Teeth crowding

Crowding of teeth is an anomaly of the structure of the dentition (shape and size), characterized by a close arrangement of a group of frontal teeth due to a decrease in the longitudinal length of the dental arch compared to the sum of the mesiodistal dimensions of the crowns of the teeth that form it.

Pic.25. Crowding of the front teeth of the upper and lower jaws.

Etiology, pathogenesis:

- heredity;

- harmful habits of biting the cheeks, lips;

- impaired breathing, speech, closing the lips, which leads to underdevelopment of the jaws;

- abnormal attachment of soft tissues to the jaws, namely: the frenulum of the lower lip, tongue, shallow vestibule of the oral cavity;

- disorder of the myodynamic balance of the perioral area in case of dysfunctions of the oral cavity;

- change in the valve function of the lips (hypertonicity or hypotonicity of the orbicularis oris muscle);

- mismatch of the sizes of the teeth and jaw;

- delayed physiological change of temporary teeth;

- trauma to teeth, alveolar process, jaws;

- macrodentia (absolute or individual);

- presence of supernumerary tooth;

- disorder of tooth setting;

- micrognathia of the jaw;

- eruption of third molars;

- premature extraction of temporary molars without preventive measures;

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

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

- disorders of calcium-phosphorus metabolism;

- disorders of the musculoskeletal system;

- pathological changes in periodontal tissues;

- vitamin D deficiency.

Functional disorders:

- breathing;

- speech;

- chewing;

- impaired lip closure;

- dysfunction of the temporomandibular joint;

- periodontal tissue diseases (localized, generalized).

Aesthetic changes:

- half-open mouth;

- visualization of abnormally positioned teeth when talking and smiling.

Clinical forms:

- mild (space deficiency) - up to 5 mm;

- moderate - up to 5-8 mm;

- heavy – more than 8 mm.

Pic.26. Crowding of the front teeth of the upper and lower jaws.

Degree of severity

- mild (space deficiency) - up to 5 mm;

- moderate - up to 5-8 mm;

- heavy – more than 8 mm.

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.

Treatment principles:

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 abnormally located teeth: expansion of the dentition, lengthening of the dentition, distalization of the teeth, etc.);

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

- surgical treatment methods (serial sequential extraction of teeth according to Hotz; extraction of individual teeth; plastic surgery of the lips, tongue; deepening of the vestibule of the oral cavity; removal of supernumerary tooth, etc.);

- stripping.

Active period of orthodontic treatment in permanent occlusion:

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

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

- stripping;

- 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).