Distal occlusion (upper macrognathia, prognathia)

Mesial occlusion or occlusion is one of the types of defects in which the closure of the anterior dentition is disrupted. Outwardly, this manifests itself in the dominance of the lower jaw over the upper. With such a violation, not only an aesthetic defect is observed. This leads to abrasion of tooth enamel and changes in facial expression. Typically, malocclusion develops due to genetic predisposition or exposure to causative factors during a certain period of development.

Mesial occlusion can be corrected professionally. A competent approach, modern equipment and doctors will be able to restore the aesthetic appearance of the face. Dental clinic PROPRIKUS provides treatment of mesial occlusion without the use of surgical intervention. To correct malocclusion, we use aligners, including Invisalign. They are considered the most effective and help correct even complex cases of pathological occlusion.

Symptoms and causes of mesial occlusion

Patients with this pathology have a concave profile: the lower part of the face is increased in size due to a sharply protruding chin. The lower lip appears thicker than the upper lip, and the jaws are not closed properly. The lower row of teeth is pushed forward. In addition to external manifestations, deformation affects functionality:

• speech is disrupted;
• difficulty biting and chewing food;
• sometimes an open or crossbite develops.

Due to uneven load on the incisors of the jaws, early tooth loss is possible. In 50% of cases, the cause of the anomaly was disturbances in fetal development in the prenatal period. Among the main factors influencing the formation of malocclusion are: birth injuries, viral infections during pregnancy, rickets, osteomyelitis, incomplete development of the dentition. Today, the PROPRICUS clinic successfully corrects mesial occlusion in both adults and children of all ages.

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Classification

By severity:

1. Gnathic form. Develops due to improper development of the cranial bones.
2. Dentoalveolar. It is formed when the tooth roots are incorrect or when there are significant differences in the sizes of the lower and upper jaws.

The pathology may have a mixed form.

By localization:

1. General. The defects extend to both the front and side elements.
2. Partial. The anomaly concerns the front teeth.

By etiology:

1. True progeny. The anterior and posterior teeth have an irregular position, with space present between the anterior units. Pathology reduces the functional abilities of the dentofacial apparatus, and protrusion of the movable jaw brings psychological discomfort.
2. False. Affects only a few frontal units. The anomaly is more common in elderly patients and may also be a consequence of improper surgical treatment.

Methods for correcting mesial occlusion in adults

Mesial occlusion, which is detected before the age of 12 years, is more treatable. Unfortunately, this does not always happen and often adult patients seek help in correcting their bite. Conservative orthopedic methods for correcting occlusion are sometimes ineffective. Often teenagers and adults complain of pain and discomfort when installing a corrective structure. But at the PROPRICUS clinic they use the most effective methods. Serious defects can be corrected with veneers, aligners, and mouth guards. We treat mesial occlusion in adults even in the most difficult situations, when it seems that it is impossible to return the teeth to their normal appearance.

How to fix

Progenia and prognathia can be corrected, but treatment methods may vary. In childhood, bones are pliable and respond well to therapeutic manipulation.

Methods for treating progeny in children:

• frenulum correction;
• use of occlusal pads;
• myogymnastics (muscle warm-up to optimize their functioning);
• massage of the alveolar process;
• use of plates and activators.

Devices for correcting bites
In adolescents, coping with the defect can be much more difficult. It takes more time and effort than with babies. They are indicated for orthodontic correction using braces, mouthguards or trainers. In parallel with this, it is recommended to visit a speech therapist (if there are problems with speech).

To eliminate the defect in adults, you can use the following products:

• arc devices with intermaxillary traction;
• Bruckle's apparatus;
• braces.

In difficult cases, surgical intervention is indicated. This could be a simple tooth extraction or surgery on the lower jaw.

To treat prognathism in children, specialists use devices that accelerate the growth of the lower row of teeth and inhibit the growth of the upper jaw. These include:

• activator tools;
• compression bandages;
• Frenkel apparatus.

In adults, distal occlusion is corrected with braces. If indicated, surgical intervention may be performed.

Types of mesial occlusion

Pathology is classified depending on the cause of origin and form.

There are the following types of occlusion in form:

• Dentoalveolar - accompanied by incorrect position of the teeth, corrected with the help of orthodontic structures;
• skeletal form - refers to more complex forms; malocclusion is formed due to pathology in the development of the jaws.

By nature of occurrence:

• micrognathia of the jaws - characterized by their increase or decrease in size;
• prognathia of the lower jaw - normal closure of the jaws is impossible due to individual teeth;
• retrognathia - characterized by a normal jaw size, but its incorrect position;
• macrodentia and microdentia.

If parents are diagnosed with this disorder, then it is necessary to carefully monitor the condition of the child’s teeth. Genetic predisposition and exposure to adverse factors increase the risk. It is important to take your child to see a dentist every six months. Early loss of primary incisors due to trauma or caries is dangerous for the development of mesial occlusion in the future, even with correct occlusion. The pathology can be noticed at an early age - by an enlarged lower jaw and lower incisors overlapping the upper ones.

