What is the name of the complete or partial absence of teeth. Partial absence of teeth

Adentia, depending on the causes, can be primary or secondary.

Primary adentia is congenital. The reason for it is the absence of rudiments of teeth, which is most often a manifestation of anhydrotic ectodermal dysplasia. Also, the symptoms of this disease are changes in the skin (lack of hair, early aging of the skin) and mucous membranes (pallor, dryness).

In some cases, it is not possible to establish the cause of primary adentia. It is assumed that the resorption of the tooth germ can occur under the influence of a number of toxic effects or be the result of an inflammatory process. Perhaps hereditary causes and a number of endocrine pathologies play a role.

Secondary adentia is more common. This adentia appears due to partial or complete loss of teeth or rudiments of teeth. There can be many reasons: most often these are injuries or a consequence of neglected caries.

According to the number of missing teeth, adentia can be complete or partial. Complete adentia is the complete absence of teeth. Most of the time it's primary.

Adentia Clinic

Depending on whether this adentia is complete or partial, the clinic also manifests itself.

Complete adentia leads to a serious deformation of the facial skeleton. As a result, speech disorders appear: slurred pronunciation of sounds. A person cannot fully chew and bite off food. In turn, malnutrition occurs, which leads to a number of diseases of the gastrointestinal tract. Also, complete adentia leads to dysfunction of the temporomandibular joint. Against the background of complete adentia, the mental status of a person is disturbed. Adentia in children leads to a violation of their social adaptation and contributes to the development of mental disorders.

Primary edentulousness in children is very rare and serious illness in which there are no rudiments of teeth. The cause of this type of adentia is a violation of intrauterine development.

The clinic, in the absence of timely treatment, is extremely severe and is associated with pronounced changes in the facial skeleton.

Secondary complete adentia is the loss of all teeth in their original presence. More often, secondary complete adentia occurs due to dental diseases: caries, periodontitis, as well as after surgical removal of teeth (for oncology, for example) or as a consequence of injuries.

Secondary partial adentia has the same causes as the primary one. With the complication of this adentia by the wear of the hard tissues of the teeth, hyperesthesia appears. At the beginning of the process, a setback appears when exposed to chemical stimuli. With a pronounced process - pain when closing teeth, exposure to thermal, chemical stimuli, mechanical stress.

Diagnostics

Diagnosis is not difficult. Enough clinic. To confirm some types of adentia, an x-ray examination is necessary.

Treatment of adentia

Primary complete adentia in children is treated with prosthetics, which must be carried out starting from 3-4 years of age. These children need dynamic supervision of a specialist, tk. there is a significant risk of a child's jaw growth failure as a result of the pressure of the prosthesis.

With secondary complete adentia in adults, prosthetics are carried out using removable plate dentures.

When using the method of fixed prosthetics with complete adentia, it is necessary to carry out preliminary implantation of the teeth.

Complications of prosthetics:

Violation of the normal fixation of the prosthesis due to atrophy of the jaws;

Allergic reactions to denture materials;

The development of the inflammatory process;

Development of bedsores, etc.

Treatment of secondary partial adentia complicated by hyperesthesia includes depulpation of the teeth.

In the treatment of secondary adentia, it is imperative to eliminate the causative factor, i.e. disease or pathological process that led to adentia.

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The concept of adentia

The complete or partial absence of teeth is called adentia. This symptom occurs equally often in both children and adults. The etiology of the onset of the disease is different for everyone, so the symptoms are different. Sometimes the patient is diagnosed with only a partial violation of the dentition.

Often adentia affects only milk teeth. It should be borne in mind that the disease is not always congenital. Improper oral hygiene and the presence of other adverse factors can provoke acquired symptoms.

In order to avoid unpleasant manifestations in yourself and your loved ones, it is better to be fully armed and study the disease in more detail.

Depending on the form of the disease, certain changes in the jaw can be observed.

Complete absence of teeth

This is the most annoying variety. Patients with this diagnosis suffer the most changes. This is definitely a facial deformity. The cheeks in this case are sunken, the skin on them has a stretched, withered appearance. There is premature aging of the skin of the face. Almost always, speech suffers, especially with congenital adentia.

An aggravating factor is difficult meals. The patient cannot eat fully, because it is almost impossible to chew and bite off solid food. As a result, there is a general weakening of the immune system and the whole organism as a whole. In this case, it is also difficult to avoid the development of chronic diseases of the digestive system.

Significantly such a defect affects the psychological state of a person. Patients often, along with adentia, acquire numerous complexes, withdraw into themselves.

Partial absence of teeth

Sometimes one of the jaws or parts of it develop without any abnormalities. Then the adentia is considered partial. The external manifestations of the disease directly depend on the number of missing teeth. Pathology basically also leads to facial deformity, impaired speech and eating. Patients with partial dentition often suffer from malocclusion, cross or deep.

Along with the partial absence of teeth, dentists can detect various displacements, shortening or narrowing of one of the jaws. The temporomandibular joint also suffers pathological changes. Due to the minimum chewing load, the muscles of the mouth are weakened, thinning of the bone tissue occurs.

The absence of one or more teeth practically does not cause any inconvenience to a person, but the body suffers inevitable negative changes. It:

• displacement of the entire dentition;
• violation of intestinal motility;
• load on the gastrointestinal tract;
• mineralization of tooth enamel slows down;
• protein metabolism suffers.

All these factors inevitably lead to the development of pathologies more serious than the absence of a pair of teeth.

Diagnostic methods

The correct diagnosis can only be established by a specialist in the field of clinical examination and a number of studies. To examine children who still do not have teeth due to their age, the dentist uses exclusively tactile methods. The baby's gums are felt for the presence of rudiments of milk teeth. As a rule, an experienced doctor can feel them from a very early age.

In more ambiguous situations, the orthodontist recommends that the child undergo an x-ray examination of the jaw. Panoramic x-ray will give a complete picture of the disease. Here you can consider in detail the structure of the root system of the tooth and the features of the development of the jaw. Visible on the X-ray and the alveolar process.

Features of the diagnosis of secondary (acquired) adentia

In the secondary form of the disease, the examination is not much different from the diagnosis of a congenital malformation of the jaw. Often, a series of laboratory tests is added to the review to establish the cause of tooth loss. Sometimes this is caused by complex chronic diseases that prevent prosthetics from being carried out. Without prosthetics, it is impossible to achieve the expected results of treatment. Contraindications may be:

• benign and malignant neoplasms in the body;
• diseases of the mucous membranes;
• the presence of an inflammatory process in the blood;
• remnants of the roots of the teeth under the mucous membranes.

To start treatment, it is necessary to remove all obstacles, otherwise complications are possible.

Reasons for the development of the disease

It is difficult to isolate the main cause of congenital absence of teeth and their loss in adulthood. Scientists have proven that the hereditary factor plays a significant role in the formation of pathology. For example, underdevelopment of teeth even in the prenatal period.

There is also such a pathology as the embryogenesis of dental tissues, which does not allow the jaw and dentition to form normally. The absence of lateral incisors and molars is called phylogenetic reduction.

Caries, violations of tooth enamel, inflammation of the oral cavity, pulpitis can also lead to complete or partial loss of teeth. Therefore, at the slightest uncharacteristic manifestations in the oral cavity, it is better to immediately contact the orthodontist for a qualified consultation. Any delay in dental health is almost always fraught with consequences.

Varieties of adentia

Primary (congenital) complete edentulous

Pathology is extremely rare and in the circle of specialists is considered a complex genetic disease. In this case, the rudiments of the teeth are completely absent. Accompanied by pathology and other physical manifestations. The facial oval of a child with congenital adentia differs significantly in appearance from the face of a healthy baby. The lower part of the face is reduced, the alveolar processes of the jaw are not fully formed, which is easily visualized. The mucous membranes of such children are pale and dry. The patient can eat only soft or liquid food. Because of the defect, speech does not develop.

Most children with primary edentulous syndrome suffer from the absence of hair on the head, eyebrows and eyelashes. The fontanel of such an infant tightens slowly, and may not narrow at all. The nail plates are either absent or excessively brittle and soft. Therefore, we can say that congenital adentia is a complex of complex genetic defects that are formed during a woman's pregnancy.

Congenital partial disorders of the dentition

It has slightly different symptoms and milder consequences. Occurs during eruption of milk teeth. Some teeth, against all odds, just don't grow. Rudiments are not detected by palpation and x-ray examination.

As a result, gaps are formed between the teeth, which will inevitably lead to a displacement of the entire row. With a large number of missing teeth, underdevelopment of the jaw is diagnosed. With a mixed bite, when the first teeth fall out, and permanent ones grow in their place, a lot of empty places form in the oral cavity. There is a risk of loosening of the supporting teeth and a violation of the protective enamel layer, which leads to many complications. For example, deformation of the jaw or the appearance of a crossbite.

Acquired complete edentulous

There is a complete absence of teeth in both jaws. They can be both dairy and permanent. There is the concept of secondary childhood adentia, when the teeth grow normally, but eventually fall out for some reason.

Common causes of the acquired form of the disease can be:

• dropping out;
• removal due to caries, which is not treatable;
• periodontitis;
• removal for surgical reasons, such as oncology.

Over time, the alveolar processes atrophy, the lower jaw tightly adjoins the nose. The main symptom of the initial stage of secondary adentia is the erasure of tooth tissues. Because of this, the patient feels discomfort when the jaw is tightly closed.

Secondary partial

The most common type of pathology. Most people at different ages have experienced it. This may be the removal of teeth due to caries or an inflammatory process in the gums. In this case, the alveolar processes continue to function normally. Displacement occurs rarely and depends on the time elapsed since the removal of adjacent teeth.

It rarely happens that with a mixed bite, a shift of the row occurs. Then there is not enough space for the growth of a permanent tooth. Therefore, parents should pay attention to the delay in eruption, and if necessary, visit a pediatric dentist with the baby.

Treatment of the disease

It is prescribed depending on the type of adentia and other indicators identified during the examination. Most often used:

• prosthetics with crowns or inlays;
• the use of implants;
• installation of bridges;
• the introduction of a removable or non-removable prosthesis.

Prosthetics are carried out equally often, both with the use of removable and non-removable prostheses. For children, the first option is more suitable. jaw endure age-related changes and in the future, the fixed prosthesis may be deformed or displaced, which is highly undesirable.

All prostheses, regardless of the material of manufacture, are made on the basis of a cast made in advance. This is required so that it fits perfectly to the patient's jaw, does not cause discomfort.

Many parents refuse to carry out prosthetics for their children. This is a wrong perception. Even temporary removable dentures able to restore the aesthetics of the dentition. The child can fully eat, develop chewing function.

With acquired partial adentia, dentists decide on artistic restoration. This method allows you to restore the integrity of the dentition with minimal effort. For this, ceramics and photo composites are used. Depending on the selected material, the service life of the prosthesis is determined.

Implants will help to properly distribute the load on the dentition. This is their advantage over bridges. Features of the installation make them the safest type of treatment in relation to neighboring teeth.

At what age should treatment begin?

Orthodontics recommend starting prosthetics with complete congenital adentia from the age of three. Just at this age, the baby's body is much stronger, and the disease can be diagnosed most accurately. The dentist should pay special attention to the shape of the prosthesis, as an ill-fitting one can provoke a delay in the development of the jaw.

You should not save on the material of prostheses. This directly affects their lifespan. Although the process of their installation is painless due to the use of anesthetics, it is still not the most pleasant. Especially for children.

Adentia is a complex and very unpleasant disease. But, it is not hopeless. Each patient can count on a positive outcome of treatment with a timely visit to the clinic. Treatment can hardly be called cheap, however, the result will help solve not only physiological, but also psychological problems. After visiting the clinic, a person who previously suffered from complete or partial absence of teeth will soon be able to return to everyday life.

Thanks to a wide range of treatment methods, any patient will find the best way to get rid of such a nuisance.

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Some clinicians distinguish between acquired (as a result of disease or injury) and congenital or hereditary adentia. "Partial secondary adentia" as an independent nosological form of damage to the dentition is a disease characterized by a violation of the integrity of the dentition. In the definition of this nosological form, the term "edentia" is supplemented with the word "secondary", which indicates that the tooth (teeth) is lost after its eruption as a result of a disease or injury. In this definition, according to the author, there is a differential diagnostic feature that makes it possible to distinguish this disease from primary, congenital adentia and tooth retention.

Summarizing, it should be noted that it is more convenient to use the terms "defect" instead of "secondary adentia"; “true adentia”, when there is no tooth in the dentition and its germ in the jaw, and “retention or false adentia”, that is, a tooth that has not erupted.

The causes of adentia can be heredity, dysfunction of the endocrine glands, violations of mineral metabolism in the prenatal period due to diseases of the mother and after the birth of a child due to diseases of early childhood. The death of tooth germs occurs in ichthyosis and endocrinopathies, hypothyroidism and cerebral dwarfism. Violations of the embryogenesis of dental tissues, acute inflammatory processes that developed during the period of milk occlusion also lead to the death of the rudiments of permanent teeth and, subsequently, to underdevelopment of the jaw. These same processes can cause partial or complete retention.

