c


 

     

  
 

Last time we talked about the development of face. We said the face formed by a num. of dermal processes.


Today we are going to talk about the development of the palate. The development of palate starts at the î 
 and we have to define two types of two part of the palate; Primary palate and Secondary palate, The
anterior region of the palate that carries the central and lateral incisors is called the primary palate and the
remain part is called the secondary palate. +Primary and secondary palates form separately, and finally they
fuse together forming the whole palate.

+ Secondary palate has two parts, one on the left side and one on the other side. These are called the palatine
processes. At first these processes are vertical. Why are they vertically oriented and not horizontal? Because we
have a structure that occupies the space between them, this space is occupied by the tongue, with time, with the
facial growth, the tongue becomes lower and drops in the space between the two palatine processes, which
allows the processes to go horizontally and fuse with the primary palate. [So now we have primary palate
anteriorly and two palatine processes posteriorly, the three part fuse together, and form the whole palate] that's
why they start to adjust themselves (they start to go horizontal, instead of vertical).

+ In anatomy, the palate is formed by two bones; the maxilla and the palatine bones. Here we talk about
separate processes, and not separate bones, that help in forming the palate. So, the tongue is in between,
horizontal reorientation, and then they start to reorient themselves, the tongue goes down, first they fuse with
the primary palate, second they fuse with each other, and finally they fuse with the nasal septum, because in the
nasal cavity we have the nasal septum, so all of these fuse together.

+ The palate is completed by 60 days, the point of fusion is the point where the two sides meet with primary
palate, and then fusion goes in three directions.

+ If we have a problem in fusion, this problem actually will be seen as failure of fusion, some people (one case
in every 700 birth) are born with the cleft palate. Why this happens? It¶s because we have many reasons of
fusion failure. Most of the cases are because of genetic problems, so when the two palatine processes failed to
develop,

They form what we call  


, what happens when the primary palate fails to fuse with one or both of
the secondary palates? It gives what we call   ; the primary palate which also called the 

is
formed by the palatine processes of the maxilla so when the intermaxillary projections are failed to fuse to each
other the resultant will be cleft lip, and failure of fusion of the primary and secondary palate to each other.

+ Sometimes, when the patient is unlucky, we'll have a bilateral cleft. For example when the two palatine bones
fail to fuse to each other and also fail to fuse with the primary palate (premaxilla).

+These patients of cleft lip and palate require multiple surgical procedures which needed to be completed before
the age of 12, so the management is going to be at early age.
    
  
]
   

    








 




  




 








 












 






 


  


  






   

! 

" 




#






   $%


   &


 
  
 













   

 

 
 
 













' 
 








 


 


!

 



()
 





 


$*
 





 
 
 








 


 




 






 


   
  
 

+
   









 is formed by intramembranous ossification, despite the fact we have cartilage in the region of the
body of the mandible which called ,


 but this cartilage have nothing to do with development
itself it only guide the development so it act as scaffold

+The ramus of the mandible is formed by endochondral ossification; we have two site of cartilage:




, it appears at the 11 week after fertilization and continues to provide growth for the
mandible until 21 years old and it provide growth for the mandible in height.
 

, it only active prenatally because just before birth it gets replaced by bone

+The other thing that we need to understand is that when we have muscle attachment there will be growth of
bone.

The angle of the mandible has two muscles of mastication attached to it which contribute to its growth:

 
  




  

The coronoid process has muscle attached to it which also contribute to its growth and called temporalis muscle










 





 


-
 $



2
     

We are going to talk about the development of tooth and their supporting structures. We have three overlapping
phases in tooth development (This means that they are not separate).

+The first phase is  

mwhich is the site where the future teeth is established. And we have the
development of the structure called dental lamina, this is important for tooth formation, and then appearance of
tooth germ.

+The second phase is 


m when the shape of the crown is determined; Morphology is the
study of form, size and shape.

All the processes that take place to give the three dimensional shape of the crown of the tooth, they are actually
classified under morphogenesis.

