Deployed teeth. Anomalies of the position of individual teeth

Most often there are cutters, fangs and premolars on both jaws.

This anomaly can be caused by the incorrect laying of the fracture of a constant tooth, early removal of the milk tooth and the subsequent medial displacement of the worsening teeth, the presence of a super commissioned or retained tooth, underdevelopment of jaws, etc.

Clinical signs when choosing an orthodontic apparatus design for tooth turning: the degree of rotation of the teeth along the longitudinal axis, the presence, deficit or absence of the place required to establish the rotated tooth in the correct position in the dental arc; The degree of formation of the root of the turning tooth.

Treatment of turns of teeth is carried out mainly by mechanical acting devices. In the teeth cementing crown or rings with hooks. Spring or stationary arc, depending on the presence or lack of space in the dental arc, is tightly suited to the turned tooth. The ending rubber ring between the crochet, soldered to the arc, and the crochet, soldered to the ring, pull up the tooth and turn it around the axis.

This anomaly can also be treated with the help of stationary orthodontist of orthodontics and crowns with a "propeller", i.e., the beast with curved in different directions by the ends soldered to the crown diagonally from the neck of the tooth to the lowered corner of the cutting edge. The stationary arc is bent along the shape of the tooth row, the hooks are soldered to it at a different distance from the rotated tooth (they are located on the side where to turn the tooth). Tooth turns produce rubber tag.

Sometimes for the treatment of this anomaly, along with an outer arc applied internal. Tooth rotation also produce with rubber thrust.

Correct the rotated teeth with the presence of a place in the dentition can also be a removable plate with a vestibular handler and extensors made of spring wire. The vestibular handle should be pressed on the surface of the tooth, the surrender vestibularly, and the extensor is on the surface of the tooth rotated to the oral cavity (Fig. 122).

The correction of the plates spend once a week at the point of contact of it with the neck of the rotated tooth. Activate the device by insignificant stretching of the spring process and easy squeezing of the vestibular arc in the loop-shaped bends area.

3. S. Vasilenko (1962) To correct the turns of the tooth, proposed a device with long spring levers, consisting of a metal crown on an incorrectly located tooth and a reference crown on the molar. To the crown, fixed on the incorrect tooth, solder the horizontally target tube, and on the crown of the supporting tooth from the vestibular side also in the horizontal direction - loops. Tooth rotation is carried out using a spring lever made from a wire with a diameter of 0.6 mm. The lever bended in such a way that the ends of it in the form of a loop are injected one into the tube, and the other in the loop. After final suction, the lever is activated and the end of it with some force is placed in the tube on the crown of an incorrect tooth (Fig. 123). In the future, the removable spring lever is recommended to activate once every 15-20 days in mixed and in 10-15 days in a constant bite.

You can accelerate the rotation of the teeth by the surgical method, the essence of which consists in replacing the chronic perodont injury by acute injury. The main operational intervention with this anomaly is a quick turn of the tooth (Redreseman Forse). But with this operation, complications often occur.

You can rotate the teeth of orthodontics with a preliminary surgical intervention in the periodontal slit. The dissection of periodontal fibers followed by orthodontic movement of the tooth contributes to changing the orientation of the fibers. Treatment of treatment and retention period are significantly shortened. With a large disadvantage or complete absence of places in the dentition of teeth turns are treated with a combined method, that is, with the removal of a less complete tooth and the correction of the position of the rotated tooth with orthodontic devices.

After the treatment of the turn of the tooth, the operating device is necessary to replace the reflexion. Since this anomaly has a great tendency to relapses, the retention apparatus must be prepared in advance and keep the tooth in a new position for a long time.

The easiest retention device is a ring recorded on a rotator, with two beans, resting on the lip and parallery surfaces of neighboring teeth. The retention of the results achieved can also be ensured by a tire made of fast-hardening plastics.

With a significant axial turn of the teeth, their position can be corrected with prosthetics. To this end, the teeth are depulted, the coronal part is cut to the level of the gums and prepare a cultive pin plastic or porcelain crown.

