Abnormal abrasion of teeth

Pathological abrasion of teeth is a dental disease, which is characterized by the fact that with an abnormally high intensity there is a decrease in hard dental tissues.

The development of this pathological process affects one tooth, so several teeth can be involved in it. At him also the anatomical shape of the tooth crown is violated.

This dental pathology is a fairly frequent phenomenon and occurs even more often than every tenth person. And most men are susceptible to this disease.

It is necessary, however, to take into account that the actual process of erasing the teeth as such is not something that is not entirely characteristic of the human body. Throughout life, the tissues of the tooth gradually decrease because of their natural physiological erasure.

Thus, during the period from 25 to 30 years, the molars' molars are smoothed and the teeth of the incisors are erased.

Before the age of 40-50 years, teeth are abraded within their enamel.

Those who have crossed the 50-year boundary, dental tissues abrade to the limits of the enamel border with dentin, with partial abrasion of the latter.

In those cases when there is a decrease in the tissue of the teeth with a degree of expression exceeding the existing age norms, this is the basis for saying that there is abnormal abrasion of the teeth.

[1]

Causes of pathological abrasion of teeth

The causes of abnormal abrasion of teeth often lie in the presence of an abnormal occlusion in a person. A factor that largely determines the development of this disease is the presence of a direct and deep occlusion, in which tooth enamel is especially quickly erased and dentin is exposed.

The erasure of dental hard tissues can occur as a result of the increased strain on the remaining teeth after one or more teeth have been lost.

To lead to this dental pathology can improperly spent dental prosthetics.

Among the most common causes, due to which teeth are abnormally abraded, is bruxism. This disorder is characterized by abnormal chewing activity with involuntary clenching of the jaws and friction of the teeth against each other. There is a similar for the most part, when a person sleeps, so this phenomenon can also be considered one of the sleep disorders.

Pathological abrasion of teeth can manifest itself as a negative concomitant phenomenon associated with a person's professional activity. There is it when it works for a long time under conditions in which in air in the room there is a large small number of particles that can produce a mechanical abrasive effect on the teeth. Or, if you have to deal with acids, the evaporation of which also has a negative effect on the condition of the teeth.

As a cause of tooth erosion, there are often disruptions in the development of teeth that can occur due to hereditary factors, and in addition, the presence of such dental diseases as hypoplasia, fluorosis, etc.,

Abnormal abrasion of teeth can also occur against the backdrop of all kinds of abnormalities in the functioning of the endocrine system, the thyroid gland, the pituitary gland, etc. This dental abnormality can be triggered by diseases of the central nervous system, often resulting from chronic intoxication of the body.

The causes of abnormal abrasion of teeth in relation to the strength of the negative impact and the intensity of the unfavorable factor cause different degrees of decrease in hard tissues of the teeth, each of which is classified based on inherent characteristics of pathological changes.

[2], [3]

Symptoms of abnormal abrasion of teeth

Symptoms of abnormal abrasion of teeth have as their main manifestations the formation of sharp edges of the enamel shell of teeth due to the erasure of enamel and dentin. Due to this in many cases, the mucous membrane is traumatized on the inner surface of the cheeks and lips.

If you do not take timely measures to treat this disease, teeth are shortened, bite is broken. Adverse phenomena occur with the face - it decreases in the lower third, in the corners of the mouth there is the appearance of pronounced nasolabial folds.

The change undergoes the position in which the temporomandibular joint is located, in connection with which in its area there are pain symptoms that also spread to the tongue. In some cases, even deterioration of hearing can be noted.

Teeth defeated by pathological erasability processes begin to acquire increased sensitivity to various kinds of irritants of mechanical, chemical and temperature properties. This manifests itself in the painful reaction of the teeth to hot or cold, sour, sweet food, etc.

Pathological abrasion is largely fraught with a threat of increased likelihood of occurrence and development in the affected teeth of carious cavities. In turn, it can provoke pulpitis. Activation of pulp protective mechanisms can trigger the mechanisms of secondary dentin formation. If this happens, then the hypersensitivity of the teeth may not be noted.

All these symptoms of abnormal abrasion of teeth in their totality are indicative of the need to begin appropriate treatment. However, in order to select the necessary rational medical measures for this dental pathology, it must be preceded by appropriate diagnostic measures.

Classification of abnormal abrasion of teeth

Classification of abnormal abrasion of teeth is carried out, first of all, on the basis of division into groups of physiological and pathological abrasion.

The physiological erasure of the teeth is classified by its manifestations characteristic of each specific age of a person throughout life.

Thus, from the 25th to the 30th years, the molars of molars and premolars are smoothed, the teeth of the incisors are abraded.

Teeth in the process of their abrasion approach the limits of enamel to 45-50 years of age.

In people older than 50 years, the erasure of teeth reaches the border of enamel with dentin and to some extent extends to dentin.

Pathological abrasion of the teeth may differ localized (from 1 to 2 teeth) or generalized (multiple teeth, up to the whole dentition) coverage of abrasion of hard tissues.