Stanton Capdepon Syndrome described in the literature under various names: "imperfect dentinogenesis", "transparent teeth", "opalescent dentin", etc. This disease is hereditary, affects milk and permanent teeth. With normally formed enamel, the structure of dentin can be disturbed (less mineral salts, fewer tubules and they are wider, their direction is changed). On the radiograph, a decrease in size or complete obliteration of the cavity of the teeth and root canals is determined due to the formation of replacement dentin. Due to the thinness of the roots, the risk of fractures during trauma is higher. The color of the teeth is blue-brown, purple or amber. Due to the lower mineralization of the teeth, early progressive abrasion occurs, up to the gum. Treatment is prosthetic, without extraction of teeth, that is, the manufacture of overlapping removable dentures (partial or complete).

Partial adentia(hypodontia) can be without obvious systemic diseases. If we trace hypodontia among various functional groups of teeth, then the absence of distally located teeth will be characteristic for all of them: in the group of molars, this is usually the third; from premolars the second, from incisors - lateral. Canine adentia is rare. The most commonly missing are the upper lateral incisors, wisdom teeth on both jaws, and the lower second premolars.

Sometimes there are very severe forms of partial adentia, when almost all milk teeth are missing or there are only 6 permanent teeth. YES. Kalvelis observed such a patient for 6 years (9-15 years): the cause of adentia could not be established, general development and jaw growth were normal despite the absence of permanent teeth.

Adentia in the milk bite should be considered as congenital, since the formation of crowns of almost all milk teeth ends in the prenatal period. As for adentia in permanent occlusion, the conclusion about its congenitality should be made with caution, since the death of the tooth germ is possible due to infection or dysfunction of the endocrine glands, accompanied by a violation of calcareous metabolism in the phase of calcification of the crowns of the teeth. The dental follicle, without calcification, loses its viability and dies.

Clinical picture with complete adentia characterized by a violation of the appearance, a decrease in the lower third of the face, retraction of the lips and cheeks, a violation of chewing and speech. According to the literature, multiple adentia occurs in 0.3% of people. Dr. L.E. Davidson reports on an 8-year-old boy who was born to healthy parents and had no deviations in pediatric status, and milk anterior teeth of a conical shape, up to 4.0 mm wide, were observed in the oral cavity; the roots of the molars had a rounded shape; X-ray examination revealed the complete absence of the rudiments of permanent teeth in both jaws, the mobility of milk teeth due to the absence of roots; Removable dentures were made for the child.

With partial edentulous clinical manifestations more diverse and depend on the number of missing teeth and their former location. In the absence of one or two symmetrical teeth of the same name, there may not be a free gap in their place, because the jaw in this area developed poorly, and the teeth standing behind erupted next to those standing in front. When the tooth is retained in the place where it was supposed to erupt, there usually remains a free gap, although it is narrowed. This is one of the differential signs of adentia and retention. In addition, adentia is characterized by a thinned edentulous alveolar process or the presence of milk teeth inconsistent with the timing of eruption of permanent teeth.

Adentia is symmetrical and asymmetrical. The absence of even one tooth in the dentition changes the location of the rest: gaps appear between them, the median line shifts, the dentition narrows and shortens, and the bite changes. In the absence of a lateral incisor, its place is occupied by a moving mesially milk canine, and then a permanent one and the entire dental arch is shortened. In the absence of both lateral incisors, the central ones are displaced distally, a diastema appears between them. Adentia, as a rule, leads to underdevelopment of the jaws, which is more noticeable, the more teeth are missing. Thus, the presence of a complete set of teeth is important not only for chewing and aesthetics, but also for the prevention of displacement of the posterior teeth.

Adentia classification

Depending on the causes and time of occurrence, primary (congenital) and secondary (acquired) adentia, as well as adentia of temporary and permanent teeth, are distinguished. In the absence of a tooth germ, they speak of true congenital adentia; in case of fusion of adjacent crowns or delay in the timing of teething (retention) - about false adentia.

Depending on the number of missing teeth, adentia can be partial (some teeth are missing) or complete (all teeth are missing). Partial congenital adentia refers to the absence of up to 10 teeth (usually upper lateral incisors, second premolars and third molars); the absence of more than 10 teeth is classified as multiple adentia. The criterion for partial secondary adentia is the absence of one jaw from 1 to 15 teeth.

In the practice of orthopedic dentistry, the classification of partial secondary adentia according to Kennedy is used, which distinguishes 4 classes of defects in the dentition:

• I - the presence of a bilateral end defect (distally unlimited defect);
• II - the presence of a unilateral end defect (distally unlimited defect);
• III - the presence of a unilateral included defect (distally limited defect);
• IV - the presence of a frontal included defect (absence of anterior teeth).

Each class of partial secondary edentulousness is in turn divided into a number of subclasses; in addition, defects of various classes and subclasses are often combined with each other. There are also symmetrical and asymmetric adentia.

Causes of adentia

The basis of primary adentia is the absence or death of the rudiments of teeth. In this case, primary adentia can be caused by hereditary causes or develop under the influence of harmful factors acting during the formation of the dental plate in the fetus. So, the laying of the rudiments of temporary teeth occurs at 7-10 weeks of intrauterine development of the fetus; permanent teeth - after the 17th week.

Complete congenital adentia is an extremely rare occurrence that usually occurs with hereditary ectodermal dysplasia. In this case, along with adentia, patients usually have underdevelopment of the skin, hair, nails, sebaceous and sweat glands, nerves, eye lenses, etc. In addition hereditary pathology, primary adentia may be due to the resorption of tooth germs under the influence of teratogenic factors, endocrine disruptions, infectious diseases; disorders of mineral metabolism in the prenatal period, etc. It is known that the death of tooth germs can occur with hypothyroidism, ichthyosis, pituitary dwarfism.

The cause of secondary adentia is the loss of teeth by the patient in the process of life. Partial absence of teeth is usually the result of deep caries, pulpitis, periodontitis, periodontitis, extraction of teeth and / or their roots, dental trauma, odontogenic osteomyelitis, periostitis, pericoronitis, abscess or phlegmon, etc. Sometimes the cause of secondary adentia may be improperly performed therapeutic or surgical treatment of teeth (resection of the apex of the root, cystotomy, cystectomy). In case of untimely orthopedic care, partial secondary adentia contributes to the progression of the process of tooth loss.

Symptoms of primary adentia

Primary complete adentia occurs in both milk and permanent dentition. With complete congenital adentia, in addition to the absence of tooth germs and teeth, as a rule, there is a violation of the development of the facial skeleton: a decrease in the size of the lower part of the face, underdevelopment of the jaws, a sharp expression of the supramental fold, a flat palate. Non-fusion of fontanelles and skull bones, non-union of maxillofacial bones may be noted. With anhydrotic ectodermal dysplasia, adentia is combined with anhidrosis and hypotrichosis, the absence of eyebrows and eyelashes, pallor and dryness of the mucous membranes, and early skin aging.

A patient with a primary complete form of adentia is deprived of the opportunity to bite off and chew food, therefore he is forced to eat only liquid and soft food. The result of the underdevelopment of the nasal passages is mixed oro-nasal breathing. Speech disorders are represented by a multiple violation of sound pronunciation, in which the articulation of lingual-dental sounds (and their soft pairs, as well as sound) is the most defective.

The main sign of partial primary adentia is a decrease in the number (underset) of teeth in the dentition. Between the adjacent teeth, three are formed, the neighboring teeth are displaced into the area of ​​​​dental defects, there is an underdevelopment of the jaws. At the same time, antagonistic teeth may be crowded, outside the dentition, piled on top of each other, or remain impacted. With adentia in the region of the anterior group of teeth, interdental pronunciation of whistling sounds is noted. Trema and misalignment of the teeth can lead to the development of chronic localized gingivitis.

Symptoms of secondary adentia

Secondary adentia in milk or permanent occlusion is the result of loss or extraction of teeth. In this case, the integrity of the dentition is violated after the eruption of the formed teeth.

With the complete absence of teeth, a pronounced displacement of the lower jaw towards the nose, retraction of the soft tissues of the oral region, and the formation of multiple wrinkles are noted. Complete adentia is accompanied by a significant reduction of the jaws - first, osteoporosis of the alveolar processes, and then the body of the jaw. Often there are painless exostoses of the jaw or painful bony protrusions formed by the edges of the sockets of the teeth. Also, as with primary complete adentia, nutrition is disturbed, speech suffers.

With secondary partial adentia, the remaining teeth gradually shift and diverge. At the same time, in the process of chewing, they have an increased load, while in the areas of adentia there is no such load, which is accompanied by destruction of bone tissue.

Partial secondary adentia can be complicated by pathological abrasion of teeth, hyperesthesia, pain when closing teeth, exposure to any mechanical or thermal stimuli; the formation of pathological gingival and bone pockets, angular cheilitis. With significant partial adentia, habitual subluxation or dislocation of the temporomandibular joint may occur.

Cosmetic defects in adentia are characterized by changes in the oval of the face, pronounced nasolabial folds, chin fold, drooping corners of the mouth. In the absence of a group of frontal teeth, "retraction" of the lips is noted; with defects in the region of the lateral teeth - hollow cheeks.

Patients with adentia often develop gastritis, gastric ulcer, colitis, and therefore they need not only the help of a dentist, but also a gastroenterologist. Loss of teeth is accompanied by a decrease in a person's self-esteem, psychological and physical discomfort, and a change in social behavior.

Diagnosis of adentia

Adentia is a problem in the diagnosis and elimination of which dentists of various specialties take part: therapists, surgeons, orthopedists, orthodontists, implantologists, periodontists.

Diagnosis of adentia includes anamnesis, clinical examination, comparison of chronological age with dental, palpation examination. In the presence of a local defect after the expiration of the eruption of the tooth, aiming intraoral radiography is usually used to clarify the diagnosis. In the case of multiple or complete adentia, panoramic radiography or orthopantomography is performed, if necessary, radiography or CT scan of the temporomandibular joint. X-ray examination allows you to identify the absence of the rudiments of teeth, to detect roots covered with gums, exostoses, tumors of the oral cavity, to assess the state of the tissue of the alveolar process, signs of inflammation, etc.

At the stage of planning the treatment of adentia, impressions are taken, diagnostic models of the jaws are made and studied.

Treatment of adentia

The main method of eliminating adentia is prosthetics using fixed (bridge-like) orthopedic structures and removable dentures (clasp, plate). The choice of adentia treatment method is determined by the orthopedic dentist, taking into account the anatomical, physiological, and hygienic features of the patient's dentoalveolar system.

Fixed prosthetics with complete adentia involves the installation of supporting dental implants (mini-implants), on which the prosthetic structure is then attached. With partial adentia, intact or well-healed teeth are used as abutments. The method of choice for the elimination of secondary partial adentia is classical dental implantation with the installation of a crown.

Treatment of children with congenital adentia can begin from 3-4 years of age. Orthopedic measures for complete primary adentia are reduced to the manufacture of complete removable lamellar dentures, which in children should be replaced with new ones every 1.5-2 years. Prosthetics with a partially removable laminar prosthesis is also indicated for primary partial adentia. Replacement of a removable prosthesis with a bridge is carried out only after the end of the growth of the jaws.

When using removable plate dentures, there is a risk of developing prosthetic stomatitis, decubitus ulcers of gum tissue, allergies to dyes and polymers of the prosthesis material. Before proceeding with the treatment of partial adentia, a complete professional oral hygiene is required, if necessary - complex treatment caries, pulpitis, periodontitis, periodontitis, elimination of hyperesthesia of teeth, removal of roots and teeth that are not subject to preservation.

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What is Partial adentia (partial absence of teeth)

Adentia- Absence of several or all teeth. There are acquired (as a result of a disease or injury), congenital hereditary adentia.

In the special literature, a number of other terms are used: defect of the dentition, absence of teeth, loss of teeth.

Partial secondary adentia as an independent nosological form of damage to the dentoalveolar system is a disease of the dentition or both dentitions, characterized by a violation of the integrity of the dentition of the formed dentoalveolar system in the absence of pathological changes in the remaining links of this system.

In the definition of this nosological form, next to the classical term "adentia" is the definition of "secondary". This means that the tooth (teeth) is lost after the final formation of the dentition as a result of a disease or injury, i.e., the concept of “secondary adentia” contains a differential diagnostic sign that the tooth (teeth) formed normally, erupted and functioned for some period. It is necessary to single out this form of damage to the system, since a defect in the dentition can be observed with the death of the rudiments of the teeth and with a delay in eruption (retention).

An analysis of the study of dental orthopedic morbidity in the maxillofacial region according to the data of the appealability and planned preventive sanitation of the oral cavity shows that secondary partial adentia ranges from 40 to 75%.

The prevalence of the disease and the number of missing teeth correlate with age. In terms of frequency of removal, the first permanent molars occupy the first place. Rarely, the teeth of the anterior group are removed.

