Mesial occlusion in adults and children: correction of malocclusion, what to do if the lower jaw protrudes forward. Treatment of distal occlusion in adults. Difficult oral hygiene

Veronica N., patient of the clinic " Private practice": "When my son was two years old, the dentist advised us to pay attention to the malocclusion that was forming incorrectly and prescribed gymnastics for the mouth. But my son resisted doing the exercises, and we, to be honest, then thought that he would outgrow it, and didn’t really insist. Now he is 17 years old, his upper jaw“bulges forward, and you definitely need to get braces.”

Bite is the arrangement of the jaws and teeth relative to each other. It can be either physiological, that is, correct, or pathological, that is, incorrect.

What are the causes of malocclusion?

The bite is finally formed by the age of 15. However, the first signs of malocclusion development can be detected already in one year old. There are no reasons for the development correct bite there may be several:

• using a pacifier or pacifier that does not match the shape of the mother's nipple at the time of breastfeeding
• incorrect position baby's head during sleep
• long-term constant sucking of a pacifier (it is recommended to wean a child from a pacifier from 10-12 months)
• the presence of such a bad habit as thumb sucking, which can lead to the appearance of a gap between the teeth
• incorrect posture and stoop also negatively affect the formation correct location jaws
• frequent illnesses respiratory tract experienced in childhood
• habit of breathing through the mouth.

In addition, bite characteristics can be inherited.

What are bite pathologies?

Eat various classifications pathological bites. To make it easier for patients to understand their problem, we present one of the classifications below:

• prognathic or distal occlusion when the upper jaw is too developed compared to the lower jaw
• mesial or medial (reverse) bite, When lower teeth protrude too far and even overlap the upper ones.
• deep (traumatic) bite, When upper teeth cover the lower ones by more than 50%
• crossbite, when the rows of teeth intersect each other according to the principle of the letter “x” or scissors. Therefore, the second name of this pathology is scissor bite
• open bite when the teeth of the upper and lower jaws do not close (do not contact)
• reducing bite, which is formed against the background of tooth abrasion due to bruxism (teeth grinding).

How to correct a pathological bite

Modern orthodontics offers many methods for correcting malocclusion. Depending on the extent of the problem, doctors use physiotherapeutic techniques, such as gymnastics and massage. Or they use hardware correction. Or they install braces. Or they resort to at least- surgical treatment of malocclusion in combination with the installation of braces.

Malocclusion: common misconceptions

There is an opinion that using any pacifier or pacifier will definitely ruin the child’s bite, and that the only panacea is breastfeeding. This is wrong. The modern market for children's goods is replete with nipples and pacifiers, which are in no way inferior in shape natural form breasts during feeding. Limited breastfeeding is not a reason to say goodbye to the correct bite in advance.

Malocclusion- this is a violation natural function closing of teeth. This defect is one of the most common problems in orthodontics. At the same time, correction, as well as its detection and prevention, are equally important for both children and adults.

Photo 1. Dental malocclusion has been treated, is being treated and will continue to be treated

Signs: what it looks like

To understand what malocclusion means and how to determine it, you must first understand what the bite should be ideally. An “orthognathic bite” is considered healthy when the upper row of teeth slightly overlaps the lower one. At the same time, the chewing function is as effective as possible. If disturbances occur during teething or jaw growth, negative changes may occur:

1. With an incorrect bite, lower jaw pushed forward, or more often there is a violation - the lower jaw is located back, and the upper teeth protrude strongly forward.
2. The teeth located in the dentition are out of place - loss from the dentition, second row of teeth.
3. Underdevelopment of the lower jaw, as well as a common phenomenon when the upper jaw protrudes strongly forward.

Unfortunately, such defects in children are not always a cause for concern for their parents, and some of them even like such changes. However, as the child grows up, his facial features change only for the worse: ugly smile and clearly crooked arrangement of teeth, as well as the risk of developing periodontal disease - these are the unpleasant consequences who are already waiting for him adolescence. Thus, this defect should be identified and corrected from childhood.

And although to determine exact condition bite can only be done by a qualified orthodontist, there are the most common changes that are clearly visible visually:

• protruding upper lip;
• crooked teeth;
• incorrectly touching dentition;
• overdeveloped lower jaw, protruding forward.