Diagnostics

To draw up a complete clinical picture and treatment plan, you need high-quality diagnostic data of several types:

1. Visual examination of teeth and face by an orthodontist. Usually occurs at the first consultation. The doctor evaluates the position, size and condition of the teeth. If necessary, refers to additional specialists.
2. Assessment of jaw position and size using CBCT. Only a 3D image of the entire skull will give the doctor an accurate idea of ​​how the jaws are positioned relative to each other and the condition of the temporomandibular joint. Based on these data, a plan for moving the teeth is drawn up, and the need for surgical intervention or additional treatment of joint dysfunction is assessed.
3. Assessing the position, relationship and closure of teeth using impressions.
4. A detailed photo protocol for drawing up a treatment plan and further monitoring the dynamics of treatment.

Causes of mesial bite

In the early stages of development:

• genetic predisposition - congenital anomalies in the structure of the skull and facial bones occur;
• illnesses suffered during pregnancy, deficiency of vitamins and nutrients, living in unfavorable conditions;
• increased size of the child's tongue;
• pathologies of the thyroid gland, rickets;
• short frenulum, improper breastfeeding.

During the period of milk and permanent teeth:

• insufficient wear of primary teeth in children 3-6 years old;
• premature loss of teeth in the upper jaw due to caries or impact;
• late appearance of teeth on the upper jaw;
• bad habits - resting your chin on your hand, sleeping in a position with your head bowed to your chest.

Most often, abrasion is disrupted on temporary canines due to the late period of physiological change. This prevents the closure of the dentition, and therefore mesial occlusion is formed. The correction scheme depends on the severity of the deformity. Therefore, PROPRICUS dentistry uses several treatment methods. The patient undergoes a detailed diagnosis by several specialists to understand how to correct the mesial bite.

What exactly should you do if the baby has prognathia : the chin is absolutely not “strong-willed”, the lower jaw “crawled” back, and the upper teeth, like those of a rabbit, protrude forward? Exercises for the lips and lower jaw - myogymnastics, are carried out in parallel with breathing exercises and wearing a vestibular plate (with the visor pointing down). Naturally, during myogymnastics the plate should not be in the baby’s mouth. The exercises are done 2-3 times a day, first for 5 minutes, then for 10-15 minutes, sitting in front of a mirror. Do not take the whole complex at once to work with your child. Start with one or two exercises. When you get good at them, master the next ones, but don’t forget to repeat the previous ones. And it would be a good idea to visit a speech therapist before starting self-study at home.

1. Exercise “Smile”. The lips smile naturally, the teeth are clenched in a “fence”, i.e. The upper teeth “stand” above the corresponding lower ones. The front teeth are clearly visible. Maintain this position for at least 10 seconds (the time lengthens from activity to activity).

2. Exercise “Tube”. The teeth are tightly clenched. Pull your lips forward with a tube and hold in this position for at least 10 seconds (the duration gradually increases).

3. Alternate exercises “Smile” - “Pipe” at the count of “one-two” at least 10-15 times. Teeth are clenched all the time! Take your time! Fix one or the other position of the lips.

4. Exercise “Fish” . The teeth are clenched tightly, the lips are extended forward (see exercise “Tube”). The lips open and close (as a fish does with its mouth in an aquarium).

5. Exercise “Funnel ”. Move the lower jaw forward, open the mouth slightly, and open the teeth. On the count of “one”, pull your lips forward with a “horn”; on the count of “two”, pull your lips inside your mouth, tucking them behind your teeth (the lower jaw is still pushed forward!). Do at least 10 repetitions.

6. Exercise “Annoyance”. Bite your upper lip with your lower front teeth at least 10-15 times. Hold this position for 5-10 seconds. The lower jaw is pushed forward as much as possible.

7. Exercise “Timpani”. The lips are slightly curled behind the teeth inside the mouth. Slap them one against the other, making a characteristic patting sound. The lower jaw is pushed forward as much as possible. Do this at least 10 times.

8. Exercise “Snorting horse ”. Relax your lips and snort, like a horse does. Move the lower jaw forward as much as possible. Do this at least 10 times.

9. Exercise “Deadbolt”. Move the lower jaw forward as much as possible. Move it from side to side at least 10-15 times with maximum amplitude.

10. Exercise “Hide and Seek”. a) “Hide” the upper lip by biting it with the lower front teeth. Only the lower lip is visible, it stretches up towards the nose. Hold in this position for at least 5 seconds (the time to complete the exercise increases from session to session);

b) “Hide” the upper and lower lips, drawing them into the mouth and slightly squeezing them with the front teeth. The lower jaw is pushed forward as much as possible. Hold in this position for at least 5 seconds (the time to complete the exercise increases from session to session).

11. Exercise “Plane” . “Cross” the lower central incisors along the upper lip at least 10-15 times. The lower jaw moves forward and “works” energetically.

How to eliminate progeny?