What provokes Partial adentia (partial absence of teeth)

Among etiological factors that cause partial adentia, it is necessary to distinguish between congenital (primary) and acquired (secondary).

The most common causes of secondary partial adentia are caries and its complications - pulpitis and periodontitis, as well as periodontal diseases - periodontitis.

In some cases, tooth extraction is due to untimely treatment, resulting in the development of persistent inflammatory processes in the periapical tissues. In other cases, this is a consequence of incorrectly carried out therapeutic treatment.

Pathogenesis (what happens?) during Partial dentition (partial absence of teeth)

Pathogenetic bases of partial secondary adentia how independent form lesions of the dentition are due to large adaptive and compensatory mechanisms of the dentoalveolar system. The onset of the disease is associated with the extraction of a tooth and the formation of a defect in the dentition and, as a consequence of the latter, a change in the function of chewing. The dental system, which is united in morphological and functional terms, disintegrates. Xia in the presence of non-functioning teeth (these teeth are devoid of antagonists) and groups of teeth, the functional activity of which is increased. Subjectively, a person who has lost one, two or even three teeth may not notice a violation of the function of chewing. However, despite the absence of subjective symptoms of damage to the dentition, significant changes occur in it.

Increasing over time, the quantitative loss of teeth leads to a change in the function of chewing. These changes depend on the topography of defects and the quantitative loss of teeth: in areas of the dentition where there are no antagonists, a person cannot chew or bite off food, these functions are performed by the preserved groups of antagonists. The transfer of the biting function to a group of canines or premolars due to the loss of anterior teeth, and in case of loss of chewing teeth, the function of chewing to a group of premolars or even anterior group of teeth disrupts the functions of periodontal tissues, the muscular system, and elements of the temporomandibular joints.

Biting off food is possible in the area of ​​the canine and premolars on the right and left, and chewing in the area of ​​the premolars on the right and the second and third molars on the left.

I. F. Bogoyavlensky points out that changes that develop under the influence of function in tissues and organs, including bones, are nothing more than “functional restructuring”. It can proceed within the limits of physiological reactions. Physiological functional restructuring is characterized by such reactions as adaptation, full compensation and compensation at the limit.

The works of I. S. Rubinov proved that the effectiveness of chewing with various types of adentia is practically 80-100%. Adaptive-compensatory restructuring of the dentition, according to the analysis of masticograms, is characterized by some changes in the second phase of chewing, the search for the correct location of the food bolus, and a general lengthening of one complete chewing cycle. If normally, with intact dentition, it takes 13–14 s to chew the almond kernel (hazelnut) weighing 800 mg, then if the integrity of the dentition is violated, the time is extended to 30–40 s, depending on the number of lost teeth and remaining pairs of antagonists. Based on the fundamental provisions of the Pavlovsk school of physiology, I. S. Rubinov, B. N. Bynin, A. I. Betelman and other domestic dentists proved that in response to changes in the nature of chewing food with partial adentia, the secretory function of the salivary glands and stomach changes, the evacuation of food and intestinal motility slow down. All this is nothing but a general biological adaptive reaction within the limits of the physiological functional restructuring of the entire digestive system.

Pathogenetic mechanisms of intrasystemic restructuring in secondary partial adentia according to the state of metabolic processes in the jaw bones were studied in an experiment on dogs. It turned out that in the early stages after partial extraction of teeth (3-6 months), in the absence of clinical and radiological changes, changes occur in the metabolism of the bone tissue of the jaws. These changes are characterized by an increased intensity of calcium metabolism compared to the norm. At the same time, in the jaw bones in the region of teeth without antagonists, the degree of severity of these changes is higher than at the level of teeth with preserved antagonists. An increase in the incorporation of radioactive calcium into the jawbone in the area of ​​functioning teeth occurs at the level of a practically unchanged content of total calcium. In the area of ​​teeth that are out of function, a significant decrease in the content of ash residue and total calcium is determined, reflecting the development of initial signs of osteoporosis. At the same time, the content of total proteins also changes. A significant fluctuation in their level in the jawbone is characteristic, both at the level of functioning and non-functioning teeth. These changes are characterized by a significant decrease in the content of total proteins in the 1st month of creating an experimental model of secondary partial adentia, then its sharp rise (2nd month) and again decrease (3rd month).

The duration of the action of unfavorable factors on the periodontium and jaw bones, such as increased functional load and complete shutdown from function, leads the dentoalveolar system to a state of "compensation at the limit", sub and decompensation. The dentoalveolar system with impaired integrity of the dentition should be considered as a system with a risk factor.

Symptoms of Partial dentition (partial absence of teeth)

The peculiarity of the studied nosological form is that it is never accompanied by a feeling of pain. In young and often in adulthood, the absence of 1-2 teeth does not cause any complaints from patients. Pathology is detected mainly during dispensary examinations, with planned sanitation of the oral cavity.

The variety of options for secondary partial adentia, which have a significant impact on the choice of a particular treatment method, has been systematized by numerous authors. The classification of dentition defects developed by Kenedy has become the most widespread, although it does not cover combinations that are possible in the clinic.

The author identifies four main classes. Class I is characterized by a bilateral defect not limited distally by teeth, II - by a unilateral defect not limited distally by teeth; III - unilateral defect limited distally by teeth; Class IV - the absence of front teeth. All types of dentition defects without distal limitation are also called terminal, with distal limitation - included. Each defect class has a number of subclasses. General principle

subclassing - the appearance of an additional defect inside the preserved dentition. This significantly affects the course of the clinical justification of tactics and the choice of one or another method of orthopedic treatment (type of denture).

Diagnosis of Partial adentia (partial absence of teeth)

Diagnosis of secondary partial adentia presents no difficulty. The defect itself, its class and subclass, as well as the nature of the patient's complaints, testify to the nosological form. It is assumed that no other changes in the organs and tissues of the dentoalveolar system have been established by all additional laboratory research methods.

For primary adentia due to the absence of rudiments of teeth, underdevelopment in this area of ​​the alveolar process, its flattening. Often, primary adentia is combined with diastemas and tremas, an anomaly in the shape of the teeth. Primary adentia with retention is usually diagnosed after an X-ray examination. It is possible to make a diagnosis after palpation, but with subsequent radiography.

Secondary partial edentulous as an uncomplicated form, it should be differentiated from concomitant diseases, such as periodontal disease (without visible pathological tooth mobility and the absence of subjective discomfort), complicated by secondary adentia.

Treatment of Partial dentition (partial absence of teeth)

Bridge-like non-removable prosthesis called a medical device that serves to replace the partial absence of teeth and restore the function of chewing. It is strengthened on natural teeth and transmits chewing pressure to the periodontium, which is regulated by the periodontal muscle reflex.

It is generally accepted that treatment with fixed dentures can restore up to 85-100% chewing efficiency. With the help of these prostheses, it is possible to fully eliminate phonetic, aesthetic and morphological disorders of the dentoalveolar system. Almost complete compliance of the design of the prosthesis with the natural dentition creates the prerequisites for rapid adaptation of patients to them (from 2 - 3 to 7 - 10 days).

Removable plate prosthesis called a medical device that serves to replace the partial absence of teeth and restore the function of chewing. It is attached to natural teeth and transmits chewing pressure, regulated by the gingivomuscular reflex, to the mucous membrane and bone tissue of the jaws.

Taking into account the fact that the base of the removable laminar prosthesis completely relies on the mucous membrane, which, according to its histological structure, is not adapted to the perception of masticatory pressure, the chewing efficiency is restored by 60-80%. These prostheses allow to eliminate aesthetic and phonetic disorders in the dentoalveolar system. However, the methods of fixation and a significant area of ​​the basis complicate the mechanism of adaptation, lengthen its period (up to 1-2 months).

Byugel prosthesis called a removable medical apparatus for replacing the partial absence of teeth and restoring the function of chewing. Reinforced behind natural teeth and relies on both natural teeth and mucous membranes, masticatory pressure is regulated in combination through periodontal and gingivomuscular reflexes.

In the process of biting off and chewing food, chewing pressure forces of various duration, magnitude and direction act on the teeth. Under the influence of these forces, responses occur in periodontal tissues and jaw bones. Knowledge of these reactions, the influence of various types of dentures on them underlies the choice and reasonable use of one or another orthopedic apparatus (denture) for the treatment of a particular patient.

Theoretical and clinical bases for choosing a method of treatment with fixed bridges

Practically the same problems are faced by an orthopedist with a significant correction for the biological object of influence of the bridge structure. Any design of a dental bridge includes two or more supports (medial and distal) and an intermediate part (body) in the form of artificial teeth.

• the supports of a fixed bridge prosthesis return to their original position after the load is removed, and since the load develops not only during chewing movements, but also when swallowing saliva and establishing dentition in central occlusion, these loads should be considered as cyclic, intermittently constant, causing complex a complex of responses from the periodontium.

Clinical stages of treatment with fixed bridges

After completing the diagnostic process and determining that the treatment of partial adentia is possible by using a bridge prosthesis, it is necessary to choose the number and design of the supporting elements: the nature of the preparation of the supporting teeth depends on the type of construction.

Artificial crowns are often used as supports in the clinic. More complex types of supporting elements include inlays, semi-crowns, pin teeth or “stump structures”. General requirement, presented to the abutment teeth for bridges - the parallelism of the vertical surfaces of the supports to each other. If, in relation to two supports in the form of stamped or cast crowns, it is possible to “by eye” determine their parallelism to each other after preparation, then with an increase in the number of supports, it is difficult to assess the parallelism of the walls of the crowns of the prepared teeth. Already at this stage of treatment with fixed bridges, it becomes necessary to study diagnostic models before or after preparation in order to create parallel surfaces of all supporting teeth. The starting point in this case is the orientation when finding parallelism by 1-2 teeth, as a rule, located closer to the front. However, there are often cases when the search for parallelism, especially in the upper jaw, makes you focus more on the molars. By tilting the parallelometer table and, consequently, the diagnostic model, an analysis of the location of the clinical equator is carried out, thereby determining the volume of tissues removed during preparation. Having chosen the position of the model, in which the equator on all abutment teeth comes closer to the cheap edge, take it as best option. An equator line is drawn on the teeth with a pencil, i.e., the zones of the greatest grinding of hard tissues are marked. The position (tilt) of the cast is recorded as this determines the route of insertion of the prosthesis to secure it to the prepared teeth.

It is advisable to check the quality of the preparation in the parallelometer. If the parallelism of all walls on the stumps of the prepared abutment teeth is achieved, the line of the clinical equator will not be indicated - the analyzer pin for all teeth will pass along the level of the gingival margin.

After the preparation of the teeth, it is necessary to take casts from both jaws. The impression can be ordinary (gypsum, from elastic masses), if metal stamped crowns are used as supports. In all other cases, it is almost always necessary to obtain a double, refined impression.

With a significant removal of the hard tissues of the crowns, in order to protect the pulp, it is necessary to cover the teeth with temporary caps (metal) or temporary plastic crowns. Coating the prepared surface with fluoride varnish should also be considered as a preventive measure.

The next clinical stage is the determination of central occlusion. The task is to achieve close contact between the natural antagonists and the occlusal planes of the ridges when introducing wax bases with bite ridges into the mouth by correcting them (cut off or build up the ridge). Then diagonal cuts are made on one of the rollers (one, two or three), a wax roller with a diameter of 2-3 mm is applied to the other, it is heated, wax bases with bite rollers are inserted into the mouth and the patient is asked to close his teeth. It is advisable to place the heated wax roller opposite the maximum number of natural teeth. If there are no front teeth, it is necessary to draw a mid-sagittal line (the position of the central incisors) on the vestibular surface of the roller.

If enamel and dentine wear is observed on the remaining antagonistic teeth, as a result of which the height of the lower part of the face in central occlusion is reduced, and also if the preserved teeth do not have antagonists, it is necessary to first establish the normal height of the lower part of the face in central occlusion on the occlusal rollers, and then fix it.

The starting point is to determine the height of the lower part of the face with a relative physiological rest of the lower jaw. The pattern is that the height of the lower part of the face in the central occlusion is 2–4 mm less than this distance. Based on this, by reducing the height of the occlusal roller or increasing it, this difference is achieved, i.e., the desired height. At the same time, the position of the lips, cheeks, the severity of the nasolabial and chin folds are taken into account. The final stage - fixation - does not differ from that described above. There are frequent cases when, after establishing the height of the lower part of the face in central occlusion, in the presence of teeth that do not have antagonists, the occlusal plane has an atypical curvature. The developed deformation must be eliminated.

The third clinical stage is the fitting of supporting elements: crowns, semi-crowns, pin teeth, etc. In cases where a soldered bridge is made, at this stage, stamped crowns are checked and fitted. The patterns of fitting crowns are similar to the fitting of single structures. The stage ends with the removal of casts (possibly with the re-determination of central occlusion), the selection of the color of the plastic for cladding metal frame. When using cast structures, casts are not taken, but all elements of the prosthesis frame and the route of its introduction are evaluated. The final stage is to check the design of the bridge prosthesis, if the prosthesis is ceramic-metal - correction of the coating in relation to adjacent teeth and antagonists. It should be carefully checked whether the intermediate part is pressing on the gingival papillae, there should be a gap of 0.2 - 0.3 mm between them. After applying the glaze and general fitting, the bridge is fixed with phosphate cement.

