FUNCTIONAL

MATRIX
HYPOTHESIS

Presented by: Dr H M Manisha

PG Ist Year
 CONTENTS
 Introduction
 Functional Matrix Hypothesis
 Functional Cranial Component
 Skeletal Unit
 Functional Matrix
 Functional cranial analysis of Maxilla
 Functional Cranial analysis of Mandible
 Neurotrophism
 Clinical Implication
 References Dr Melvin Moss
 INTRODUCTION

The theory of the functional cranial components of Van der Klaauw laid the
foundations of the concept concerning the functional matrix developed by
Moss. Functional matrix theory maintains that apart from initiating the
process of development, heredity and genes play no active role in growth
of skeletal structures in general and craniofacial skeleton in particular.

The craniofacial skeleton develops initially and later grows in direct

response to the extrinsic epigenetic environment.
Moss states that “BONES DO NOT GROW- BONES ARE GROWN”
The functional matrix hypothesis claims that epigenetic, non skeletal factors
or processes are the prior, proximate, extrinsic and primary cause of all
adaptive, secondary responses of skeletal tissues and organs.

The responses of the skeletal unit are not controlled by informational content
of the skeletal cell genome but by the functional matrix operations.
Proponents of FMH states that the expansion of soft tissue matrix is primary
and bone growth is purely a secondary and compensatory event. Translation
of various bones of the face is by volumetric expansion of the encapsulated
space or tissues.
 FUNCTIONAL MATRIX HYPOTHESIS

FMH claims that the origin, growth and maintenance of all skeletal tissues
and organs are ALWAYS secondary, compensatory and obligatory responses
to temporally and operationally prior events or processes that occur in
specifically related non-skeletal tissues, organs or functioning
spaces(matrices).
There is no direct genetic influence on the size, shape or position of skeletal
tissues only the initiation of ossification. All genetic skeleto-genetic activity is
primarily upon the embryonic functional matrices.

He considers that the growth of the face occurs as a response to functional

needs and is mediated by soft tissue in which the jaws are embedded. In a
conceptual view, the soft tissues grow, and both bone and cartilage react.
 Moss stresses on the dominance of non-osseous structures of the
craniofacial complex over the bony part.
DIAGRAMMATIC REPRESENTATION OF FUNCTIONAL MATRIX THEORY
 FUNCTIONAL CRANIAL COMPONENT

The head is a composite structure, operationally consisting of a number of

relatively independent functions olfaction, respiration, vision, digestion,
speech, audition, equilibration and neural integration. Each function is
carried out by a group of soft tissues which are supported and/or protected
by related skeletal elements.
The totality of all the skeletal structures, soft tissues and functioning spaces
necessary to carry out a specific function is collectively called as functional
cranial component.
 FUNCTIONAL CRANIAL COMPONENT

SKELETAL UNIT FUNCTIONAL MATRIX

MACROSKELETAL MICROSKELETAL PERIOSTEAL CAPSULAR

UNIT UNIT MATRIX MATRIX

TRANSFORMATION

TRANSLATION

GROWTH
 SKELETAL UNIT

The skeletal unit refers to the bony structure that supports the functional
matrix and these are necessary or permissive for that function. The
skeletal unit does not refer to the individual bone directly but to the
function it supports.
1. Microskeletal units
2. Macrokeletal units
 MICROSKELETAL UNITS

Bone composed of several contiguous skeletal units. Both maxilla and

mandible are formed of a number of such contiguous micro skeletal units.
Microskeletal units are parts of bone whose growth is modulated by
periosteal matrices. Functional variation within the periosteal matrices may
be expressed within.
The possible interaction between periosteal matrices and microskeletal unit
includes-Temporalis muscle and coronoid process, masseter muscle-medial
pterygoid and gonial angle, teeth and alveolar bone.
The change in size and shape of microskeletal units occur independently of
the changes in spatial position.
Melvin Moss used the terms transformation or intraosseous growth for this.

Microskeletal units of mandible includes alveolar, angular, coronoid,

condylar, gonial, mental and basal units. Microskeletal units of maxilla
include orbital, pneumatic, palatal and basal units.
 MACROSKELETAL UNITS

 When adjoining portions of a number of neighboring bones are united to

function as a single cranial component, it is termed as macro-skeletal unit.
Eg: endocranial surface of the calvaria, core of maxilla and, mandible.

