Lingual teeth position

Lingual position of individual teeth or groups of teeth can occur as an independent anomaly or together with other anomalies of teeth and dentition. Lateral incisors are especially often in this position. This is explained by the fact that the follicles of these teeth are normally located orally from the root of the temporary teeth. Later, under the influence of jaw growth and tongue pressure, the teeth during eruption move vestibularly and occupy the correct position in the dental arch. With delayed growth of the lower jaw, teeth 32 and 42 remain in the lingual position. This anomaly can also occur with early extraction of temporary teeth, due to delayed change of temporary teeth, with underdevelopment of the lower jaw apical base, the presence of supernumerary teeth, mesial displacement of teeth.

Pic.10. Lingual position of teeth 32 and 42.

The crowding of the lower frontal teeth reduces the resistance of the teeth to the carious process, creates conditions for the development of periodontal diseases, and the formation of periodontal pockets.

Etiology, pathogenesis:

- heredity;

- harmful habits of the tongue sucking, pencil, pen and other objects;

- disorder of respiratory and speech functions, leading to underdevelopment of the jaws;

- mismatch of the teeth and jaw size;

- crowding of the frontal teeth;

- insufficient space in the dental arch for the lower canines;

- delayed physiological change of temporary teeth;

- trauma of the teeth, alveolar process, jaws;

- macrodentia (absolute or individual);

- presence of supernumerary tooth;

- disorder of the teeth clenching;

- micrognathia of the jaw;

- mesial displacement of teeth surrounding the abnormally located tooth;

- premature extraction of temporary teeth without preventive measures;

- narrowing and shortening of the dentition and apical base of varying degrees;

- underdevelopment of the upper jaw frontal area;

- discrepancy between the width of the dentition and apical base.

Functional disorders:

- speech;

- biting off food;

- lengthening of food chewing time;

- disturbance of rhythm of chewing;

- grinding type of chewing;

- decrease of indicators of chewing efficiency;

- disturbance of closing of lips;

- abrasion of crowns of abnormally located teeth;

- diseases of periodontal tissues (localized, generalized);

- disturbance of function of temporomandibular joint.

Aesthetic changes:

- disturbance of a lip step;

- convex profile;

- reduction of the lower third of the face;

- deepening of a labial-mental fold;

- non-coincidence of cosmetic center of a face with the center of the upper and lower dental arches.

Forms of anomaly:

- with space in the dentition;

- without space in the dentition;

- with concomitant anomalies of the dentition and bite;

- with compensated deficiency of space in the dentition;

- with decompensated or complete deficiency of space in the dentition.

All of the listed forms can be combined with different depths of overlap in the frontal area of the dental arches (slight, medium and deep).

Research methods:

1. Clinical.

2. Paraclinical.

X-ray:

- orthopantomography;

- computer tomography.

Biometric:

- dental examination by methods:

Tonn

Bolton

Pont and H. Linder, G. Hart

Korkhaus

Snagina

Little

Nance

Schwarz

Fuss

Schmuth

Facial photometry.

Reopardodontography.

Principles of treatment:

Preparatory period

- psychotherapeutic preparation;

- elimination of the risk factor (if possible);

- elimination of the etiological factor (if possible);

- oral cavity sanitation;

- checking the state of oral hygiene, if necessary - training;

- prosthetic preparation (according to indications);

- surgical preparation (according to indications).

Active period of orthodontic treatment in temporary and mixed occlusion:

- functional treatment methods (myogymnastics, massage, etc.);

- use of a spatula, wooden stick (if there is space);

- appliances treatment method taking into account the clinical manifestation of the pathology (creation of space in the dental arch for an abnormally located tooth: expansion of the dentition, lengthening of the dentition, distalization of the teeth, etc.);

- leveling the depth of overlap (disconnection of dental arches) using a cap fixation, occlusal overlays, an inclined plane;

- normalization of functions (aesthetic, speech, chewing).

- surgical treatment methods (serial sequential extraction of teeth by Hotz; extraction of individual teeth; extraction of supernumerary tooth, etc.);

- stripping.

Active period of orthodontic treatment in permanent occlusion:

- normalization of functions (aesthetic, speech, chewing).

- surgical treatment methods (extraction of individual teeth; supernumerary tooth, compact osteotomy, insert of orthodontic implants, etc.).

- stripping;

- prosthetic treatment;

- functional treatment methods (myogymnastics, massage, etc.);

- physiotherapeutic treatment method: vacuum therapy, low-frequency therapeutic vibration, MRI-magnetic resonance reflexotherapy, ultraphonophoresis, ultrasound, electrophoresis, etc.

Retention period of orthodontic treatment

- preservation of the achieved result and prevention of relapse with the help of special equipment - retainers (fixed, removable);

- functional adaptation to the newly created occlusion;

- extraction of the rudiments of third molars (if necessary).