GROWTH

AND
DEVELOPMENT
OF
CRANIAL BASE

Presented by
Dr. FARAH MEHJABEEN
(JR 1)

Department Of Orthodontics and

Dentofacial orthopedics
 CONTENTS
INTRODUCTION
ANATOMY OF CRANIAL BASE
FUNCTIONS OF CRANIAL BASE
PRENATAL GROWTH OF CRANIAL BASE
POST-NATAL GROWTH OF CRANIAL BASE
SYNCHONDROSES
DISPLACEMENT OF NASOMAXILLARY
COMPLEX
UPRIGHT NATURE OF HUMAN FACE
ANGULATION OF CRANIAL BASE
CLINICAL IMPLICATION OF STUDY OF CRANIAL
BASE
CONCLUSION
REFRENCES
 INTRODUCTION1
The basicranium floors the cranium and provides the platform upon which the brain grows
and around which the face grows.
The ectocranial side of the cranial floor is the interface with the face suspended beneath it.
The perimeter, alignment, and configuration of the basicranium prescribes a "template" that
establishes the growth fields within which both the mandible and nasomaxillary complex
develop.
It has often been presumed that the face is more or less independent of the basicranium, and
that facial growth processes and the topographic features of the face are unrelated to the
size,shape, and growth of the floor of the cranium.This is not the case at all.

ANATOMY OF CRANIAL BASE4

The cranial base forms the floor of the cranial vault and extends from the foramen caecum
anteriorly to the basioccipital bone posteriorly. It is essentially a midline structure comprising
parts of the nasal, orbital, ethmoid, sphenoid, and occipital bones. Sella turcica lies near the
center of the cranial base and divides it into anterior (sella to nasion) and posterior (sella to
basion) limbs.

Although the cranial base largely develops in cartilage (chondrocranium), it depicts both
neural and somatic types of growth patterns. Postnatal growth, especially after early
childhood, in the anterior segment is mainly due to enlargement of the frontal sinuses and
surface remodeling in the nasion region. Posteriorly the growth occurs mainly at the spheno-
occipital synchondrosis (SOS).

The two limbs of the cranial base form a flexion of 130135 at sella. The maxilla appears
attached to the anterior segment and the mandible to the posterior segment. It would be
reasonable to assume, just from this geometric relationship, that any change in flexion would
alter maxillary and mandibular positions relative to the cranial base as well as to each other.
This in turn may influence the skeletal pattern and type of malocclusion.
The cranial base is divided into three main parts:-

ANTERIOR CRANIAL FOSSA

MIDDLE CRANIAL FOSSA
POSTERIOR CRANIAL FOSSA
A, Exocranial view of the skull base. B, Endocranial view of the skull base
 1.ANTERIOR CRANIAL FOSSA4

The boundaries of anterior cranial fossa are:-

Anteriroly - Orbital part of frontal bone

Medially - Cribriform plate of ethmoid
Posteriorly- Anterior part of the body & lesser wing of sphenoid.

Structures present are :-

1.CRIBRIFORM PLATE Of ETHMOID

It separates the fossa from nasal cavity & forms the roof of the nasal cavity.

2. CRISTA GALLI
A median crest like elevation

3.ORBITAL PLATE OF FRONTAL BONE

It separates the orbit and its contents from the inferior surface of the frontal
lobe of the brain. Its antero medial part split into 2 laminae.

4. FRONTAL SINUS

Sutures:-
Fronto-ethmoidal
Spheno-ethmoidal
Spheno-frontal
 2.MIDDLE CRANIAL FOSSA4

It is deeper than the anterior fossa in front it is bounded by posterior borders of the lesser wing
of the sphenoid and the body of the sphenoid.