AT last years non-removable bridges are being used, fixed to the intact crowns of the abutment teeth with the help of adhesive compositions. The supporting elements of these prostheses are modified occlusal linings or solid clasps. The advantage of such prostheses is the exclusion of the stage of preparation of abutment teeth.

At the end of treatment, it is necessary to warn the patient about the hygienic maintenance of the mouth, especially the area where the bridge is located, as well as the obligatory visit to the doctor once a year for examination. Together, these are measures to prevent various types of complications in such a massive form of treatment of dental patients.

Which doctors should you contact if you have Partial dentition (partial absence of teeth)

Dentist

Orthodontist

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Adentia(adentia; a - prefix, meaning the absence of a sign, corresponds to the Russian prefix "without" + dens - tooth) - the absence of several or all teeth. There are acquired (as a result of a disease or injury), congenital hereditary adentia.

In the special literature, a number of other terms are used: defect of the dentition, absence of teeth, loss of teeth. Partial secondary adentia as an independent nosological form of damage to the dentoalveolar system is a disease of the dentition or both dentitions, characterized by a violation of the integrity of the dentition of the formed dentoalveolar system in the absence of pathological changes in the remaining links of this system.

With the loss of part of the teeth, all organs and tissues of the dentition can adapt to a given anatomical situation due to the compensatory capabilities of each organ of the system. However, after the loss of teeth, significant changes can occur in the system, which are classified as complications. These complications are discussed in other sections of the textbook.

In the definition of this nosological form, next to the classical term "adentia" is the definition of "secondary". This means that the tooth (teeth) is lost after the final formation of the dentition as a result of a disease or injury, i.e., the concept of “secondary adentia” contains a differential diagnostic sign that the tooth (teeth) was formed normally, erupted and for some period functioned. It is necessary to single out this form of damage to the system, since a defect in the dentition can be observed with the death of the rudiments of the teeth and with a delay in eruption (retention).

Partial adentia, according to WHO, along with caries and periodontal diseases, is one of the most common diseases of the dentition. It affects up to 75% of the population in various regions of the globe.

An analysis of the study of dental orthopedic morbidity in the maxillofacial area according to the data of the appealability and planned preventive sanitation of the oral cavity shows that secondary partial adentia ranges from 40 to 75%. The prevalence of the disease and the number of missing teeth correlate with age.

In terms of frequency of removal, the first permanent molars occupy the first place. Rarely, the teeth of the anterior group are removed.

Etiology and pathogenesis

Among the etiological factors that cause partial adentia, it is necessary to distinguish congenital (primary) and acquired (secondary).

The causes of primary partial adentia are violations of the embryogenesis of dental tissues, as a result of which there are no rudiments of permanent teeth. This group of reasons should also include a violation of the eruption process, which leads to the formation of impacted teeth and, as a result, to primary partial adentia. Both of these factors can be inherited.

The most common causes of secondary partial adentia are caries and its complications - pulpitis and periodontitis, as well as periodontal diseases - periodontitis. In some cases, tooth extraction is due to untimely treatment, resulting in the development of persistent inflammatory processes in the periapical tissues. In other cases, this is a consequence of incorrectly carried out therapeutic treatment.

Sluggish, asymptomatic necrobiotic processes in the dental pulp with the development of granulomatous and cystogranulomatous processes in the periapical tissues, cyst formation in cases of a complex surgical approach for resection of the root apex, cystotomy or ectomy are indications for tooth extraction. Removal of teeth treated for caries and its complications is often caused by spalling or splitting of the crown and root of the tooth, weakened by a large mass of the filling due to a significant degree of destruction of the hard tissues of the crown.

Injuries to the teeth and jaws, chemical (acid) necrosis of the hard tissues of the crowns of the teeth, surgical interventions for chronic inflammatory processes, benign and malignant neoplasms in the jaw bones also lead to the occurrence of secondary adentia. In accordance with the fundamental points of the diagnostic process in these situations, partial secondary adentia recedes into the background in the clinical picture of the disease.

Pathogenetic bases of partial secondary adentia as an independent form of damage to the dentition are due to large adaptive and compensatory mechanisms of the dentoalveolar system. The onset of the disease is associated with the extraction of a tooth and the formation of a defect in the dentition and, as a consequence of the latter, a change in the function of chewing.

Rice. 97. Changes in the functional links of the dentoalveolar system in adentia.

a - functional centers; 6 - non-functional links.

A single morphologically functional dentoalveolar system disintegrates in the presence of non-functioning teeth (these teeth are devoid of antagonists) and groups of teeth, the functional activity of which is increased (Fig. 97). Subjectively, a person who has lost one, two or even three teeth may not notice a violation of the function of chewing. However, despite the absence of subjective symptoms of damage to the dentition, significant changes occur in it.

Increasing over time, the quantitative loss of teeth leads to a change in the function of chewing. These changes depend on the topography of defects and the quantitative loss of teeth: in areas of the dentition where there are no antagonists, a person cannot chew or bite off food, these functions are performed by the preserved groups of antagonists. The transfer of the biting function to a group of canines or premolars due to the loss of the anterior teeth, and in case of loss of the masticatory teeth, the function of chewing to the group of premolars or even the anterior group of teeth disrupts the functions of periodontal tissues, the muscular system, and elements of the temporomandibular joints.

So, in the case shown in Fig. 97, biting off food is possible in the region of the canine and premolars on the right and left, and chewing in the region of the premolars on the right and the second and third molars on the left.

If one of the groups of chewing teeth is missing, then the balancing side disappears; there is only a fixed functional center of chewing in the area of ​​the antagonistic group, i.e., the loss of teeth leads to a violation of the biomechanics of the lower jaw and periodontium, a violation of the patterns of intermittent activity of the functional centers of chewing.

With intact dentition, after biting off food, chewing occurs rhythmically, with a clear alternation of the working side in the right and left groups of chewing teeth. The alternation of the load phase with the rest phase (balancing side) causes a rhythmic connection to the functional load of periodontal tissues, a characteristic contractile muscle activity and rhythmic functional loads on the joint.

With the loss of one of the groups of chewing teeth, the act of chewing takes on the character of a reflex given in a certain group. From the moment of the loss of a part of the teeth, a change in the function of chewing will determine the state of the entire dentoalveolar system and its individual links.

I. F. Bogoyavlensky (1976) points out that changes that develop under the influence of function in tissues and organs, including bones, are nothing but “functional restructuring”. It can proceed within the limits of physiological reactions. Physiological functional restructuring is characterized by such reactions as adaptation, full compensation and compensation at the limit.

The works of I. S. Rubinov proved that the effectiveness of chewing with various types of adentia is practically 80-100%. Adaptive-compensatory restructuring of the dentition, according to the analysis of masticograms, is characterized by some changes in the second phase of chewing, the search for the correct location of the food bolus, and a general lengthening of one complete chewing cycle. If normally, with intact dentition, it takes 13-14 s to chew the kernel of an almond (hazelnut) weighing 800 mg, then if the integrity of the dentition is violated, the time is extended to 30-40 s, depending on the number of lost teeth and remaining pairs of antagonists. Based on the fundamental provisions of the Pavlovsk school of physiology, I. S. Rubinov, B. N. Bynin, A. I. Betelman and other domestic dentists proved that in response to changes in the nature of chewing food with partial adentia, the secretory function of the salivary glands, stomach changes , food evacuation and intestinal peristalsis are slowed down. All this is nothing but a general biological adaptive reaction within the limits of the physiological functional restructuring of the entire digestive system.

Pathogenetic mechanisms of intrasystemic restructuring in secondary partial adentia according to the state of metabolic processes in the jaw bones were studied in an experiment on dogs. It turned out that in the early stages after partial extraction of teeth (3-6 months), in the absence of clinical and radiological changes, changes occur in the metabolism of the bone tissue of the jaws. These changes are characterized by an increased intensity of calcium metabolism compared to the norm. At the same time, in the jaw bones in the region of teeth without antagonists, the degree of severity of these changes is higher than at the level of teeth with preserved antagonists. An increase in the incorporation of radioactive calcium into the jawbone in the area of ​​functioning teeth occurs at the level of a practically unchanged content of total calcium (Fig. 98). In the area of ​​teeth that are out of function, a significant decrease in the content of ash residue and total calcium is determined, reflecting the development of initial signs of osteoporosis. At the same time, the content of total proteins also changes. A significant fluctuation in their level in the jawbone is characteristic, both at the level of functioning and non-functioning teeth. These changes are characterized by a significant decrease in the content of total proteins in the 1st month of creating an experimental model of secondary partial adentia, then a sharp rise in it (2nd month) and again a decrease (3rd month).

Consequently, the response of the jaw bone tissue to the changed conditions of the functional load on the periodontium is manifested in a change in the intensity of mineralization and protein metabolism. This reflects the general biological regularity of the vital activity of bone tissue under the influence of adverse factors, when mineral salts disappear, and the organic base, devoid of the mineral component, remains for some time in the form of osteoid tissue.

The mineral substances of the bone are quite labile and, under certain conditions, can be “extracted” and again “deposited” under favorable, compensated conditions or conditions. The protein base is responsible for the metabolic processes in the bone tissue and is an indicator of ongoing changes, regulates the processes of mineral deposition.

The established pattern of changes in the exchange of calcium and total proteins in the early periods of observation reflects the reaction of the jaw bone tissue to new conditions of functioning. Here, compensatory capabilities and adaptive reactions are manifested with the inclusion of all the protective mechanisms of bone tissue. During this initial period, with the elimination of functional dissociation in the dentoalveolar system caused by secondary partial adentia, reverse processes develop, reflecting the normalization of metabolism in the jaw bone tissue.

The duration of the action of unfavorable factors on the periodontium and jaw bones, such as increased functional load and complete shutdown from function, leads the dentoalveolar system to a state of "compensation at the limit", sub-decompensation. The dentoalveolar system with impaired integrity of the dentition should be considered as a system with a risk factor.

Clinical picture

Complaints of patients are of a different nature. They depend on the topography of the defect, the number of missing teeth, the age and gender of the patients.

The peculiarity of the studied nosological form is that it is never accompanied by a feeling of pain. In young and often in adulthood, the absence of 1-2 teeth does not cause any complaints from patients. Pathology is detected mainly during dispensary examinations, with planned sanitation of the oral cavity.

In the absence of incisors, fangs, complaints of an aesthetic defect, speech impairment, saliva splashing during conversation, and the inability to bite off food predominate. If there are no chewing teeth, patients complain of a violation of the act of chewing (this complaint becomes dominant only with a significant absence of teeth). More often, patients note inconvenience when chewing, the inability to chew food. Complaints about an aesthetic defect in the absence of premolars in the upper jaw are not uncommon. It is necessary to establish the reason for the extraction of teeth, since the latter is important for the overall assessment of the state of the dentoalveolar system and prognosis. Be sure to find out whether orthopedic treatment was previously carried out and what designs of dentures. The need to determine the general state of health at the moment is indisputable, which can undoubtedly affect the tactics of medical manipulations.

On physical examination, there are usually no facial symptoms. The absence of incisors and canines in the upper jaw is manifested by the symptom of "retraction" of the upper lip. With a significant absence of teeth, "retraction" of the soft tissues of the cheeks and lips is noted. Partial absence of teeth in both jaws without the preservation of antagonists is often accompanied by the development of angular cheilitis (jamming); during swallowing movement, the lower jaw makes a large amplitude of vertical movement.

When examining the tissues and organs of the mouth, it is necessary to carefully study the type of defect, its length (size), the condition of the mucous membrane, the presence of antagonizing pairs of teeth and their condition (hard tissues and periodontal), as well as the condition of the teeth without antagonists, the position of the lower jaw in central occlusion and in a state of physiological rest. The examination must be supplemented with palpation, probing, determination of the stability of the teeth, etc. An X-ray examination of the periodontal teeth, which will be supporting for various designs dentures.

The variety of options for secondary partial adentia, which have a significant impact on the choice of a particular treatment method, has been systematized by numerous authors.

The classification of dentition defects developed by Kenedy has become the most widespread, although it does not cover combinations that are possible in the clinic.

The author identifies four main classes. Class I is characterized by a bilateral defect not limited distally by teeth, II - by a unilateral defect not limited distally by teeth; III - unilateral defect limited distally by teeth; Class IV - the absence of front teeth. All types of dentition defects without distal limitation are also called terminal, with distal limitation - included. Each defect class has a number of subclasses. The general principle of subclassing is the appearance of an additional defect inside the preserved dentition. This significantly affects the course of the clinical justification of tactics and the choice of one or another method of orthopedic treatment (type of denture).

