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EVOLUTION OF

THEORIES

Craniofacial biology as
Normal Science
David S. Carlson

The Structure of Scientific Revolutions


Thomas Kuhn (1970)
NORMAL SCIENCE:
Research firmly based upon one or
more past scientific achievements,
achievements that some particular
scientific community acknowledges as
supplying the foundation for its further
practice.
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paradigm

Model or concept

A conceptual scheme that encompasses


individual theories and is accepted by a
scientific community as a model and foundation
for further research.

SCIENTIFIC COMMUNITY group


characterized by its consensus about a paradigm
& commitment to relate that paradigm to the
rest of the natural world.
Conflict between scientific communities.
SCIENTIFIC REVOLUTION Change in
paradigm brought about by inconsistencies
within the old scheme or by technologic
developments that permit scientist to ask new
questions & gain new data.

Changing paradigms
INTRINSIC GENETIC FACTORS
FUNCTIONAL FACTORS
EPIGENETIC FACTORS

1920-1940
Study of craniofacial skeleton with no
consideration to function
- Anthropologic
craniometry
-Racial analysis for socioeconomic structure of
western Europe
Krogman- static approach
Moss(1982)1. Pre-radiologic phase - craniometry
2.
Radiologic phase no conceptual change
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Studies based on
Comparative anatomy,
Craniometrics,
Radiographic cephalometrics

Anatomic intuition & extrapolation from other parts of


body- growth immutable & genetically pre-determined.

Moss- Classic Triad


1. Sutures are primary growth sites
2. Growth of the cranial vault occurs only by periosteal
deposition and endosteal resorption.
3. All cephalic cartilages are primary growth centers
under direct genetic control

Genomic paradigm
Genetically determined so growth pattern
invariant.
norms or standards
Treatment of bones of face ignored
heredity & unmodifiable
Focus on the more plastic dentoalveolar
area.
If not alter facial growth acceptable
dental alignment.
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1940-1960

Increase in experimental animal research.

Methodologic change- Technological


developments:1. Use of Radioopaque Implants.
2. Vital Dyes.
3. Autoradiography.
4. In-vivo and In-vitro transplantations.

Conceptual change- too many variations in


growth to be genetically determined; affected
by modifying influences
Mid to late 1950s- PRE-REVOLUTIONARY 10

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The end of 1950s 2 approaches within


genomic paradigm (Krogman 1974)

1. COMPREHENSIVE APPROACH
2. STRUCTUROFUNTIONAL APPROACH

Comprehensive approach:
descriptive
continued craniometrics with more
sophisticated hardware -radiographs,
cephalostats and software (statistical
models).
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Structurofunctional Approach:
Experimental & analytic
Concentrated more on cause and effect
relationships
Effect of altered or abnormal function on
form

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The end of 1950s -genomic paradigm put


into question
Periosteal and sutural bone growth removed from genomic paradigm - given
the status of secondary, compensatory or
adaptive phenomena
Lack of evidence- genomic paradigm
remained dominant
Alternative view-Function plays a major
role - continued to gather momentum.
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1960-1980
Early 1960s- period of Revolution.
Development of alternative paradigm mostly
associated with Melvin Moss
Functional Matrix Hypothesis- some consider it
to be an alternative paradigm itself.
David Carlson- major component of
FUNCTIONAL PARADIGM
Daniels & Kremanak has probably both
stimulated & inhibited thinking &
experimentation. It may be harmful in thinking.
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Functional Matrix Hypothesis- a topic


of theoretical debate involving people likeMoorrees(1972)
Koski(1972)
Wayne Watson(1982)
Johnston(1976)
Alexander Petrovic and associates(1975)proposed the Cybernetic theory.

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2 Paradigms :

1. Genomic--Exists primarily on the strength of


the
belief that facial growth and
form should be encoded genetically.
2. Functional--Includes the Functional Matrix
Hypothesis and its extension-The epigenetic
hypothesis
At present - a confluence of these two
paradigms is seen until a new one is
proposed.
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Theories of growth
Different theories differ in the location
at which genetic control is established.
3 major theories explaining primary
determinant of craniofacial growth
1. Bone
2. Cartilage
3. Soft-tissue matrix

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Growth site versus growth


centre
Cranial growth centers: Facts or
fallacies? Koski
AJO-DO 1968 Aug (566-583)
BAUME:
Growth Centre- site of endochondral
ossification with tissue-separating force,
contributing to the increase of skeletal
mass.
i.e. location at which independent
(genetically controlled) growth occurs.
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Growth site: regions of periosteal or


sutural bone formation and modeling
resorption adaptive to environmental
influences.
i.e. merely location at which growth
occurs.