BORDERS
Anteriorly posterior border of lesser wing of sphenoid
anterior clinoid process &anterior margins of sulcus chiasmaticus
Posteriorly- superior border of petrous part of temporal bone
dorsum sella of the sphenoid
Laterally- greater wing of sphenoid
Antero-inferior angle of parietal bone
Sqamous temporal bone in the middle

STRUCTURES

Centrally:-
OPTIC CANAL
HYPOPHYSEAL FOSSA

Laterally:-
SUPERIOR ORBITAL FISSURE
FORAMEN ROTUNDUM
FORAMEN OVALE
FORAMEN SPINOSUM
FORAMEN LACERUM

SUTURES
Spheno-parietal
Spheno-squamosal
Spheno-petrosal
 3.POSTERIOR CRANIAL FOSSA4

Largest and deepest of the cranial fossa.

BORDERS

Anteriorly Dorsum sellae of the sphenoid bone

Superior border of petrous part of temporal bone
Posteriorly Squamous part of the occipital bone
Laterally Petrous & mastoid parts of temporal bone

VARIOUS FORAMINA
FORAMEN MAGNUM
JUGULAR FORAMIN
INTERNAL ACOUSTIC MEATUS
FACIAL CANAL
HYPOGLOSSAL CANAL

SUTURES

Occipito-mastoid
Parieto-mastoid
 FUNCTIONS OF THE CRANIAL BASE3

The cranial floor and calvaria are adapted to upright body posture and the development
of relatively large cerebral hemispheres.
Cranial base flexure achieves a forward alignment of the face and orbits.
The basicranium supports and protects the brain and spinal cord.
Articulates the skull with the vertebral column, mandible and maxillary region.
One of its important functions is as an adaptive or buffer zone between the brain, face,
and pharyngeal region, whose growths are paced differently.

GROWTH OF CRANIAL BASE3

Growth of the basicranium is carried out by a complex balance among sutural

growth, elongation at synchondroses, extensive cortical drift and remodeling.

This combination provides:-

1. Differential growth enlargement between the cranial floor and the calavira.
2. Expansion of confined contours in the various endocranial fossae.
3. Maintenance of passages and housing for vessels and nerves and such appendages as
the hypophysis.

Elongation of the cranial base is provided by growth at the synchondroses and direct
cortical growth. The process of cortical drift in the cranial floor produces regionally
variable growth movements in a generally ectocranial direction by surface resorption
from the endocranial site, with proportionate deposition on external surfaces.
Growth of the cranial floor has a direct effect on placement of the midface and
mandible. As the anterior cranial fossae and cranial floor elongate, the underlying
space occupied by the enlarging nasomaxillary complex, pharynx, and ramus
increases correspondingly.
The spheno-occipital complex elongates, displacing the entire middle face anteriorly,
producing an enlargement of the pharyngeal region. Correspondingly, the ramus
enlarges as the mandible is displaced anteriorly in conjunction with the forward
displacement of the maxilla. Thus, the anteroposterior growth of the basicranium has
an important role in both nasomaxillary and mandibular growth.
The cranial fossae show reduced rates of remodeling with the completion of brain
growth.
The cranial synchondroses, however, are paced differently, and the fossae continue to
grow somewhat in length for an extended period of time.
The basicranium is generally considered to be the most stable of all portions of the
craniofacial skeleton and least affected by external influences such as altered
neuromuscular function or orthodontic treatment.
 PRENATAL GROWTH OF CRANIAL BASE5,6
During the late somite period(4th-8th week of intrauterine life),the earliest evidence of
cranial base formation is seen.The occipital sclerotomal mesenchyme concentrates around the
notochord underlying the developing hindbrain. From this region, the mesenchymal
concentration extends cephalically, forming a floor for the brain.
Conversion of the ectomeninx mesenchyme into cartilage constitutes the beginning of the
chondrocranium, starting on the 40th day of intra-uterine life.