Diagnosis

Diagnosis of secondary partial adentia is not difficult. The defect itself, its class and subclass, as well as the nature of the patient's complaints, testify to the nosological form. It is assumed that no other changes in the organs and tissues of the dentoalveolar system have been established by all additional laboratory research methods.

Based on this, the diagnosis can be formulated as follows:

Secondary partial adentia on the upper jaw, IV class, the first subclass according to Kenedy. Aesthetic and phonetic defect;

Secondary partial adentia on the lower jaw, class I, second subclass according to Kenedy. Chewing dysfunction.

In clinics where there are rooms for functional diagnostics, it is advisable to establish the percentage of loss of chewing efficiency according to Rubinov.

During the diagnostic process, it is necessary to differentiate primary from secondary adentia.

Primary adentia due to the absence of tooth rudiments is characterized by underdevelopment in this area of ​​the alveolar process, its flattening. Often, primary adentia is combined with diastemas and tremas, an anomaly in the shape of the teeth. Primary adentia with retention is usually diagnosed after an X-ray examination. It is possible to make a diagnosis after palpation, but with subsequent radiography.

Secondary partial adentia as an uncomplicated form should be differentiated from concomitant diseases, such as periodontal disease (without visible pathological tooth mobility and the absence of subjective discomfort), complicated by secondary adentia.

If secondary partial adentia is combined with pathological wear of the hard tissues of the crowns of the remaining teeth, it is of fundamental importance to establish whether there is a decrease in the height of the lower face in the central occlusion. This significantly affects the treatment plan.

Diseases with pain syndrome in combination with secondary partial adentia, as a rule, become leading and are dealt with in the relevant chapters.

The rationale for the diagnosis of "secondary partial adentia" is the compensated state of the dentition after partial loss of teeth, which is determined by the absence of inflammation and dystrophic processes in the periodontium of each tooth, the absence of pathological abrasion of hard tissues, deformities of the dentition (Popov-God ona phenomenon, displacement of teeth due to periodontitis ). If the symptoms of these pathological processes are established, then the diagnosis changes. So, in the presence of deformations of the dentition, a diagnosis is made: partial secondary adentia, complicated by the Popov-Godon phenomenon; Naturally, the treatment plan and medical tactics of managing patients are already different.

Treatment

Treatment of secondary partial adentia is carried out with bridge-like, removable plate and clasp dentures.

A bridge-like and fixed prosthesis is a medical device that serves to replace the partial absence of teeth and restore chewing function. It is strengthened on natural teeth and transmits chewing pressure to the periodontium, which is regulated by the periodontal muscle reflex.

It is generally accepted that treatment with fixed dentures can restore up to 85-100% chewing efficiency. With the help of these prostheses, it is possible to fully eliminate phonetic, aesthetic and morphological disorders of the dentoalveolar system. Almost complete compliance of the design of the prosthesis with the natural dentition creates the prerequisites for rapid adaptation of patients to them (from 2-3 to 7-10 days).

A removable lamellar prosthesis is a medical device that serves to replace the partial absence of teeth and restore chewing function. It is attached to natural teeth and transmits chewing pressure to the mucous membrane and bone tissue of the jaws, regulated by the gingivomuscular reflex (Fig. 101).

Taking into account the fact that the base of the removable laminar prosthesis completely relies on the mucous membrane, which, according to its histological structure, is not adapted to the perception of masticatory pressure, the chewing efficiency is restored by 60-80%. These prostheses allow to eliminate aesthetic and phonetic disorders in the dentoalveolar system.

However, the methods of fixation and a significant area of ​​the basis complicate the mechanism of adaptation, lengthen its period (up to 1-2 months).

A clasp prosthesis is a removable medical apparatus for replacing the partial absence of teeth and restoring chewing function.

It is strengthened behind natural teeth and relies both on natural teeth and on the mucous membrane, masticatory pressure is regulated in combination through periodontal and gingivomuscular reflexes.

The possibility of distribution and redistribution of masticatory pressure between the periodontium of the abutment teeth and the mucous membrane of the prosthetic bed, combined with the possibility of refusing to prepare teeth, high hygiene and functional efficiency, made these dentures one of the most common modern types of orthopedic treatment. Almost any defect in the dentition can be replaced with a clasp prosthesis, with the only caveat that with certain types of defects, the shape of the arch is changed.

In the process of biting off and chewing food, chewing pressure forces of various duration, magnitude and direction act on the teeth. Under the influence of these forces, responses occur in periodontal tissues and jaw bones.

Knowledge of these reactions, the influence of various types of dentures on them underlies the choice and reasonable use of one or another orthopedic apparatus (denture) for the treatment of a particular patient.

Based on this basic provision, the following clinical data significantly influence the choice of the design of the denture and abutment teeth in the treatment of partial secondary adentia: the class of the dentition defect; defect length; condition (tonus) of chewing muscles.

The final choice of treatment method can be influenced by the type of occlusion and some features associated with the profession of patients.

Lesions of the dentoalveolar system are very diverse, and there are no two patients with exactly the same defects. The main differences in the state of the dental systems of the two patients are the shape and size of the teeth, the type of bite, the topography of the defects in the dentition, the nature of the functional relationships of the dentition in functionally oriented groups of teeth, the degree of compliance and the threshold of pain sensitivity of the mucous membrane of the edentulous areas of the alveolar processes and the hard palate, the shape and the size of the edentulous areas of the alveolar processes.

The general condition of the body must be taken into account when choosing the type of medical device. Each patient has individual characteristics, and in this regard, two outwardly identical in size and location of the defect of the dentition require a different clinical approach.

Theoretical and clinical bases for choosing a method of treatment with fixed bridges

The term "bridge" came to orthopedic dentistry from technology during the period of rapid development of mechanics and physics and reflects the engineering structure - the bridge. It is known in technology that the design of a bridge is determined based on the expected theoretical load, i.e. its purpose, span length, ground conditions for supports, etc.

Almost the same problems are faced by an orthopedic doctor with a significant correction for the biological object of influence of the bridge structure. Any design of a dental bridge includes two or more supports (medial and distal) and an intermediate part (body) in the form of artificial teeth (Fig. 102).

Rice. 102. Varieties of fixed prostheses used for the treatment of secondary adentia.

Fundamentally various conditions The statics of a bridge as an engineered structure and a fixed dental bridge are as follows:

Bridge supports have a rigid, fixed base, while fixed bridge supports are mobile due to the elasticity of periodontal fibers, the vascular system, and the presence of a periodontal gap;

The supports and span of the bridge experience only vertical axial loads in relation to the supports, while the periodontium of the teeth in the bridge-like non-removable denture experiences both vertical axial (axial) loads and loads at different angles to the axes of the supports due to the complex relief of the occlusal surface of the supports and the body of the bridge and the nature of the chewing movements of the lower jaw;

Rice. 103. Statics of the bridge as an engineering structure.

In the supports of the bridge and bridge prosthesis and the span after the load is removed, the internal stresses of compression and tension that have arisen subside (extinguish); the structure itself comes to a “calm” state;

The supports of a fixed bridge prosthesis return to their original position after the load is removed, and since the load develops not only during chewing movements, but also when swallowing saliva and establishing dentition in central occlusion, these loads should be considered as cyclic, intermittent-constant, causing a complex set of responses from the periodontium (see "Biomechanics of the periodontium").

Thus, the statics of a bridge with two-sided, symmetrically located supports is considered as a beam lying freely on rigid "bases". With a force K applied to the beam in the center, the latter bends by some amount S. At the same time, the supports remain stable (Fig. 103).

A fixed dental bridge with bilateral, symmetrically located supports should be considered as a beam rigidly fixed on an elastic base (Fig. 104).

The load K, applied in the center of the intermediate part (body) of the bridge, is evenly distributed between the supports.

K=P1+P2; R1R2

The force K, when applied to the body of a bridge, causes a moment of rotation (M), which is equal to the product of the magnitude of the force K and the length of the arm (a or b). Since when the force K is applied in the center of the body of the bridge, the shoulders a and brava, then two moments of rotation - Ka and K "b, having opposite signs, are balanced.

If the force K moves towards one of the supports (Fig. 105), then the moment of rotation and the load in the area of ​​\u200b\u200bthis support increase, and at the opposite one they decrease (shoulder a

1. What is adentia
2. Primary full
3. Primary partial
4. Secondary complete
5. Secondary partial
6. Symptoms of adentia
7. Diagnosis of adentia
8. Treatment of adentia
9. Consequences of adentia

The term "adentia" is not the most common in dentistry, so not every patient understands what is at stake on the first try. The phenomenon of adentia - congenital or acquired absence of teeth - is not so rare. Complete adentia (absence of all teeth) is rare, and partial (with the loss of several) is common. Is it necessary to treat adentia or can it be considered as a cosmetic defect?

What is adentia

Adentia is the complete or partial absence of permanent or milk teeth. There are several types of adentia:

• complete;
• partial;
• primary;
• secondary.

If you analyze this list, you can see the classification pattern according to the principle of appearance - primary (the second name is congenital) and secondary (in a different way - acquired) and by the type of prevalence (full or partial). The causes of adentia are not fully understood. It is believed that it occurs after the resorption of the follicle, which occurs under the influence of general diseases or inflammation.

Adentia of permanent teeth may appear as a complication for milk teeth, especially if the latter were not treated on time and of poor quality. Doctors do not exclude the hereditary factor, problems in the endocrine system, as a result of which deviations occur during the formation of tooth germs. In most cases, in the presence of adentia, patients may experience abnormal formation of nails, hair and other organs of actodermal origin.

There is a pattern in the absence of some permanent teeth - lateral incisors, lower premolars, wisdom teeth. According to statistics, dentists do not observe second incisors in 0.9%. The rudiments of the second lower premolar are absent in 0.5% of children. The reasons for this phenomenon are explained by the fact that the chewing apparatus in modern conditions does not have such a serious load as that of distant ancestors. Evolution has changed the size of the jaw, the number of rudiments of permanent teeth, since there is no place for them in the changed jaw - the reduction of the jaw leads to the reduction of the teeth.

With a symmetrical incomplete number of teeth, the role of hereditary factors is great. There are cases when the tooth germs are everything, but some of them do not erupt, remaining retained in the alveolar bone. This fact is also confirmed by radiography. In a milk bite, this phenomenon is rare. An impacted tooth can create many problems for the jaw: displacement of adjacent teeth, deformation of adjacent roots. Often such a tooth causes pain of a neuralgic nature, can serve as a source of focal infection.

In childhood, it is necessary to take into account the likelihood of teething with a delay, sometimes beyond the physiological period. The tooth may be delayed due to lack of space in the dentition. Timely orthodontic intervention is important here.

Genuine adentia must be distinguished from retention - a delay in tooth growth after the eruption of permanent teeth set in terms of timing. Retention can cause vitamin, hormonal disorders, hereditary factors. As a rule, impacted teeth are displaced. Sometimes, even after decades, they still erupt. This process can be stimulated by orthopedic intervention. Retention causes deformation of the jaw, changes in the position of adjacent teeth, pressure from a displaced tooth on a neighboring root causes pulp atrophy, suppuration, root resorption (destruction of its tissues), so it is important to control this process.

Primary full

Complete primary adentia is a very serious anomaly, which, fortunately, is very rare. It occurs in the bite of milk or permanent teeth. The patient is completely devoid of the rudiments of all permanent teeth. This condition inevitably provokes violations of the symmetry of the face. At the same time, the alveolar processes of both jaws develop incorrectly. The mucous membrane of the oral cavity is pale and dry.

With adentia of milk teeth, there are no rudiments of them at all; when feeling the jaw, this is easy to diagnose. On the radiograph, the rudiments of milk teeth are completely absent, and the jaws are underdeveloped, which causes a strong decrease in the lower part of the face.

Adentia of permanent teeth is usually detected when changing milk to permanent. On the radiograph, the doctor observes the absence of the rudiments of permanent teeth, pulling the lower jaw to the upper, followed by asymmetry of the face.

Primary partial

Primary partial adentia is much more common than complete. In the dentition with this form, several or one milk or permanent teeth are missing. On the radiograph, there are no rudiments of missing teeth, and gaps appear between the erupted teeth - three. If a significant part of the teeth is missing in the dentition, then the jaw is formed underdeveloped.

Partial adentia is symmetrical and asymmetrical. With symmetrical adentia, there are no teeth of the same name on the right and left in the dentition - for example, the right and left incisors. With asymmetric - there are no opposite teeth from different sides.

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Secondary complete

Secondary adentia has a different name - acquired. Teeth in the dentition are completely absent in the secondary form, both on the upper and lower jaws. Secondary adentia occurs in both permanent and milk teeth. This phenomenon is observed after the loss or extraction of teeth.

With complete secondary adentia, there are no teeth at all in the patient's mouth, so the lower jaw approaches the nose, and the soft tissues of the mouth area noticeably sink. With complete secondary adentia, the alveolar processes and the body of the jaw atrophy. The patient cannot bite off or chew food, he is not able to clearly pronounce sounds.