If you detect at least one of the listed signs, you should immediately make an appointment with a specialist.

Causes

Usually, to find out why a malocclusion formed, you need to look into the patient’s childhood. Most often, the cause of this defect is a genetic factor, when a child inherits the size of teeth and bite shape of his parents. In this case, the resulting pathologies are very serious and difficult to treat. Another common cause of dental problems is intrauterine development: anemia, metabolic problems, viral diseases, intrauterine infection, as well as other pathologies of pregnancy (bite treatment and pregnancy), which can lead to further development diseases.

But even excluding genetic and intrauterine factors, the likelihood of a defect in the formation of the dentition after the birth of a child is also quite high. This is due to many underlying causes that influence the formation of teeth and bite. Here are some of them:

• birth injury;
• artificial feeding;
• breathing problems;
• thumb or pacifier sucking;
• haste or delay in removing baby teeth;
• incorrect bite after prosthetics;
• deficiency of fluorine and calcium in the body;
• disruption of the eruption process;
• malnutrition and dental caries;
• metabolic problems;
• diseases and injuries dental system.

As for malocclusion in adults, the most common cause its formation is the untimely replacement of extracted teeth through dental implantation or less effective, but more affordable prosthetics on bridges

Consequences: does it need to be corrected and why is it dangerous?

With an incorrect bite, the consequences can be very serious: the load on individual teeth increases, the enamel wears off much faster, and sensitivity increases. If the bite height decreases, the face loses symmetry and the risk of damage to the temporomandibular joint increases. The frequency of injuries to the surface of the cheeks and tongue is increasing, which leads to the formation of traumatic ulcers.

Among the dangers of malocclusion are often added physical damage to the gums, as well as general disorder functions of chewing, breathing, speech, swallowing and facial expressions. Thus, with a frontal open bite, biting and speaking become significantly more difficult. In the case of the lateral one, the chewing function suffers. And with the distal form of deep bite, breathing disturbance is observed. Against the background of these changes, a number of diseases of the digestive organs, nasopharynx, hearing aid And respiratory system.

Kinds

To highlight the main types of this disease First of all, you should understand the types of it correct form, and also find out what is affected by malocclusion with physiological point vision.

The determination of the correct bite is based on the natural closure of both jaws, in which the upper dentition should overlap the lower one by 1/3, and the interaction of the molars is based on the principle of clear closure of antagonist teeth with each other.

Main features

• When the jaws close, the teeth located in the upper row naturally come into contact with the teeth of the same name from the lower row;
• a conventional vertical line drawn along the face runs in the center between the lower and upper central incisors;
• there are no significant gaps between adjacent teeth of the same row;
• speech and chewing functions are normal.

An abnormal or malocclusion, in turn, is the result of genetic or acquired changes that cause various defects of the jaw and/or dentition. Usually they mean various deviations from the norm in the process of closing the lower and upper teeth, at which it is possible complete absence contact in certain areas, which leads to significant distortion of the shape of the face and disruption of the functions of the dentofacial apparatus.

Depending on the characteristics of the existing anomaly, it is customary to distinguish the following types of malocclusion:

• open(most of the teeth of each row do not close);
• deep(the incisors of the upper row overlap the front surface of the lower teeth by more than 50%);
• mesial(there is a noticeable protrusion of the lower jaw forward);
• distal(underdevelopment of the lower jaw or overdevelopment of the upper jaw);
• dystopia (some teeth are out of place);
• cross(one side of either jaw is not fully developed).

To understand what any type of malocclusion leads to, it is enough to remember the consequences of not healthy teeth for the whole organism, which, as is known, always pose a danger. Therefore, bring this problem before extreme It is not recommended at all, otherwise new diseases may arise that require separate treatment.

Prevention of development

As mentioned earlier, most dental defects come from childhood. And in order to avoid unnecessary hassle on how to correct the bite and what to do, parents should prevent the development of this disease in their child.