Correcting progeny (the lower jaw protrudes unnaturally) can be difficult. But regularly wearing a vestibular plate (with the visor pointing upward) and performing articulation exercises (myogymnastics) help cope with this malocclusion.

The child needs to imagine that his teeth and lips are “stubborn doors” that always strive to “skew.”

1. Articulation exercise “Aligning the doors” : a) open your mouth slightly, then, slowly moving the lower jaw back, place the edges of the lower central teeth on the edges of the upper ones, hold this position for 5-10 seconds;

b) open your mouth, then, moving the lower jaw back, compress your lips tightly, slightly biting them with your teeth, hold for 5-10 seconds.

What should you do if one door leaf prevents the other from closing? That's right, take a plane and remove all the “unnecessary”!

2. Exercise “Plane” : “Cross” the upper central teeth along the lower lip at least 10-15 times. The lower jaw moves back and actively “helps” in this work.

3. Exercise “Rabbit”: a) bite the lower lip with your upper front teeth at least 10-15 times. Then grab your lower lip with your upper teeth and hold this position for 5-10 seconds. The upper front teeth are clearly visible during this exercise.

b) try to reach the upper part of the chin with your upper incisors and also lightly bite it. Fix this low position of the upper jaw on the chin and hold it for 5-10 seconds. The upper front teeth are clearly visible.

And now he will play hide and seek with his lips and teeth.

4. Exercise “ Hide and Seek ”: “hide” the lower lip behind the upper front teeth and the upper lip, biting it. In this case, only the upper lip is visible, it seems to hang over the chin, but the upper teeth are not visible. Hold in this position for at least 5 seconds (the time increases from session to session.

With the help of articulation exercises and plates, the child acquires useful skills that help him cope with the pronunciation of difficult sounds, and he develops a correct bite. But you have to be prepared for the fact that wearing the plates and producing sounds will last for several years. This will require enormous patience from parents and children.

Methods for treating mesial occlusion

Aligners are one of the most practical, convenient, safe and effective correction methods. They are made from polymer materials according to the patient’s individual impression. Therefore, the risk of the structure shifting is completely eliminated. Aligners follow the anatomical shape of the teeth and jaw. They cannot be seen on the teeth due to the complete transparency of the trays. Patients observe minor defects within 2-3 days after installation. They do not interfere with chewing, drinking, or brushing your teeth. You should remove your aligners before performing oral hygiene and eating.

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Advantages of aligners:

• do not stain;
• not visible to others;
• soft and elastic;
• safe for health;

One of the most advanced foreign bite alignment systems is Invisalign. This is an innovative product from an American company that is used in our clinic. Therapeutic mouth guards create pressure on the teeth, causing them to return to their normal position. We use only original products and are completely confident in the effectiveness of orthodontic treatment with aligners.

During the initial examination, the doctor assesses the condition of the patient’s oral cavity, diagnoses the condition of the jaw system, draws up a treatment plan and names its cost. Before the treatment plan is approved, the patient is shown what the oral cavity will look like after treatment. After agreeing on the details and signing the contract, the doctor performs sanitation of the oral cavity, if there is an indication for this. Therapeutic mouth guards take 2 weeks to make. The elements will have to be changed and will have to be changed every 2-3 weeks. The average duration of treatment with aligners is 6 months to 1.5 years.

What if distal bite is not treated?

Distal occlusion requires treatment. What complications arise if the distal bite is not treated can be found in the list below:

1. Local overload of the chewing teeth due to the lack of vertical contact of the upper and lower anterior teeth. This leads to their abrasion and destruction.
2. Dysfunction and subsequent pain occur in the mandibular joint, which leads to the inability to open the mouth and limited chewing.
3. Difficulties arise during dental prosthetics and redistribution of chewing loads, both with the help of crowns and with removable dentures.
4. Restrictions in chewing, and as a result, problems with the gastrointestinal tract.
5. Problems with diction.
6. Aesthetic problems of the face, disproportionate facial profile, protruding upper teeth.

As a rule, the “ostrich position” with such an occlusion pathology ends in serious health problems. The cost (price) of turnkey treatment of distal occlusion in Moscow depends on the specific diagnosis of the patient. Correcting distal occlusion at a promotion, with a discount on orthodontic treatment, is possible with a large volume of orthodontic treatment. Turnkey treatment of distal occlusion starts from 150,000 rubles.

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Prevention

To prevent progenia and prognathia, experts give the following recommendations:

• timely treat pathologies of the dental system;
• wean children from bad habits (sucking fingers, lips and others);
• control the position of the child’s body and head during sleep;
• monitor the child's posture.

Pregnant women need to be careful about their health. Proper nutrition with the required amount of vitamins and microelements is important. Also, you should try to protect yourself from infections and minimize stress. It is always easier to avoid violations than to deal with treatment later.

Timely detection of progenia and prognathia guarantees simpler and more effective therapy. Therefore, if you have symptoms of mesial or distal occlusion, you should not postpone a visit to the doctor.