At the 1 st degree, abrasion does not go beyond the enamel, sometimes only partially affecting the dentin.

The 2nd degree is limited to the area of abrasion covering the limits of the main dentin. The cavity of the tooth is not translucent at the same time.

The third degree characterizes the fact that the dentine is subjected to abrasion, in which there is a transmission of the dental cavity.

In the presence of the 4th degree, the entire tooth crown is worn.

As we see, the classification of pathological abrasion of teeth provides for the division of this disease into subgroups according to the criteria for the number of teeth affected by this pathological process, the degree to which the teeth were erased, and the forms of abrasion of hard tooth tissues.

[4], [5]

Forms of abnormal abrasion of teeth

The main forms of abnormal abrasion of the teeth are horizontal and vertical.

The horizontal form of erasability can be manifested in the onset of this pathological process on the teeth of both the upper and lower jaws. It is characterized by the fact that the hard tissues of the tooth decrease predominantly in the horizontal plane. This process is accompanied by a loss of cutting edges and bumps in the chewing teeth, and subsequently the height of the crowns decreases. When the negative progress of the disease continues for a long time, there is practically nothing left of the crowns except for small stumps, slightly protruding above the gum.

With the vertical form of abnormal abrasion, the teeth of the upper and lower rows appear to be stitched in the places where they are in contact. This form is inherent in the loss of hard tissues of the teeth, which occurs from the side of their surface that is on the palate on the upper front teeth, and on the lower ones - from the side facing the lips.

In some cases of increased erasure, only one of the jaws is affected. This form of this dental pathology is characterized by the formation of horizontal zones in which there are fascinating facets similar to craters. On the molars, their edges can be confined to residual fragments or dentin, forming a kind of corolla.

In addition to these basic forms, which can take abrasion of the teeth, there are also mixed, stepped, patterned, honeycomb.

Regardless of the form of abnormal abrasion that may occur in a person, it should be noted that as a result of this disease, the sharp edges of the enamel covering the tooth eventually form and they are able to act as a traumatic factor for the very sensitive to all mechanical effects of the oral mucosa .

[6], [7]

Diagnosis of abnormal abrasion of teeth

Diagnosis of abnormal abrasion of the teeth is carried out through a comprehensive examination of the patient, adhering to a certain existing scheme.

First of all, the patient's history and history are carefully studied, his complaints are listened to, after which a general external examination is carried out, paying special attention to examination of the oral cavity organs.

As a further diagnostic measure, the medical specialist should be palpated with chewing muscles, temporomandibular joint, etc. By this action, it becomes possible to detect soreness, the presence of muscle swelling, and to reveal a hypertension state. And if there is a hypothesis that there is a parafunction, assign an additional diagnosis, for example, electromyography. In addition, palpation of the temporomandibular joint helps to identify pathologies that are frequent in the pathological abrasion of teeth of generalized or localized type, which is burdened by partial adentia.

Then auscultation of the temporomandibular joint is performed, and in case of need the patient is sent to undergo diagnostic procedures using the methods of sight and panoramic teeth and jaws of radiography, electrodontodiagnostics, roentgenotropholometry, arthrography, tomography, electromotonometry.

Thus, the diagnosis of abnormal abrasion of the teeth involves both examining the patient, especially the maxillofacial area, and then attracting all sorts of technical diagnostic methods in order to more accurately determine the objective condition of the patient and based on the data obtained, to prescribe the required treatment. Accurate diagnosis in many cases is an absolute guarantee of successful cure.

[8], [9]

Treatment of abnormal abrasion of teeth

Treatment of abnormal abrasion of teeth is based on an individual approach to each patient based on the reasons for this disease, at what stage of pathological progress it is, its nature, and also the characteristics of the patient's body.

The first task in the treatment of this disease of teeth is to establish what, first of all, provokes pathological abrasion of teeth, and based on this, take appropriate measures aimed at eliminating this negative factor.

In this regard, there may be a need for a complete sanation of the oral cavity, which becomes particularly relevant in the treatment of hypoplasia, dental fluorosis, etc.

One of the required conditions is capable of the option in which you first need to heal bruxism, or it takes some time to wear special kappa.

Great importance for the treatment of abnormal abrasion of teeth can be the removal of an incorrect bite and the timely dosing of teeth.

Perhaps in some cases it makes sense for a person to think about the possibility of changing jobs or optimizing working conditions, if by occupation he has to deal with acids, soda, abrasive substances.

Actually, the process of treatment of abnormal abrasion of teeth consists in grinding off all sharp edges of worn teeth in order to make them trauma-safe for the mucous membranes of cheeks, lips, and tongue. At the initial stages, when the disease does not exceed 1 st and 2 nd degree, prosthetics is carried out using crowns of cermets and metal alloys. The third and fourth stages require prosthetics in conjunction with the orthodontic treatment of bite.

Orthopedic treatment of abnormal abrasion of teeth

Before starting the orthopedic treatment of abnormal abrasion of teeth, it is necessary to determine what is the main etiological factor, with the most possible justification, to identify in what form and at what stage this disease is located - generalized or localized, compensated, or decompensated. It is also necessary to give an objective assessment of the condition of the tooth crowns and periodontium on the basis of their radiography, as well as conduct an orthodiagnosis of the pulp, ascertain the presence of possible changes in appearance and joint.