Secondary partial

Partial secondary adentia is the more common form. With this disease, there are no several (or one) milk or permanent teeth in the dentition. With insufficient tooth enamel, the hard tissues of the tooth are erased, causing hyperesthesia. The disease makes it difficult to eat hot or cold food, forming a habit of liquid food that does not need to be chewed. In the photo - adentia is complete and partial, adentia in children.

Symptoms of adentia

Symptoms of adentia are simple - complete or partial absence of teeth. In addition to the direct symptom, there are also indirect ones:

• reduction of one or both jaws;
• retraction of soft tissues of the oral part of the face;
• atrophy of the alveolar processes;
• formation of a network of wrinkles near the mouth;
• atrophied muscles in the mouth area;
• blunting of the angle of the jaw.

With partial adentia, a deep (distorted) bite is formed. The teeth gradually move towards the missing ones. In the area where there are no antagonistic teeth, the dentoalveolar processes of healthy teeth lengthen.

Diagnosis of adentia

Diagnosing adentia is not difficult. When examining the patient's oral cavity, the dentist notes the complete or partial absence of teeth in a row. An x-ray examination of both jaws is mandatory, especially with primary adentia, since only in the picture can you see the absence of the rudiments of permanent or milk teeth.

When diagnosing adentia in children, a panoramic X-ray of the jaw is made - it is she who allows you to determine the absence of tooth rudiments, the structure of the roots of the teeth and the bone tissue of the alveolar process.

When diagnosing, it is necessary to exclude factors that do not allow for urgent prosthetics. The dentist highlights the following points:

• the presence of unremoved roots, covered with mucous;
• the presence of exostoses;
• the presence of tumors and inflammation;
• the presence of diseases of the oral mucosa.

After the final elimination of all provoking factors, prosthetics can begin.

Treatment of adentia

The most effective method of treating adentia is orthopedic. The doctor draws up a treatment regimen based on the degree of atrophy of the alveolar processes and tubercles. In the treatment of primary adentia, depending on the age of the patient, they are registered for dispensary registration, and a pre-orthodontic trainer is installed for him.

With partial primary adentia in children, it is necessary to stimulate the correct dentition to prevent jaw deformation. When the seventh permanent teeth erupt, the dentist explores options for prosthetics of missing teeth:

• prosthetics with ceramic-metal crowns and inlays;
• production of an adhesive bridge;
• implantation of missing teeth.

Treatment of primary adentia in children with the help of prosthetics is carried out by prosthetics from the age of 3 years. Such children should be under the constant supervision of a specialist - due to the pressure of the prosthesis, there is a danger of impaired jaw growth in the baby.

In the treatment of secondary complete adentia, the dentist restores the functionality of the dentition, preventing the development of complications and pathologies, and after restoration, he is engaged in prosthetics using removable lamellar dentures. In the treatment of secondary adentia, it is important to eliminate the cause that causes the pathological process that provokes adentia.

With complete adentia, preliminary implantation of teeth is carried out.

When treating adentia with prosthetics, complications are possible

• violation of the normal fixation of the prosthesis due to jaw atrophy;
• allergic reaction to denture material;
• inflammatory process;
• bedsore formation.

Important point - psychological help patients experiencing psychological discomfort from tooth loss.

Consequences of adentia

• Adentia is a complex dental disease, and without proper treatment, the patient's quality of life can suffer markedly. With complete adentia, speech is impaired, it becomes inarticulate. The patient is unable to chew and bite off solid food. Malnutrition leads to gastrointestinal problems, beriberi.
• With the complete absence of teeth, the temporomandibular joint does not function properly, which often leads to the development of inflammatory processes.
• It is impossible not to take into account psychological discomfort, lowering the patient's social status, self-esteem. All this provokes regular stress and the occurrence of nervous disorders.

Adentia must be treated without fail, and without much thought.

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Most patients require maxillary bone augmentation, as it does not have enough volume for implant placement. The procedure, in which the volume of the tissues of the maxillary bone is increased to the required thickness, is called a sinus lift.

Lack of teeth is a problem that cannot be ignored - the load on the jaw increases, the shape of the face changes. Sometimes it happens that the adentia of the molars is inherited, in this case it is important to recognize and eliminate the problem in a timely manner in childhood.

Partial absence of teeth can occur at any age, but older people most often face this nuisance. In children, adentia appears when milk or molars do not erupt. Let's try to figure out why this pathology occurs, what types of it are, and how to overcome tooth loss.

The concept and causes of adentia

Loss of teeth, or adentia, is a violation of the condition of the oral cavity. The fact of missing teeth can be congenital, this pathology is inherited, so if your close relatives suffer from this disease, you should pay special attention to the condition of the jaw.

There are many reasons why a person develops partial loss of teeth, and one of them cannot be called the main one. This may be the influence of the mother’s improper lifestyle during the period of bearing a child, the presence of other diseases of the oral cavity, and heredity. Some experts cite the resorption of the follicle as the main cause of tooth loss, which, in turn, is destroyed under the influence of other factors. Thyroid dysfunction can also affect partial tooth loss.

The causes of acquired adentia are pathologies of the oral cavity, especially in running form, as well as jaw injuries, poor-quality dental treatment. Untreated caries also eventually leads to missing teeth.

Due to the many factors that can provoke partial loss of teeth, it is important to conduct a comprehensive diagnosis, to cure those areas that are still treatable. After that, you can proceed to the procedure of prosthetics - the only method of salvation from the deformation of the jaw and face.

Varieties and symptoms of pathology

In modern dentistry, adentia is usually divided into primary and secondary, and each of these types is subdivided in turn into complete and partial. In accordance with this division, it is possible to identify the nature of the occurrence of the pathology and its prevalence.

Based on the name, it is clear that the main symptom of adentia is the complete and partial loss of all or several teeth. Each of these varieties needs to be discussed separately.

Primary (full and partial)

Complete primary adentia is a pathological congenital condition that occurs infrequently. It is characterized by the absence of milk or molars, while even their rudiments are not observed on the x-ray. Complete adentia leads to deformation and asymmetry of the shape of the face, a change in the mucous membranes is noted, they look dry and light in appearance.

The diagnosis of complete adentia implies the complete absence of units, such a condition can be determined simple method jaw palpation. There are no hints of rudiments on the x-ray, the jaw looks underdeveloped, and the lower part of the face is visually smaller in size.

The loss of teeth in childhood manifests itself at the moment when dairy teeth must give way to indigenous ones. On the x-ray, the origin of the molars is not observed, the lower jaw gradually approaches the upper one, and the deformation of the face circumference begins. Cases of partial tooth loss of this type are quite rare.

Primary partial loss of teeth is more common. Such a diagnosis is made when one or more dairy or root units are missing in a row. The rudiments are not visible on the radiograph, and gaps gradually appear between the chewing organs that have grown. The condition of tooth loss leads to deformation and abnormal development of the jaw.

Secondary (full and partial)

Secondary adentia in dentistry is also called acquired. It is characterized by a complete or partial absence of teeth in a row, occurs both among milk teeth and among permanent ones, and occurs in connection with their removal or loss.

Complete secondary adentia is a condition in which the elements of the jaw are completely absent, so it begins to deform. Its upper part tends to the nose, it is visually noticeable that the lips tumble inward. With secondary adentia, the alveolar processes and jaw bones die over time, and therefore the patient loses the ability to eat normally. A patient with complete adentia begins to have difficulty pronouncing sounds.

The most common form of secondary adentia is the partial absence of teeth. With this disease, there is a loss of one to several teeth - milk or permanent. Due to the insufficient amount of enamel, hard tissues are erased, while doctors make a concomitant diagnosis - “hyperesthesia”. With secondary partial loss of teeth, the patient complains of pain when chewing, when exposed to hot and cold, gradually develops the habit of eating liquid food, which does not aggravate his condition.

Diagnostic methods

Diagnosis of adentia is not very difficult; at the first examination, the doctor sees the complete or partial absence of teeth in the patient. For the final diagnosis of primary adentia, an X-ray examination is prescribed to clarify whether there are rudiments of milk or indigenous units.

When it comes to prosthetics, it is important to note the presence of the following factors that interfere with the procedure:

• the presence of root residues after partial adentia, which are invisible during external visual inspection;
• partial exostoses;
• inflammatory diseases of hard and soft tissues of the oral cavity;
• mucosal diseases.

After completing a full examination, the doctor must tell the patient in detail about all treatment options, paint the pros and cons of each. Only after the specialist is convinced that the client fully understands the prospects and risks, it is possible to proceed with the chosen method of restoring tooth loss.

Features of the treatment of primary and secondary adentia

Treatment of pathology associated with the absence of teeth is carried out by an orthopedic method. The specialist decides on the type of prosthetics, based on the state of the alveolar processes.

The primary form of adentia is treated depending on the age of the patient. The most common decision that is made in relation to the majority of patients with this pathology is to wear a pre-orthodontic trainer. In this case, a person with loss of teeth is registered in the clinic.

With partial primary adentia in young children during the period of the appearance of the first permanent teeth, it is important to start eruption stimulation in time to prevent the development of jaw deformity. It is necessary to wait for the appearance of the seventh units in a row, and then proceed to work out possible options for prosthetics for those that are not enough.

The treatment for secondary complete edentulism is to restore normal functioning jaws, to prevent deterioration of the patient's condition and deformation of the bones of his jaw, and only then think about prosthetics. The doctor must reassure the patient and present him with the most successful outcome of the operation, so as not to give rise to psychological complexes in a person associated with the absence of teeth.

Prevention of tooth loss

Prevention is always better than long and expensive treatment, therefore, in order to prevent partial or complete loss of teeth, it is necessary to pay attention to close attention oral health. Remember to follow these simple tips:

• in the absence of problems with the teeth, undergo a preventive examination at least once a year, and if there are any, at least once every six months;
• at the first suspicion of the onset of partial loss of teeth, immediately contact a specialist, do not postpone the visit for a long time;
• if one or more teeth are lost, immediately start preparing for prosthetics - this way you can localize the problem;
• You can prevent complete edentulism in an unborn baby by using foods recommended by your doctor and vitamin supplements with sufficient calcium content;
• If you are concerned that your child's teeth do not erupt for a long time, or you are faced with untimely loss of teeth in your baby, contact a pediatric dentist.

We rarely attach importance to the existence of each tooth in our mouth. But if it suddenly does not become, it is noticeably felt.

Adentia is the absence of teeth. This disease is characterized by their complete or partial loss.

The disease can be congenital or acquired. Depending on this, she divided into primary and secondary.

Common causes of development

Since primary adentia is very rare, the specific causes of this disease are poorly understood, and statistics on the frequency of occurrence by sex are insufficient. It is known that the laying of tooth cells occurs at 7-10 weeks of gestation, and the rudiments of permanent ones appear after 17 weeks.

Perhaps the action of various toxic substances during this period leads to their absence.

Most often, this type does not manifest itself, it accompanies other abnormalities in the development of the embryo or is a symptom of a systemic disease. Often, primary adentia manifests itself along with changes in the structure of the skin and mucous membrane of the baby.

Causes of the secondary view are dental pathologies, such as:

• pulpitis;
• advanced caries;
• periodontitis;
• periodontitis;
• removal.

You can also lose teeth with the development of pathological processes in their roots that occur with periostitis, pericoronitis, odontogenic osteomyelitis, phlegmon or abscesses.

A person can be left without teeth as a result of incorrect or unsuccessful treatment, for example, if the top of the root was touched during therapy or an infection got there. If in this case, help is not provided in time, you can lose not one, but several at once.

Adentia can be the result of an injury or an accident.

Varieties

Classification according to ICD10 depending on on the number of teeth that have fallen out and their initial presence highlights:

• complete primary;
• partial primary;
• complete secondary;
• incomplete secondary.

Kennedy's classification of dentition with defects includes four classes, depending on the location of the defects.

Primary full

Complete (subtotal) congenital form of the disease - there are no teeth on the upper and lower jaws in the milk and permanent bite.

The main symptoms of this disease, in addition to the absence of teeth on both jaws, there are violations in the development of the shape of the face, its skeleton. The consequence of reducing the load on the jaw is its decrease at the bottom, underdevelopment, the severity of the supramental fold, the palate becomes flat.

In some cases, these symptoms are supplemented by hypotrichosis or a general lack of human hair (including eyebrows, eyelashes), pallor and dryness of the mucous membranes, as well as too early aging of the skin.

With this form of the disease, a person cannot perform such seemingly simple functions as chewing and biting, so only liquid food is used.

Because of this disease not only jaws are affected, but also breathing and nasal passages. Subsequently, such a child cannot learn to speak correctly for a long time, he has articulation defects, difficulties with pronouncing a large number of sounds.

Acquired full

It differs from the first one in that a person had formed teeth and performed all the functions assigned to them, but were lost for various reasons already a few years after their second eruption.

In this case, the lower jaw is strongly shifted, which leads to the fact that the lips, soft tissues sink down, forming new wrinkles. The jaw is significantly reduced in size, the alveolar process suffers, all hard tissues in the oral cavity atrophy, changing in size.

