Prognathic bite is an abnormality of the closing of teeth( occlusion) due to the displacement of the upper jaw forward. It occurs quite often - in about 15% of adolescents and in 30% of adults, if we take into account the entire structure of dentoalveolar disorders.
material Content
- 1 Forms prognathic bite
- 2 reasons prognathic bite
- 3 Symptoms prognathic bite
- 4 Diagnostics prognathic bite
- 5 treatment in childhood
- 6 treatment in adults
- 6.1 Video - Stages correction of malocclusion
- 7 Prevention prognathic bite
Forms prognathic bite
Orthodontistsdistinguish several clinical forms, according to the accepted classification:
- increase in the upperjawbone with normally developed mandibular bone;
- underdevelopment of the mandibular bone with a normally developed maxillary bone;
- enlargement of the maxillary bone with simultaneous underdevelopment of the mandibular bone;
- irregular structure of the maxillary with compression in the lateral divisions.
It should be noted that this classification is applicable only to adults. It is believed that the formation of bite in children continues until a complete change of teeth.
Causes of prognathic bite
Causes of a pathological bite are dozens, and it is on them that emphasis should be placed in developing a treatment plan.
What causes the appearance of a distal occlusion? Why do the jaws first, and then the dentition, deviate from the normal position? Specialists identify the following reasons:
- Hereditary predisposition, which develops into the disease under the influence of the outside in 80% of cases. The scientists found out that the prognathic bite is the dominant factor of heredity.
- Diseases of the breast and early age associated with a violation of calcium metabolism - primarily rickets. According to observations, 60% of children suffering from rickets, subsequently had a bite pathology, including distal occlusion.
- Diseases of ENT organs with violation of free nasal breathing: all kinds of chronic rhinitis, adenoiditis, an increase in pharyngeal tonsils, a change in the nasal septum, frequent respiratory viral infections.
- Anomalies of bone development, jaw injuries, including birth defects, shortening of the frenulum of the tongue, early loss or removal of milk teeth.
- Disorders of posture, pathology of the musculoskeletal system.
- Some bad habits, for example, constant thumb sucking or dummy pacifiers, lip-biting.
- Absence or lack of solid food.
Also one of the possible reasons doctors call artificial feeding. The fact is that at birth all children have peculiarities in the structure of the jaw system: the lower jaw is located behind the upper one, forming a distance of up to 10 millimeters( sagittal slit).Over time, the situation is leveled, this is facilitated by natural feeding and the subsequent development of masticatory functions with the beginning of complementary feeding of solid foods. When feeding through a bottle, the child does not need to apply such efforts during sucking, and the growth of the lower jaw is suspended because of insufficient stimulation.
Symptoms of Prognathic Bite
Prognathic bite is not a local, but a large-scale and multifaceted problem, which has many symptoms at different levels of the body.
All signs of prognathic bite are divided into two categories - intraoral and facial. The former lead to functional changes, the latter to aesthetic shortcomings. However, in addition to this, there are signs of distal occlusion at the level of posture. These include scoliosis, stoop, constant head incline and even flat feet.
Intraoral signs | Face signs |
---|---|
Upper anterior teeth extended forward | General facial proportions broken |
Incisors from above and from below do not close, a gap is defined between them | Profile changed, convex |
Upper incisors inclined back to the sky, withthis slot is not visualized | Mouth half open, nasolabial folds smoothed |
Incisors may have twisted appearance, reminiscent of | fan Upper lip raised and jaw set |
Lower incisors overlapped by upper | Lower lip extends beyond upper incisors |
All lateral teeth | dislocated. Chin skewed and flattened, angle of lower jaw lower than normal |
No facial and intraoral signs observed all at once. As a rule, two or three symptoms are found, and what they will be depends on the form of the distal occlusion.
Throughout life, a person has to adapt to a wrong bite and the main difficulty is the aesthetic side of the matter. However, it must be remembered that other health consequences will sooner or later have an effect. In the distal occlusion, the functional of the dento-maxillary apparatus inevitably suffers, the work of the respiratory organs and articulation is disrupted. In such people, the process of eating and chewing is fraught with considerable difficulties - the jaw closure is almost impossible, the main load is placed on the back teeth. As a consequence, they are more prone to caries. Patients with an incorrect bite can feel uncomfortable during a conversation, the reason for this is poor mobility of the jaw. Often there is a crunch and pain when smiling or swallowing, periodic headaches in the temporal region. These signs arise because of the unnatural position of the joint connecting the temporal bone with the lower jaw. Over time, if adequate measures were not taken, the symptoms progress, giving the person a lot of suffering. In children with a prognathic bite, speech disorders that are difficult to correct are formed. Launched cases with a pronounced clinical picture lead to a decrease in self-esteem and psychological problems that the child takes with him into adulthood.
Diagnosis of the prognathic bite
Modern dentistry has an impressive arsenal of diagnostic tools that can help determine the shape of the distal occlusion, as well as the causes of its appearance.
An orthodontist with appropriate experience can determine the prognathic bite already with visual inspection. Attention is drawn to how the dentitions are arranged relative to each other, what the size of the jaws is, or there is or is not a sagittal slot. However, the final diagnosis is made after assessment of the dentoalveolar system and a number of additional studies.