Formation of the cartilages

Chondrification centers is formed around the cranial end of the notochord called the
parachordal cartilages. A caudal extension of chondrification incorporates the fused
sclerotomes arising from the four occipital somites surrounding the neural tube.
The sclerotome cartilage, the first part of the skull to develop, forms the boundaries of the
foramen magnum, providing the anlagen for the basilar and condylar parts of the occipital
bone.
Two hypophyseal (postsphenoid) cartilages develop on either side of the hypophyseal stem
and fuse to form the basisphenoid (postsphenoid) cartilage, which contains the hypophysis
and which will later give rise to the sella turcica and posterior part of the body of the
sphenoid bone.
Cranial to the pituitary gland, fusion of two presphenoid (trabecular) cartilages forms the
precursor to the presphenoid bone that will form the anterior part of the body of the sphenoid
bone.
Laterally, the chondrification centers of the orbitosphenoid (lesser wing) and alisphenoid
(greater wing) contribute wings to the sphenoid bone. Most anteriorly, the fused presphenoid
cartilages become a vertical cartilaginous plate (the mesethmoid cartilage) within the nasal
septum.

Cartilages of the fetal chondrocranium and their derivatives(The vomer and maxilla are of
intramembranous origin)
An adult cranial base, indicating sites of primordial cartilages of chondrocranium (in black) and extent of
endochondral (light stipple) and intramembranous (heavy stipple)ossification .

The mesethmoid cartilage ossifies at birth into the perpendicular plate of the ethmoid bone,
its upper edge forming the crista galli that separates the olfactory bulbs The otic capsules
chondrify and fuse with the parachordal cartilages to ossify later as the mastoid and petrous
portions of the temporal bones. The optic capsule does not chondrify in humans.
The initially separate centers of cranial base chondrification fuse into a single, irregular, and
much-perforated basal plate. The early (prechondrification) establishment of the blood
vessels, cranial nerves, and spinal cord between the developing brain and its extracranial
contacts is responsible for the numerous perforations (foramina) in the cartilage basal plate
and the subsequent osseous cranial floor The ossifying chondrocranium meets the ossifying
desmocranium to form the neurocranium. The developing brain lies in the shallow groove
formed by the chondrocranium. The deep central hypophysial fossa is bounded by the
presphenoid cartilage of the tuberculum sellae anteriorly and the postsphenoid cartilage of the
dorsum sellae posteriorly.
The human cranial base first appears during the second embryonic life called the
chondrocranium.
By the 7th week: 9 groups of paired cartilagenous precursors are present
By the 8th week: 41 ossification centers appears in the chondrocranium
By the mid of the 3rd month: 1 ossification centre appears in the Basioccipital region
By the 4th month: 2-4 ossification center in the post-sphenoid
By the 5th month: 2 ossification center in the presphenoid
By the 1st year after birth: one center in the mesethmoid

Postnatal growth of basicranium2,5,6

Expansion of cranial base occurs by:-

Growth of the cartilage remnents of the chondrocranium.

Cranial base acts as a template from which the face develops.
The endocranial surface of the basicranium is resorptive in most areas
Remodelling is required to accomodate the massively enlarged human brain.
 THE CALVARIA

The bony surface of the whole cranial floor is predominantly resorptive . This is in contrast
to the endocranial surface of the calvaria, which is predominantly depositry.
As the brain expands the separate bones of the calvaria are correspondingly displaced in outward
directions the primary displacement causes tension in the sutural membranes which responds
immediately by depositing new bone on the sutural edges thereby enlarges in circumference.
The whole bone receives a small amount of new deposition on the flat surfaces of both the
ectocranial and endocranial sides.
The arc of curvature of the whole bone decreases, and the bone becomes Flatter.

Two depository surfaces: outer (cutaneous) inner (meningeal).