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Sutural dominance theory


SICHER studies using vital dyes sutures
caused much of growth
.the primary event in sutural growth is the
proliferation of the connective tissue between
the two bones. If the sutural connective
tissue proliferates it creates the space for
oppositional growth at the borders of the two
bones.
Connective tissue in sutures of nasomaxillary
complex & vault separated bones like
synchondrosis & epiphyseal plate
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Sicher ascribes equal value osteogenic


tissues, cartilage, sutures & periosteum.

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2 differing views concerning the structure of


the sutures
1. Three-layer structure:
- Connective
tissue between the two bones - same as
cartilage at the base of the skull, epiphyses,
and articular surfaces of long bones
- "spreading" of the suture,
initiated by the proliferation of the middle layer
cells of the sutural tissue.
-"tissue-separating
force" in the sutural tissue.
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2. Five-layer structure :
-Each bone at the suture has its own twolayer periosteum covering + opposing surfaces of
the bones
-fifth layer between these periosteal
layers - allows for slight adjustments between the
bones during growth -active proliferating role layers of the periosteums of each bone.

Histologic specimens of sutures examined same


interpretation different.

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Evidence against sutural theory


1. Subcutaneous autotransplants of the
zygomaticomaxillary suture area in the guinea
pig have not been found to grow lack of innate
growth potential.
2. Growth of sutures respond to external stimuli.
3. Extirpation of facial sutures - no appreciable
effect on growth of the skeleton.
4. Shape of sutures - depends on functional stimuli
5. Closure of sutures -extrinsically determined.
6. Sites of sutures - not predetermined .
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CONCLUSION:
Sutures are growth sites not centres.
Adaptive, compensatory or secondary
growth.

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Cartilaginous theory
SCOTTS HYPOTHESIS:
Intrinsic growth-controlling factors in cartilage &
periosteum.
Sutures are secondary & dependent on extrasutural
influences.
Cartilaginous part of skull must be recognised as
primary centres of growth, with nasal septum being
a major contributor in maxillary growth, per se.
Sutural growth responsive to synchondrosis
proliferation & local environmental factors.
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Cranial base synchondroses

Removal of spheno-occipital synchondrosis results in an arrest of growth in length of


the cranial base .
Pressure & tension little effect on cartilage.
Intramembranous bone- immediate response.

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Endochondral cranial base lesser


response to brain growth than
intramembranous cranial vault.
Primary centres of growth Sarnat,
Burdi, Baume, Petrovic & others.
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Endochondral ossification at the


synchondroses- only a response to external
stimuli?
Cartilage- lacks same amount of
independent growth potential as transplants
of epiphyseal cartilage under similar
experimental conditions.
Spheno-occipital synchondrosis appears to
close much earlier than is usually stated in
the textbooks -11 to 16 years of age
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Nasal septal cartilage


Scott- primary cartilage in nasal septum
primary mechanism for growth of
nasomaxillary complex.
Latham- ligament extending from nasal
septal cartilage to to anterior premaxillary
region SEPTOPREMAXILLARY
LIGAMENT.
This is an important relation between
midfacial & nasal septal growth especially
before birth.
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Histologic examination - endochondral


ossification at the septo-ethmoidal junction and
area of proliferation at the vomeral edge of the
cartilage
In the palatal area - resorption on the nasal side
and apposition on the oral side of the bony
palate.
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Experimental excision of the nasal septum


affects the growth of the upper face
considerably - due to trauma.
Nasal septum - central support for the upper
facial area, and its loss results in a predictable
collapse in the area.

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Arrhinencephalic 9-month-old child (with


the septum missing) - resorption and
apposition processes in the bony palate
normal.
Height of the upper face not greatly
affected, although the sagittal development
of the middle third of the face was retarded
In recent experiments growth as well in
culture as epiphyseal plate cartilage.

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Condylar cartilage
Growth of the condylar cartilage is responsible
for the anteroposterior growth of the mandibleprimary growth centre.

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Scott- growth of the condylar cartilage enables the


condyle "to grow upwards and backwards so as to
maintain the contact at the temporomandibular joint
as the mandible is carried downwards and forwards
by the growth of the upper facial skeleton."
If the condylar cartilage is transplanted to a relatively
nonfunctional site, such as the subcutaneous or brain
tissue, it does not maintain its structure and does not
behave like the condylar cartilage in situ.
Bilateral condylectomy, congenital absence of the
rami- no appreciable effect on the growth of the rest
of the mandible in humans.

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Studies involving the use of metallic


implants - actual growth of the condyle
is sometimes upward and backward and
sometimes upward and forward.

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