- Teleradiography of is the main method in modern orthodontics. It is carried out for the analysis of X-ray cephalometric parameters: the relationship between size and interposition of the bony and soft tissues of the face.
- Tomography is a layered X-ray image used to refine a defect, often to determine the position of the temporomandibular joint.
- Radiography is a routine study, very common in diagnostic dentistry. In this case, the state of masticatory muscles and articular apparatus is evaluated.
- Electromyography and rheography - methods are used to assess the tone of the chewing musculature.
- Manufacturer diagnostic model - a copy of the patient's jaw, which is cast from the cast by the cast. Valuable method of diagnosis, has a high informative, but it is simple and accessible. It is used to differentiate the shape of the prognathic occlusion.
- Definition of the constructive bite - modeling using a special wax pattern is necessary for the manufacture of any orthodontic device.
Treatment in childhood
In young children, the bite can be normalized independently, after the elimination of all causes of its occurrence.
The best result can be expected if the correction of this bite begins in childhood, even before the growth of permanent teeth. Orthodontists are united in their opinion - the smaller the child, the easier it will be to achieve the desired. Therapy is aimed at activating the processes responsible for the growth of the lower jaw, and most importantly - to eliminate the causes that caused the formation of distal occlusion. These actions are necessary and mandatory, since already alone this is able to solve the problem forever.
If such measures were not enough, then a complex treatment is appointed, including wearing removable orthodontic equipment, myogymnia, normalization of free nasal breathing, and so on. In a number of cases, an operation to remove some supercomplete teeth is shown.
The main goal of treatment during the period of the change of teeth is correction of deformation and incorrect ratio of dental arches. As a rule, for this purpose, plate-like devices are used that are removable. In addition to the plates, often use silicone tires, trainers( elastic double-jaws), LM-activators, miobreys( removable silicone apparatus) and others. The therapeutic effect of such removable devices will be noticeable only if the wearing mode is strictly observed - this is usually a few hours in the afternoon and all at night.
Treatment in adults
After completion of growth and formation of jaws, plate correction becomes impossible. Therefore, to treat prognathic bite in adults, non-removable bracket systems are used.
The braces design is an arc connected by special locks. They can be located both on the outside( vestibular) and on the inside( lingual) of the teeth. According to the type of material used, the brackets are divided into several types. Each of them has both advantages and disadvantages. Let us consider them in more detail.
View of bracket system | Pros | Cons |
---|---|---|
Metallic | Robust( made of special stainless steel, or made of titanium and nickel alloy).It is possible to vary the composition of the metal, thus eliminating allergic reactions. Affordable and easy to care for | Causes discomfort when wearing. Of all bracket systems, they have the lowest aesthetic values of |
Ceramic | Robust( made of polycrystals, for example aluminum).Imitate the color of the teeth, due to what is not so conspicuous. Do not oxidize and do not stain | Require thorough care. The duration of treatment is increased in comparison with metal treatments. Are characterized by a complex process of removal from the teeth and a high price. |
Metal Ceramic | Robust( composed of combined elements).Do not oxidize and do not affect the internal environment of the oral cavity. More aesthetic than all-metal | Regular maintenance is required. The removal process can be difficult, as in the case of ceramics |
Composite( plastic) | Good aesthetic qualities. Available for | patients The design is not very robust. Are erased during treatment, have poor adhesion to teeth. Over time, fade and look less attractive |
Sapphire | Durable( made from a single crystal sapphire).Very attractive in appearance. Do not cause irritation, hypoallergenic, comfortable for patients | Several times more expensive than traditional braces. Without proper care, they lose their luster. The term of treatment is increased because of the removable nature. Not suitable for all bite defects |
There are also gold and platinum bracket systems. They are made of precious metal, as the name implies. Such braces are used in certain circles, rather as a way to emphasize their status and financial capabilities.
Orthodontic devices are made individually for each patient, according to the model of his jaw. Only in this case they will properly sit and perform their function. The tension created by the braces makes the teeth gradually move in the right direction. This process is not fast, depends on many factors - the age of a person, the state of bone tissue, the severity of the defect. The term of wearing bracket systems lasts an average of three to four years without taking into account the rehabilitation period. Upon termination, other orthodontic constructions - retainers are installed. They are worn even more long time in order to prevent the return of the teeth to their original place.
In complex cases, if the cause of distal occlusion is hidden in pronounced developmental anomalies, and conservative treatment will certainly not be successful, resort to surgical intervention.
Video - Stages of incorrect bite correction
Prevention of prognathic bite
Prophylactic measures are very important, and in many cases help prevent the development of distal occlusion.
To prevent the disease, you need to closely monitor the development of the child from an early age. First of all, this applies to children with a hereditary burden - they are certainly at risk. So, what steps should parents take to minimize the likelihood of a distal occlusion:
- to preserve breastfeeding in the first year of life;
- promptly enter into the diet solid food;
- to prevent the development of rickets, lack of vitamins and trace elements;
- timely treat respiratory diseases;
- to control the correct posture;
- to avoid bad habits;
- monitor the condition of the milk teeth, preventing their premature loss;
- visit the orthodontist to monitor the condition of the dentoalveolar system.
If signs of a malocclusion have appeared, then this problem needs to be solved in the early stages. It should be remembered that in childhood, the prognathic bite is much more easily amenable to correction.