Deposition (periosteal): ectocranial sides of skull roof
Resorption (endosteal): inner sides of the skull

THE BASICRANIUM

The cranial floor is the template from which the face develops.
The endocranial surface of the basicranium, in contrast to the roof, is
characteristically resorptive in most areas.
Fossa enlargement is accomplished by direct remodeling, involving deposition on the
outside with resorption from the inside.
Remodeling process that provides for the direct expansion of the various endocranial
fossae in conjunction with sutural (and also synchondrosis) growth. The reason is that
as the fossae expand outward by resorption, the partitions between them must enlarge
inward, in proportion, by deposition.
The midventral segment of the cranial floor grows much more slowly than the floor
of the laterally located fossae. This accommodates the slower development of the
 medulla, pons, hypothalamus, optic chiasma, and so forth, in contrast to the massive,
rapid expansion of the hemispheres. Because the floor of the neurocranium enlarges
by remodeling in addition to sutural and synchondrosis growth these differential
extents and rates of expansion can be carried.
Unlike the skull roof, the floor of the neurocranium provides for the passage of cranial nerves
.o

and the major cerebral blood vessels. Because the expansion of the hemispheres would cause
marked displacement movements of the bones in the cranial floor.
The foramen moves by deposition and resorption, keeping pace with the
corresponding movement of the nerve or vessel it houses as the brain expands
carrying the nerves with it. This relocation movement is differential in magnitude and
direction related to the remodeling movements of the lateral walls of the fossa, thus
requiring sensitive differences in respective regional remodeling.
The midline part of the basicranium is characterized by the presence of synchondroses
During the childhood period of development, however, it is the spheno-occipital
synchondrosis that is the principal "growth cartilage" of the basicranium.
The spheno-occipital synchondrosis provides a pressure-adapted bone growth
mechanism. This is in contrast to the tension-adapted sutural growth process of the
calvaria.
The sphenoid and the occipital bones become moved apart by the primary
displacement process and at the same time, new endochondral (medullary fine-
cancellous) bone is laid down by the endosteum within each bone.
Compact cortical (intramembranous) bone is formed around this core of endochondral
bone tissue. Each whole bone (the sphenoid and the occipital) thereby becomes
lengthened.
Both bones also increase in girth by periosteal and endosteal remodelling.

SYNCHONDROSES 1,2,8

They are a retention left from the primary cartilages of the chondrocranium after the
endochondral ossification centers appear during fetal development.A number of
synchondroses are operative during the fetal and early postnatal periods.
Synchondroses found in cranial base are:-
1.Spheno occipital 3. inter- sphenoidal
2. spheno ethmoidal 4. intra- occipital
During the childhood period of development, it is the spheno-occipital synchondrosis that is
the principal "growth cartilage" of the basicranium. As with all growth cartilages
associated directly with bone development, the spheno-occipital synchondrosis provides a
pressure-adapted bone growth mechanism.
The spheno-occipital synchondrosis is retained throughout the childhood growth period as
long as the brain and basicranium continue to develop and expand. It ceases growth activity
at about 12 to 15 years of age, and the sphenoid and occipital segments then begin to become
fused in this midline area through about 20 years of age1.
The presence of the spheno-occipital synchondrosis provides for the elongation of the midline
portion of the cranial floor by its pressure adapted mechanism of endochondral ossification.
The floor of the cranium also has sutures in the lateral areas, but
(1) the force of the compression produced by the growing neural mass is accommodated by
the synchondrosis,not the sutures
(2) the expansion of the laterally located hemispheres produces tension in these lateral sutural
areas, unlike the more slowly growing midline part of the brain and basicranium not related
directly to the hemispheres.
Sutures are connective tissue membranes that provide tension-adapted sites of
intramembranous bone growth, spheno-occipital synchondrosis has been regarded as the
growth "center" and pacemaker that programs the development of the basicranium. The
development of the basicranium is quite multifactorial and not merely the product of
localized, midline cartilages structure of the synchondrosis is similar to the basic plan for all
"primary" types of growth cartilages, in contrast to the secondary variety of cartilage, zones,"
including the familiar reserve, cell division, hypertrophic, and calcified zones .
Similar to an epiphyseal plate, but unlike the condylar cartilage, the chondroblasts in the cell
division zone are aligned in distinctive columns that point along the line of growth. the
synchondrosis has two major (bipolar) directions of linear growth. Structurally, the
synchondrosis is essentially two epiphyseal plates positioned back-to-back and separated by a
common zone of reserve cartilage.
Endochondral bone growth by the spheno-occipital synchondrosis relates to primary
displacement of the bones involved. The sphenoid and the occipital bones become moved
apart by the primary displacement process , and at the same time, new endochondral
(medullary fine-cancellous) bone is laid down by the endosteum within each bone.Compact
cortical (intramembranous) bone is formed around this core of endochondral bone tissue.
Each whole bone (the sphenoid and the occipital) thereby becomes lengthened. Both bones
also increase in girth by periosteal and endosteal remodeling. As the midface becomes
progressively displaced forward and downward, the sphenoidal body must remodel to retain
contact with it.
The sphenoidal sinus is thereby formed and progressively enlarges. Sphenoidal sinus
expansion does not "push" the maxilla. However , this sinus secondarily "grows" as the body
of the sphenoid bone expands around it keeping constant junction with the moving
nasomaxillary complex.
Traditionally, the cranial cartilages (and the whole basicranium in general) have been
regarded as essentially autonomous growth units that develop in conjunction with the brain,
but somehow independent of it.
Studies show that the independent proliferative capacity of a synchondrosis does not
approach that of epiphyseal plates in long bones. This suggests that whatever capacity the
basicranium (not calvaria) does have for continued growth, extrinsic control factors are also
required.

