Prosthetics for malocclusion. Here are some examples of the work of Dial-Dent specialists. Identification of malocclusion

Dental implants

Implantation - The best way reconstruction of the missing elements of the dentition. After a series of procedures, the bite looks aesthetically flawless, the functions of the chewing apparatus are fully restored. Unfortunately, the installation of implants is not for everyone. Let's take a closer look: How is implantation carried out? Who can't do it?

There are a number pathological conditions organisms that make dental implantation impossible. Doctors of the clinic "My Orthodontist" carefully study the anamnesis of each patient. What conditions should be excluded?

• Violation of hemocoagulation (the process of blood clotting). Implantation is always accompanied slight bleeding- this is normal. If you ignore the pathology of blood clotting, there will be serious complications.
• Diabetes mellitus (today it is not an unconditional contraindication, but the operation can be performed only in patients with compensated type II diabetes. With type I diabetes, implantation is not indicated).
• Autoimmune and inflammatory pathologies of connective tissue. These conditions will interfere with the healing of periodontal tissues.
• Any malignant neoplasm.
• HIV and venereal diseases.
• Open form of tuberculosis.
• Immune disorders (they will interfere with tissue healing and bone regeneration).
• Osteoporosis.
• Mental and nervous diseases, addiction. Implantation requires a restrained behavior from the patient, compliance with all medical recommendations. People with neuroses, mental and behavioral disorders may not be able to cope with this task.
• hypertonicity facial muscles(chewing muscle).

There is relative contraindications which hinder immediate implantation. They can be eliminated surgical methods, cured therapeutically or resolved naturally. These "temporary" bans include:

• carious teeth, tartar;
• inflammation of the gums, temporomandibular joint;
• malocclusion and jaw defects;
• infections and inflammation of the oral mucosa;
• partial resorption bone tissue gums (for correction is carried out bone grafting, sinus lift);
• smoking, alcoholism;
• pregnancy.

There are a number of general health contraindications. Implantation should not be carried out when the patient is exhausted, weakened by long-term illnesses, or has anemia. In case of intolerance local anesthetics procedures will also fail. Dental implants can lead to deterioration in the condition of "cores", rheumatic patients, people with CFS and chronic stress. Taking immunosuppressants and some other medicines may prevent postoperative healing fabrics.

Implant placement is a complex procedure, but it can be made as easy as possible by following simple guidelines.

• Don't worry. Before the procedure, you can take a herbal sedative preparation: valerian extract, motherwort tincture or decoction.
• Do not go to the procedure on an empty stomach, be sure to eat.
• Check again if your teeth and mouth are healthy. Tell your doctor about any suspicions - infection at the time of surgery is unacceptable.
• Do not smoke, do not drink alcohol even the day before.
• Strictly follow medical prescriptions throughout all stages of implantation.

It is better to make an appointment with an implantologist at the beginning of the day: human psyche in the first half of the day it is easier to cope with stress.

After studying your history and eliminating contraindications, you can proceed with the operation. If no preliminary surgical procedures are required for implantation, the procedure will consist of three successive stages.

First stage. Under local anesthesia a recess is made in the jaw where the implant is inserted. From all sides, the intraosseous element is covered with mucous. It takes up to six months for it to fully grow into the bone tissue of the jaw. The control of ingrowth is carried out by X-ray.

Second phase. Under local anesthesia put a gum shaper to give the tissues a natural anatomically shaped. After a few days, if there are no complications and the patient does not notice discomfort in oral cavity, the shaper is changed to a titanium abutment - a cylindrical screw that acts as a transitional element between the implant and the artificial tooth. Prosthetics are appointed in one to two weeks.

Third stage. An orthopedic dentist takes a cast of the jaws, which serves as a model for creating a prosthesis. A dental technician makes a crown. You will be tried on the manufactured design several times; The prosthodontist will adjust the crown to a perfect match with the adjacent natural teeth.

The result of a series of procedures will be a completely restored dentition. High-quality implanted teeth cannot be visually distinguished from real ones.

The risk of complications or an unsuccessful result during implantation is possible - usually such an outcome is associated with mistakes by implantologists. Sign up for the procedure only in a trusted clinic with a good name, study patient reviews, do not be afraid to inquire about licenses medical institution and qualifications of physicians.

Implantation is considered a low-traumatic intervention. The intraosseous element takes root in 97-98% of cases. A successfully placed implant completely fuses with the surrounding jaw tissues. Specialists of the clinic "My Orthodontist", observing the treated patients, note the durability of "new" teeth and normal condition surrounding tissues.

The success of the operation depends on the coordinated work of the team of specialists and the behavior of the patient. Before the operation, the doctor will consult you on oral hygiene, tell you what pastes, brushes, flosses you need to buy. Regular care of implanted teeth is easy.

At the end of the main procedures, a schedule of inspections is drawn up. You will visit the doctor once every six months (in some cases - every 3 months). On the preventive examination the specialist will evaluate the quality of oral hygiene and the condition of the jaw tissues.