+ In addition to establishing the shape of the tooth, we also want to changes in the cells that will form the tooth,
And these are included under histogenesis (the internal changes that that take place in the cells that form the
tooth that are needed to the formation of hard tissue and soft tissue of the tooth) that's why it involves
differentiation of cells [cells start as simple cells, later they start to differentiate and they start to involve certain
functions; some cells will be responsible to form the enamel, and other cell will form the dentin and so on.
That's why it's called differentiationm the internal changes that take place inside these cells to be responsible for
different functions, This is called Histogenesis , but morphogenesis include the changes to give the three
dimensional shape and size of the tooth.

+Let's start with the early signs. The first sign is the condensation of the ectomesenchymal tissue and capillary
network beneath oral epithelium at specific sites. Why at specific sites? Because we have more than one tooth
and each tooth should be developed at specific site, so at the site where the tooth should be developed, we have
condensation of the ectomesenchyme.
+ Where do we have the stomodeum (primitive mouth) the primitive mouth is lined by ectoderm, and beneath
the ectoderm we have the mesoderm (and we said that mesoderm in this region, the head region, is not actually
the real mesoderm, it is ectomesenchymal tissue, Which means that it rises from neural crest cells) the site
where one tooth is going to develop, we have condensation of ectomesenchymal tissue just under the ectoderm.

+ Also we have capillary network at specific site then it leads to the formation of Primary Epithelium Band
(PEB) = when the oral epithelium thickens and invagenates into condensed ectomesenchyme. After that, the
PEB divides into two parts: one part goes facially, and also called vestibular lamina, and the other part goes
lingually, and also called dental lamina.

+ The dental lamina is the structure that will develop the tooth, and the vestibular lamina will become the sulcus
(space), it goes buccully and labially to form the oral vestibule (vestibular laminam with time, the cells inside it
become lost, and we'll get a space, This is the space between the teeth and the cheeks mposteriorlym or the teeth
and the lips ± anteriorlym), and the remaining part which goes lingually is called the dental lamina.

So the vestibular lamina goes buccully to form the oral vestibule (the space between the teeth and the cheeks or
the teeth and the lips)

The dental lamina goes lingually to form the teeth. That's why it's called arch shaped banded tissue, going
lingually, and it is surrounded by a condensation. At the end of each one it will form a teeth   




 . A series of swelling happens at the deep surface, y3ny at the terminal end of the dental laminae.
These swelling at the terminal end is called Enamel organ which is the swelling that happens in the first part of
the tooth bud.


 : is the early part of the tooth that formed, it includes the enamel organ and the surrounding
ectomesenchymal tissue, and we divide it into 3 different stages:

. 








(.



. 



+ It involves the formation of enamel organ which will form the outer surface of the crown which is the enamel.
* Enamel organ= Early structure of tooth that come from ectoderm.

So the enamel organ is the one which determine the three dimensional shape of the crown

REMEMBER that teeth cannot develop at the same time. It's impossible to see the entire tooth developing at the
same time

+in the bud stage the enamel organ look spherical or ovoid

+In the bud stage the tooth is poorly morphodifferentiated so the three dimensional shape of the crown is not
recognized and poorly histodifferentiated so we can¶t recognize different type of cell.
+Successive development of tooth germ involve complex interaction between epithelial and mesenchymal
component so if we make tissue culture for the enamel organ there will be no tooth development because there
no mesenchymal tissue which is needed for process to continue and the opposite is true

+The basement membrane which separate between the epithelium and the underlying mesenchymal tissue play
an important role in order to facilitate this interaction

Remembermthe epithelium is the enamel organ and the epithelium is ectodermal origin





We divide it into m
  m and  m  m

-





+The down surface of enamel organ invaginate to form a cap shaped structure (hence the name)

+Cell is still poorly differentiated y3ny not similar to each other but still we able to differentiate between two
populations of cell which arem

1) Inner (central) cell which have no specific function and it rounded in appearance

2) Peripheral cell which further divided intom

a) Internal enamel epithelium (IEE)

b) External enamel epithelium (EEE)

/




+here we have the development of cells called stellate reticulum which in the early cap stage were round cell
with no specific function but here in this stage the cell start to develop intercellular spaces

+the IEE cell becomes columnar in shape

+the EEE become cuboidal
+the ectomesenchymal tissue which surround the enamel organ is recognized here in 2 different region
1) Dental papilla which is the future pulp
2) Dental follicle

[