Four basic considerations involved in the growth of the cranial floor.2

First, The cranial floor conforms in its growth to the differential degrees of expansion of
those particular portions of the brain that it encloses.

Second, Its growth pattern must provide positioning for the numerous passageways to and
from the cranial cavity, through which the spinal cord, cranial nerves, and blood vessels pass.
The cranial floor, in contrast to the vault, is the gateway for these structures.

Third, It adjusts to the placement of the skull as a whole in relation to the vertebral column
and the posture of the body.

Fourth, Its configuration directly influences the disposition of the contiguous facial complex.

A key factor involved in the basic mode of growth in the cranial floor, as compared with
the calvaria, is the marked differential rate and extent of enlargement in the dorsal and
lateral portions of the brain relative to its midventral region.

Ventral axis (floor of the brain comprising the underside of the hypothalamus, the
medulla, pons, etc.) is relatively stable. Its rate and extent of growth lag considerably,
relative to the enormous enlargement of the cerebral hemispheres.
This complex pattern of growth involves combinations of :-
(1) extensive cortical drift associated with the predominantly resorptive surface of
the endocranial floor
(2) endochondral growth at synchondroses
(3) a differential gradient of sutural growth as the walls of the calvaria grade into the
lateral parts of the cranial floor.

Growth Processes in the Cranial Vault and the Cranial Base involve the
following factors2
1. The roof of the skull expands largely by sutural growth with corresponding, proportionate
increases in cortical thickness on the periosteal surfaces of both the internal and external
tables.

2. The longitudinal base of the brain grows at a differentially limited rate and extent relative
to the massive hemispheres

3. The cranial floor is compartmented into numerous fossae, in contrast to the lateral walls
and the roof.
4. The cranial floor is the pathway for nerve, spinal cord, and blood vessel passage.

5. Growth in the cranial floor involves a decreasing gradient of sutural activity as a result of
differential growth. Sutures in the endocranial fossae are oriented so that they cannot provide
the total extent of contour expansion.

6. The elongation of some portions of the cranial base is provided by synchondroses.

7. Outward expansion of the cranial floor as a whole is largely accomplished by the process
of cortical drift in an ectocranial direction.

8. In addition to providing outward growth, the process of drift also produces the remodelling
expansion of contours in the various endocranial compartments.

9. Cortical drift in the floor and sutural growth in the vault provide the basis for their
differing rate and extent of enlargement.

10. A key factor is that cortical drift provides a mechanism for local remodelling changes.

11. The mode of growth in the cranial floor provides a basis for structural relationships
between the vertebral column, upright posture, and the vertically oriented facial complex.

These factors involve a marked downward flexure of the cranial base, a circumstance also
associated with the disproportionate nature of growth in the calvaria and the cranial base.