Dental implantation is a progressive method of restoring the chewing apparatus and a beautiful smile. This is a complex multi-stage process, but the result is worth it!

As a rule, the need for dental prosthetics is obvious: it occurs when the tooth is destroyed. At the same time, many people do not notice malocclusions and live with them for years - until they find themselves in the office of an implantologist. And here they can expect unpleasant news: due to problems with the bite, implantation cannot be performed immediately. What is the relationship between these two areas of treatment?

Correct and incorrect bite

Bite is a way of closing the dentition. Correct, or orthognathic, bite is one in which the upper incisors cover the lower ones by 1/3 evenly along the entire row of teeth. If the lower jaw is too forward or, conversely, pushed back, the teeth close differently - such a bite is incorrect.

There are several types of malocclusion, but a common problem one: improper closure of the dentition leads to an increased load during chewing. Enamel, especially the incisal edge, wears out faster, and the roots of the teeth can suffer from malnutrition. If the bite is not corrected, the problem can lead to tooth loss in the future.

Why bite affects prosthetics?

Implant placement is a complex multi-stage procedure that requires extremely accurate calculations. Its first stage - the implantation of the implant - should be carried out after the diagnosis, which will show the doctor how the roots of the teeth are located in the jaw, whether the bone tissue is thinned. The doctor must calculate the place and angle of the implant. If the teeth are in wrong position, there may simply not be a suitable place for installation! A conscientious specialist in this case will refuse to perform the operation. Indeed, in this case, the implant with highly likely may not take root - an incorrectly distributed load on the teeth during chewing will interfere.

What to do?

Correct malocclusion - and as soon as possible. Even if it's too early for you to think about implants. When visiting a dentist, you will probably hear about malocclusion, if you have them. In this case, do not postpone a visit to the orthodontist. The sooner you correct your overbite with braces (and this is far from being as long as it seems), the more likely that a healthy, correct arrangement of teeth will allow them not to collapse (as a result, implantation will not be needed at all).

Braces and a cup of coffee

Agree, having addressed to the doctor-implantologist, it is unpleasant to hear refusal in carrying out treatment. Or find out that it is possible only after wearing braces. It is much more profitable to immediately correct all problems with the location of the teeth and in the future only maintain their health by visiting a doctor at scheduled appointments.

But what if the cost of orthodontic treatment seems too high for you? Specially for you in the clinic "Super Smile" there is a promotion: modern, effective and very beautiful Damon-Q braces for the price... only 3,000 rubles a month, or 100 rubles a day! That's less than a cup of takeaway coffee from a coffee shop.

For this money you get fast, comfortable treatment and the result is perfect smile. Straight, correctly closing teeth are a guarantee that they will not suffer from increased load, they will be easier to clean, which means that you will protect yourself from caries and other diseases that lead to tooth loss for a long time.

Most likely, you simply do not need implantation. But even if you need to undergo such treatment, you can do it without laying time for alignment of the bite.

Treatment must be comprehensive.

Experts distinguish two degrees of occlusion violation:

1. Jaw displacement. With a slight displacement, implantation is possible. Sometimes in similar situation the problem can be corrected by the use of dentures. When there is severe misalignment of the jaws, implantation is likely to be denied.
2. Misaligned teeth. When the roots of adjacent units do not interfere with the installation of the implant, pay attention to aesthetics. If it is not possible to achieve the ideal look immediately, alignment with a bracket system is required. Another option is to remove interfering units.

For more exact definition clinical situation, preliminary x-ray examination oral cavity and take casts of the jaws.

Minor deformities include:

• lack of space in the dentition for the installation of a full-fledged crown on the implant;
• inclination or incorrect rotation of some teeth;
• large gaps between teeth.

With minor violations, implantation can be carried out. However, the patient is informed of possible risks. If he is ready to put up with it, the procedure is performed.

With a pronounced deformation of the bite, it is impossible to install titanium roots until the alignment of the dentition. For this purpose, preliminary orthodontic treatment is carried out. Otherwise, there is a risk of fixation and strengthening of the deformity, which can even harm the patient. Therefore, the implant surgeon may refuse to perform implantation.

What is the dentition and why deviations occur

The dentoalveolar system refers to the upper and lower jaws, as well as all their constituent elements:

• temporomandibular joints;
• gums;
• chewing muscles;
• teeth;
• bone tissue;

When all the teeth are in place, the occlusion is correct, and there are no inflammatory processes in the oral cavity, then dental system normal and functioning well. At the same time, the teeth are able to withstand maximum chewing loads and are not injured. In the presence of defects, chewing dysfunction occurs, which creates obstacles for the installation of implants. The most common abnormal changes in the dental system are:

• bite deformity - displacement of the jaws relative to each other;
• incorrect arrangement of teeth, the presence of gaps between them;
• anomalies in the structure of the bone tissues of the jaw;
• loose bone structure or its atrophy.

