
fossa has secondary
displacement effect on
anterior Cranial floor and
thus on underlying NASO
MAXILLARY COMPLEX.
Growth occurs in all the three dimensions:

• A-P dimension(in length)

• Transverse dimension (in width)
• Vertical dimension (in height)
SECONDARY DISPLACEMENT(TRANSVERSE
DIMENSION)
• Left and right temporal lobes move away from each other
• Increase in transverse width of middle cranial fossa
• Increase in width of maxilla by-
Growth in mid palatine suture
Remodeling at lateral aspect of alveolar process
SECONDARY DISPLACEMENT (A-P DIMENSION)

• Ant. & Middle cranial fossa move away from each other NMC
carried in forward direction
• Bone deposited in tuberosity area
• Increase in A-P dimension
SECONDARY DISPLACEMENT(VERTICAL
DIMENSION)
• Middle cranial base is in inclined plane
• Increase in dimension of Middle cranial base causes
displacement of NMC in downward direction
GROWTH AT SUTURES:

The maxilla is connected to the cranium and cranial base by a number of sutures.

These sutures include:

• Fronto-nasal suture

• Fronto-maxillary suture

• Zygomatico-maxillary suture

• Zygomatico-temporal suture

• Pterygopalatine suture
GROWTH OF MAXILLA:
• Growth in height - vertical
• Growth in width - transverse
• Growth in length –Anterio posterior
TRANSVERSE DIMENSION (IN WIDTH)

• Growth in midpalatine suture

• Remodelling at lateral surface of alveolar process
GROWTH IN LENGTH –ANTERIO POSTERIOR
GROWTH IN HEIGHT - VERTICAL
3)SURFACE REMODELING
Remodeling occurs by bone deposition & resorption to bring about:
a) Increase in size
b) Change in shape
c) Change in functional relationship
Bone remodeling seen in the midfacial region
Bone remodeling of the palate resulting in its downward displacement
Growth of the palate exhibiting V pattern of growth
The naso-maxillary complex as it emerges from beneath the cranium
NASOMAXILLARY REMODELLING
• Clinically and biologically all inside and outside parts participate directly
in growth
So key factors in NMC growth includes
• Lacrimal suture
• Maxillary Tuberosity
• Vertical drift of teeth
• Nasal airway
• Palatal remodeling
• Cheek bone & zygomatic arch
• Orbital remodelling
LACRIMAL SUTURE(KEY GROWTH MEDIATOR)
• Diminutive flakes of bony islands surrounded by many sutures
forms peri lacrimal sutural system
• Without it a developmental ‘gridlock’ will occur among
differentially developing multiple bones
• It slides maxilla downward along its orbital contacts.
• This allows whole maxilla to get displaced inferiorly
MAXILLARY TUBEROSITY
• The horizontal lengthening of the bony maxillary arch is produced by
remodeling at the maxillary tuberosity
• Established by the posterior boundary of anterior cranial fossa
• It is a depository field
• maxillary tuberosity is important in clinical orthodontics.
• it is also a major site of maxillary growth
• It lengthens posteriorly
• Deposits on buccal surface width
• Deposits on alveolar ridge height
KEY RIDGE:

• Reversal lines occur at Key Ridge

Anterior to it : Resorption
Posterior to it: Apposition
* Reversal line: Irregular lines containing concavities directed away from
the bundle bone and serving as histologic indications that resorption has
taken place up to that line from the marrow side.
THE NASAL AIRWAY

• Lining surface of bony wall and floor

• Resorptive
• Lateral and anterior expansion of nasal chamber
• Downward relocation of palate
• The airway functions as a key stone for face
• Its obstruction can cause variation in facial skeleton
PALATAL REMODELING
• Anteriorly - labial side is Resorptive
• oand palatal side is depository causes o widening of palate
acc to V principle
• As the palate grows inferiorly by the remodeling process, a
nearly complete exchange of old for new hard and soft tissue
occurs
• Growth at mid palatal suture plays a role in the progressive
widening of the palate and alveolar arch
MAXILLARY SINUS

• All internal surfaces are resorptive except medial nasal wall

• Rapid continous downward growth
• EXPANSION OF MAXILLARY SINUS
• At birth - 7 mm length - 4 mm height - 4 mm width
• Expands at rate of - 2 mm vertically
• yearly - 3mm A-P yearly
• Expansion by - bone resorption - by tooth eruption (as vacated
bone become pneumatized) teeth
THE CHEEK BONE & ZYGOMATIC ARCH
• The growth changes of the malar complex are similar
to those of maxilla itself
• The malar region and the anterior part of the zygoma
undergo posterior remodeling movements.
• The inferior edge of the zygoma is heavily depository
• As the malar region grows and becomes relocated
posteriorly, the nasal region is enlarging in an
opposite,anterior direction,drawing out the nose and
making face deeper,anteroposteriorly
ORBITAL GROWTH
• Follows ‘V’ principle
• Enlarging displacement occurs
• Growth at sutures
• orbital floor moves
PALATE
• The Palate anatomically separates the
nasal cavity from the oral cavity and
structurally has a bony (hard) anterior
component and a muscular (soft)
posterior component ending with the
uvula.
 PARTS OF PALATE
• The PRIMARY PALATE is formed by
two parts:

Maxillary components of the first

pharyngeal arch
Frontonasal prominence

• The SECONDARY PALATE :

Anterior hard palate - ossified
Posterior soft palate - muscular.
DEVELOPMENT OF
PALATE

The palate is formed by

the contribution of:
• Maxillary process.
• Palatal shelves given
off by the maxillary
process
• Fronto-nasal process
SECONDARY PALATE
• The development of the secondary palate
commences in the sixth week of human
embryological development.
• It is characterised by the formation of two
palatal shelves on the maxillary prominences
• As the palatal shelves grow medially their, their union is
prevented by the presence of tongue
• Initially the developing palatal shelves grow vertically
toward the floor of mouth
• During 7th week of intrauterine life, a
transformation in the position of the palatine shelf
occurs
• They change from a vertical to a horizontal position
• Various reasons are given to explain how this transformation
occurs. They are:
• Alteration in biochemical and physical consistency of the
connective tissue of the palatal shelves
• Alteration in vasculature and blood supply to the palatal
shelves
• Apperance of an interensic shelf force
• Rapid differential mitotic activity
• Muscular movements
• The 2 palatal shelves, by 8 ½ weeks of intra uterine life are in close
approximation to each other
• Initially the 2 palatal shelves are covered by an epithelial lining. As they
join the epithelial cells degenerate
• The connective tissue of the palatal shelves intermingle with each other
resulting in their fusion
• The entire palate does not contact and fuse at the
same time.
• Initially the contact occurs in the central region of the
secondary palate posterior to the premaxilla
• From this point, closure occurs both anteriorly and
posteriorly
OSSIFICATION OF PALATE
Ossification of the palate occurs from the 8th week of intra-
uterine life. This is an intramembranous type of ossification
The palate ossifies from a single centre derived from the
maxilla
The most posterior part of the palate does not ossify.
This forms the soft palate
The mid palatal suture ossifies by 12-14 yrs
DEVELOPMENT OF PALATE (ORAL VIEW):
DEVELOPMENT OF PALATE (FRONT VIEW):
DEVELOPMENT OF FETAL PALATE: