Retrusion and protrusion - what to do if the mouth has teeth-"upstarts" and "recluses"

Not all people are lucky enough to grow up and live life with teeth ideal or at least tolerable in terms of physical and aesthetic, retraction and protrusion - the phenomenon between people is quite ordinary.

A clear illustration of this pathology is the mouth of the crocodile: teeth protruding from the row forward or forward-sideways - a sample of their protrusions, protruding backwards, often with crawling on the palate - these are the teeth are retroactive.

Each of these terms has synonyms: the protrusion is also called the vestibular( or cheek-labial), the retraction is the oral( or palate-lingual) position of the teeth.

Unlike prognathia and retrognathia( with an increase or decrease in the size of the jaw with the general correct position of the teeth in the row), the retror or protrusion position is an anomaly of the position of finding one or more teeth in the "unlawful", in contrast to the place it has established by nature.

With the frequent location of teeth with "crawling" on each other, one can speak about the variant of their crowding, when several teeth are located in front of the others with the jaw extended forward when the dentition is closed - the bite anomaly.

Vestibular position

To the tooth grow abnormally in front of the rest of the line, there must be validreasons in the form:

• lack for him a place in the row( with underdevelopment of the jaw, makrodentii - too large neighbors, with supercomplexand teeth);
• abnormalities of the bookmark and placement of the rudiments of permanent teeth( as with premature removal of dairy);
• of the late change of "milk";
• pathological habits in the form of a constant breath with your mouth, sucking your finger or gnawing a hand-tucked object( pen, pencil).

As a result, the consequences of anomalies are manifested by speech function disorders and aesthetic disharmony due to:

• occurrence of three;
• denseness of teeth;
• increases the size of the front of the dental arch.

The classification subdivides the buccal-labial positioning of the teeth into:

• bimaxillary-obocephalous( with forward incisors of both jaws);
• with protrusion of incisors of the upper jaw;
• with outward protrusions of mandibular incisors.

Features of the clinical picture

Typical symptoms of protrusions include the anomalous position of the lips either in the form of their protruding forward with the outward inversion, or lip insolvency - the impossibility of their free without the application of clamping force, with gaping gap gaping during their relaxation. The presence of both these signs is not necessary.

When the position of the incisors causes a degree of separation of the lips at rest more than 4 mm, the protrusion is excessive.

Correction methods

In the presence of an anomaly, its degree is assessed and either a correction of the position of the teeth or a surgical correction of the pathology with the need for extraction of individual teeth is performed.

The category of the corrective design depends on the nature of the pathology: in the presence of free space in the jaw, the teeth are uniquely placed in a row using brackets, a vestibular plate or with a retrograde arch, and using the Engl's sliding arc( providing a lingual inclination of the front teeth at a speed of 1 mm / month).With narrowed dental arches, the apparatus extending them is used.

In the absence of free space in the series, extraction is performed:

• or the first premolars with a pronounced bimaxillar form of protrusion of the incisors followed by retraction of the bracket-tusk or otherwise,
• or excess teeth, if any.

In the presence of frontal pathology( I category according to Engle) with lip dissociation at rest:

• less than 4 mm surgical intervention is not required - treatment is limited to conservative measures;
• 5-9 mm - in the solution without dispensing it is necessary to expand the premolar and molar zones of the dentition;
• 10( or more) mm - shows the use of the surgical method.

Treatment, combining the removal of premolars with the rearrangement of other teeth, should not be performed during the period of the bite, waiting until the bite late replacement or early permanent.

In the presence of deep incisal overlap, the cause of vertical bite disturbance is eliminated, treatment of the pathology of the lower incisors is the use of extraoral traction( due to the contraindication of the use of functional apparatuses).

In addition to the main method of correction or treatment, it is mandatory to use myoterapia - physical education for the circular muscle of the mouth and get rid of harmful habits learned from childhood.