Experts distinguish five types of deformation:

• deep- when the bottom row is almost completely covered by the top one;
• distal- the upper jaw protrudes significantly forward compared to the lower;
• mesial- sagittal anomaly of occlusion, when the chin (lower jaw) strongly protrudes forward;
• open- partial or complete non-closure of teeth;
• cross- a transversal anomaly, in which one of the jaws is only partially formed or is displaced to the side from the other.

because of not correct bite the load on the jaw is unevenly distributed, which leads to premature destruction of the units located in the zone of maximum pressure. If there is an implant, peri-implantitis may develop, which provokes rejection. Therefore, before the implantation of titanium roots, all problematic points are necessarily eliminated.

What could be the consequences if implants are installed and the anomaly is not corrected?

Before implantation, it is important to consult with an orthodontist in order to select methods for correcting existing defects in advance and plan the stages of treatment. Otherwise, the following complications may occur:

• violation of the integrity of the temporomandibular joints (clicks, crunch, pain appear);
• destruction of certain teeth subject to the greatest chewing load;
• increased abrasion of tooth enamel;
• premature loosening of the artificial root and development inflammatory process(peri-implantitis);
• psychological discomfort and internal discontent;
• reduced service life of the implant due to uneven load on it;
• chronic headaches resulting from pressure nerve endings and muscle spasms;
• exacerbation of the deformity.

Can an overbite be corrected if the implant is already in place?

Correction of violations of occlusion after implantation is not carried out. The fact is that the artificial tooth root after osseointegration becomes absolutely immobile in the jawbone. This is its main difference from natural, which is a little springy or "damping" and can be artificially moved.

The implant after engraftment is motionless and cannot be moved

The titanium rod is implanted at a certain angle and repeats the position/tilt natural teeth. When living units begin to move, the implant moves with them, which can provoke rejection. Therefore, bite correction is always carried out before implantation.

If the patient has implants in his mouth and occlusion correction is required, they are removed. This is followed by orthodontic treatment and re-implantation of titanium roots, taking into account the formed occlusion. There are single exceptions - when the implant is installed before the defects of the jaw closure are corrected, and then the own teeth are displaced, attracting or repelling them from the immovable metal root.

Price

Dentists joke that twice God gives teeth to a person for free, and you have to pay for the third. Teeth are not capable of self-healing. Losing even one is not as harmless as it might seem. In addition to aesthetic discomfort, facial features change, chewing function and digestion are disturbed. Dental implantation comes to the rescue - you can return a beautiful smile quickly and forever. About all the nuances of restoring teeth with implants, tells the implant surgeon and orthopedist of Vimontale dentistry in Moscow.

How did dental implants come about?

Oscar-winning actors usually thank God and their parents. People who restore their teeth and a comfortable lifestyle with the help of implantation, kind word must remember the Swedish professor Per-Ingvar Brånemark. Quite by accident, he revolutionized dentistry.

In 1965, Brånemark was doing research with a group of scientists. The professor implanted a titanium capsule in the rabbit and was very surprised when he could not remove it. So Lucky case helped establish that titanium fuses with bone. Brånemark decided to use the discovery in prosthetics.

The first lucky titanium implants- Gust Larsson. A simple carpenter, like Professor Brånemark, entered the history of implantology. Larsson, 34, had a completely toothless mouth. Not life, but torment: eating, talking, smiling - everything is difficult. The man himself found Brånemark, accidentally learning about his experiments. There was nothing to risk, and Larsson became the first person in the world to have implants implanted. The patient lived with them for more than 40 years, until his death, proving the effectiveness and reliability of the new method.

The first experience was successful, but the patient Brånemark was in no hurry to announce a revolution in dentistry. The scientist spoke publicly about his discovery 20 years later. The post made a splash! An accidental discovery turned the world of prosthetics upside down and returned a comfortable lifestyle to edentulous patients.

What is dental implantation?

Dental implantation of teeth is the implantation of an artificial root in the upper or lower jaw. The implant is titanium, so it is completely biocompatible. This reliable support for crowns consists of:

• titanium screw (implanted in the jaw during surgery);
• abutment (attached to the implant, resembles a turned tooth).

The answer to the question of whether to do a dental implant is unequivocal: of course, yes. Today it is the most progressive method of prosthetics.

Photos before and after dental implantation

Operation in the posterior part of the chewing teeth.

Placement of an implant in the area of ​​the anterior teeth.

The photo of dental implantation shows clinical case when the patient is completely edentulous upper jaw and missing a few teeth on the bottom.

Leading implant manufacturers

Methods of dental implantation

A variety of methods of dental implantation allow you to choose the ideal option for each patient.

