Anomalies of jaw development
Last reviewed: 23.04.2024
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Anomalies of the development of the jaws can be congenital or arise due to the transferred diseases, radiotherapy, trauma.
Congenital clefts of the alveolar process and hard palate are the most common defect, they are recognized clinically. In 20-38% of cases, the defect is genetically determined. Clefts of the alveolar process and the hard palate are often combined with abnormalities of the teeth (superfine, retaned teeth, absence of rudiments), incorrect location 4321234. With this anomaly, a delay in the formation of permanent teeth, underdevelopment of the alveolar process, deformation of the nasal cavity. For recognition of clefts, panoramic radiography should be preferred.
The clefts of the hard palate can be combined with crevices of the soft palate and upper lip (in 50% of cases), they are complete and incomplete, one-sided and bilateral, localized in the area of the lateral incisor and canine, rarely between the central incisors, very rarely in the midline of the lower jaw . One-sided crevices are usually of a bulbous shape, two-sided ones are represented in the form of a slit-like clarification with even, clear contours.
Dysostosis - a violation of bone development as a result of an inherited family disease of the bone system. The most important varieties are the clavicle-cranial, craniofacial and maxillofacial dysostosis, hemifacial microsomia and Goldenhar syndrome.
Children with clavicular-cranial dysostosis have hypoplasia of the facial bones, jaws, mainly the upper (the maxillary sinuses are underdeveloped), and the integumentary bones of the skull in combination with complete or partial underdevelopment of one or both of the clavicles. There is an induration or later infection of cranial sutures or fontanelles, convex forehead. There is a false impression of the presence of a lower macrognathia (an apparent increase in the lower jaw). There are violations of the formation of roots, a delay in the eruption of dairy and permanent teeth, often there are supercomplete teeth. There are violations in the formation of pelvic bones, shortening of the fingers, lengthening of the metacarpal bones.
Cranial-facial dysostosis - underdevelopment of the bones of the skull, brain, upper jaw, nasal bones, pronounced lower macrognathia. In patients, premature closure of cranial sutures, exophthalmos, strabismus, nystagmus, and visual impairment are noted.
In the x-ray picture of maxillofacial dysostosis (Franceschetti syndrome), the main symptom is the bilateral underdevelopment of the zygomatic bones and zygomatic arches.
Disturbances of bones and soft tissues on the right and left side can be expressed unequally. The large mouth (macrostomy) gives the person a distinctive "fish" or "bird's" face, wide-spread eye fissures, dysplastic development of the teeth, deformation of the auricles, sometimes disturbances in the middle and inner ear with deafness according to the sound-conducting type. Changes from the side of the maxillofacial region are combined with abnormalities of the thorax and spine (supercomplete vertebrae, block of upper cervical vertebrae). Inheritance by the dominant type is noted.
Congenital malformations of the first and second branchial arches are manifested in the form of syndromes of hemifacial microsomy and Goldiehar. The changes are unilateral and are manifested by hypoplasia of the condylar process or condylar and coronary processes of the lower jaw, zygomatic bone and arch, upper jaw and temporal bone. It was noted that the malformation of the lower jaw is a kind of indicator that indicates changes in other bones of the skull. These children also have anomalies in the development of the spine and urinary tract.
If suspicion of congenital changes associated with the developmental defects of the first and second branchial arches, orthopantomograms and radiographs in the chin-nasal projection are informative enough. When planning reconstructive operations, it is necessary to perform craniometry using teleradiography. In children with Down's disease, the first milk teeth appear only to 4-5 years, sometimes remain in the dentition up to 14-15 years.
In children who have a reduced thyroid function, there is a delay in the eruption of dairy and permanent teeth, multiple dental caries, and underdevelopment of the jaws.
With insufficient activity of the anterior lobe of the pituitary gland, the roots of the baby teeth sometimes do not resolve and persist for life, permanent teeth do not tend to erupt. The removal of milk teeth in these cases is not shown, since one can not be sure of erupting constants. There is a primary adentia.
Hyperfunction of the pituitary gland at an early age causes an increase in root growth with a normal crown size, diastemes and tremas are formed, shortening of the timing of eruption and loss of temporary teeth, hypercementosis at the tips of the roots. There is a need to change removable and non-removable prostheses.
Post-traumatic deformations and deformations caused by osteomyelitis cause a one-sided violation of teeth closing. In children and adolescents, trauma to the condylar process and joint can lead to the development of arthritis with a violation of the development of the corresponding half of the lower jaw on the side of the lesion (micrognathia), in adults - to arthrosis.
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