The nutrition of a person is disturbed, since he cannot chew normally. Various protrusions or exostoses on the gums may appear.

congenital partial

There are norms for the number of teeth in children that should erupt by a specific age of the child. If parents notice that at the age of two there are no necessary 20 teeth, there are few of them and they no longer grow, this indicates that the baby has partial primary adentia.

Its main symptom is understaffing. In this case, a gap is formed between the grown teeth, which is closed by the displacement of a number of growing ones. The underdevelopment of the jaws is also manifested.

Photo: adentia of the upper lateral incisors (twos)

In this case, the teeth themselves may grow crowded or, conversely, have large gaps between them. Wide trems and improper growth eventually lead to the development of chronic gingivitis and other unpleasant diseases.

Secondary partial

In the case when a person does not lose all his teeth, but only some, the process of performing the function of chewing and biting in him still changes over time. The remaining teeth no longer grow together, but move away from each other. There is an increase in the gap between them.

The patient, continuing to chew and bite, may notice that it has become more difficult for him to do this: the bone atrophies, becomes thinner. This is especially often manifested in the loss of the first and second molars of the lower jaw (36, 37, 46, 47).

The remaining teeth also suffer from a double load - the need to perform functions for themselves and the fallen neighbor. As a result, they begin to wear out faster, become susceptible to thermal stimuli.

If too many teeth are missing in one place, even subluxation of the temporomandibular joint can occur during active chewing.

Such a pathology leads to a change in the shape of the face: the cheeks may fall, the lips may fall in, the nasolabial triangle may unnecessarily appear.

If the function of pre-processing food (nibbling and chewing) is disrupted, then the process of its digestion will also be disrupted, which can cause diseases such as gastritis, abdominal pain, colitis, ulcers.

What processes occur during secondary adentia, look at the video:

An important point is the psychological well-being of the patient. If this disease has arisen, a person ceases to perceive himself as a full-fledged person.

His self-esteem is noticeably reduced, he becomes withdrawn and refuses constant communication. He seems to be becoming ugly.

Diagnostics

For treatment, especially congenital adentia, a thorough examination is required so as not to be mistaken in one's conclusions.

This is dangerous, because if the diagnosis is not confirmed and the child's teeth are simply late, they can grow after the installation of artificial ones. Therefore, it is important to carry out all diagnostic measures for reliable definition forecast.

In children

It is clear that in the absence of milk teeth, it is difficult for children to chew food. Therefore, after clarifying the diagnosis, it is necessary to put prostheses as soon as possible. In this case, a parallel diagnosis is carried out, the results of which show whether it is possible to install artificial ones for the child.

The main diagnostic measures are a clinical examination and the collection of a medical history with the preparation of a complete protocol. The bite is determined, factors that interfere with the installation of prostheses or other mechanisms are identified.

The most informative is an x-ray, which shows whether there are rudiments of the tooth in the gum. If they are not there, the directions of treatment are thought out so that the child does not suffer from bite.

In adults

To prescribe treatment in the adult category of patients, the dentist also collects an anamnesis, in addition, prescribes X-rays and tomography to accurately determine the presence of an unerupted tooth in the gum - this also occurs in adulthood.

An effective and informative diagnostic method for adentia in adults is tomography. This method has recently become widespread in dentistry, it is used by almost everyone if there are controversial points when prescribing treatment.

The result of the examination is a three-dimensional view of the jaw, bone tissue. The picture shows the number of channels, their length. With these results, the doctor can choose the necessary prosthesis or perform implantation.

A tomographic image is very helpful if you need to accurately calculate the movement of the teeth and see the condition of the roots in the gum.

Treatment

Treatment of adentia should be started as early as possible. Before it starts, the dentist plans his actions based on a three-dimensional image, takes casts of the patient's remaining teeth, and studies diagnostic models of the jaw.

At what age do you start?

The beginning of treatment should not coincide with the moment of teething of the first teeth of the child. Usually, doctors recommend starting therapeutic measures after his second molars have erupted.

Prior to this, a variant of therapeutic treatment of congenital adentia is possible, which can begin after the child reaches 3-4 years of age. But with prostheses, you need to be extremely careful, as they put too much pressure on the jaw, thereby disrupting and slowing down its growth.

Methods Used

For the treatment of adentia, orthodontic constructions are used, which are aimed either at leveling the row and restoring the functions of existing teeth, or replacing those lost on the gums (removable and fixed prosthetics).

Basic structures for treatment:

• removable prosthesis;
• bridge-like non-removable structures;
• dental implants;
• installation of crowns;
• for children, plate prostheses are used;
• preorthodontic trainer;
• adhesive bridge;

It is important to prepare the oral cavity and teeth for the installation of therapeutic devices in order to avoid complications. Constantly need to be observed by the dentist.

Price

Depending on the type of design chosen for treatment, its price will also fluctuate.

A budget option is a partially removable prosthesis, the cost of which starts from 14000 rubles.

Prosthetics on implants, regardless of the material of the crown (cermet, plastic, etc.) is an expensive pleasure - replacement of one tooth will cost at least 35,500 rubles. Therefore, the choice of which prosthesis is better to choose remains at the discretion of the patient.

Forecast

In most cases, the prognosis of the disease is favorable, both with partial and with complete adentia.

According to those who inserted implants, this method allows you to fully restore chewing functions even with complete adentia, since prostheses make up for the absence of a dentition.

Prevention

Special attention should be paid to the prevention of this disease, since it causes aesthetic, physiological and psychological discomfort.

AT early age you need to monitor teething, stimulating this process, if necessary. It is advisable to visit the dentist regularly and monitor the absence of deformations of the dentition.

In adulthood, it is also necessary to visit a doctor at least once a year, monitor the oral cavity and treat diseases of the teeth and gums in time.

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In dentistry, there are a lot of diseases that can not only cause a lot of discomfort, but also significantly worsen appearance. One of these pathologies is adentia.

The disease is characterized by the absence of teeth, depending on the form, it can be a partial or complete loss of them. Only a specialist can diagnose the form of a violation. In this case, an examination, palpation examination, orthopantomography and targeted intraoral radiography are carried out.

In the treatment of adentia, most often rational is carried out using full and partial and, or.

Adentia, in which there is a complete congenital loss of teeth, is quite rare, a partial form of pathology develops a little more often. Against this background, there is a change in the social behavior of a person and psychological maladjustment.

Classification of missing teeth

In dentistry, primary, that is, congenital, and secondary, otherwise acquired adentia, are distinguished. It depends on the time and causes of the disease. In addition, there is adentia of permanent and temporary teeth.

True congenital pathology is diagnosed if there is no tooth germ. At the same time, a complex form of the disease is characterized by a delay in and fusion of adjacent crowns.

Adentia comes in the following forms:

1. Extremely rare in patients primary form of violation, which is a consequence of developmental disorders at the stage of the embryo. In this case, the fetus may partially or completely lack tooth germs.
2. Secondary the form of the disease is typical for people in old age and is the result of tooth decay due to diseases or mechanical trauma.
3. Complete the absence of teeth is a rather rare occurrence, but if installation is required on both jaws, then specialists often remove all remaining teeth.
4. The most common form is partial adentia, it is observed in all children during the period of change of milk teeth and in adults in case of neglect of the rules of oral hygiene. And also in the absence of prevention and timely treatment.

The diagnosis of partial or complete adentia depends on the number of missing teeth. In this case, the latter is characterized by a complete loss, and with a partial individual or group loss of up to 10 teeth. If the volume is over 10, then the multiple form is diagnosed. When up to 15 teeth fall out on one jaw, a partial secondary form of the disease is noted.

In medicine, secondary partial adentia also has several classes:

• the first is characterized by the presence of a bilateral end defect;
• in the second, a one-sided end defect is observed;
• in the third case, there is a one-sided included defect;
• the fourth class is diagnosed in the case of a frontal included defect, which is characterized by the absence of front teeth.

Often classes and subclasses are combined. In addition to the above classes, asymmetric and symmetrical loss of teeth is noted.

Causes and provoking factors

It is very difficult to name the exact cause of the development of the disease, since the disease has not been fully studied to date. There is a version that the origin of the pathology begins even during the formation of the fetus, in fact, at this moment, the formation of the roots of the teeth and the violation of the development of the ectodermal layer occur.

There are cases when adentia appears against the background of intrauterine diseases of the endocrine system and due to a hereditary factor.

A secondary form of the disease occurs much more often, and it can manifest itself in several ways. According to statistics, tooth loss can be provoked by:

• development and lack of treatment;
• untimely or complete lack of treatment of other diseases responsible for the destruction of the dentition (most often and);
• pathologies that contribute to the general deterioration of the human condition and reorganization of the body;
• often the reason is age factor, despite the fact that by the age of 60 many people have a lot of health problems, including teeth suffer;
• most common mechanical factor, so tooth loss can be triggered by a strong blow;
• and, of course, plays an important role hereditary factor.

Features of symptoms depending on the form

Diagnosing the development of an anomaly on your own is quite simple, since it is simply impossible not to notice the loss of teeth. In addition to the visual characteristic picture, wrinkles in the oral cavity, as well as gaps between them, can also be noted.

If the teeth fall out in front, then in the future there may be a sinking of the cheek and upper lip. Also, the development of pathology can cause serious problems with speech.

In general, each form of adentia has its own symptoms, so the following clinical picture is noted:

1. At partial In this form, several teeth are missing, chewing is disturbed, unpleasant sensations appear, problems with speech, problems when biting and chewing food, and active splashing of saliva is noted.
2. At complete form of the disease, all teeth are missing. At the same time, a change in the shape of the face is observed, a whole network of wrinkles appears around the mouth, and a change in speech is also noted. Also, thinning of the bone tissue occurs and the patient has to give up solid food, and this leads to a lack of vitamins in the body.
3. Currently, dentists also highlight relative complete adentia, with it, some teeth remain in their places, but are subject to complete removal due to severe damage to the general row.
4. Complete primary the form is characterized by a violation in the work of the mucosa. In the full form of the disease, even the rudiments of teeth are not visible. If some teeth erupt, then large gaps are observed between them. Often a symptom of this form is the formation of an uncut tooth hidden in the jawbone or covered by the gum.
5. Secondary manifested by loss, both partial and complete. At the same time, a change in the skeleton of the face is observed, problems appear when chewing and biting off food. The secondary form is accompanied by a deterioration in diction. If partial adentia is observed, then the remaining teeth begin to shift, bone tissue is depleted, and discomfort appears when eating too cold or hot food.

Diagnostic criteria

Adentia is a rather serious problem and only specialists can diagnose this pathology, using modern methods. Therapists, surgeons, orthopedists, implantologists, orthodontists and periodontists.

Diagnosis requires anamnesis, examination by a specialist, palpation examination and comparison of dental and chronological age.

If there is a local defect at the moment when the period for eruption has already expired, specialists resort to targeted intraoral radiography.

In case of suspicion of a multiple or complete form, orthopantomography is performed or. Also, if necessary, the patient undergoes computed tomography of the temporomandibular joint or radiography.

Modern Dental Practice

In order to cure a partial form of adentia, specialists use and.

Prosthetics is the main method of correcting the dentition. This method is used when one tooth is missing. If there is a loss of several, then the procedure is much more difficult. In this case, one or another orthopedic design is already used.

The method of prosthetics is also used in the complete absence of teeth. In this case, both fixed and removable models of prostheses are also used. If the first option is used, then immediately before the procedure, installation is required, which will perform the function of a kind of support.

Removable plastic plates used for complete secondary edentulous. This method of correction is often used for people from the older age group. The use of plates is quite convenient, because they can be removed and cleaned. Prosthetics can also be carried out for children from the age of four, but this can provoke disturbances in the development of bone tissue.

In some cases, some difficulties may be observed. For example, in case of violations in the development of bone tissue, fixation for the prosthesis will be insufficient. In addition, some patients have an allergic reaction to the materials that are used during prosthetics. In such cases, a modern one is used.

With adentia of twos, braces are initially installed to form a place for the implant

Currently, there are several methods:

1. Classical two-stage implantation- This is a method that is used for partial and complete loss of teeth. The procedure is possible even if the teeth have been missing for a long time. In this case, it may be necessary to build up bone tissue, restore it for several months, and then temporary implantation is carried out. Only after the implants have taken root, a permanent structure is installed. This method has been around for quite some time.
   If mobile or destroyed teeth are observed, then it is applied. But this procedure is not possible in all cases, it may require a month of treatment before it.
2. Express implantation involves the use of a whole range of technologies for the restoration of teeth. In this case, implants are used. This method is often used with a complete form of adentia. Since it is possible to install the implant at an angle, this makes it possible to bypass atrophied areas of bone tissue and fix the structure as reliably as possible. But, despite the low level of trauma, a permanent implant cannot be installed immediately, for a start a temporary bridge is used for 2 or 3 years and only after that a permanent one, which has reliability and aesthetics.
3. Despite being inferior to the previous methods, it has its advantages. This option is used to ensure that the removable structure is attached more securely. In this case, thin and small unilateral implants are used, the fixation of which occurs by puncturing tissues, the level of trauma in this case is minimal. Over time, subsidence of prostheses occurs, so their service life does not exceed 10 years.

