ANOMALIES OF INDIVIDUAL TEETH POSITION. ETIOLOGY, PATHOGENESIS, CLINICAL FEATURES, DIAGNOSTICS, PREVENTION AND TREATMENT

Etiology, pathogenesis:

- heredity;

- harmful habits of biting the cheeks, lower lip;

- impaired breathing, speech, lip closure, leading to underdevelopment of the jaws;

- impaired formation of the tooth root or alveolar process;

- mismatch of the size of the teeth and jaw;

- delayed physiological change of temporary teeth;

- trauma of the teeth, alveolar process, jaws;

- macrodentia (absolute or individual);

- presence of supernumerary tooth;

- impaired tooth eruption;

- micrognathia of the jaw;

- premature extraction of temporary molars without preventive measures;

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

- mismatch of the width of the dentition and apical base;

- mechanical obstacle to tooth eruption;

- calcium-phosphorus metabolism disorders;

- vitamin D deficiency states.

Functional disorders:

- breathing;

- speech;

- chewing;

- lip closure disorders;

- chronic injury of the mucous membrane of the palate or upper lip;

- dysfunction of the temporomandibular joint;

- periodontal tissue diseases (localized, generalized).

Aesthetic changes:

- half-open mouth;

- visualization of an abnormally positioned tooth when talking and smiling;

- deep supramental furrow;

- everted lower lip with tooth impressions on the mucous membrane.

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. 

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.);

- 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, elongation of the dentition, distalization of the teeth, etc.);

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

- normalization of the bite height (if necessary);

- surgical treatment methods (serial sequential extraction of teeth according to Hotz; extraction of individual teeth; removal of supernumerary tooth(s), etc.);

- intrusion of the teeth of the lower jaw (with dentoalveolar elongation);

- stripping.

Active period of orthodontic treatment in permanent occlusion:

- 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.);

- 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;

- intrusion of the teeth of the lower jaw (with dentoalveolar elongation);

- 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 germs of third molars (if necessary).