Single stage

For those who do not want to wait a long time and who have no contraindications, dentists offer one-stage implantation with immediate loading. The peculiarity of the method is that temporary prosthesis and the implant is fixed in one session. Only a small incision is made in the gum. The temporary crown is replaced with a permanent one after 3-5 months. During this time, the dental implant finally takes root.

two-stage

Two-stage implantation is time-tested. The operation takes more time, but the risk of complications is minimal - the doctor sees well what he is operating on due to the incision of the gums and the folding of its flap. The abutment is installed six months after the engraftment of the implant, the crown - one week after the abutment. This classical implantation teeth, proposed by Professor Brånemark.

Simultaneous

Simultaneous - implantation takes place simultaneously with the removal of the tooth. It is ideal for anterior teeth where esthetics are at the forefront. For chewing teeth this technique rarely used.

Stages of dental implantation

before implantation. Dental implantation of teeth, like any other operation, requires careful preparation. The result depends on it. The doctor must plan the implantation procedure as accurately as possible and identify all possible contraindications. At the first appointment, the implantologist asks general issues for health. Referral to analyzes and consultations of other specialists is given if necessary. The oral cavity should be healthy - without caries and inflammation of soft tissues. A few days before the operation, you need to sign up for a cleaning.




Anesthesia. As a rule, local anesthesia is used for implantation. Modern drugs completely relieve the patient from pain and discomfort. If necessary, sedation or anesthesia is applied.



1. Installation of an implant. If the process of dental implantation goes without surprises, according to a pre-planned plan, the operation will take 20-40 minutes. First, the doctor will install the implant, then check the degree of primary stabilization, and then decide whether to load it with a crown or not.

Crown fixation. The temporary crown is fixed when the dental implant is firmly anchored in the bone. In case of problems with primary stabilization The implant will be placed only by the gum shaper. A permanent crown can be placed after the complete engraftment of the artificial root, after 3-5 months. An abutment will be fixed on the implant, and a permanent crown will be fixed on it.

How long does the implant procedure take?

Installation of one implant takes no more than 20 minutes. An artificial root takes root from 3 to 5 months. The entire period of treatment and recovery may take a year. The terms are different for everyone, depending on the number of implants - some need to have 6 or more teeth implanted, others need only one. The duration of the process is affected by the volume and quality of bone tissue. There are features in the jaws. On the bottom, the dental implant fuses with the bone faster, in 3-4 months, because the bone is denser. In the upper jaw, its volume is smaller, because of this, the period of osseointegration is longer, 5-6 months. The end of implantation is the fixation of permanent crowns. Occurs after complete healing of the implant.

Types of prostheses based on implants

Implant-supported prostheses are securely attached to the jaw. There are several types of orthopedic structures. A suitable doctor will help you choose.

• Not removable dentures. Crowns are placed on the implants, outwardly such teeth are no different from real ones. The method is suitable for the loss of one tooth or several in a row.


• Bridge-like fixed prostheses. A bridge instead of single crowns is an economical option for the patient. Used for an area with several missing teeth in a row. Minimum - 2 implants.


• Removable dentures. As a rule, they are used for complete edentulous. Installation on the implant ensures that the prosthesis does not fall out of the mouth due to secure fixation. At the same time, it is easy to remove it by unfastening the zippers. The patient chews easily, diction does not change, there is no gag reflex.


• Conditionally removable prostheses. They are very similar to removable dentures, but they cannot be removed without the help of a doctor. The prosthesis is fixed not with locks, but with screws. The most common installation methods differ in the number of implants on which the structure is attached. The minimum can be three, four and six titanium roots.

Implantation of 1 tooth usually does not affect the patient's lifestyle. The installation of several implants, and even with bone grafting, may cause a slight swelling. The problem disappears 2-4 days after the operation. In order for the implant engraftment and recovery process to be successful, it is worth listening to the doctor's recommendations:

1. avoid too hot at first cold food;
2. chew on the side where there was no operation;
3. brush your teeth gently;
4. bath, sauna - postpone;
5. do not overcool.

After bone augmentation - sinus lift - there are more restrictions:

1. do not fly on an airplane;
2. do not dive;
3. do not blow your nose;
4. sneeze and cough with open mouth;
5. do not drink through a straw;

After 3-4 weeks, the restrictions are lifted. Follow-up care after dental implants is no different from oral hygiene with your own teeth. It is also necessary to thoroughly brush your teeth, rinse your mouth after eating, once every six months to pass hygienic cleaning. To regular brush and pasta, experts recommend adding an irrigator. The device is especially useful after complex implantation with restoration. a large number teeth.

Indications and contraindications

Dental implants can be used in the absence of one, several or all teeth. Many are afraid of this technique, considering it a risky business. The list of contraindications is not as large as it might seem.

Absolute contraindications:

• age (the jawbone is fully formed only by 17-22 years);
• blood clotting problems;
• oncological diseases;
• osteoporosis;
• recovery after myocardial infarction;
• cardiovascular diseases in the acute stage;
• diabetes in the stage of decompensation;
• connective tissue diseases;
• alcoholism;
• diseases skeletal system;
• work disruption nervous system;
• chronic insufficiency liver, kidneys;

Relative contraindications:

• bearing and feeding a child;
• active smoking;
• abnormal bite (requires correction);
• acute periodontitis (requires treatment);
• tartar (requires removal);
• diabetes mellitus in the stage of compensation;
• bruxism.