Tooth turn (more often permanent cutters and fangs) around its longitudinal axis arises as a result of Macroventia, narrowing of dental arcs and a lack of space in a dental row for individual

Fig 14 8 Orthodontic devices for turning tooths axis (Scheme)

teeth, early Loss of temporary tooth and displacements nearby located teeth Wrong position junction of tooth, availability Super counterparts or recycling teeth, harmful habits (with csus pencil, etc.). Teeth turned along the axis can be located in the dental row either outside it.Their turn may be different; more often meetturn up to 45 °

After creating a place in the dental arc for rotated along the axistuba his Install in the right position through.removable or non-removable orthodontic devices, applytwo opposing forces. In removable plates, the vestibular retraction arc and a lingual protraction spider are more often made. At the same time with compression loops on the arc cut down Plastics at the place of adjustment of the record to the oral side of the moved tooth when contacting the moved tooth with antagonists should be dismissing bite with helpfurious platform, occlusive linings.

When designing devices for turning, the tooth around the axis provide simultaneous impact on the mesi-albertic and distal side in opposite directions on the trimmed tooth, it is advisable to fix the ring with hooks soldered from the vestibular and oral side. Tooth is rotated using a rubber ring. So that the stretched ring does not slide on the cutting edge crowns, K. Ring solder extra hooks (Fig14.8).

From non-removable devices, the ENGLA device is often used in combination with a ring on a movable tooth, rubber or ligature. The best results are achieved with the help of edzhuiz technology.

When applications orthodontic devices for turn Tuba around the axis occurs tension Periodionon fibers that and interdental ligaments, Espiring to reduce. Due with this for property The effectiveness of treatment requires a long period of retention (up to 2 years). Premature removal of the reference apparatus can Be the reason for the recurrence of anomaly.

Cactotoseotesy of the moved tooth in front of ortho-dontic treatment contributes to the achievement of its sustainable results after 2-3 months after the end of treatment.

The transposition of the teeth is the wrong position in which the teeth change places, for example, side cutters and fangs or fangs and the first premolars. The reason for such an anomaly is the incorrect bookmark of incar of teeth.

Plan treatment with the transposition of teeth, follows the radiograph of the region of incorrectly located teeth. The choice of a method of treatment is surgical (removal of individual teeth) or orthodontic - depends on the degree of their offset and inclination of the roots. Teeth, cutting out of the dentition and rotated around the axis, it is advisable to delete. With the distal transposition of the upper constant canine and the temporary fang delay, you can remove the temporary tooth and move the first premolamber to its place, setting the fang between the premolars. This treatment is effective in the event of a mesial tilt of the first premolant root. For treatment, removable plates with springs and non-removable devices of Engla, Mershon, Begga and Edjuiz appliances are used.

Orthopedic treatment consists in changing the shape of the crown of the teeth by prosthetics.

The duration of the orthodontic treatment of anomalies of the position of the teeth depends on:

1) the presence of a place in a dental arc for an incorrect tooth;

2) the depths of the rubber overlap;

3) combinations of anomalies of the position of individual teeth and bite anomalies in the sagittal, transversal and vertical directions;

4) the period of the formation of bite, the state of the moved teeth;

5) Treatment method - orthodontic or combined with surgical, protethic and Dr.;

6) Contact patient with a doctor.

Moving teeth in the mesial direction - treatment of diasthemia, moving side teeth after elimination Causes caused anomaly, often occurs way Self-regulation for 6 months. Lateral move front teeth and distal side t. e. Move vs Directions of natural growth teeth, represents difficulties and most effectively in the initial period replaceable bite

The duration of treatment also depends on the value of the required movement of the teeth. The movement of teeth in the vestibulo-oral direction occurs faster as indicated to the tilt of the teeth (1 mm for 1 month) and much slower with the testimony to their body movement. The turn of the tooth relative to the vertical axis can be carried out for 2-4 months, which depends on the degree of its turn. The movement of individual teeth is accelerated by 2-3 times after preliminary compactotototomy (see section 19.4).

