Orthodontic treatment of secondary deformations in adult patients with defects of dentition

Abstract

In the presence of dentition defects there is a complex of morphological, aesthetic and functional changes that significantly complicate the process of diagnosis and treatment of this pathology. Dentition defects, combined with various dental anomalies and deformations very often impede rational prosthetics and at times make it impossible at all. The aim is to increase the effectiveness of orthodontic treatment of secondary deformations in patients with dentition defects by using primary dental implants as an additional skeletal support. For clinical evaluation of the effectiveness of treatment of secondary deformations in 20 patients with partial dentition defects there was performed orthodontic treatment using a straight arc technique with metal braces of the Roth system and primary detailed one-component implants as an additional skeletal support. On the diagnostic models of the jaws, the meso-distal dimensions of the lost teeth and their possible position in the dentition were determined, the shape of the dentition by methods of Pon and Korkhaus, the position of the teeth in the area of dentition defects was analyzed and the jigs of occlusion according to Andrews were defined. The use of primary dental implants as an additional skeletal support in the area of dentition defects makes it possible to control the rotation of the teeth and at the same time to use orthodontic forces of different intensity during their distal or mesial movement. As a result of orthodontic treatment of secondary deformations, we managed to achieve positive changes in the normalization of angles of dental inclination that limit the defect in patients with dentition defects. Along with the normalization of the angles of dental inclination (torque and angulation) which limit dentition defects we have noticed an increase in the distance between these teeth, which allows to restore dentition defect with dentures, better corresponding to the size of the lost teeth. Important, in our opinion, is the possibility, when using a primary dental implant as an additional skeletal support, to use the technique of segmental braces. The use of primary dental implants in the area of the dentition defect as an additional skeletal support makes it possible to restore angulation and torque of the teeth, which limit the defect, using orthodontic forces of different intensity. As a result of orthodontic treatment of secondary deformations, the distance between teeth limiting dentition defects on the upper jaw increased on average by 2.39 mm (p<0.001) and on the lower jaw – by 2.57 mm (p<0.001).