Pregnancy and breastfeeding are relative contraindications to dental implants for women. But doctors still recommend postponing the procedure. Women who are expecting a baby are generally not recommended surgical interventions without special indications, especially in the first trimester, when the laying of the vital organs of the child occurs. Implantation is performed using local anesthesia, after the operation, painkillers and anti-inflammatory drugs are prescribed, before implantation, x-rays. All this is highly undesirable for pregnant women. During pregnancy, immunity is reduced, recovery after implantation may be delayed. Breast-feeding- Another reason to postpone implantation: medicines are prohibited, and milk can disappear from stress.

Feelings during surgery

Installing 1 implant feels like removing one tooth. Doctors make this comparison when patients ask them what to expect from dental implant surgery. In most cases, artificial roots are implanted under local anesthesia. But patients who start to worry even before the start of the operation are sedated with local anesthesia. This is not an anesthetic, but a sedative, relieves stress, anxiety, increases pain threshold. The patient remains conscious, but in a state close to deep sleep. Pain impulses are blocked, fear, anxiety go away, while the contact between the patient and the doctor is maintained. After sedation, there are no memories of the operation, neither good nor bad.

Strong fear, especially difficult treatment, complex implantation of teeth - in these cases, the patient can be put to sleep using anesthesia. falls asleep with toothless mouth, wakes up already with teeth.

Risks of implantation

Survival of implants today is a record - 99%. But no one will ever give 100%, it is impossible to eliminate all risks. Someone will definitely fall into this 1%. Complications during implantation are very rare, but they do happen. During the implantation of an artificial root, the following can happen:

1. Inflammation of the tissues around the implant (peri-implantitis). The doctor will exclude the cause of inflammation, treat the root with special solutions. In case of recurrence, the implant will have to be removed, and the bone tissue will have to be restored.


2. Rejection of the implant. It happens extremely rarely. The artificial root is removed.


3. The implant is unscrewed together with the plug. This can happen during abutment placement. In the absence of inflammation, the titanium root is put in place.


4. The implant is pushed into the maxillary sinus. In such cases, only the removal of the titanium root will help.


5. Exposure of the upper part of the implant. Enough frequent complication, which affects aesthetics to a greater extent than health.

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Surgeon, Therapist, Orthopedist, Implantologist

An overbite is the relationship between the upper and lower teeth. mandible when they close. Correction of bite - achieving the correct relationship of the dentition, is one of the main tasks of any dental treatment, along with proper occlusion (correct tooth contact). That is, a competent physician integrated approach to treatment initially sets the task of achieving the correct bite, correct occlusion, and builds all subsequent treatment on this independently or with the involvement of relevant specialists, the main place among which is occupied by orthodontists.

Contrary to the popular belief among patients that it is necessary to correct the bite mainly from an aesthetic point of view, even small bite pathologies lead to both a deterioration in the condition of the teeth and an overload of the temporomandibular joint, and hence to headaches and other unpleasant consequences. Our country is only on the way to realizing the need to correct the bite in most adolescents, in contrast to Western countries, where the installation of braces is often included in medical insurance, because. treatment of the consequences of malocclusion is much more difficult, longer and more expensive.

Fortunately, currently bite correction in adulthood is an absolutely normal practice, many patients older than 50-60 successfully correct their bite.

Why it is necessary to correct an overbite

Speaking about the need to correct malocclusion, one could enumerate many indirect consequences, such as the effect on digestive system etc. But, despite their importance, for an ordinary person they seem distant and intangible, therefore, let us dwell on the specific consequences of malocclusion and lack of proper contact of teeth:

• In the absence of contact, teeth tend to opposing teeth; with supercontact or improper closing, the teeth are destroyed, tooth abrasion appears. Both cases lead to a gradual loss of teeth, and the process occurs over the years, and not to old age, as many believe. There is sensitivity in the teeth. The installation of one high-quality implant costs from 70-100 thousand rubles, and on the front teeth (which often suffer due to malocclusion), it is necessary to install metal-free crowns, which are even more expensive, but they will not replace healthy teeth. This is not counting the fact that bone grafting is often necessary before implant placement. Thus, bite correction, the prices for which are much more affordable than subsequent orthopedic treatment, has a very specific economic justification.
• Incorrect closure of the teeth leads to an overload of the temporomandibular joint. Previously, this point was given insufficient attention, but modern concepts proceed from the need to create conditions correct operation joint during dental treatment. The consequences of improper operation of the joint appear quickly enough: a crunch, clicks or discomfort appears. Often, headaches are added to them.
• It is impossible not to mention social consequences malocclusion: with medical point vision, they are not so important, but for patients they are usually the decisive factor. AT modern world straight teeth are part of the image of a healthy, successful person. In addition, malocclusion leads to incorrect, unnatural facial proportions. Beautiful smile helps to arrange a personal life, to receive a higher income, it is easier to find contact with people - all this is difficult to measure in monetary terms.