Schematic interpretation of growth in the cranial base and calvaria.

Figure 1: bones of the calvaria (a) are separated by sutures ( S ) . The bones of the cranial floor
(b, c, y) are also separated by sutures (S) or by synchondroses. The circumcranial line of
reversal is indicated by R.
Figure 2:The endocranial fossae are represented by x. Position markers are shown in both the
calvaria and the cranial base (black triangles and large dots).
GROWTH OF THE CALVARIA AND EACH COMPONENT OF THE CRANIUM

THE OCCIPITAL BONE1,2

GROWTH BY - REMODELLING PROCESS:
Above the line : deposition
Below this line : resorption

DIRECTION OF THE GROWTH :

Outward and backward enlargement of the posterior cranial fossa greatly exceeds a
corresponding but very slight backward movement of the more stable foramen magnum.

FORAMEN MAGNUM

GROWTH BY : Endocranial resorption and ectocranial deposition.

 DIRECTION OF GROWTH : Foramen shifts in a downward and backward
direction (CORTICAL DRIFT) .The floor of the large occipital fossa, on the other
hand, moves in an ectocranial direction by both sutural bone growth and drift in
reciprocal combinations. As one decreases the other correspondingly increases in the
two general regions of the bone. The end result is a marked downward and backward
movement of the entire posterior base of the skull, but with a significantly lesser
degree of foramen.

REMODELLING ADJUSTMENT AT SPHENOCCIPITAL COMPLEX

GROWTH BY : Elongation at the synchondroses, sutural growth in the lateral walls

and by remodeling drift.
DIRECTION OF GROWTH : Produces forward and downward rotation. A
constant process of remodeling in the sphenooccipital complex occurs in order to
maintain alignment between the foramen magnum and the floor of the frontal fossa.
This involves a downward growth movement of the cranial base in addition to its
downward manner of displacement.

THE SPHENOID BONE1,2

RESORPTIVE : Endocranial side

DEPOSTION : Ectocranial side i.e. cortex walls of the elevation and floor sella
GROWTH BY : -Cortical drift that leads to downward movement
-Sutural expansion in the lateral regions of the wings of sphenoid
-Elongation at the synchondroses

DIRECTION OF GROWTH:
-Downward direction by cortical drift
-Outward direction corresponding to generalizied growth of the endocranial portions

REMODELING ADJUSTMENT :
Sphenoid is repositioned in relation to the anterior cranial floor.
Downward drift of the foramen magnum and the lowering of the frontal floor
changes the angulation between them.

SELLA1,2
Deposition : ectocranial surface
Resorption : endocranial floor
Direction of growth : downward
- forward relocation by surface resorption.

FORMATION OF SINUS 1,2

 Resorption : Endosteal surface (inner surface)
Sphenoidal surfaces in contact with conchae
Tuberculum sellae
Deposition : periosteal sides

THE PTERYGOID PROCESSES1,2

DEPOSTION : Basal portion of pterygoid near junction with sphenoid.

Inner sides ( V principle)
RESORPTION : Medial and lateral sides of trough or Projecting processes.
DIRECTION OF GROWTH : Forward , downward and outwards
Enlargement of the base .
ADAPTIVE FUNCTION :
Resorptive role on the outer sides of the pterygoid processes
Pterygoid bone directly abuts the posterior face of the
maxillary tuberosity .

THE ETHMOID1,2

Deposition : nasal side

Resorption : endocranial side of the cribriform plate.
Direction of growth : moves in inferior course with downward drift of the anterior
cranial base floor of the frontal fossa , nasal cavities.
Secondary adjustment : the meningeal surface becomes depository relative to the
descending frontal floor on either side .