Moss and Greenberg pointed out that the basic maxillary unit is the core
which supports and protects the infraorbital neurovascular triad and in
mandible, the basal tubular portion which protects the mandibular canal.
The capsular matrix expansion causes the macroskeletal unit to passively
change the position and this process is called translational growth of skeletal
structures.

The overall skeletal growth is a combination of changes in the microskeletal

unit and macroskeletal units due to stimulation of periosteal and capsular
matrix respectively. This total growth change is termed as “ intraosseous
growth” by Moss.
 FUNCTIONAL MATRIX

The functional matrix refers to all the soft tissues and spaces that perform a
given function. Includes muscles, glands, nerves, vessels, fat, teeth and the
functioning spaces.
There are two basic types of functional matrices-
Periosteal matrix
Capsular matrix
THE NEUROCRANIAL AND OROFACIAL
CAPSULAR MATRICES
 Periosteal matrix

Include muscles, vessels, teeth et cetera. The effects of periosteal matrices can
be best exemplified by the effect of muscles upon the skeletal units: lack of
muscle contraction leads to atrophy of concerned bone.

Blood vessels, nerves, and glands produce morphologic changes in their related
skeletal units in a completely homologous manner; the changes of related
osseous tissue size and shape are brought about by the deposition and
resorption of bone tissue.
Functioning muscles influence developmental changes in the form of skeletal
tissues to which they are attached and it is achieved through muscle bone
interface.

Sim and Kelly suggested that osseous blood flow adjusts to prior changes in
osseous metabolism and they further noted that blood flow is increased at
resorption site and depositary areas are poorly vascularised. The periosteal
matrices stimulation causes growth of the microskeletal units. They act to
alter the size or shape or both of the bones. The growth process that occurs
due to periosteal matrix stimulation are called "transformation"
 Periosteal matrix affect a microskeletal unit meaning that the spare of
influence is usually limited to a part of muscle.

Coronoid process first arises within the earlier form of anlage of the
temporalis muscle whose contractile abilities are well developed in prenatal
stages. Its subsequent growth also occurs within this muscular matrix.

The experimental removal of the temporalis muscle or its denervation

invariably result in the actual diminution of the size and shape of the coronoid
process or even its total disappearance. Similarly, hyperactivity of the
temporalis muscle produces increase in the size and shape of the coronoid
Teeth are also a functional matrix and is responsible for the alveolar bone that
supports it; Extraction of tooth causes disappearance of microskeletal unit
(alveolar process).

Indeed most orthodontic therapy is based firmly on the fact that when this
functional matrix grows or is moved, the related skeletal unit ( the alveolar
bone) responds appropriately to this morphogenetically primary demand.
 CAPSULAR MATRIX

The "capsular matrix" is defined as the organs and spaces that occupy a
broader anatomical complex. The functional cranial components arise, grow
and are maintained within a series of capsules. Each capsule is an envelope
which contains a series of functional cranial component, skeletal units and
their related functional matrices and is sandwiched between two covering
layers.
E.G neurocranial capsule, orofacial capsule
 CAPSULAR MATRIX

All spaces intervening between functional components themselves and

between them and the limits of the capsule are filled with indifferent loose
connective tissue. Each capsule surrounds and protects a capsular functional
matrix. The capsular matrices exist as volume.
 Neurocranial capsule

In the neurocranium, it is the volume of the total neural mass which is

morphogenetically significant. The expansion of the enclosed and protected
capsular matrix volume is the primary event in the expansion of the
neurocranial capsule.
As the capsule enlarges, the whole of the included and enclosed functional
components, that is the periosteal matrices and the microskeletal units are
carried outward in a totally passive manner. The calvarial functional cranial
components as a whole are passively and secondarily translated in space.
S-Skin; C-dense connective tissue layer; A-aponeurotic layer; L- loose connectivetissue layer; P-periosteum
T.M- Temporalismuscle; P.L.D.M.- periosteal layer of dura mater; F.L.D.M.- fibrous layer of dura mater;
S.S.- sagittal suture.
In the neurocranium, hydrocephaly is such a condition in which reabsorption
of the CSF is impeded, the fluid accumulates and intracranial pressure builds
up.