Forecast of treatment I. The duration of the retention period is due to the interdependence between the created form of dental arcs and functions dental system After Normalization of functions Treatment results there are more stable. The design of the reference apparatus is elected taking into account the direction of movement of the teeth. Such The devices must prevent the displacement of the teeth in the original position.

Olga Emelyanova

Chief Physician of the International Orthodontic Center Invisalign, Moscow.

If you ever watched American teenage comedies, then the brackets for sure you are associated with the image of the loser and botany, and getting rid of them - with the first step towards turning the ugly duck in the swan. Alas, the transformation occurs precisely during the wearing braces, and this process is quite long. However, technology does not stand still, dentistry today offers many variants of teeth leveling.

Is it necessary to align the teeth?

The current tendency to accept itself and the imperfections of their body is certainly very useful. Chasing the ideal from the picture, of course, not worth it. But the curvature of the dental rows is a problem both aesthetic and functional.

The curves are fraught not only by an ugly smile, but also voice impairment (notorious defects of diction), microtrams of the mucous membrane of the oral sheath, the incorrect distribution of the load on chewing, resulting in excessive abrasion of enamel, and microcracks are formed on its surface. Also, the curvature of the dentitions are capable of provoking migraines, clocks by jaw, bruxism (uncontrollable brine to the teeth), problems with the temporomandibular joint due to excessive tension of the lower jaw. In the case of serious curvatures, the quality of food is worsens, which is why the gastrointestinal tract suffers.

Psychological problems are also likely: understated self-esteem, stress due to peers, if we are talking about teenagers.

In all cases helps the installation of bracket systems?

If we speak exactly the curvature of the dentitions (protruding forward or, on the contrary, recessed teeth; increased gaps between the front (diasthemia) and side (three) teeth; expanded the position of some teeth; cross-bite), then any of the methods of alignment, whether it Vestibular, lingual braces or elineers, with a competent approach and patient compliance with all the recommendations of the doctor necessarily help.

If problems at the level of dental rows are combined with bite disorders at the level of the jaws, a competent and experienced specialist in the first reception will appoint additional research (most often x-ray) and will determine which orthodontic system will better cope with your problem. It may be necessary to install additional intraper traction.

In particularly severe cases combined with a bite impairment, a surgeon intervention may be required.

Alas, with all the possibilities of modern orthodontics there are still similar cases when the bite does not fix without maxillofacial surgery. That is why it is important to turn to a proven specialist who will not be in vain to spend your money and time (treatment with the use of brackets takes, as a rule, from six months to two years) and will send you to another doctor if necessary. However, fortunately, most problems with a bite, not to mention the curvature at the level of dental rows, today they are successfully solved using the installation of braces or wearing elineers.

What orthodontic systems are more effective?

From a functional point of view, all orthodontic systems are equally effective and reliable. The difference between them lies in a large account in comfort. The more modern system, the more aesthetic and more convenient. It is not difficult to guess that comfort and aesthetics are proportional to the cost.

The choice of a specific orthodontic design should be based on the following factors:

1. How important is the appearance? (Here it is necessary to remember that even metal braces today are not a sentence, they are much aesthetically of their predecessors of twenty years ago).)
2. How much time are you ready to wear a design?
3. What are your financial opportunities?

When it's too early to wear braces, and when is it too late?

We have to recognize that the situation in Russia and the world is very crying. According to different statistical data, up to 80% of the population of the Earth have problems with a bite of one severity. If today you meet a person with an absolutely even dental side, most likely, he passed an orthodontic treatment.

The formation of incorrect bite and the curvature of dental rows affects many factors from ecology to heredity, but the most serious problems arise due to improper bottle of feeding and bad habits in infancy, such as the sucking of the finger.

Therefore, for the first reception to the orthodontist should be taken up to 5 years.

The braces at this age are not yet put on, but the competent doctor will already be able to determine if the child will have problems with a bite in the future. If serious disorders are already observed, removable designs will help: plates or trainers. The doctor will determine which impact it is necessary.