THE VOMER1,2

DEPOSITION : Trough of the vomer by two alar plates

DIRECTION OF GROWTH :
- - Upward and backward growth but displacement takes place in
opposite , forward and downward direction.
- Enlarging vomer entrails the forward growing septal cartilage and
perpendicular bone of ethmoid .
Growth by intramembranous.(septal cartilage as stated by scott)

THE FRONTAL BONE 1,2

( CONSTITUTES ORBITAL ROOF AND FORMS THE FOREHEAD)

DEPOSITION : Cutaneous
Skull roof
Endocranial surface

RESORPTION : Floor of anterior cranial fossa

Reversal line bisects the forehead and below this line the
meningeal surface is Resorptive .

GROWTH BY :
Combination of sutural growth
Cortical drift

DIRECTION OF GROWTH :
Forward which results in the formation of the bulbous forehead.

THE TEMPORAL BONE2

GROWTH PATTERN OF THE TEMPORAL BONE INVOLVES COMBINATION OF1,2

Sutural growth
Cortical drift : An adaptation to differential growth , Fossa expansion and
maintenance of Cranial nerve and vessel relationships

Growth process of Squamous part of temporal bone :

DEPOSTION : Cutaneous side ( external )

RESORPTION : Below the circumcranial line of reversal .

GROWTH PROCEEDS BY :
Cortical drift
Sutural growth at temporal , parietal and sphenoidal Junctions.

DISPLACEMENT OF NASO MAXILLARY COMPLEX1,2

Expansion of the middle cranial fossa and its neural contents have a major secondary
displacement effect on the anterior cranial floor, the underlying nasomaxillary complex
suspended from the latter, and the mandible.
Because the posterior boundary of the maxillary complex is developmentally positioned to
exactly coincide with the boundary between the anterior and middle cranial fossae, a like
amount of forward displacement of both the anterior cranial fossa and the
nasomaxillary complex1 suspended beneath it occurs.
The enlarging middle cranial fossa does not in itself push the mandible, anterior cranial fossa,
and maxillary complex forward.

Visualize the enlarging temporal and frontal lobes of the cerebrum as two expanding
rubber balloons in contact. They are each displaced away from the other, although the net
effect is a forward direction of movement from the foramen magnum.
The temporal and frontal ''balloons'' have fibrous attachments to the middle and anterior
cranial fossae, respectively. As both balloons expand, these two fossae are thus pulled away
from each other, but both also being moved together in a protrusive direction.
This sets up tension fields in the various frontal, temporal, sphenoidal, and ethmoidal sutures,
and this presumably triggers sutural bone responses (in addition to direct basicranial
remodeling expansion by resorption and deposition all over all other inside and outside
surfaces).
Both fossae are thus enlarged, and the nasomaxillary complex is carried along anteriorly
with the floor of the anterior cranial fossa from which it is suspended any further
developmental protrusion of the forehead is a result of thickening of the frontal bone and
enlargement of the frontal sinus within it The anterior fossae and the maxillary complex are
carried anteriorly by the frontal lobes, which is moved forward because of temporal lobe
enlargement behind it the lining side of the forward wall of the middle cranial fossa.

(1) Deposition on the orbital face of the sphenoid and in the sphenofrontal suture.
 (2) Forward displacement of the anterior cranial fossae as the frontal lobes are
displaced anteriorly.
(3) The petrous elevation increases by deposition on the endocranial surfaceLengthening of
the clivus occurs by growth at the spheno-occipital synchondrosis.
(4) The foramen magnum is progressively lowered by resorption on the endocranial
surface and deposition on the ectocranial side. This also contributes to the lengthening
of the clivus.
(5) The perimeter of the foramen enlarges to match myelination and further enlargement
of the spinal cord.
Inferior to the circumcranial reversal line , the endocranial fossae enlarge by a combination of
endocranial resorption and ectocranial deposition that occurs in addition to growth at the
basicranial sutures.

