PubMed · 13393921
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M S BURSTONE. 1957. Esterase activity of developing bones and teeth.. https://pubmed.ncbi.nlm.nih.gov/13393921/
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We report on a 4-year-old boy who presented to the ophthalmology department for assessment of convergent strabismus. Ophthalmic examination showed a left morning glory optic disc anomaly and retinal detachment. Plain films obtained for investigation of short stature prior to ophthalmic examination revealed delayed bone age. Ophthalmological findings prompted CT and MRI imaging and angiographic investigations. Midline cranial defects and abnormal carotid circulation were identified. These findings may be associated with morning glory optic disc anomaly, and their association is often under-recognized. It is important that clinicians and radiologists be aware of this spectrum of disorders, as the vascular abnormalities may predispose the patient to transient ischemic attacks and strokes. Growth delay may result from hypopituitarism.
Developmental dysplasia of the hip (DDH) is the most common orthopedic problem of newborn children. Most clinicians and researchers agree that the primary cause of DDH is abnormal mechanical forces on the head of the femur due to limb position, pressure from the womb, or ligament laxity. The abnormal mechanical forces result in altered growth and bony deformities, in particular large neck-shaft and anteversion angles in the proximal femur and a shallow acetabulum. Previous studies have suggested that intermittent octahedral shear stress promotes growth and ossification, while intermittent hydrostatic compressive stress inhibits growth and ossification. We implemented these mechanobiological principles into a finite element model to predict the rate of progression of the growth front and the formation of coxa valga (large neck-shaft angle) in DDH. Under the assumed normal fetal loading conditions the hydrostatic stress was even across the growth front, but the octahedral shear stress was higher in the center than at the edges. This stress profile promoted growth in the center and a produced a convex growth front shape. Under loading conditions of the dysplastic hip, the octahedral shear stress was much larger on the medial side than on the lateral side, which promoted growth on the medial side and resulted in coxa valga. These results indicate that abnormal forces on the prenatal hip might influence total bone morphology and the development of DDH. These findings might help in understanding the etiology and pathology of other developmental bone deformities.
This clinical report describes the simultaneous use of functional and fixed appliances to modify the pattern of dentofacial development and align teeth in preparation for prosthodontic habilitation of a growing child with hypohidrotic ectodermal dysplasia. The treatment objective was to create a more favorable starting point for the prosthodontic phase of habilitation by improving the sagittal and vertical skeletal relationships and facial esthetics. This was accomplished through growth modification with functional appliances conducted simultaneously with eruption of maxillary and mandibular molars, dental arch expansion, alignment, and space management using fixed orthodontic appliances. Orthodontic retention was accomplished by means of removable partial dentures. A second phase of orthodontics conducted closer to the age of skeletal maturation will aim at definitive tooth alignment in preparation for dental implant-supported restorations.