As for treatment with the help of non-coordinated structures (braces) and elineers, it can be started as soon as the bite is fully formed, and the milk teeth will change constant. It is not necessary to wait for the teething of the eight of the eight of the so-called wisdom teeth.

But the upper bar does not exist. Even the elderly, the leveling of the teeth is not contraindicated, and successfully spent treatment at times improves the quality of life.

Do I need to remove teeth to install braces to install braces, such as eights?

Only orthodontist after inspection and x-ray examination can answer this question. However, the removal of teeth, whether the teeth of wisdom or fangs, it is not always not always for the installation of an orthodontic design. If severe crowned is observed, then perhaps the eights will have to get rid of, but most likely they will not interfere with treatment.

What is the difference between braces and when each of them is preferable?

As mentioned above, the difference is in the level of aesthetic and comfort. The simplest (and affordable price) braces systems are metallic. Not very conscientious doctors continue to call them the most reliable, but this is not the case: according to reliability, the same sapphire braces are not inferior to metallic. But first things first.

Metal braces

Metal braces are noticeably the rest. But if you are not confused by the fact that the surrounding will be aware of your treatment, today there are many ways to decorate brackets: rhinestones, multicolored ligatur gums and much more.

Metal braces are most often recommended for adolescents, as they do not differ in diligence in daily hygiene. As for comfort, to metal brackets will have to get used to it, they can injure the inner surface of the lips (in this case the doctor will write a special means). You will need special V-shaped, as well as monopropic brushes or rods for cleaning brackets themselves.

For the period of treatment, some products will have to be excluded from the diet, and hard fruits and vegetables can not be biled, you will need to cut on slices.

Ceramic braces

Ceramic braces are more expensive and much aesthetic metallic. They are less visible on the teeth, as they are made by the color of your enamel, and their arc can be painted.

Some discomfort you initially also experience, but when the period of addictive will pass, the inconvenience will only be given the restriction in nutrition.

As for the care of teeth with ceramic braces, it is necessary to remember that the raids around them will be much more noticeable than when wearing a metal structure, so you need more thorough daily hygiene and more frequent visits to professional cleaning sessions.

Special variety of ceramic braces - sapphires. They are completely transparent and many more like more, but there are no fundamental differences from ceramic.

It should be remembered that, no matter what kind of bracket systems, you choose with your doctor, you will have to come to "suspenders" with a certain periodicity - adjusting the pressure moving the teeth in the right direction.

And one more lifehak ... The teeth after orthodontic treatment will never return to the previous position only in one case: if, after removing the braces on the back surface, a retailer will be installed - a thin imperceptible wire that does not give teeth to move into the previous position.

Regarding the retairener, doctors still argue: whether it is necessary to wear it the rest of his life, or a long time, twice the socks of braces. In any case, without a retailer, freshlywired teeth can return to the usual position by inertia, and all treatment will come to no. By the way, the retainer on the teeth is not felt at all.

But the lingual braces are orthodontic structures that are installed on the back surface of the teeth - you will feel the first time. Lingval systems are absolutely invisible on their teeth and are also effective as vestibular (fastening to the front surface of the teeth), but addictive to them can take a few more time, the diction will especially suffer.

Is there an alternative to brackets?

There is an alternative to brekes, and these are the elineers - the most modern and comfortable way of equalizing the teeth. The main difference between the stores from braces - if necessary, you can remove them.

Eleperers are absolutely transparent, completely imperceptible on the teeth of Kapa, \u200b\u200bwhich you shoot at the time of reception of food. Consequently, no restrictions in nutrition are needed. If necessary, you can remove them before any important event, but this is excessive precaution: to see the elineers in your mouth will only be able to work with this system orthodontist and only if it will look at your mouth specifically.

Also, transparent kaps do not require any additional hygienic devices. You simply remove them, clean the usual brush and paste, and the elineers are rinsed under the water stream and, if necessary, clean the same brush.

In terms of efficiency, the eLINERs are not inferior to ordinary braces, but only under the observance of two conditions:

1. Kapaps must be on the teeth at least 20-22 hours per day.
2. Kits must change in a timely manner. During each of your visit, the doctor will give you a few couples cap and tell when they need to be changed.