As a result of orthopedic treatment, the normal functionality of the jaws is restored, which is manifested in the improvement of the masticatory function, and it is also a factor that positively influences the aesthetic aspects of the patient's appearance. Prosthetics performed during abnormal abrasion of teeth also play an important role in prevention in order to protect hard teeth from further abrasion. In addition, it has not the last significance for preventing diseases that can develop in the temporomandibular joint.

In the early stages of pathological abrasion of teeth, the main task is to minimize the possibility of its further progression. Treatment in this case is mainly preventive. Prescribed therapeutic measures using appropriate medications and the use of physiotherapy methods.

If in the course of conservative medical effects, their insufficient effectiveness is noted, there are indications for orthopedic treatment. Its essence consists in restoring the form and function of the teeth subjected to irregularities with the help of removable or non-removable prostheses, based on the appropriateness of using one or another of their types.

In the presence of minor violations of occlusion, the edges of the teeth, protruding and thinned by abnormal abrasion, are selectively selected.

The degree of loss of dental hard tissues determines which type of prosthesis is most suitable in a particular case. So if the hard tissue of the teeth is worn from 2 to 3 millimeters and from the vestibular side is not broken anatomical shape, tabs are applied. They should cover the entire occlusive surface on which the abrasion occurred, as a result of which the form of such tabs can be the most diverse. As retention points for the tabs, there are cavities formed by caries, cavities present in the dentin, as well as retentional pins. To the application at given scales of pathological dullness of teeth artificial crowns of all kinds are allowed.

Pathological sirativeness of teeth generalized with a decrease in dental hard tissue by 2-3 mm suggests that you can use both tabs and crowns covering the teeth in the opposite dentition - chewing on the right and left sides, and the front.

With regard to the material of the crowns, it should be noted that the all-cast metal is optimal, since metal stamped can be moved deep into the gingival pocket, leading to the destruction of the circular ligament of the tooth, and provoking inflammation in the marginal periodontium. They also wear off for a shorter time.

Orthopedic treatment of abnormal abrasion of teeth, therefore, is regulated by a variety of various factors. It is aimed at achieving two main goals - therapeutic to ensure normal chewing functions, and preventive to prevent further abrasion of dental hard tissues.

Prevention of abnormal abrasion of teeth

Prevention of abnormal abrasion of teeth is the need to protect them as much as possible from the impact of all kinds of negative factors.

If a person has to work with acids on the basis of his work activity or in conditions when there is a large number of abrasive particles in the air, a dense mask or respirator should be worn. Such a protective agent will prevent them from entering the oral cavity. And from the negative effects of acid evaporation as a preventive measure, regular mouth rinsing with a soda solution is possible.

If the friability of the front teeth is detected, which becomes apparent in the course of pathological erosion in the first place, you should not postpone visiting a medical specialist. In this connection, it must also be remembered that only a highly qualified dentist should be trusted.

The basis for an immediate visit to him should be the appearance of symptoms inherent in this disease. And this is the appearance on the tooth enamel of areas of yellowness, increased sensitivity of teeth to hot or cold, etc.

Proper organization of the human diet is also an important preventive factor. A person needs to pay due attention to what and how he uses for food. In particular, it is better to drink acid-containing beverages through a tube.

When abnormal abrasion of the teeth is at the initial stage, a preventive tool can be the use of kappas from silicone or acrylic. Kappas are dressed for the night before going to bed, or they can be worn all the time.

In cases where hard tooth tissues have undergone considerable abrasion, the mouthguards often fail. Then it is advisable to use veneers, ultras, crowns.

Prevention of abnormal abrasion of the teeth, for which all that is required of a person - is to adhere to simple and not very complex rules, is aimed at preventing this disease. After all, any disease is easier to prevent, than later to deal with the myriad of its negative consequences.

Prognosis of abnormal abrasion of teeth

Physiological abrasion of teeth is a natural process and does not call for any medical measures directed against it. However, if the loss of hard tissues of the tooth acquires a large scale, you need to seek medical help. When the medical specialist draws up an individual scheme of treatment and prophylactic measures, the causes of this dental pathology, its nature, and the degree that the disease acquired during development are taken into account. The forecast of abnormal abrasion of teeth at the modern level of dental treatment in most cases seems favorable.

Among the fundamental factors contributing to the successful cure of this disease is the timely correction of malocclusion, treatment of bruxism, the implementation of the necessary denture. In some cases, in order to eliminate negative effects on the condition of the teeth, it may be necessary for a person to change jobs, or to optimize the working conditions of his current activities, to take care of personal protective equipment against unfavorable production factors.

To be sure that the prognosis of abnormal abrasion of the teeth will be positive, give rise to existing progressive orthopedic and orthodontic methods. Thanks to x application, it becomes possible to restore both the impaired functionality of the teeth and to provide aesthetics of the patient's appearance.