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Essentials of Facial Growth
by Enlow and Hans
Table of
Contents
OVERVIEW OF CRANIOFACIAL GROWTH AND DEVELOPMENT
The Big Picture
A Cornerstone of the Growth Process
The “Genic” Tissues
Regional Control of Development
The Three Principal Regions of Facial and
Neurocranial
Development
The Brain and Basicranium
The Airway
The Oral Region
Craniofacial Levels
The Two Basic Clinical Targets
Child-to-Adult Changing Proportions
Tooth Movement
Drift
A Fundamental Principle of Growth
BASIC GROWTH CONCEPTS
Remodeling
Fields of Remodeling
Implant Markers
The “V” Principle
The Relocation Function of Remodeling
The Displacement Process
Growth Rotations
Remodeling and Displacement Combinations
Superimposing Headfilm Combinations
THE DEVELOPMENTAL SEQUENCE
Regional Change (Stage) 1
- 17
GROWTH OF THE MANDIBLE
Mandibular Remodeling
The Ramus
The Lingual Tuberosity
The Ramus-to-Corpus Remodeling Conversion
The Mandibular Condyle
The Condylar Question
The Adaptive Role of the Condyle
The New Image of the Condyle and “Condylar
Growth”
The Ramus and Middle Cranial Fossa
Relationship
Ramus Uprighting
The Human Chin
The Ramus-Corpus Combine
THE NASOMAXILLARY COMPLEX
The Maxillary Tuberosity and Arch Lengthening
The Biomechanical Force Underlying Maxillary
Displacement
Nasomaxillary Remodeling
The Lacrimal Suture, A Key Growth Mediator
The Maxillary Tuberosity and the Key Ridge
The Vertical Drift of Teeth: An Important
Clinical
Consideration
The Nasal Airway
Palatal Remodeling
Downward Maxillary Displacement
Maxillary Sutures
The Cheekbone and Zygomatic Arch
Orbital Growth
THE NEUROCRANIUM
The Calvaria
The Basicranium
FACIAL GROWTH AND TOOTH MOVEMENT BASICS
FACIAL FORM AND PATTERN
Headform
The Dinaric Headform
Male Versus Female Facial Features
Child Versus Adult Facial Features
The Changing Features of the Growing Face
Facial Variations
THE PLAN OF THE HUMAN FACE
Brain Enlargement, Basicranial Flexure, and Facial
Rotations
Nasomaxillary Configuration
Growth Field Boundaries
NORMAL VARIATIONS IN FACIAL FORM AND THE ANATOMIC BASIS
FOR MALOCCLUSIONS
Headform and Malocclusion Tendencies
The “Effective Dimension”
The Dimensional Factor of Alignment
Dimensional and Alignment Pattern Combinations
Growth “Compensations”
Dentoalveolar Compensations
Dentoalveolar Curve (of Spee)
Summary of Class II and III Skeletal Features
The Facial Spectrum
The Continuous Facial Sequence and
Developmental
Intergrades
THE STRUCTURAL BASIS FOR ETHNIC VARIATIONS IN FACIAL
FORM
CONTROL PROCESSES IN FACIAL GROWTH
Synopsis of Craniofacial Growth Control Theories
The Genetic Blueprint
Biomechanical Forces
Sutures, Condyles, and Synchondroses
The Nasal Septum
The Functional Matrix
Composite Explanations
Control Messengers
Bioelectric Signals
Other Factors of Growth Control
The Architectonics of Growth Control: A
Summary
PRENATAL FACIAL GROWTH AND DEVELOPMENT
Remodeling in the Fetal Face
Nasomaxillary Complex
The Mandible
A Developmental Timetable
MATURATION OF THE OROFACIAL NEUROMUSCULATURE
Robert E. Moyers and David S. Carlson
Prenatal Maturation
Neonatal Oral Functions
Infantile Suckling and Swallowing
Maintenance of the Airway
Infant Cry
Gagging
Early Postnatal Development of Oral Neuromuscular
Function
Mastication
Facial Expression
Speech
Mature Swallow
Neural Regulations of Jaw Positions
Occlusal Homeostasis
Effect of Neuromuscular Function on Facial Growth
Effects of Orthodontic Treatment on the
Musculature
CEPHALOMETRICS
B. Holly Broadbent Jr.
Orientation
Tracing the X-Rays
Norms, Variability, and Comparison
Bolton Standards
Summary
Counterpart Analysis (of Enlow)
Computerized Cephalometrics and Videoimaging
Glossary of Terms
BONE AND CARTILAGE
Bone
Bone Tissue Types Related to Development and
Function
Haversian Systems
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