Another advantage of the eleiners is a predictable result. At the stage of treatment planning with a special computer program, you can see how your teeth will move. Naturally, treatment with the help of elineers is the most expensive way to level the teeth, but these attachments are justified by comfort, aesthetic appearance and predictable result.

What would be your financial capabilities and aesthetic requirements, choose an appropriate orthodontic design to you, to determine the exact time of treatment, find out whether additional surgical interventions are required, can only dentist-orthodontist. It should be remembered that an experienced and competent doctor even with the help of the most ordinary metal braces will eventually achieve the perfect result. That is why it is so important to find a good clinic and a conscientious doctor.

This anomaly It may be caused by an improper laying of the fracture of a constant tooth, an early removal of a milk tooth, followed by a mesial displacement of in-depth teeth, the presence of an overseexplex tooth and so on.
Treatment of this anomaly It is carried out in a constant bite mainly mechanical-operating devices.

Tooth turn, Cement Ring with hooks. The arc is located so that it fits tight to the edge of the tooth, which is shifted vestibularly. The rubber ring, stretching between the arc crochet and the crochet crown of the tooth, pulls it up and turns around the axis.

This anomaly can be treated Also with the help of a stationary arc of Engla and crowns with a propeller, that is, beams with curved in different directions by the ends soldered to the crown diagonally from the neck of the tooth to the corner of the cutting edge, which must be lifted.

Stationary arc bend Exactly on the shape of the dental arc, the nuts should be dripped into the tubes and tapping the arc to the side teeth of the wire ligature. On the arc you need to solder hooks at a different distance from the turning tooth: on the other side where the tooth turns and closer on the opposite side.
Tooth turn is made rubber.

Sometimes for treatment of this anomalyAlong with the outer arc, the inner arc is used. Tooth rotation occurs also with rubber thrust.
Treat turns of teeth With the presence of a place in the dental arc, you can also be a removable plate with vestibular arc and levers made from spring wire. The device acts on the turning teeth on the principle of the pair of forces.

Sometimes do it plantenot adjacent to the edge of the tooth, which will be vestibularly (the plate is repeated periodically) and often build a plate with a rapid-hardening plastic in the region of the rib of the tooth turned into the oral cavity.

On the III Congress dentists of Ukraine Z. S. Vasilenko He reported on the treatment of turning to the tooth around the longitudinal axis with the help of an enlarge-improved Engel apparatus with long spring levers consisting of a metal crown on the ypochivally located tooth and crowns on the reference tooth - molar, premolar or fang on the opposite side of the jaw.

To the crown incorrectly located tooth It turns out in the horizontal direction of the tube, and the supporting tooth is soldered from the vestibular side, also in the horizontal direction, loop. Tooth rotation is carried out using a spring lever made of a wire with a diameter of 0.6 mm, manufactured by the Leningrad plant of dental materials for orthodontic practice. The lever bended in such a way that the ends of it, curved in the form of a loop, are entered by one in the tube, and the other in the loop. After the final suction, the lever is activated and with some effort the end is placed in the tube on the crown of an incorrect tooth. The action of the device is intermittent, the strength of the action is regulated by the doctor.

The advantage of the device It is the fact that the current part of its removable, and also that it has a property to prevent the relapse of the tooth, that is, is the resulting device.

Recommended application This apparatus for the treatment of rotation of premolars, fangs, and cutters turned 45-180 degrees and more. After achieving positive results of treatment, when the teeth turns, the active active apparatus is necessary to replace the revital.

As when turning teeth There is a great tendency to relapses, it is necessary to prepare the retention device as in advance. The retention of the achieved results can be ensured by a tire made of fast-hardening plastics according to M. Mareya method.

The easiest reitivity apparatus It is a ring on a rotated tooth with two beets, resting on the lip and the breadless surface of the teeth located on the sides of the corrigated tooth.

There is a considerable amount of different. This is justified by the fact that the health of the teeth depends on the many different factors.

