Symmetry of pathological processes in the oral cavity

Abstract

The human dentition is characterized by bilateral symmetry, inextricably linked with the equivalent functional load falling on the right and left sides of the row. Some articles of domestic and foreign authors contain conclusions that testify to the symmetry of the carious process in the oral cavity. However, these data are collected on different populations, an incomplete set of teeth and using a limited range of diagnostic methods. The aim of this work was to determine the distribution of a symmetrical carious process in a population of Russian patients of different ages using a wide range of diagnostic tools. Materials and methods. To achieve this goal, 403 patients were examined: 167 men and 236 women. The mean age was 27.37±12.09. In addition to the examination, patients were prescribed an orthopantomogram, and, according to indications, a cone-beam computed tomography. Results. After examination and analysis of orthopantomography images, symmetrical caries was found in 386 patients. In 17 examined patients, symmetrical caries was not detected, and therefore patients were additionally prescribed cone-beam CT. Ultimately, signs of a symmetrical carious lesion were detected in all 100% of patients. Discussion. Our results confirm the data of other researchers on the presence of the symmetry phenomenon in the development of carious processes. Conclusions: 1) When a carious process occurs and develops, in 100% of cases there are signs of damage to the hard tissues of both symmetrical teeth. 2) The use of cone beam computed tomography makes it possible to finally confirm the symmetry of the carious process, and this method should be included in the mandatory standard for diagnosing caries in dental institutions. 3) Asymmetry of the carious process can occur only in cases of unilateral/asymmetrical traumatic or other lesions in the maxillofacial region in history. 4) Microorganisms should not be considered the causes of a symmetrical carious lesion, since they realize their pathogenic effects already in altered tooth tissues, in violation of the integrity of the enamel, pulp trophism, etc.