Popov-Godon phenomenon: dentoalveolar lengthening, classification according to Ponomareva

Snow-white, even teeth indicate beauty, health and make up the image of a modern person.

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It is now possible to get rid of the curvature of the teeth with the introduction of the latest developments at any age.

What is the Popov-Godon phenomenon?

Popov-Godon phenomenon - dentoalveolar pathology, expressed in abnormal dental shifts, provoked by tooth extraction and refusal of timely prosthetics of the defect (loss of an element dentition).

The syndrome was originally recorded in 1880. V. O. Popov. Then in 1904 g. Godon also noticed a modification of the dentition due to the loss of some of the links.

Often, the teeth, devoid of opposing analogs, move quite noticeably and almost come into contact with the mucous membrane of the alveolus on the opposite side. The work of the muscles of the lower jaw is immediately blocked.

Popov-Godon phenomenon in the photo:

The test results indicate that a similar syndrome rebuilds the alveolar bones in dental units, remained without opposite analogs: the periodontal gap narrows, the routes of collagen fibers. However, in pulp certain dystrophic transformations take place.

Such situations occur repeatedly and complicate the process of prosthetics, and therefore orthodontic appliances have been created that are designed based on the category of removable or fixed dentures. By means of them, teeth without antagonists are allowed into the occlusion, along with the synchronous separation of other links.

With a noticeable displacement of the dental unit, the pulp is removed from it and cut within the framework occlusion curve. Substantial exposure of cement provokes its extraction.

If it is necessary to wear the plates for 18 hours a day, the treatment will last at least six months and depends on the complexity of each individual case. With a less positive effect of orthodontic treatment, prosthetics are performed.

About 30% of the population, removing a tooth, often do not even think about its restoration, explaining this by their refusal to spoil the neighboring links.

Physiologists, thanks to research, have revealed that with the loss of a dental unit, a person does not at all lose the opportunity to chew food qualitatively. But the body does not put up with emptiness, and the adjacent teeth, moving, try to hide the gap, provoking the appearance of gaps between themselves.

Even more serious is the situation where the dental analogue from the opposite site grows towards the void, interferes with correct chewing and increases the functional load, contributing to the modification of the bite.

A visual video about the deformation of the dentition:

Classification of manifestations according to Ponomareva

Based on the research materials of the symptoms of Popov-Godon syndrome, V. A. Ponomareva identified two forms of the phenomenon.

One is distinguished by the fact that, in addition to the displacement of the dental unit, a noticeable increase in the process of the alveoli is formed, although this does not expose the dental root and does not form a gingival pocket.

The second form provides for dental shift, accompanied by necrosis of periodontal matter and exposure of root cement. It includes two subgroups.

In the first, an increase in the process of the alveoli is noted, if the resorption of the periodontium is insignificant. In another subgroup, a similar phenomenon is not observed; resorption of periodontal tissues is at least half the size of the root.

Certain signs allow diagnosing partial adentia aggravated by Popov-Godon syndrome.

The main ones:

• fragmentary loss of teeth;
• modifications of the occlusal surface;
• a decrease in the height of the occlusion is not observed;
• reduction of the distance (or absence) from the occlusion surface of the displaced link to the process of the alveolus of the opposite jaw.

Secondary:

• increase in the size of the process of the alveoli;
• the presence or absence of resorption of the amphodont of the displaced elements;
• invariability of the structure of hard tissues and periodontium of natural teeth.

Distinguish the syndrome from other varieties adentia allows the study of the correlation of the set of teeth with the lower jaw in the resting position.

In this case, having determined the main jaw ratio, the diagnostic models are fixed in the occluder, the deviations are investigated occlusion, the interval between dental units without opposing analogs, and the process of the alveoli of the missing fragment.

Methods for treating dentolveolar lengthening

Partial adentia, aggravated by the curvature of dental units, is eliminated one by one: first, the curvature is corrected, then regenerated.

They get rid of the syndrome in different ways, based on the type, stage and severity of abnormal curvatures:

• grinding method;
• method of sequential de-occlusion;
• hardware-surgical;
• surgical method.

Sanding

Most often, the grinding method is considered to be in demand in the elimination of Popov-Godon syndrome. It is suitable for patients over 35 years old with an offset of no more than 1/2 of the tooth height. It is intended for use in the second type of the syndrome and the ineffective use of the de-occlusion technique.

When calculating the degree of abrasion, you must first analyze the diagnostic models or lateral extraoral radiographs and teleroentgenograms.

Having determined the occlusal plane, a dental shift is established in order to determine the volume of tissues removed over the occlusion surface. On x-rays, the location of the line indicates the need for depulpation.

When the offset is small, you can simply grind the fabric down to the enamel. Upon completion, it is recommended to undergo a fluoride lacquer therapy course. If it is advisable to remove the dentin layer, the tooth must be covered with a crown.

When the vertical extension has developed due to the disintegration of its antagonist, both the destroyed element and the opposite analogue are covered with crowns. The required height for the new crown is formed and the blockage of the activity of the lower jaw in the sagittal direction is eliminated.

Jaw prosthetics. Video:

Sequential deocclusion

The de-occlusion method is effective in the first form of Popov-Godon syndrome in the treatment of people under 40 years of age and is based on the formation of a discrete effect due to increased pressure on the teeth drawn into the process with the involvement of a therapeutic apparatus.

The apparatus is a plate orthopedic device (prosthesis) with a bite pad that antagonizes the offset teeth and separates the bite in the links of the dental system.

Often, the method of separation of natural teeth does not completely align the occlusion curve, which is why the healing process is carried out in stages. If the prosthesis no longer helps, then it is time to proceed to the second stage of deocclusion.

It consists in covering the bite pad with a fast-hardening plastic and ensures the separation of the teeth by no more than 2 mm. The occlusion is corrected with this technique until the deformity disappears completely. Following the correction of the occlusion of the dentition, the void is replaced by a prosthesis based on the indications.

With a decent shift of the teeth, the deviations can be eliminated in several strokes, therefore, the gradual build-up of the bite pad with plastic is permissible only on a removable device.

It more accurately sets the alignment with the shifted teeth and the adjustment of the bite pad in a direction that is convenient for them to move. The structure of the device provides the patient with the opportunity to disinfect the oral cavity on their own, and the doctor to control the process of dentoalveolar changes.

Correction of warping on video:

Hardware-surgical

In situations where inflammation is detected in the shifted teeth, and by the end of the cure procedure, modifications in the alveolar process are absent, it is recommended to think about the hardware-surgical option, which consists in selective compactosteotomy and the use of prosthesis.

Having made a U-shaped or angular section with the use of local anesthesia, stepping back 5 mm from the border of the gums of the shifted elements, the periosteal flap is folded back.

The transverse line of the corticotomy is placed over the projections of the upper portions of the roots (for the upper row).

It is also necessary to make laxative holes from the palate area along the surface of the projections of the roots. After suturing, the patient is treated as after surgery on the alveolar ridge.

Surgical

A similar method is applicable in the absence of prohibitions and restrictions on surgical interventions. Extraction of teeth is permissible with the second form of Popov-Godon syndrome and significant deviations of the occlusal curve, dental mobility, and protracted incurable pathologies.

With an excessive increase in the alveolar process, if other methods do not work or are unsafe, extraction of teeth is provided, incomplete resection of the alveolar process and the tubercle of the maxilla.

The resection level is entirely due to the dislocation of the maxillary sinus, that is, before the intervention, radiographs should be taken to establish the scope of the operation.