When is an overbite corrected?

Normal (orthognathic) bite is considered when upper teeth slightly overlap the lower ones. There are many other signs - the relationship, location, inclinations of specific teeth, their turn, closure, etc., therefore, only an orthodontist can accurately determine whether a person has a normal bite.

Unfortunately, the bite is not ideal for most of the world's population. However, this is not always a direct indication for bite correction (from a medical, not an aesthetic point of view).

There are cases when it is obvious to the patient that his bite is wrong, the lower jaw is too forward or backward, the teeth do not close, etc. However, most situations are borderline.

Thus, in view of the large percentage of cases of detection of malocclusion, the importance of its correction and the impossibility of determining the need for treatment by the patient on their own, we recommend that everyone, without exception, visit an orthodontist to determine the correct bite, occlusion (tooth closure) and determine the need for treatment, or lack thereof.

It is correct to visit the orthodontist in the following periods of life:

• During the formation of a temporary bite, when the child is 4-6 years old. The doctor will determine whether the bite is formed correctly, give recommendations on the use of children's orthodontic appliances that prevent the formation of bad habits.
• From 6 to 11 years old, the doctor may prescribe treatment with plates or other devices, which later will help simplify the treatment on braces (kappa), or avoid it altogether.
• During the formation of a permanent bite from 11-12 years old (or later, when the doctor prescribes) - the most correct period to control and correct an already permanent bite with braces, mouthguards or other orthodontic appliances.
• At any older age. At the same time, it is not necessary to visit the orthodontist in each of these periods: at the first visit, the doctor will determine how the dentoalveolar system is developing and will give recommendations on the need and time of the next visit.

Contraindications for bite correction

It's hard to talk about absolute contraindications to correction of the bite: there are situations when the doctor together with the patient decides whether it is possible and necessary to correct the bite in each particular case, or how to eliminate obstacles.

What can interfere with orthodontic treatment:

• Serious periodontal disease (gums and everything that holds the tooth in the jaw). When correcting an overbite, the teeth move, therefore, it is necessary that they be fixed in a new place. This can be difficult to do with severe periodontitis - in this case, prior periodontal treatment or abandonment of orthodontic treatment is required.
• Mental illness can interfere with the correction of the bite, because. bite correction is a long process, it is necessary to follow the doctor's recommendations, etc.
• Carious and other lesions of the teeth, poor hygiene- these are overcome obstacles: before starting treatment, the orthodontist necessarily sends the patient for examination to the therapist in order to carry out a complete sanitation.
• Pregnancy is not a direct contraindication. However, it should be borne in mind that the process of bite correction is lengthy, requires visits to the doctor (usually once a month or once every 2 months, depending on the case and the equipment chosen for treatment), which can be difficult during pregnancy. In addition, orthodontic treatment often does not require anesthesia or x-rays, but they may be required if other manipulations are needed - dental treatment or extractions, which sometimes accompany bite correction. And we should not forget that a lot of calcium, resources, energy goes into the development of the child, which can affect the treatment. Although there are many cases in practice when, for example, braces are used during pregnancy, it is better to plan for the correction of the bite for the period after the birth of the child. But if pregnancy occurs during the period of orthodontic treatment, there is nothing to worry about, mouthguards: braces during pregnancy are a completely normal situation.
• Other situations where it is difficult to visit a doctor. For example, long-distance business trips can interfere normal treatment, although many of our patients arrive for appointments from abroad and successfully undergo treatment.
• Allergy to metal and mature age are not contraindications, as it was before: treatment is performed at any age, and other materials can be used instead of metal.
• No matter how strange it may sound, the reluctance to correct the bite is the main contraindication. After all, the process takes quite a long time, it is necessary to follow all the recommendations of the doctor, carefully monitor hygiene, etc. Therefore, in the absence of desire, including in a teenager, when he is forced (and does not explain the need for treatment), it is extremely difficult to achieve a good result.

Types of malocclusion

Normal, healthy is orthognathic bite. When determining one or another type of malocclusion, Angle's classification is most often used, who identified several classes of occlusion. The basis, among other things, is the ratio of the location of the sixth teeth of the upper and lower jaws:

• Class 1 - neutral bite, when the ratio of the teeth of the lower and upper jaw is normal, however, there may be crowding or gaps and other deviations from the normal position of the teeth.
• Grade 2 - distal occlusion when the lower jaw is pushed too far back. If in childhood a distal occlusion is detected, its correction takes place by limiting the growth of the upper jaw, and stimulating the growth of the lower. In adulthood, special equipment is used to push the lower jaw forward.
• Grade 3 - mesial bite, when the lower jaw is too advanced forward. Correction of the underbite, especially when the size of the lower jaw is too large, is a rather complicated and lengthy process with the use of additional functional devices.

