Etiopathogenesis and Diagnostics of the Mandibular Permanent First Molars Retention

Voronkova, H.V.; Смаглюк, Л.В.; Karasiunok, A. Y.

doi:10.31718/mep.2019.23.3-4.10

Cited by 5 publications

(4 citation statements)

References 14 publications

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“…Ураховуючи багатофакторний характер передумов затримки прорізування зубів, підхід до лікування має бути спрямований на провідні ланки патогенезу цього феномена [9]. У наявних наукових публікаціях досить детально описана морфологічна структура ясен і окістя в нормі [10].…”

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Morphological Features of Mucous Membrane Over Impacted Teeth Dependening on Conditions of Their Position

et al. 2020

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Impacted teeth are rather common and complex dentofacial anomaly, which requires a balanced approach not only in differential diagnosis of its specific nosological form, but also in a choice of rational treatment methods. Taking into account the multi-factor nature of conditions formation for delay of teeth eruption, an approach to treatment should be directed towards guiding links of pathogenesis. The aim of the study is to increase effectiveness of surgical and orthodontic treatment of patients with impacted teeth of anterior maxillary region by studying morphological features of mucous membrane over impacted teeth, depending on conditions of their positioning. A group of 21 individuals aged from 15 to 17 years was formed to evaluate objectively the results of our work. Clinical situation in all the patients was the same according to diagnostic criteria as presence of impacted maxillary canines and medium level of vertical depth of impaction (in alveolar process); root formation: completely formed, with deviation of longitudinal axis of impacted tooth from correct axis of eruption from 15º to 45º. During further analysis, clinical subgroups were identified depending on conditions of impacted teeth positioning in vestibular-oral direction. Moderate dystrophic changes in stratified squamous epithelium, moderate sclerotic changes in papillary layer of lamina propria were found based on findings of microscopic structure of mucous membrane over palatal positioning of teeth. During investigation of morphological structure of mucous membrane over labially positioning of impacted teeth, there were phenomena of hyperkeratosis, an increase in the number of intraepithelial lymphocytes, presence of epithelial cells in the basal layer with signs of hydropic degeneration. In papillary layer of lamina propria of mucous membrane, sclerotic changes were observed, which were more pronounced in comparison with palatal positioning of impacted teeth. Complex analysis of results of morphological studies showed that in mucous membrane positioning over impacted teeth there is deterioration with anemia in filling conditions of microcirculatory bed, discirculatory disorders, which leads to formation of ischemic zones and development of dystrophic and sclerotic processes. Morphological features of the structure of mucous membrane over impacted teeth is an important to consider while planning surgical and orthodontic treatment, and to some extent, it is possible to adjust management tactics of such patients, taking into account labial or palatal positioning of impacted teeth.

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Morphological Features of Mucous Membrane Over Impacted Teeth Dependening on Conditions of Their Position

et al. 2020

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“…За даними сучасної літератури, у багатьох країнах світу спостерігається зростання частоти зубощелепних аномалій (ЗЩА) із порушенням процесу прорізування зубів. Вплив на організм дитини шкідливих факторів і місцевого, і загального характеру спричиняє формування цієї ортодонтичної патології [1][2][3][4][5][6]. Науково обґрунтовано, що між кількістю зубів, що прорізалися, і ЗЩА є сильний кореляційний зв'язок.…”

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Morphological Condition of the Mucous During the Period of Physiological Change of the Canines of the Upper Jaw

Cholovskyi

2020

Ukr. Dent. Alm.