The upright nature of the human face2

The wide, flat, characteristically vertical face of man is a composite result produced
by several morphogenetic circumstances. The interrelated factors involved are
associated with an enlarged cranium and with upright body stance.
The difference in configuration of the cranial base in the human and the nonprimate
skulls.
In non primates, the sloping spheno-occipital complexis relatively straight, and the
backward facing foramen magnum is located at the posterior aspect of the cranium.
In man, the cranial floor is characterized by a distinctive downward bend with the
foramen located on its ventral side. This is directly related to both upright body
posture (Weidenreich, 1924).
The marked expansion of the anterior, middle, and posterior cranial fossae with their
associated parts of the brain.Cerebral expansion produces a disproportionately
enlarged cranial vault relative to the much lesser extent of growth in the cranial base.
The bending of the spheno-occipital complex provides an adaptive adjustment
between these two differentially growing regions of the cranium also results in the
placement of the foramen magnum in a ventral location compatible with vertical
posture and the spheroidal configuration of the whole skull.
The human face, rather than comprising a projecting group of bones that extends
essentially forward from a horizontally oriented cranium, is composed of a
comparatively abbreviated composite of bony elements located in the space produced
by the cranial flexure. The face in general grows downward to a somewhat greater
extent than it moves forward, and this inferior manner of enlargement utilizes the
region made available by the cranial flexure.

THE CRANIAL BASE ANGULATION5,7,9

The chondrocranium is important as a shared junction between the neurocranial and facial
skeletons; its endocranial surface relates to the brain whereas its ectocranial aspect responds
to the pharynx and facial complex and their muscles. The central region of the cranial base is
composed of prechordal parts (located posterioly) and chordal parts that meet at an angle at
the hypophysial fossa (sella turcica).

The lower angle, formed by lines from nasion to sella to basion in the sagittal plane is
initially highly obtuse: approximately 150 in the 4-week-old embryo (precartilage stage).
It flexes to approximately 130 in the 7- to 8-week-old embryo (cartilage stage) and
becomes more acute (115 to 120) at 10 weeks (preossification stage).
Between 6 and 10 weeks, the whole head is raised by extension of the neck, lifting the face
from the thorax This head extension is concomitant with palatal fusion. At the time of
ossification of the cranial base (between 10 to 20 weeks), the cranial-base angle widens to
between 125 and 130 and maintains this angulation postnatally. As the chondrocranium
retains its preossification acute flexure in anencephaly, the flattening of the cranial base is
probably caused by rapid growth of the brain during the fetal period.

Angulation
The postchordal (posterior cranial base) plane is most commonly defined using 2 landmarks,
usually basion and sella, or using the line created by the dorsal surface of the basioccipital
clivus.
The prechordal plane (anterior cranial base) has been measured in more diverse ways:
a. Sella to Nasion
b. Sella to Foramen Caecum
c. Planum Sphenoideum

CLINICAL IMPLICATION OF STUDY OF

CRANIUM GROWTH10
 Craniofacial skeletal growth is very important in orthodontics since craniofacial
morphology are the source of serious malocclusions.
The configuration of the basicranium determines a persons head form type, which in
turn sets up many proportionate features characterizing facial type.
If the basicranium is long and narrow, this result in dolicochphalic facial type, which
will result anterio-posteriorly and vertically, elongated facial profile and this will
result in mandibular retrusion.
If the basicranium is round, this will result in brachycephalic facial type, this will
result in anterio-posteriorly and vertically shorter facial profile. This will result in
either mandibular protrusion or bimaxillary protrusion
The growth of the cranium also has direct effect on the placement of maxilla and
mandible.
The mandible is attached to mid cranial fossa through the condyles.
Thus ramus places the mandibular arch in occlusion with the maxillary arch following
a pattern set up by the basicranium.
Similarly, the nasomaxillary complex is suspended from the anterior cranial fossa.
So the configuration of the palate and maxillary arch is thus established by the
basicranium .

CONCLUSION

A thorough background in craniofacial growth is necessary for every orthodontist.

Even for those who never work with children. It is difficult to comprehend conditions
observed in adults without understanding the development processes that produced
these problems.
Craniofacial skeletal growth is very important in orthodontics, since variations in
craniofacial morphology are the source of most serious malocclusions and clinical
damages.

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