Hydrocephalic may have small brain and enormous growth of the cranial
vault- cranium two or three times its normal size with enlarged frontal,
parietal and occipital bones. The expansion of the neurocranial capsule is
always proportional to the increase in neural mass. But in hydrocephaly,
increase in intracranial pressure, obliterates vascular flow within the capsule
and so prevents periosteal accretion of bone at sutural areas, thus producing
the characteristic large fontanelles, and other sutural dehiscence.
The neural skull does not grow first and provide space for the secondary
expansion of the neural mass. Rather, the expansion of the neural mass is the
primary event which causes the secondary and compensating growth of the
neural skull.
 Orofacial capsular matrix

Surrounded by the orofacial capsule. Limiting layers of this cavity are skin on the
external aspect and mucous membrane internally.
Establishment of the morphogenetic primacy of the orofacial functioning spaces
will cause translation of all skeletal units embedded within the orofacial capsule.
The human oro-nasopharyngeal space increases in size from the third month of
pregnancy. This volumetric increase produces a compensatory increase in the
size of the orofacial capsule.
As the capsule enlarges, both the periosteal matrices along with the
respective skeletal units are passively and secondarily translated to a new
position in space.
Thus the enclosed capsular matrices act indirectly on the macroskeletal units
or on entire functional cranial component. They do not act by the process of
osseous deposition or resorption or by affecting cartilages directly. They do
not alter the size or shape of the skeletal units; instead they change their
location in space.
According to Moss, the nasal cartilage and the condyles of the mandible are
growth sites and therefore incapable of tissue separating force. As a
consequence, the translation of the middle and the lower face downward
and forward must be accomplished by the oral-nasal- pharyngeal capsules.

The soft tissues of these capsules are of necessity the determinant of their
size and position in space. The skeletal units only respond, offering
continually adapting biomechanical support. The factor that dictates the size
of the facial capsules is the volume of the functioning spaces. The patency
and adequacy of oronasal tubes are so fundamental that nature programs
their size and guarantees that the increased demands of somatic growth are
met by craniofacial expansion.
 Functional Cranial Analysis
of Maxilla
The basal bone designates the maxillary skeletal unit which serves to protect
and support the infraorbital neurovascular triad. It is that portion of the
maxilla that is left over when all the other maxillary skeletal units have been
subtracted. Moss and Greenberg point out that the basic functional matrix for
the basic skeletal unit is the infraorbital neurovascular triad.

The maxillary division of the trigeminal nerve plays the major role in
maintaining the spatial constancy of the infraorbital canal to the anterior
cranial base.
The orbital mass functional matrix virtually ceases their volumetric growth by
the end of first decade. The definitive height of the nasal cavity is attained at
the same time. Mostly all the functional matrices that might affect the position
of maxillary basal skeletal unit come to rest at this time and do not participate
in further growth of the maxillary complex. The nonbasal maxillary matrices
related to oral and dental function continue to grow after 10 years of age.

The facial bones are enclosed within an orofacial or splanchnocranial capsule.

So the maxillary base is passively carried downwards, forwards and laterally as
a result of expansion of their capsule (orbital, nasal, oral matrices).
Functional cranial analysis of maxilla in
lateral view
Moss and Greenberg state that there are three types of bone growth
changes seen in maxilla.
1. Associated with compensation for the passive motion of the bone
brought about by the primary expansion of the orofacial capsule. These
changes help to maintain anatomical and functional continuity between
maxilla and adjacent bones.
2. There are changes in bone morphology associated with alterations in
absolute volume, size, shape or spatial position of any or all of the several
relatively independent maxillary functional matrices like orbital mass.
3. Bone changes associated with the maintenance of the form of the bone
itself. The posterior repositioning of the zygomatic arch which accompanies
relative forward movement of the arch is an example.
 Functional Cranial Analysis of Mandible

The mandibular matrix consists of:

• All muscles with mandibular attachments
• Neurovascular triads (arteries, veins and nerves)
• Associated salivary glands
• The teeth
• Fat, skin and connective tissues
• The tongue
• The oral and pharyngeal spaces.
Mandibular growth demonstrates the integrated activity of periosteal and
capsular matrices in facial growth. Orofacial capsular matrix growth causes an
expansion of the capsule as a whole. The enclosed and embedded,
microskeletal unit is passively and secondarily translated to successively new
positions.
According to Moss, three important phenomena occur during mandibular
growth:
• Constancy of the relative position of mental foramen in the mandibular
corpus
• Absolute migration of the dentition through the alveolar bone
• Change in the direction of mental foramen
 RELATIVE POSITION OF MENTAL FORAMEN