In case of absence genetic predisposition All prevention is based on simple rules:

• Take care of your health during pregnancy. Mineralization of a child's teeth begins from the 20th week, and therefore during this period it is extremely important to consume required amount calcium and fluorine;
• Follow the rules of feeding your baby. Since the lower jaw of a newborn is smaller than the upper, its dimensions are equalized during the sucking process, when all the main muscles of the face are involved. In case of artificial feeding this doesn't happen because big sizes holes in the bottle make the baby swallow milk more quickly. As a result, the risk of developing malocclusion increases significantly;
• Monitor your child's breathing - he should breathe through his nose. Only oral or mixed breathing causes a narrowing of the upper row of teeth and slows down the growth process of the upper jaw, which often leads to the development of an open bite;
• rid your child of old habits. Formation is often associated with thumb or pacifier sucking at the age when baby teeth begin to emerge. And even incorrect posture can lead to the development of serious defects;
• visit the dentist. To once and for all stop thinking about what to do if a malocclusion develops, regularly take your child for examination to a specialist, who will diagnose and eliminate this problem in a timely manner.

How to fix it: treatment with and without braces

The options for how to hide and treat malocclusion in childhood and adulthood are very similar, but still differ in their specificity. Thus, the main problem in treating malocclusion in adults is that their jaw bones are fully formed and grow slowly, requiring great effort to effective correction. Also, “aged” patients most often have not the healthiest teeth, often covered with fillings and partially destroyed various factors, which greatly complicates dental prosthetics.

On the other side, high level motivation and conscious interest in a positive result can compensate for the physical characteristics of adult patients, and therefore treatment of malocclusion can be slow but stable.

Correction

When treating malocclusions, braces are the primary treatment option among teenagers and adults. This orthodontic design is non-removable and consists of a chain of locks or brackets fixed to the surface of the teeth with special glue and an arch. The most common are metal braces. At the same time, they can be very aesthetic. There are also vestibular and external brace systems made from completely transparent materials: ceramics, sapphire or plastic. And lingual (internal) structures allow you to completely hide the fact of their presence, since they are attached to the back surface of the teeth.

Treatment by surgery

Despite the popularity of braces, many people want to know whether malocclusion can be corrected. surgically. Yes, this treatment option is possible. However, it is justified only in the case of very serious defects: disruption of the structure of the jaw bones, their asymmetry and disproportion. In general, this approach is very effective, but also more dangerous, since any operation is, first of all, a risk.

80% of the world's inhabitants face the problem of malocclusion.

But few people fully understand what this condition entails, what the causes are and the need to prevent the disease.

Jaw development disorders occur in both young children and adults. To avoid problems, you need to regularly visit your dentist.

Malocclusion is an anomaly that occurs when there are disturbances in the development of the dentition and jaw. With an incorrect bite, one of the jaws is pushed forward or may be underdeveloped.

The incorrect position of the teeth relative to each other does not allow them to completely close, which gradually creates a disruption in the functioning of the digestive organs and alters the symmetry of the face.

Such violations cause serious problems with health and worsen a person’s standard of living, so it is recommended to correct the pathology already in childhood.

With a pathological bite, the following occurs:

• speech disorder;
• problems chewing and swallowing;
• the occurrence of gastrointestinal diseases;
• the appearance of frequent headaches and problems with the spine;
• formation of uneven teeth;
• early damage and loss of teeth;
• development of infections in oral cavity.

What happens?

In orthodontics, there are two types of occlusion - correct (physiological) and incorrect (pathological).

At proper development The teeth are straight, the jaws close perfectly and ensure high-quality grinding of food. The face is symmetrical and has regular shapes.

There are several types of correct occlusion: orthognathic, straight, biprognathic and progenic.

With a malocclusion, the teeth and jaws are misaligned. Asymmetry appears in the patient's face, jaws protrude and lips droop. Depending on the type of pathology, several types of anomalies are distinguished.

The video talks about the types of bites.

Types of pathologies

All deformations cause problems of various nature, including external changes person's face.

Deep

The upper row of teeth greatly overlaps the lower one, when ideally the upper teeth should overlap the lower ones by 1/3. This type of bite is also called traumatic, since patients’ enamel wears off over time and teeth are destroyed precisely against the background of this anomaly.