Preventive actions

To avoid the development of adentia in children, first of all, favorable conditions at the embryonic stage. In addition, it is important to ensure that the deadlines are not extended. To detect pathology in early stage You need to visit the dentist at least once every six months.

To avoid the development of a secondary form of a violation, a constant examination by a specialist and compliance with all hygiene standards are also required. With partial loss of teeth, prosthetics are necessary, such a measure will stop tooth loss in the future.

Adentia refers to diseases of the oral cavity and implies the partial or complete absence of teeth.

Adentia, depending on the causes, can be primary or secondary.

Primary adentia is congenital. The reason for it is the absence of rudiments of teeth, which is most often a manifestation of anhydrotic ectodermal dysplasia. Also, the symptoms of this disease are changes in the skin (lack of hair, early aging of the skin) and mucous membranes (pallor, dryness).

In some cases, it is not possible to establish the cause of primary adentia. It is assumed that the resorption of the tooth germ can occur under the influence of a number of toxic effects or be the result of an inflammatory process. Perhaps hereditary causes and a number of endocrine pathologies play a role.

Secondary adentia is more common. This adentia appears due to partial or complete loss of teeth or rudiments of teeth. There can be many reasons: most often these are injuries or a consequence of neglected caries.

According to the number of missing teeth, adentia can be complete or partial. Complete adentia is the complete absence of teeth. Most of the time it's primary.

Adentia Clinic

Depending on whether this adentia is complete or partial, the clinic also manifests itself.

Complete adentia leads to a serious deformation of the facial skeleton. As a result, speech disorders appear: slurred pronunciation of sounds. A person cannot fully chew and bite off food. In turn, malnutrition occurs, which leads to a number of diseases of the gastrointestinal tract. Also, complete adentia leads to dysfunction of the temporomandibular joint. Against the background of complete adentia, the mental status of a person is disturbed. Adentia in children leads to a violation of their social adaptation and contributes to the development of mental disorders.

Primary complete adentia in children is a very rare and serious disease in which there are no rudiments of teeth. The cause of this type of adentia is a violation of intrauterine development.

The clinic, in the absence of timely treatment, is extremely severe and is associated with pronounced changes in the facial skeleton.

Secondary complete adentia is the loss of all teeth in their original presence. More often, secondary complete adentia occurs due to dental diseases: caries, periodontitis, as well as after surgical removal of teeth (for oncology, for example) or as a consequence of injuries.

Secondary partial adentia has the same causes as the primary one. With the complication of this adentia by the wear of the hard tissues of the teeth, hyperesthesia appears. At the beginning of the process, a setback appears when exposed to chemical stimuli. With a pronounced process - pain when closing teeth, exposure to thermal, chemical stimuli, mechanical stress.

Diagnostics

Diagnosis is not difficult. Enough clinic. To confirm some types of adentia, an x-ray examination is necessary.

Treatment of adentia

Primary complete adentia in children is treated with prosthetics, which must be carried out starting from 3-4 years of age. These children need dynamic supervision of a specialist, tk. there is a significant risk of a child's jaw growth failure as a result of the pressure of the prosthesis.

With secondary complete adentia in adults, prosthetics are carried out using removable plate dentures.

When using the method of fixed prosthetics with complete adentia, it is necessary to carry out preliminary implantation of the teeth.

Complications of prosthetics:

Violation of the normal fixation of the prosthesis due to atrophy of the jaws;

Allergic reactions to denture materials;

The development of the inflammatory process;

Development of bedsores, etc.

Treatment of secondary partial adentia complicated by hyperesthesia includes depulpation of the teeth.

In the treatment of secondary adentia, it is imperative to eliminate the causative factor, i.e. disease or pathological process that led to adentia.

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Adentia is perhaps the most unexpected and at the same time unpleasant dental disease. Most people are not even aware of the existence of this disease, but some had to face it first hand. What is this, what are the symptoms and how is this disease treated? There are many questions, each of which has detailed answers.

The complete or partial absence of teeth is called adentia. This symptom occurs equally often in both children and adults. The etiology of the onset of the disease is different for everyone, so the symptoms are different. Sometimes the patient is diagnosed with only a partial violation of the dentition.

Often adentia affects only milk teeth. It should be borne in mind that the disease is not always congenital. Improper oral hygiene and the presence of other adverse factors can provoke acquired symptoms.

In order to avoid unpleasant manifestations in yourself and your loved ones, it is better to be fully armed and study the disease in more detail.

Depending on the form of the disease, certain changes in the jaw can be observed.

This is the most annoying variety. Patients with this diagnosis suffer the most changes. This is definitely a facial deformity. The cheeks in this case are sunken, the skin on them has a stretched, withered appearance. There is premature aging of the skin of the face. Almost always, speech suffers, especially with congenital adentia.

An aggravating factor is difficult meals. The patient cannot eat fully, because it is almost impossible to chew and bite off solid food. As a result, there is a general weakening of the immune system and the whole organism as a whole. In this case, it is also difficult to avoid the development of chronic diseases of the digestive system.

Significantly such a defect affects the psychological state of a person. Patients often, along with adentia, acquire numerous complexes, withdraw into themselves.

Sometimes one of the jaws or parts of it develop without any abnormalities. Then the adentia is considered partial. The external manifestations of the disease directly depend on the number of missing teeth. Pathology basically also leads to facial deformity, impaired speech and eating. Patients with partial dentition often suffer from malocclusion, cross or deep.

Along with the partial absence of teeth, dentists can detect various displacements, shortening or narrowing of one of the jaws. The temporomandibular joint also suffers pathological changes. Due to the minimum chewing load, the muscles of the mouth are weakened, thinning of the bone tissue occurs.

The absence of one or more teeth practically does not cause any inconvenience to a person, but the body suffers inevitable negative changes. It:

• displacement of the entire dentition;
• violation of intestinal motility;
• load on the gastrointestinal tract;
• mineralization of tooth enamel slows down;
• protein metabolism suffers.

All these factors inevitably lead to the development of pathologies more serious than the absence of a pair of teeth.

Diagnostic methods

The correct diagnosis can only be established by a specialist in the field of clinical examination and a number of studies. To examine children who still do not have teeth due to their age, the dentist uses exclusively tactile methods. The baby's gums are felt for the presence of rudiments of milk teeth. As a rule, an experienced doctor can feel them from a very early age.

In more ambiguous situations, the orthodontist recommends that the child undergo an x-ray examination of the jaw. Panoramic x-ray will give a complete picture of the disease. Here you can consider in detail the structure of the root system of the tooth and the features of the development of the jaw. Visible on the X-ray and the alveolar process.

Features of the diagnosis of secondary (acquired) adentia

In the secondary form of the disease, the examination is not much different from the diagnosis of a congenital malformation of the jaw. Often, a series of laboratory tests is added to the review to establish the cause of tooth loss. Sometimes this is caused by complex chronic diseases that prevent prosthetics from being carried out. Without prosthetics, it is impossible to achieve the expected results of treatment. Contraindications may be:

• benign and malignant neoplasms in the body;
• diseases of the mucous membranes;
• the presence of an inflammatory process in the blood;
• remnants of the roots of the teeth under the mucous membranes.

To start treatment, it is necessary to remove all obstacles, otherwise complications are possible.

Reasons for the development of the disease

It is difficult to isolate the main cause of congenital absence of teeth and their loss in adulthood. Scientists have proven that the hereditary factor plays a significant role in the formation of pathology. For example, underdevelopment of teeth even in the prenatal period.

There is also such a pathology as the embryogenesis of dental tissues, which does not allow the jaw and dentition to form normally. The absence of lateral incisors and molars is called phylogenetic reduction.

Caries, violations of tooth enamel, inflammation of the oral cavity, pulpitis can also lead to complete or partial loss of teeth. Therefore, at the slightest uncharacteristic manifestations in the oral cavity, it is better to immediately contact the orthodontist for a qualified consultation. Any delay in dental health is almost always fraught with consequences.

Varieties of adentia

Primary (congenital) complete edentulous

Pathology is extremely rare and in the circle of specialists is considered a complex genetic disease. In this case, the rudiments of the teeth are completely absent. Accompanied by pathology and other physical manifestations. The facial oval of a child with congenital adentia differs significantly in appearance from the face of a healthy baby. The lower part of the face is reduced, the alveolar processes of the jaw are not fully formed, which is easily visualized. The mucous membranes of such children are pale and dry. The patient can eat only soft or liquid food. Because of the defect, speech does not develop.

Most children with primary edentulous syndrome suffer from the absence of hair on the head, eyebrows and eyelashes. The fontanel of such an infant tightens slowly, and may not narrow at all. The nail plates are either absent or excessively brittle and soft. Therefore, we can say that congenital adentia is a complex of complex genetic defects that are formed during a woman's pregnancy.

Congenital partial disorders of the dentition

It has slightly different symptoms and milder consequences. Occurs during eruption of milk teeth. Some teeth, against all odds, just don't grow. Rudiments are not detected by palpation and x-ray examination.

As a result, gaps are formed between the teeth, which will inevitably lead to a displacement of the entire row. With a large number of missing teeth, underdevelopment of the jaw is diagnosed. With a mixed bite, when the first teeth fall out, and permanent ones grow in their place, a lot of empty places form in the oral cavity. There is a risk of loosening of the supporting teeth and a violation of the protective enamel layer, which leads to many complications. For example, jaw deformity or the appearance of a crossbite.

Acquired complete edentulous

There is a complete absence of teeth in both jaws. They can be both dairy and permanent. There is the concept of secondary childhood adentia, when the teeth grow normally, but eventually fall out for some reason.

Common causes of the acquired form of the disease can be:

• dropping out;
• removal due to caries, which is not treatable;
• periodontitis;
• removal for surgical reasons, such as oncology.

Over time, the alveolar processes atrophy, the lower jaw tightly adjoins the nose. The main symptom of the initial stage of secondary adentia is the erasure of tooth tissues. Because of this, the patient feels discomfort when the jaw is tightly closed.

Secondary partial

The most common type of pathology. Most people at different ages have experienced it. This may be the removal of teeth due to caries or an inflammatory process in the gums. In this case, the alveolar processes continue to function normally. Displacement occurs rarely and depends on the time elapsed since the removal of adjacent teeth.

It rarely happens that with a mixed bite, a shift of the row occurs. Then there is not enough space for the growth of a permanent tooth. Therefore, parents should pay attention to the delay in eruption, and if necessary, visit a pediatric dentist with the baby.

Treatment of the disease

It is prescribed depending on the type of adentia and other indicators identified during the examination. Most often used:

• prosthetics with crowns or inlays;
• the use of implants;
• installation of bridges;
• the introduction of a removable or non-removable prosthesis.

Prosthetics are carried out equally often, both with the use of removable and non-removable prostheses. For children, the first option is more suitable. The jaw undergoes age-related changes, and in the future, a fixed prosthesis can be deformed or displaced, which is highly undesirable.

All prostheses, regardless of the material of manufacture, are made on the basis of a cast made in advance. This is required so that it fits perfectly to the patient's jaw, does not cause discomfort.

Many parents refuse to carry out prosthetics for their children. This is a wrong perception. Even temporary removable dentures can restore the aesthetics of the dentition. The child can fully eat, develop chewing function.

With acquired partial adentia, dentists decide on artistic restoration. This method allows you to restore the integrity of the dentition with minimal effort. For this, ceramics and photo composites are used. Depending on the selected material, the service life of the prosthesis is determined.

Implants will help to properly distribute the load on the dentition. This is their advantage over bridges. Features of the installation make them the safest type of treatment in relation to neighboring teeth.

At what age should treatment begin?

Orthodontics recommend starting prosthetics with complete congenital adentia from the age of three. Just at this age, the baby's body is much stronger, and the disease can be diagnosed most accurately. The dentist should pay special attention to the shape of the prosthesis, as an ill-fitting one can provoke a delay in the development of the jaw.

It is necessary to responsibly approach the choice of a dental clinic for the treatment of adentia. Only clinics with good diagnostic equipment can provide their patients with really high-quality care. In the treatment of this defect, it is extremely important to establish the cause of tooth loss. This may be the result of serious oncological diseases which urgently require the intervention of specialists of other profiles.

You should not save on the material of prostheses. This directly affects their lifespan. Although the process of their installation is painless due to the use of anesthetics, it is still not the most pleasant. Especially for children.

Adentia is a complex and very unpleasant disease. But, it is not hopeless. Each patient can count on a positive outcome of treatment with a timely visit to the clinic. Treatment can hardly be called cheap, however, the result will help solve not only physiological, but also psychological problems. After visiting the clinic, a person who previously suffered from complete or partial absence of teeth will soon be able to return to everyday life.

Thanks to a wide range of treatment methods, any patient will find the best way to get rid of such a nuisance.