Pathological dental Pathological dental abrasion of dental abrasion of dental hard tissueshard tissues. . Orthopedic treatment Orthopedic treatment methods.methods.

Dental abrasion is the defect Dental abrasion is the defect of enamel and dentin of the of enamel and dentin of the teeth, that appears without teeth, that appears without microbs participation and microbs participation and without softening of hard without softening of hard tissuestissues

Age-related changes of Age-related changes of dental hard tissuesdental hard tissues

А – Crown abrasion in different age;

Б – Types of abrasion: а -vertical; б – horisontal

Etiology & Etiology & Pathogenesis Pathogenesis The teeth abrasion after Shczerbakov The teeth abrasion after Shczerbakov

is devided intois devided into::

CongenitalCongenital – – as a result of enamelo- as a result of enamelo- & dentinogenesis violations& dentinogenesis violations,,

HereditaryHereditaryСпадковіСпадкові – – disease of disease of Capdepon etcCapdepon etc

AcquiredAcquired – – neurodistrofical changes, neurodistrofical changes, violations of functions of circulatory violations of functions of circulatory systemsystem, , metabolic disorders.metabolic disorders.

Classification of Classification of pathological abrasion of pathological abrasion of the teeththe teeth::• І І stagestage – – abrasion of cusps and abrasion of cusps and

cutting edges cutting edges ((up toup to 1/3 1/3 of crown of crown heightheight),),

• ІІ ІІ stage stage – – abrasion of teeth abrasion of teeth progresses up to the contact areas progresses up to the contact areas (1/3(1/3 - - 2/3 2/3 of crown heightof crown height),),

• ІІІ ІІІ stagestage – – abrasion of the teeth abrasion of the teeth reaches gumsreaches gums ( (more thanmore than 2/3 2/3 of crown of crown heightheight). ).

Forms of pathological Forms of pathological abrasion of the teethabrasion of the teeth::

VerticalVertical, ,

HorizontalHorizontal,,

MixedMixed. .

Types of pathological Types of pathological abrasion of the teethabrasion of the teeth::

LocalLocal

GeneralizedGeneralized І І groupgroup – – patients with the whole teeth row abrasion,patients with the whole teeth row abrasion, but without decreasing of the lower third of the but without decreasing of the lower third of the

face. face.

It is compensated with alveolar bone growing. It is compensated with alveolar bone growing.

ІІ ІІ groupgroup – – decompensated form.decompensated form.

Methods of diagnostic of Methods of diagnostic of pathological abrasion of the pathological abrasion of the teeth & its complicationsteeth & its complications::

Patients complainsPatients complains Examination of the face & oral Examination of the face & oral

cavitycavity Gypsum models examinationGypsum models examination X-ray of the teeth, jaws and X-ray of the teeth, jaws and

temporomandibular joint (TMJ)temporomandibular joint (TMJ)

Treatment of beginning Treatment of beginning form of pathological form of pathological abrasion without TMJ abrasion without TMJ disordersdisorders:: Production of metal inlays, or cast metal Production of metal inlays, or cast metal

crowns on the molars & premolars and their crowns on the molars & premolars and their antagonists on both sides.antagonists on both sides.

Treatment of gyperesthesia Treatment of gyperesthesia ( ( desensitizing desensitizing substancessubstances, , pastes with fluoridepastes with fluoride, , electrophoresis of 10% solution of CaCl, electrophoresis of 10% solution of CaCl, calcium gluconatecalcium gluconate) )

Treatment of the Treatment of the pathological abrasion of the pathological abrasion of the teeth wiothout defects of teeth wiothout defects of teeth rowsteeth rows

In I visit In I visit – – if there is no pathology if there is no pathology of TMJof TMJ – – with the help of crowns, halfcrowns, with the help of crowns, halfcrowns, metalic inlays etc and with arising of the bite on 2-3 metalic inlays etc and with arising of the bite on 2-3 mmmm..

In II visits In II visits – – TMJ disfunctionsTMJ disfunctions – – with the help of with the help of

dental burls and rational prosthesisngdental burls and rational prosthesisng..

Treatment of II-III Treatment of II-III stages of pathological stages of pathological abrasionabrasion

Normalization of the height between Normalization of the height between alveolar bones of upper and lower jawalveolar bones of upper and lower jaw, , correction of lower jaw localization in correction of lower jaw localization in different directionsdifferent directions, , and rebuilding of and rebuilding of the chewing muscle functionsthe chewing muscle functions,,

Rational prosthesing of the teeth rowsRational prosthesing of the teeth rows..