Causes unpleasant consequences for the patient:

1. Injuries to the oral mucosa.
2. There is a strong load on the front teeth, hence the pain.
3. Speech defects.
4. Visual changes in facial features.
5. Difficulty eating.

The face seems small underlip sticks out forward, and if a person tries to press it in, it becomes thin over time. After correction, the shape of the face and lips is normalized.

The pathology is dangerous because it severely injures the gums, causing periodontal disease, in which the patient loses teeth. In addition, with a deep bite, problems with the respiratory system may occur.

During correction, the use of a brace system, prosthetic replacement of lost teeth, consumption of hard foods, and timely sanitation of the oral cavity are indicated.

In adults, treatment is carried out using permanent braces, which are placed on the front teeth of the upper jaw.

Open

The upper and lower teeth are not connected. The pathology occurs in children in 90% of cases and is considered a severe form of jaw deformation. Dentists distinguish two types of open bite:

1. Front. The anomaly occurs most often; these disorders are associated with other diseases, for example, rickets.
2. Side view anomalies are less common.

It is manifested by several symptoms, such as a constantly slightly open mouth or, conversely, closed to hide the defect.

It is difficult for the patient to bite and chew food, the oral mucosa is constantly dry, and the face becomes asymmetrical over time.

Speech impairment is dangerous, and constant breathing through an open mouth provokes problems with the respiratory system. The inability to chew food normally affects the functioning of the digestive tract.

When correcting this pathology in children, the doctor recommends eliminating bad habits, such as thumb sucking and mouth breathing. A child's diet requires hard foods.

Wearing braces is also recommended, and serious violations required surgical intervention. Adults are usually recommended to wear permanent braces.

Cross

The jaw moves to the side, due to its insufficient development on one side. The displacement can be bilateral or unilateral, in the front or side.

The problem is best seen when smiling because the teeth overlap.

The patient cannot chew and swallow food normally, and speech is impaired. A person with this pathology chews food on one side, which causes teeth to deteriorate faster, enamel wears off, caries and periodontal inflammation occur. The pathology is often accompanied by pain and a crunching sound in the jaw when opening the mouth.

There are two types of crossbite:

• Buccal, when the upper or lower jaw can be greatly expanded or narrowed.
• Lingual when the upper row of teeth is wide or the lower row is narrow.

The face may be severely deformed and skewed. After correction, the features become symmetrical, and the oval of the face takes on a normal shape.

The disease is most often treated over the age of 7 years with the help of braces and removable appliances that straighten the dentition.

Patients over 15 years of age with running form Surgery is prescribed before and after installation of the brace system.

Distal

The upper and lower jaws are deformed. This condition of the oral cavity causes a severe discrepancy in the size of the jaws. One of the main symptoms of a prognathic bite is protrusion of the upper lip.

Violation causes improper load distribution – rear end The dentition takes on the main work when chewing food. The patient's teeth are more susceptible to caries and complete destruction.

Anomalies are divided into types:

1. The upper jaw is correctly developed and the lower jaw is underdeveloped.
2. The upper jaw is too developed and the lower jaw is not enough.
3. Severe protrusion of incisors.
4. The lower jaw is normal, but the upper jaw is strongly protruded forward.

The classification applies only to adults, since in children with baby teeth the bite is not fully formed.

With this type of bite, the person’s face is greatly deformed, the chin seems too small, and the facial features are unnatural and childish.

After correction, the shape of the face is restored, the patient looks serious and mature.

The consequences of pathology appear gradually and affect the health of teeth and gums. Periodontal diseases develop and temporomandibular joint. It is difficult for patients with an anomaly to install a prosthesis.

Correction of the distal bite is carried out using braces and special devices for children, which restrain the growth of the upper jaw.

Mesial

The lower jaw remains underdeveloped, and the upper teeth overlap the lower ones. Main symptom diseases - protruding chin. This problem is visible to the naked eye.

With a mesial bite, a person cannot chew normally and problems with the gastrointestinal tract arise. Patients complain of difficulty swallowing, which also does not have the best effect on the health of the body.