If the horizontal body is divided into premental and postmental segments and
these segments when measured at different ages, it was found that the length
of these two segments remains relatively proportional throughout life. This
proves the point that increase in corpus length cannot be solely due to
condylar growth as this would increase the relative size of the post-mental
segment.
Comparison of fetal and newborn
mandibles
 MIGRATION OF THE DENTITION

This movement which is different from mesial drift happens during the first
two decades. While the position of the mental foramen remains constant,
the relationship of mandibular dentition to it does not. This migration is most
pronounced during the eruption of permanent dentition.
 DIRECTION OF MENTAL FORAMEN

Given by LaCroix. It is claimed that the periosteum of growing bone is under

tension and that the tensile force at a given point is proportional to the
growth rates of the two ends of the bone. When the growth rate of one end
predominates, the periosteal tension in that direction will be greater. The
effect of such unequal tension is "slipping" of the periosteum and
consequent migration of the point of entry of the nutrient vessel.
This along with surface apposition of new bone which accompanies growth
in width causes the foramen to face in the direction of most rapid growth.
In the newborn, formation of chin is the most rapid mandibular growth
process and therefore foramen faces forward.
With the eruption of permanent teeth, the increase in corpus height due to
alveolar growth causes the foramen to face upward.
Subsequent addition to corpus length and posterior shift of the ramus which
occurs with eruption of permanent 2nd and 3rd molars direct the foramen
backwards. (Adults)
Newborn, 5 years old and adult mandibles
exhibiting direction of mental foramen
Two points are implicit:
(1) If the periosteal matrices are not capable of functioning normally, their
specifically related skeletal units will alter their spatial position (that is, be
translated) without undergoing consequent changes in their size and
shape.

(2) Such changes in size and shape, of themselves, are insufficient biologic
causes of translation. It is only when conceptually combined the effects of
both capsular and periosteal matrices, of growth changes in both position and
form of the skeletal units, that we begin to comprehend the phenomenon of
facial growth totally.
 REGULATION & CONTROL OF
FUNCTIONAL MATRICES
NEUROTROPHISM is a “non-impulse transmittive neuro function, involving
axoplasmic transport, providing, for the long term interaction between neurons
and innervated tissues which homeostatically regulates the morphological,
composition and functional integrity of those tissues.”
Moss does indicates that there are three general categories. .
Neuro-epithelial
Neuro-visceral
Neuro-muscular
 NEURO-EPITHELIAL TROPHISM

 It is a quality rather than type of reinnervating axons that determines

whether regeneration will occur.
As example amphibian limb regeneration is initiated only after intimate
neuroepithelial contact.
The mitotic activity necessary for normal epithelial turnover of taste buds,
the maintenance, the expression of their genomic potential in such processes
as DNA and enzymatic synthesis are all under the direct and continuous
afferent gustatory neurotrophic control.
 NEURO-VISCERAL TROPHISM

The periosteal matrices generally determine the apparent localized

neurotrophically controlled genomes.
The attributing factors that form the basis of Neurovisceral trophism, e.g.,
the salivary glands, fat tissue and other organ, regulate the embedded
passive position of the skeletal units. In the orofacial region, salivary gland is
partially trophically regulated.
The degree to which the neurovisceral control has altered the casual
change indicates the dominance of the homeostatic control of genome.
 NEURO MUSCULAR TROPHISM

Embryonic myogenesis is not under the control of nerves and neurotrophism.