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Physiological eruption of teeth indicates the proper development of the child. According to modern literature, in many countries around the world there is an increase in the frequency of dental anomalies with a violation of the eruption of teeth. Influence on the child's body of negative factors of both local and general nature causes the formation of this orthodontic. It is scientifically substantiated that there is a strong correlation between the number of erupted teeth – maxilaris anomalies. This means that the greater the prevalence of orthodontic pathology, the fewer erupted permanent teeth. Our complex analysis of micropreparations in patients with palatal and vestibularly retained canines of the upper jaw, showed changes in the microcirculatory tract with decreasing vascular density, dyscirculatory disorders, which further causes the formation of zones of ischemia, foci of initiation of necrobiotic changes. According to our data, more pronounced dystrophic and sclerotic processes were detected during vestibular placement of retained canines; instead, the processes of compensation and adjustment were less pronounced.Objective of the study: to determine the morphological features of the structure of the gums from the vestibular and palatal surfaces during the physiological change of canines. Object and research methods. For the subsequent solution of the tasks stipulated by the purpose of the work, 15 people aged 10 to 12 years with a physiological change in the canines of the upper jaw were included in the scientific work. Microscopic examination of the palatine parts of the gums revealed that the mucous membrane of the latter had a typical structure. Stratified squamous epithelium with expressive differentiation into basal, prickly granular and stratum corneum was visualized along the entire length. The formation of acanthotic epithelial cords took place in almost all cases. The latter buried deep in the lamina propria of the mucous membrane, periodically forming bizarre reticular structures. In the described epithelial complexes, an increase in the number of mitotic figures took place, indicating an increased proliferative activity of the epithelium. The study of the features of the morphological structure of the gums during the change of temporary canines suggests that signs of inflammation prevail in the mucous membrane, which are more pronounced in the vestibular areas. The study of the mucous membrane of the vestibular edge of the gums revealed almost everywhere acanthotic foci of multilayered squamous epithelium. Quite often there was a hypertrophy of an epithelial layer due to increase in cell rows of a prickly layer. Quite often in epitheliocytes of a prickly layer cells with the phenomena of a hydropic dystrophy as evidenced by detection in perinuclear space of epitheliocytes of transparent, average sizes of a vacuole were found. In 7 cases, we found inflammatory changes in our own plate, the nature of which differed slightly from those described above. Thus, inflammatory infiltration was everywhere either diffuse or large-focal in nature and spread significantly deeper into its own plate of the mucous membrane. Among the cellular elements of the inflammatory infiltrate, neutrophilic leukocytes were quite often found, which indicate the active phase of the inflammatory process. Sclerotic changes similar to those described above were also detected by us in 5 cases. Comparison of data on the structure of the vestibular and palatal areas of the gums found that in the papillary layer of the lamina propria of the gingival mucosa of the vestibular area there were signs of inflammation, which were more pronounced compared to the palatine. The higher level of signs of inflammation of the vestibular area can be explained by the peculiarities of the physiological eruption of the canines - more vestibular. It is known that a key role in the development of various symptoms of teething belongs to pro-inflammatory cytokines. The obtained data on the features of the morphological structure of the gums under conditions of physiological changes in canines can serve as qualitative indicators in the diagnosis of the state of the mucous membrane over the crowns of impacted teeth and will allow clinicians to rethink clinical approaches and determine the justification for the volume complex of surgical and orthodontic treatment of this dentoalveolar anomaly.

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“…Отже ретенція молярів розглядається як патологічне явище, що має поліетіологічну природу: недорозвинення щелеп, невідповідність розмірів зубів розмірам щелеп, наявність надкомплектних зубів, положення зубів «мудрості», характер жування, наявність супутньої як зубо-щелепної, так і загальносоматичної патології. До системних факторів затримки прорізування зубів можна віднести ендокринні розлади, такі як гіпотиреоз, гіпертиреоз, гіпопаратиреоз, рахіт, краніофаціальну гіпертрофію, клейдокраніальну дисплазію [14,15].…”

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Retention of Mandibular Molars: Etiological Factors, Current Diagnostic Approaches, and Treatment Options

Shaienko

2023

Act. Probl. of the Modern Med.

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The problem of tooth eruption is a common issue affecting nearly 20% of the population. Along with this, there is a growing trend of increased dentoalveolar anomalies in children and adults. One of such anomalies is the retention of the mandibular molars, which has always been a complex dentoalveolar pathology posing clinical challenges for orthodontists and oral surgeons. The aim of this study is to review and analyze relevant literature sources regarding the current etiological factors, diagnostic methods and treatment options for the retention of the mandibular molars. Tooth eruption is a complex and highly regulated process, which is currently the subject of research by many authors. There are various theories about the process of tooth eruption, often contradicting each other. Retention of molars should be considered as a pathological phenomenon with a multifactorial aetiology. Consequently, the approach to the diagnosis and treatment of this pathology cannot be standardized or unified. Therefore, there is a tendency to personalized approach both in the diagnosis and treatment of patients with dentoalveolar anomalies. In most cases, the diagnosis of molar retention is based on a clinical and x-ray examination. Notably, decision-making and treatment strategy selection rely on constantly evolving methods. Unfortunately, the acceleration and early completion of bone tissue maturation increase the frequency of tooth retention, pushing clinicians towards the early intervention. This, in turn, requires a revision of existing recommendations and protocols. The development of technology and the modern possibilities of digital planning open up new horizons and provide tools for addressing complex challenges; however, they require a multidisciplinary approach to implementing non-standard treatment methods involving both orthodontists and oral surgeons. Apparently, all novel techniques require careful analysis, which provides researchers with space for further investigations.

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Etiopathogenesis and Diagnostics of the Mandibular Permanent First Molars Retention

Cited by 5 publications

References 14 publications

Morphological Features of Mucous Membrane Over Impacted Teeth Dependening on Conditions of Their Position

Morphological Features of Mucous Membrane Over Impacted Teeth Dependening on Conditions of Their Position

Morphological Condition of the Mucous During the Period of Physiological Change of the Canines of the Upper Jaw

Retention of Mandibular Molars: Etiological Factors, Current Diagnostic Approaches, and Treatment Options

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