The upper teeth undergo enormous stress and are quickly worn away, causing inflammatory processes in the oral cavity, periodontal disease and caries develop.

Mesial bite provokes diseases of the temporomandibular joint, causing headaches, ringing in the ears and dizziness.

The face becomes courageous, the chin seems heavy. For a man, this situation cannot be called a minus, but women suffer. After correction, the chin does not protrude and the face is straightened.

This disease is treated with braces, myotherapy, and surgery. The complexity and duration of rehabilitation depends on the severity of the jaw deformity.

Treatment is especially effective in children under 12 years of age.

Declining (acquired)

The defect manifests itself with certain symptoms:

• jaw crunch;
• headaches and facial pain;
• hearing loss and congestion in the ears;
• dry mouth.

The disease develops from premature tooth loss and is treated with the installation of dentures and braces.

Reasons for formation

In children

There are several reasons for jaw deformation in children of different ages:

1. Artificial feeding of a baby. A child is born with an incorrectly positioned lower jaw, which straightens when suckling at the breast. If a child is bottle-fed, the jaw may remain underdeveloped.
2. Bad habits. These include thumb sucking, toys, and pacifiers. In older children, incorrect posture provokes changes in the bite.
3. Various diseases. Provoke abnormal development jaw rickets or frequent ENT diseases that force the child to breathe through the mouth.
4. Genetic factors. Children often inherit dental problems from their parents.
5. Early loss of baby teeth.
6. Jaw injuries.

In adults

1. Refusal of treatment in childhood.
2. Tooth loss.
3. Jaw injuries.
4. Installation of prostheses.

Consequences of pathologies

Jaw deformation not only creates cosmetic problems, but also worsens the functioning of the entire body, teeth and periodontium, digestive organs and the spine suffer.

Patients develop complexes that turn into serious psychological problem, especially in teenagers.

It is difficult to clean teeth with anomalies, so there is almost always plaque between them, which causes bad smell and provokes the development of caries.

It is not easy to treat the pathology; teeth often have to be removed, which further aggravates the situation.

Timely sanitation of the oral cavity in childhood and proper care taking care of your teeth will help keep them in the future good condition and avoid a lot of problems.

Correction

Correcting a bite in children and adults takes place in several stages. At the first appointment, an initial examination is carried out and an examination is prescribed.

Before starting to correct jaw deformation, doctors recommend undergoing an examination by an ENT doctor, osteopath and psychologist.

To see the exact location of the teeth, the dentist orders x-rays and takes impressions of the jaws.

After full examination The necessary treatment is selected for the patient.

There are several designs used for treatment:

1. Mouthguards are devices made according to an individual impression of the patient. You need to wear them for several months, taking them off when eating and brushing your teeth.
2. Trainers for straightening teeth made of silicone are worn from 1 to 4 hours a day.
3. Braces are a permanent device that is installed for a long time.

After the braces are removed, the patient is fitted with removable or permanent retainers, which prevent the teeth from returning to their previous position.

If the patient's condition is advanced, it is prescribed surgery, in which teeth are removed and dentures are installed.

The video talks about malocclusions and methods for correcting them.

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Bite, that is, the closure of teeth is the main parameter normal development and functioning of the dental system. An orthognathic bite, in which the upper teeth slightly cover the lower teeth, is considered normal and occurs in most people. Malocclusion develops due to genetic determination, in the presence of the habit of thumb sucking, as a result chronic disorder nasal breathing. An orthodontist deals with bite correction. It can be carried out using special devices and mouth guards, retainers and braces.

General information

Bite, that is, the closure of teeth is the main parameter of the normal development and functioning of the dental system. An orthognathic bite, in which the upper teeth slightly cover the lower teeth, is considered normal and occurs in most people.

Bite formation

There are five periods of formation of a correct orthognathic bite; if there are deviations in any of the periods, then the formation of a malocclusion and other anomalies of the dental system is possible.

The first period is from birth to six months; From 6 months to three years, the formation of a temporary bite occurs - this is the second period during which all temporary teeth erupt. The third period from 3 to 6 years is preparatory, as it begins active growth jaws for further eruption permanent teeth. From 6 to 12 years of age, active growth of the jaws is observed and they erupt in parallel. permanent teeth, therefore this period is called mixed. And the fifth period from 12 to 16 years is characterized by the final formation of the bite and the replacement of all temporary teeth with permanent ones.