If the teeth "fell through" into the mouth of the

When the "germinating" of the tooth with a deviation from the proper line back, orally - toward the tongue and the palate, they speak of their retrospective position.

The causes for such an unnatural frontal position in the upper or lower jaw can be:

• supercomplex;
• offset from the line due to extrusion by neighbors;
• disorder of the mechanics of insertion of the buds of permanent teeth;
• delayed dropout of "milk"( with the growth of the permanent tooth in bypassing the milk);
• consequences of bad habits( use of oral cavity for other purposes) and irregularity of the respiratory mechanism.

The consequences of the retraction are:

• dental crowding and trapezoidal configuration of the dentition due to shortening of the frontal segment of the gum line;
• an increase in the depth of bite with injuries of gums and periodontal structures;
• disorders of speech function and aesthetics of the perception of the face and oral cavity.

According to the accepted classification, the oral position of the dentition is divided into:

• maxillary( dorsal, with backward displacement of the upper anterior teeth);
• mandibular( inferior, with a backward deflection of the lower incisors);
• bimaxillary( with anomalies of the placement of teeth on both jaws).

Clinical manifestations

Clinical symptoms are manifested in speech disorder and cosmetic defect in the form of lip sagging, which does not contribute to external appeal, which means that it can affect the patient's character and mentality( especially the adolescent).

For, in addition to aesthetic discomfort, efforts to hide a defect lead to an overstrain of mimic and chewing muscles, which can cause difficulty in the cerebral blood supply.

With a pronounced pathology with the formation of an incorrect bite, the function of chewing food, which leads to disorders in the digestive system, suffers. To the same consequences lead and inflammatory phenomena in the gums and periodontium due to their permanent injury by incorrectly placed teeth.

Principles of correction

General principles of treatment and correction of retraction differ from those with protrusions in non-essential details.

Since the period of the replaceable occlusion is usually accompanied by the appearance of free space in the gum, methodical pressure from the inside by the tongue or a finger on the retrorively located single permanent tooth leads to its placement in the proper place.

When squeezed out of the arc, neighbors resort to the movement of teeth in place using orthodontic or surgical techniques.

With a considerable crowded dentistry, a comprehensive approach to treatment is applied with the initial removal of excess first premolars and subsequent use of removable( plates equipped with a system of screws and springs) or fixed( braces) of orthodontic structures.

Preventive measures

Because one of the main reasons leading to unnatural position of the teeth in the gum( gingival extension in the antero-longitudinal direction with the protrusion of the incisors) is the habit of sucking the fingers of the finger, parents should take vigorous measures to eradicate it.

To the same negative consequences leads and an inadequate habit of breathing all the time only the mouth. Children should be gently weaned from this method of breathing, having previously checked the child for adenoids or another obstacle for breathing with the nose.

The cheating of foreign objects during the game or at the time of testing strong emotions also does not contribute to the formation of an ideal smile.

Special attention to the state of teeth with obligatory consultations with dentists is required during the period of teeth change. So, premature removal of milk teeth can lead to the occurrence of abnormalities of dental tabs of permanent teeth, and the delayed replacement of them - to eruption in a place not intended for this.

Excessive teeth, as well as their unnatural size, is also the area of ​​tasks for taking action on the part of the dentist.

Ideally, a visit to the dentist's office at least once or twice a year should become the norm of life for every modern person, regardless of age and social status.

On the prices for

treatment Depending on the degree of complexity of correction or treatment of anomalies, the price for the complex of provided services will vary significantly.

For example, the price list of services provided for protrusions of teeth in Moscow clinics includes both a starting price in the form of an initial consultation of an orthodontist( from 500 to 550 rubles), and current expenditure, including extraction of 2-4 thousand rubles for each unit), installationBraces-systems for one row of teeth( from 9 to 10 thousand).

In the same approximate amount will cost removal of the system, and the full course of treatment with brackets costs in the amount of 70 to 150 thousand rubles.

More complex intervention involves spending even larger amounts.