These types of bite can be combined with the following anomalies in the location of the teeth:

• Deep bite - upper incisors overlapping too much lower teeth, the lower teeth do not rest on the tubercles of the upper incisors, biting off food is difficult, and therefore it is very important to start correcting a deep bite as early as possible. Often combined with a distal bite.
• Open bite - the incisors of the upper and lower jaws do not close due to the presence of a gap between them; the upper teeth are often tilted and project forward.
• Cross bite - when the teeth of the upper and lower jaw intersect; also there may be no intersection in the anterior region, but due to the displacement of the lower jaw laterally, the lower teeth may overlap the upper ones; there is no normal contact; a person usually chews food on one side. Correction crossbite very important, because missing normal function chewing food.
• Crowding - Teeth are misaligned due to lack of space. This is one of the most common pathologies. Often the result of macrodentia (large teeth), and can also occur after the eruption of the last, eighth teeth (wisdom teeth).
• The gaps between the teeth are the opposite of crowding anomaly. Including, diastema - the gap between the first incisors.
• Displacement of the center is a common anomaly, and sometimes the result of incorrect orthodontic treatment, when there is no symmetry: the center of the upper and lower jaws (which is located between the front incisors) should be in line with the nose.
• Progenia is a more general concept than underbite, when the anterior teeth of the lower jaw are in front of the anterior teeth of the upper jaw. In this case, the bite can be neutral.

bite correction methods

Correction of bite is a complex task, which involves doctors of various specialties, and the orthodontist plays a leading role in planning and treatment. Based on the age of the patient, the type and degree of pathology, as well as the wishes of the patient, one of the following methods to correct an overbite:

• Plates are removable orthodontic appliances, usually installed in childhood (up to 11-12 years old). They are made individually for the patient from plastic mass.
• Braces - most commonly used in correcting an overbite over the age of 11–12 years.
• Mouthguards are a modern alternative to braces. They are removable and made of transparent plastic individually for the patient.
• Trainers are removable orthodontic appliances, usually made of silicone. As a rule, the purpose of their application is to solve a specific problem within the framework of complex treatment(muscle relaxation, getting rid of thumb sucking habits, etc.).
• Functional devices such as Herbst apparatus, Twin Force Bite Corrector, TwinBlock, etc. also help to solve a specific problem within the framework of complex treatment - to expand the jaw, move the jaw, etc. In addition, there are many other devices that are used in conjunction with braces or mouth guards to solve specific problems when correcting an overbite.
• Orthognathic surgery - it is resorted to in rare cases. it surgery to correct bite by changing the shape of the jaw. It is usually also accompanied by orthodontic treatment.
• Installation of crowns, veneers - strictly speaking, bite - the ratio of the location of the teeth, but also when correcting the bite, they achieve the correct occlusion (correct closing of the teeth). Both tasks can be solved without moving the teeth, but by installing dentures or changing the shape of the teeth with the help of veneers. I must say that this method should be used strictly according to indications (i.e., healthy teeth should not be turned to install crowns if orthodontic treatment is possible). Also orthopedic treatment can be used in combination with orthodontic, when the correct occlusion cannot be achieved by one movement of the teeth.

Stages of bite correction in orthodontic treatment

Correction of the bite is divided into several important stages: the neglect of each of them will make the entire treatment in vain, or even harmful to health.

Diagnostics, planning, preparation

Any quality treatment should be based on correct diagnosis correctly diagnosed. Diagnosis in orthodontic treatment includes the following procedures:

• Examination of the patient, determination of the correct bite, occlusion. Determination of the need and possibility of treatment.
• Panoramic X-ray of teeth (OPTG, Orthopantomogram) is an X-ray examination. The picture shows all the teeth of both jaws at once. This image is obligatory in our clinic for all patients: it can be used to evaluate general state teeth, the condition and location of the roots, which is important when moving them, as well as to see unerupted teeth, the existence of which patients sometimes do not even know.
• A teleroentgenogram (TRG) is also an X-ray study made from a certain distance, which allows you to most accurately convey the dimensions and proportions of the jaws. Usually a lateral x-ray is taken, according to which the orthodontist can make the necessary calculations. This study It is not always carried out, as directed by a doctor.
• Taking casts and making plaster models - an exact copy of the patient's teeth - allows the orthodontist to see the picture most fully and make calculations for treatment planning.
• Computed tomography (CT) has recently been increasingly prescribed by doctors of all specialties, because it allows to reveal the smallest, hidden defects of bone tissue in a three-dimensional form.
• Photographing is a possible, but not obligatory element of diagnostics during treatment with braces. Usually required in the treatment of mouthguards, because. aligners are modeled remotely and photographs of the patient are required.