If there are disturbances in the growth of the jaws or disturbances in the eruption of teeth, this can lead to the formation of a malocclusion. For example, crowding of teeth occurs if permanent teeth erupt on time and are large, and jaw growth has stopped. Sometimes impaired jaw growth can result in the absence of canines, incisors or premolars, or the formation of spaces and diastemas. Malocclusion due to impaired growth of the jaws can be manifested by a deviation from the normal position of the teeth and rotation of part of the teeth on one of the jaws. Sometimes the incisors of one jaw significantly overlap the other; V in rare cases An open malocclusion is formed when the incisors do not close at all.

With an incorrect bite, food is poorly chewed, since the teeth do not close completely or there is no contact between them at all. This can cause illness gastrointestinal tract and caries, since proper oral care is impossible.

Stages of correcting malocclusion

Orthodontics deals with the treatment of malocclusion. At the first stage, preparation for orthodontic treatment takes place, which includes a complex diagnostic measures, based on the results of which the degree of complexity of therapy is determined. To do this, they do an orthopantomogram (panoramic photograph), radiovisiography, or use data computed tomography. The pictures allow you to see and evaluate the degree of changes in the dental system. Next, sanitation of the oral cavity is carried out: treatment of caries and professional oral hygiene. Treatment is important concomitant diseases, which may worsen during the installation of braces.

During the second stage of correcting malocclusion, braces are installed; adhesive composites are used to fix them. However, depending on the type of braces used different techniques installations. Each vestibular brace is glued to the front surface of the teeth that need correction, then support rings are attached to them, and a power arc is threaded through the clasps. The arc is made of materials that have elasticity and resilience, due to which it tends to take the shape that it was originally given.

Lingual braces are more difficult to install, since the internal relief of the dentition is more diverse. First, an impression of the dentition is made, after which the bracket system is worked out on this structure and only then fixed with glue on the inner surface of the teeth.

The process of installing braces is painless and rarely accompanied unpleasant sensations. However, within a week the patient may experience pain syndrome, which is recommended to be relieved with analgesics, in the case of severe pain You must consult a doctor who specializes in correcting malocclusion.

The third period is restorative or retention. Activities carried out during this period are aimed at consolidating the results obtained with braces. In case of malocclusion after abrupt withdrawal After braces, the teeth will return to their position after some time, to avoid this they use retainers, the wearing period of which is 2 times longer than the period of wearing braces.

The duration of wearing retainers depends on general condition dental system, on the age of the patient and on the presence of systemic diseases. Retainers can be removable or non-removable; non-removable devices are attached similarly to braces on the lingual surface of the teeth, which makes them invisible to others. Removable retainers are orthodontic plates that are attached overnight. The pressure that displaces the lower jaw is created by plastic arches and aligners. Silicone retainers are becoming more popular because they are practically invisible when talking and smiling.

Duration orthodontic treatment from six months to 2 years. All this time must be spent Special attention care of orthodontic appliances. The effectiveness of correcting malocclusion depends on how well and regularly they are cared for. When wearing braces, access to teeth is difficult, which can contribute to the development of caries. Teeth should be brushed after every meal and special brushes should be used for patients undergoing malocclusion correction. The use of superfloss, which, thanks to its hard tip, is easily threaded between the teeth at the edge of the gum, helps remove food debris from areas that are inaccessible to cleaning with a toothbrush and brush.

During the period of correction of malocclusion, it is necessary to avoid carbonated drinks, viscous foods, chewing gum, nuts, sweets and honey, as these products are difficult to clean off tooth enamel and can damage the braces.

Distal occlusion is a violation of the closure of the jaws, when the upper teeth protrude significantly beyond the edge of the lower ones. As a result of the formation of a prognathic bite, the upper jaw protrudes, the chin has a slanted shape, the front teeth do not meet, and the front teeth converge incorrectly. Deformations can be noticeable when speaking and often affect the symmetry and shape of the face.