The deviations are subject to the location of the teeth and them. A rather common pathology is the crookanomalia.

general characteristics

With croatomalia, the teeth turn relative to their vertical axis. Such a deviation has certain characteristics:

1. Most often, side cutters are scrolled, which are located on the upper jaw. Also curved can be fangs and mandibular incisors. Other teeth can be taken. However, this happens only with certain factors.
2. Tortooclusion is diagnosed with a dentist even then, the turning angle is only a few degrees. There are several degrees of the severity of pathology. The most difficult case is the turn of 180 degrees. A small deviation is observed when the reversal does not exceed 45 degrees. Serious believes when the teeth turn into a larger angle.
3. Most often, only one tooth is exposed to abnormal collar. Less often it applies to neighboring. It all depends on the causes of the appearance of deviation.

Provoking factors

There are several main reasons that provoke an abnormal "teeth dance":

Manifestations of violation

Anomaly does not have pronounced symptoms. It is manifested only by turning the teeth around the axis. Often dentists face a light stage of the curtanomalia. In this case, the turning angle is only 45 degrees.

Such a violation is not very serious and the main problem in this case includes only aesthetic aspect. Many patients are not worried about pain, but a cosmetic component.

With a serious reversal of cutters and fangs, mucous mouth can be injured. This can lead to the appearance. But even in such cases, no acute manifestations have an anomaly.

Diagnostic events

To reveal the cakeposition most often enough to have a visual inspection. Sometimes additional diagnostic methods are used:

1. Anthropometric analysis. It is carried out to determine the degree of deviation of the teeth from the normal position. During analysis, special gypsum models of jaws are used. With their help, they remove the sizes of the patient's jaws. The obtained data is analyzed and compared with information in the vessel and ustimno tables.
2. Allows you to determine the quality of the dental tissue.
3. Problem site. Determines the ratio of damaged root to the neighboring.

Treatment and correction

There are different methods for the correction of anomaly. Surgical include:

1. Extraction. The operation is carried out using the elevator. It is introduced into the upper part of the root and bundled the ligament fabrics in it. After that, the tooth is pushed out of the wells. This treatment is very effective.
2. . There is a ribbon and lattice view of this procedure. In the first case, the bone strip is removed if its width does not exceed 3 mm. With the lattice method in the root area, end-to-end holes are made. They are located in a checker order.
3. Incomplete dislocation. The tooth moves to the correct position using special surgical tongs. The procedure passes under local anesthesia.
4. Fibroidomia. The procedure that reduces the resistance of the ligament. This is done with the help of a small gear periodonta.

Conservative methods:

1. . At the initial stage of correction, nickel-titanium arc is used, which has a minimal section. Over time, it is replaced by arcs thoroughly. In the later stages, instead of an arc use an elastic chain.
2. . Apply only with a minor deviation of the crowns. They are presented in the form of a two-lean cap, which have channels for teeth and labial arcs.
3. Coffin loop. It is used for tantok conclusion, which appeared due to a narrow jaw arc. The device has two arcs that are responsible for the correction of the teeth. They put pressure on curved teeth.

Preventive measures

Specific preventive measures do not exist, but simple will help prevent the emergence of this anomaly.

In order to reveal the problems in the location of the teeth on time, it is necessary to regularly visit the dentist. Such inspections will help in time to notice the delay in the fallout of dairy teeth. It is the dairy teeth that did not fall on time, most often the reason for the appearance of the crookanomalia.

Other methods of prevention can be attributed:

• regular monitoring of the fallout and increasing teeth - early diagnosis will help prevent the emergence and development of pathology;
• in the presence of a hereditary factor, you should contact geneticists;
• it is necessary to get rid of diseases not only dental, but also in general;
• getting rid of bad habits;
• use if small deviations in the location of the crown begin to manifest.

Prevention is best practiced during the early replaceable and dairy bite. If you find pathology in adulthood, then it will have to spend more forces, time and money.

If this disease is not able to cure in a timely manner, then you can face serious consequences. These include:

• violation of natural bite;
• injuries of mucous mouth;