Based on a complete set diagnostic procedures, the orthodontist plans treatment:

• Calculations are made on the basis of plaster models and TRG: an orthodontist cannot simply estimate by eye how the teeth will stand as a result of treatment. Accurate calculations are needed to understand whether there is enough space for the teeth (or vice versa, there is too much of it), how the teeth will stand as a result of the treatment.
• Based on the calculations, examination, a treatment plan is drawn up. The need for separation (grinding the teeth from the sides) or extraction of teeth in case of insufficient space is determined. The tactics of treatment, the need to expand the jaw, the need to use rods to move the jaw, other functional devices, etc. are determined.
• Orthodontic equipment is selected for bite correction, treatment methods: braces, mouthguards or other instruments, including based on the wishes of the patient, aesthetic considerations and how much it costs to correct the bite on this equipment.

Preparation for treatment includes:

• Sanitation of the oral cavity. Before correcting the bite, it is necessary. put all the teeth in order, cure caries, remove tartar and plaque.
• Gum treatment if necessary.
• Sometimes, according to the doctor's prescription, it may be necessary to wear removable trainers before starting treatment.

Orthodontic treatment

First stage

If occlusion correction with braces was chosen, first of all, they are installed. Often braces are placed first on one jaw, and in the next appointment on the other. Installation consists in gluing the actual braces (small metal locks) on each tooth and fixing the arc on them. It is the arc that pulls the teeth in a given direction. There is direct and indirect installation of braces: with direct braces, they are glued directly to the teeth one at a time; with indirect, the brackets are fixed on the model of the teeth in the right places and then glued to the teeth all at the same time.

Contrary to the wishes of patients, even when the teeth are crooked in only one jaw, most often, braces must be installed in both, because. after moving the teeth in only one of the jaws, there will be no proper closure of the teeth.

During treatment with mouthguards (transparent plastic aligners), if necessary, the doctor glues attachments to the teeth - small tubercles that help the mouthguards to better adhere to the teeth and, accordingly, move them more efficiently. Then the doctor simply gives the patient several sets of mouthguards (which will last until the next visit). Because Mouthguards are removable, the patient independently changes them.

Continuation of treatment, scheduled visits to the doctor

Treatment depends on the diagnosis different stages, such as:

• Expansion of the jaw, freeing up space in order to place exactly all the teeth.
• Body movement of teeth (i.e., movement of the entire tooth).
• Correction of the inclination, reversal of the tooth.
• Moving the lower jaw back or forward (actual bite correction), etc.

In the case of treatment on braces, the doctor sets different archwires at different intervals - soft, hard, applies traction, elastics - each of these tools performs its function.

When treating with mouth guards, it is also possible to use additional accessories to correct the bite.

The frequency of visits to the doctor depends on the selected equipment:

• Ligature braces - about 1 time per month.
• Self-ligating braces - about 1 time in 1.5-2 months.
• Kappa - depends on the stage of treatment and the doctor's recommendations - perhaps 1 time per month or 1 time in 2 months.

End of treatment

After achieving the planned result, the doctor, in agreement with the patient, decides to end the treatment. During treatment with braces, they are removed and the remaining glue is removed from the teeth.

retention period

Highly milestone, which comes immediately after orthodontic treatment - the retention period. It fixes achieved result. It is neglect that often leads to negative reviews patients, such as "after the treatment, all the teeth returned to their place, the treatment did not make sense." The fact is that the teeth need to be fixed in the position in which they stood after the treatment. Therefore, immediately at the end of treatment, usually:

• Wire retainers are placed on 4 front teeth. This is a thin wire that is attached to inside teeth and fix them.
• For a certain period of time (for example, 6 months), a mouthguard is put on at night, which also allows you to hold your teeth, or a retention plate.

Timing for bite correction

Each stage of treatment takes certain time:

• Diagnosis, planning, preparation - can take from one day to several weeks, in the case when the patient's teeth are in bad condition and require prior long-term treatment in several stages, or the extraction of teeth is required. The first consultation itself takes about one hour.
• When treating with mouth guards or individual braces, for example Incognito, a certain time is required for their manufacture and delivery - from one to two months, because. they are made individually for each patient, often abroad - a lot of time is spent on their delivery and customs clearance.
• The installation of braces usually takes place at the next appointment after diagnosis and preparation and takes about one hour. Approximately the same amount is needed for the installation of attachments in the treatment of mouthguards.
• The timing of wearing braces is highly dependent on the diagnosis. It can be generally said that in a large percentage of cases, this period is 1-1.5 years with medium degree crooked teeth and malocclusion. In more simple cases it takes about 6 months for treatment on braces, and in difficult times it can be 2 years or more. Usually teeth move 0.5-1 mm per month.
• The removal of braces (or attachments for mouthguards) takes approximately one hour.

The retention period always lasts differently and is set by the doctor: the younger the patient, the shorter the retention period. Of course, other factors also play a role. Approximately, we can say that the wire retainer should be worn 2 times longer than the patient wore braces or mouthguards. However, the retainer does not cause inconvenience to the patient, a visit to the doctor is extremely rare, therefore, it is justified prolonged wear to fix the result.