Prognathic occlusion is formed in childhood. Parents may not know that such an anomaly exists until the first visit to the dentist or the appearance of several teeth. The defect is treated using orthodontic structures and other methods.

Classification and signs of distal occlusion

With a distal bite, a person's upper jaw protrudes above the lower jaw. Top part the masticatory apparatus may be noticeably large, or the lower one may be underdeveloped (in the practice of specialists there are different combinations). In patients, there is a longitudinal sagittal gap between the teeth, formed between the line of closure. If it is missing, then the person’s upper teeth are shifted inward. The shape of the bite is determined taking into account the position of the upper row of primary or primary elements. The most common curvatures are:

• fan-shaped arrangement of incisors at the top, narrowed lateral rows;
• palatal inclination of the upper dental units in the center with the lateral ones rotated along the axis and deviated towards the lip.

Distal occlusion with jaw displacement develops in the womb or due to external influence. This bite is characterized by the following symptoms:

• jaws do not contact when chewing;
• facial convexity;
• small lip on top;
• disproportionately short Bottom part faces;
• half-open mouth (lips do not close);
• the upper incisors hang over the lower lip;
• the fold of the chin is pronounced.

A deep distal bite is diagnosed when the crowns of the upper anterior row overlap by 1/3 or more with a similar segment of the lower one. The pathology is characteristic specifically for anterior section dentofacial apparatus, sometimes found on the lateral part. Most often, this type of bite in humans is combined with a distal one.

Causes of prognathic bite

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What a distal bite is can be seen in the photo accompanying the article. Why do changes occur? There can be many reasons, and tooth growth pathologies can be divided into groups:

• the upper teeth protrude forward due to inheritance of the defect from the parents;
• the occurrence of distal occlusion during fetal development;
• acquired in childhood under the influence of external factors.

In many cases, circumstances that provoke an incorrect prognathic relationship can be combined. This leads to rapid deformation of the face and significantly complicates the treatment of prognathic bite in the future in a child or adult.

External influence

Prolonged mechanical impact on the jaw can cause the development of distal occlusion. Bad habits include constant pressure on the chin due to it being supported by the hand when watching TV or reading. Unfavorable factors include regular pressing on the front teeth with a pen, pencil, playing on some musical instruments(for example, flute).

Hereditary predisposition

Based on a study of anomalies in the development of the dentofacial apparatus in twins, it was found that prognathic occlusion is inherited from the parent. Of the 576 cases of deviations in a study of the same families, distal occlusion was recorded in 87%. Other researchers believe that inheritance creates a predisposition, and the anomaly can develop under favorable conditions. external factors. Following preventive measures will help correct the row ratio on initial stage development of the defect.

Chronic diseases of the throat and nose

As a result of respiratory tract diseases occurring in chronic form, the prognathic relationship of the teeth in the anterior part of the jaw may be disrupted. Diseases reduce the passage of air through the nose, as a result of which a person breathes through the mouth. Improper air exchange causes the formation of a high palate, which causes the upper jaw to narrow and gradually stretch forward.

Bad habits in children

Many habits that parents do not think are harmful can lead to the formation of a sagittal fissure in babies. They cause the lower jaw to move, which becomes fixed in this position with age, remaining in the wrong position and affecting the appearance of the face. A sagittal gap greater than 9 mm requires urgent treatment. Often bad habits are combined, or when one is eliminated, another appears. Reasons for changes in bite include:

Posture

Pathologies that determine the appearance of a deformed bite in a child include incorrect posture (we recommend reading:). If the baby's torso and head are not on the same vertical, moving forward or backward, deformations of the jaw apparatus are possible. Parents should ensure that the child sits correctly during meals, games and learning.

Removing baby teeth ahead of schedule

The most common cause of abnormalities is early loss of mammary organs. The process provokes prognathism of the lower row, or distal occlusion. Unfortunately, sometimes dental units cannot be saved due to injury or deep caries. Molars are moved to the place of removed molars adjacent teeth, due to which there is not enough space for cutting through permanent elements.

