Overview
This lecture covers the anatomy, growth patterns, influencing factors, and modification methods (natural, orthodontic, pharmaceutical, and surgical) for the maxillary bone and its impact on facial aesthetics and function.
Maxillary Bone Growth and Influence
- The maxilla determines facial development, airway space, dental fit, and facial attractiveness.
- Maxillary growth occurs in three planes: anteroposterior (front-back), transverse (side-side), and vertical (up-down).
- Forward growth affects midface projection; side-side growth affects palate width and nasal space; vertical growth impacts eye support and smile appearance.
- The functional matrix theory states that muscle activity, breathing, chewing, and tongue posture guide maxillary development.
- Poor habits (mouth breathing, soft food chewing, slouching) hinder natural forward maxillary growth.
Natural and Orthodontic Modification
- Natural improvement methods include correct tongue posture, nasal breathing, hard chewing, and myofunctional therapy.
- Natural methods are most effective in childhood; after adolescence, bone structures become set and less responsive.
- Palatal expanders, Damon braces, and face masks can guide maxillary growth in children and some teens/young adults.
- Early intervention is optimal, as suture activity declines after ages 22-25.
Pharmaceutical and Surgical Options
- Peptides like IGF-1 and CJC 1295, and low-dose oxandrolone, are being researched for potential bone growth effects.
- Lefort I, II, and III osteotomies allow 3D repositioning of the maxilla.
- Augmentation methods (fat grafts, implants, hydroxyapatite) may be needed for volumetric reconstruction.
- Surgical corrections must consider both maxillary and mandibular harmony; procedures like BSSO (bilateral sagittal split osteotomy) help align occlusion and aesthetics.
Key Terms & Definitions
- Maxilla — upper jawbone crucial for facial form, airway, and dental alignment.
- Functional Matrix Theory — idea that bone growth is influenced by functional activities like breathing and chewing.
- Palatal Expander — device to widen the upper jaw.
- Lefort Osteotomy — surgical procedure to move the maxilla.
- BSSO — surgery to move the lower jaw for functional and aesthetic alignment.
Action Items / Next Steps
- Review your own facial habits (breathing, tongue posture, chewing).
- Read further on functional matrix theory and maxillary expansion methods.
- Await the next lecture for detailed surgical scenarios.