Neural innervations are established at the myoblast stage of differentiation. Moss
states that after this stage, skeletal muscle ontogenesis cannot proceed without
innervations.
Moss stated that genetic control cannot reside solely in the functional matrices
alone and there is neurotrophically regulated homeostatic control of the genome.
Disculescu et al state, “the complex chain of events leading to particular expression
of the genetic embryonic potential is not wholly within the cell but also includes
informational elements contributed by the nerve”
Muscle denervation—reinnervation:
Muscle denervation and subsequent reinnervation enabled to
differentiate effect on muscle tissue associated with the loss of impulse
conduction and muscle contraction from those due to loss of neurotrophic
factor.
If motor neurons are sectioned and the related muscles subsequently
become reinnervated, there is reformation of muscle tissue and it grows even
before the recovery of neuronal conductive function. This demonstrates
neuromuscular trophism.
Cross innervations:
Experimental cross innervations procedure wherein the first nerve is cut and
the free ends are placed in muscles supplied by slow nerves and vice versa
were carried out. After a recovery period, it was seen that fast muscles
became slow and slow muscles became fast (Previttt and Safesky). This
change is brought about by neural influence which has a direct effect on
the contraction.
Hyperneuralization:
Refers to the ability of the muscle fiber to have more than one motor end
plate. When the usual nerve, innervating a muscle is crushed, the muscle
responds to experimentally implanted second motor nerve by the formation
of the new end plate. The original end plate gets reestablished after the
original nerve recoversThe following points can be concluded from the study:
• Neurotrophism effects do not depend upon the presence of end plate.
• Neurotrophic effects could be produced by a motor nerve, while the same
nerve is totally incapable of eliciting a contractile response from the same
muscle.
• Neurotrophic material is diffusible and does not require end plate
apparatus.
 CLINICAL APPLICATIONS OF THE
FUNCTIONAL MATRIX
Orthodontic therapy involves a change in
1. Periosteal matrix(Teeth) Skeletal Unit (Alveolar bone)
And/or
2. Capsular matrix Several Skeletal Units (The Jaws) (Orofacial
Orthopedics)
1. Frankels appliance
The larger part is confined to the oral vestibule. The buccal shields and lip pads
hold the buccal and labial musculature away from the teeth and investing tissues,
eliminating any possible restrictive influence from the functional matrix.

Frankels conceives his vestibular constructions as an artificial matrix that allows

the muscles to exercise and adapt. It the buccinator - mechanism pressures are
screened from the dentition. Significant expansion may occur in the inter-canine
dimension. This relieves the crowding often seen in the lower anterior segment
which often leads to the removal of four first premolars in a fixed multi attachment
mechanotherapy. The Frankel Regulator buccal shields prevent the pressure of the
buccinator being exerted on the dento alveolar area both during deglutition and at
rest.
2. Enucleated orbit: The replacement of eyes with prostheses that are
periodically replaced by larger versions promotes growth of the orbit.

3. Widening mid palatal sutures: a form of orofacial orthopedics.

4. Repositioning of the maxillary segments of cleft patients—involve the

change in macro units.
5. Bilateral condylectomy—when anklosis of the condyles occurs in the
growing child, condylectomy removes the restrains and allows the maximum
development of the mandible in space.

6. Oblique bite plane – intra oral devices that hold the mandible in a protruded
position for the purpose of stimulating condylar growth.

7. Monobloc functional therapy: Intra oral appliance used in conjunction with

bone grafting to stimulate mandibular bone remodeling following subtotal
mandibular resection.
 REFRENCES

– Textbook of Craniofacial growth- Sreedhar Premkumar

– Essentials of Facial growth- Enlow
– Moss ML, Moss-Salentijn L, Skalak R. Finite elementmodeling of craniofacial growth and development. In:Graber L (Ed).
Orthodontics: stepping stones to the future.St Louis: CV Mosby 1986;143-68.
– Moss ML, Moss-Salentijn L. The muscle-bone interface: ananalysis of a morphological boundary. Monograph 8,Craniofacial
Series. Ann Arbor: Center for Human Growthand Development, University of Michigan: 39-72.
– Moss ML, Rankow R. The role of the functional matrix in mandibular growth. Angle Orthod 1968;38:95-103.
– Moss ML, Salentijn L. The capsular matrix. Am J Orthod 1969;56:474-90.
– Moss ML, Salentijn L. The primary role of the functional matrices in facial growth. Am J Orthod 1969;55:566-77.
– Moss ML, Young R. A functional approach to craniology. Am J Phys Anthrop 1960;18:281-92.
– Moss ML. A functional analysis of human mandibular growth. Am J Prosthet Dent 1960;10:1149-60.
– Moss ML. Functional cranial analysis of the mandibular angular cartilage in the rat. Angle Orthod 1969;39:209-14.