Consequences of distal occlusion

Due to the development of changes in occlusion, not only the functions of the jaws are disrupted, but also facial features are deformed due to the appearance of a large sagittal gap. Gastrointestinal diseases may appear due to improper chewing of food, and the risks of oral diseases increase. On the Internet you can find many photos of people who have impaired occlusion in their varying degrees. The consequences of the anomaly include:

Treatment of prognathism

Treatment methods for distal occlusion differ significantly between children and adults. In childhood, it is easier to correct pathology, since the body is in the development stage. The orthodontist chooses the method of getting rid of the defect. Correcting anomalies is problematic if the jaw has shifted due to a genetic predisposition.

The main method of therapy is wearing special structures that remove the sagittal gap between the rows of teeth; at the same time, myogymnastics for the mouth are prescribed; use in food is required solid products. To completely get rid of deformity, it will take from several months to 3 years - the period depends on the characteristics of the body, age and degree of curvature.

The child has

Distal bite can be treated if the child is 2 years old and anomalies are already noticeable. Until the age of 13, there is a chance to influence the development of the jaw and completely restore the imbalance. At the age of 6 years, correction of the bite occurs quickly and without complications. For children, therapy requires the use of removable plates. They are absolutely safe and stimulate the growth of the lower jaw while inhibiting the formation of the upper jaw. The following removable plates are installed for kids:

• Goipl or Klammt activators;
• Frenkel regulator;
• Janson bionator.

After 6 years, when baby teeth begin to fall out, the anomaly is eliminated with the help of mouthguards, vestibular plates, retainers, and the myobrace and trainer systems are used. It is believed that the impact is most positive effect up to 10 years. For children 12 years of age, vestibular or lingual braces are used - the latter can correct the deformity more quickly. They need to be worn from 6 to 24 months.

In the presence of a deep bite, the treatment system requires expansion of the dental arches, correct placement of the anterior teeth, mesial movement of the lower jaw, and adjustment of the height of the bite. For the treatment of prognathic relationship of teeth with deep bite, the Gulyaeva apparatus is used (we recommend reading:). At the entire stage of treatment of distal occlusion, the patient performs myogymnastics to provoke tissue growth. Photos before and after braces will help you evaluate the results obtained with conservative therapy.

In an adult

Due to the fact that the organs of an adult have already formed, treatment is long and difficult. Elimination of distal occlusion begins with sanitation of the mouth, and to achieve positive result a set of measures is used. It includes muscle gymnastics, the use of braces and surgery (in severe cases).

To correct distal occlusion in adults, they are used special devices, set for months or for several hours a day:

After completing the formation of the position of the teeth and jaws, specialists can offer surgical correction. In severe cases of distal occlusion, you cannot do without a scalpel - an orthognathic operation is performed with an incision of soft tissues, sawing of the bone and its displacement. Fixation is performed with titanium-nickelide plates. If the patient refuses this method, the orthodontist partially corrects the bite by aligning the dental arches.

Preventive actions

It is possible to prevent the development of distal occlusion if you engage in prevention from early childhood.

Influence unfavorable factors on the masticatory apparatus is minimized using:

• establishing breastfeeding or using a bottle with a nipple, which the child makes an effort to use;
• refusal of the pacifier after the eruption of the first tooth;
• introducing complementary foods from 6-8 months with solid food;
• control of position during sleep (the child should not sleep on one side).

Parents should ensure that their child does not form bad habits. To strengthen the jaws and shape them correct position It is required to perform myogymnastics for the tongue, lips and jaws. When the child turns one year old, you need to visit the dentist, and plan a visit to the orthodontist between the ages of 3 and 4 years.

For infants, there are special devices that allow for prevention: to prevent sucking and biting of the lip, as well as the finger or tongue. Preventing occlusion is much easier and safer for the child than treating distal occlusion later.

Before the age of six, a child should be taught to eat apples, carrots and other fresh fruits and vegetables in their raw form. Stomatitis, caries and other diseases of the oral cavity can aggravate the problem, so from 2-3 years old parents should take their child to the dentist twice a year. When changing the frenulum of the lips or tongue, plastic surgery is necessary. If you lose baby teeth early due date due to injury or destruction, it is important to consider prosthetics. This method will prevent the teeth from moving.