All about pathological tooth wear. Treatment of pathological tooth abrasion Dental abrasion causes and treatment

A person's health, as well as his attractiveness, largely depend on the condition of his teeth. Now dentists are increasingly diagnosing pathological abrasion of teeth. The risk group includes men over 30 years old, but no one is immune from the development of the disease. If the doctor has revealed increased abrasion, the disease cannot be ignored, as it can lead to tooth loss. Why does the abrasion process develop? What to do when symptoms appear? How to stop grinding and prevent abrasion of dental elements? Let's figure it out together.

Symptoms of pathological abrasion of teeth

Pathological abrasion of teeth makes itself felt by a number of characteristic symptoms. If the patient ignores the signs of the initial stages of the development of the pathology, then over time the situation worsens, and it becomes much more difficult to restore dental health (we recommend reading: how can a tooth be restored if only the root remains?). The main symptoms of pathological abrasion:

frequent "biting" of the cheeks and lips from the inside;
pain during meals;
change in the lower part of the face (if the maximum degree of wear has developed, it decreases);
with serious erasure, the process of chewing, speech is disturbed;
if you clench your teeth, the patient will have a feeling that the jaws are “stuck together”;
the patient feels that the surface of the tooth has become rough due to wear;
the shade of the enamel changes;
increased sensitivity to temperature, and subsequently to chemical stimuli;
there is a wedge-shaped defect (increased abrasion of teeth is sometimes accompanied by this symptom);
pathological changes in the jaw joints and facial muscles develop.

Causes of pathology

Tooth abrasion can develop due to the influence of various factors - both external and internal.

Among the external causes, due to which some (or all) teeth are worn out, include bruxism (the phenomenon when a person “grinds” his teeth in a dream), partial loss of teeth, installed dentures, bad habits, as well as work in conditions of increased vibration (we recommend reading: a child grinds his teeth in a dream: reasons according to Dr. Komarovsky).

Increased tooth wear caused by internal reasons, is considered more dangerous and more difficult to treat. Sometimes dental elements grind down for reasons of congenital origin. In cases where the wear of the dental elements is the result of pathological changes in the body, the disease is usually detected at an early age. Among the endogenous causes include:

osteogenesis, marble disease and other hereditary diseases;
violation of the process of mineralization and the formation of hard tissues (due to a lack of vitamins and microelements in the mother's diet during the period of bearing a child or a deficiency of essential substances in the nutrition of a baby in the first year of life);
in adults, pathology can lead to increased abrasion of teeth thyroid gland, unbalanced diet, insufficient absorption of calcium.

Ways to classify tooth wear

There are several basic ways to classify tooth wear. One type of classification is based on the form of the disease. Allocate local erasure, when the process affects small areas of the row, and generalized, in which absolutely all teeth in the jaw are erased to one degree or another.

From the point of view of the planes subjected to erasure, the classification looks like this:

horizontal - in the process of erasing, the height of the crown part of the tooth decreases;
vertical abrasion - damage occurs to the back of the upper teeth and the front of the lower dental elements (usually due to malocclusion);
mixed - the teeth are erased in two planes at the same time.

There is also a classification of the pathological process according to the degree of destruction of tooth tissues.

If the surfaces of several teeth (usually incisors) are slightly worn out, then we are talking about stage I.
Stage II is characterized by almost complete destruction of the enamel and exposure of the dentin of the crown part of the tooth.
When the affected teeth have worn off by half or more and an open cavity is visualized, stage III is diagnosed.
Stage IV is characterized by almost complete erasure of the hard tissues of the tooth, which is destroyed almost to the ground.

Diagnosis of the disease

For diagnosing increased abrasion of teeth, the contact between the dentist and the patient plays an important role. It is not enough for a doctor to identify the very fact of the development of the disease - you need to correctly establish the cause. Otherwise, it will be almost impossible to choose an effective treatment strategy.

To establish the causes, degree and form of tooth wear, the following diagnostic methods are used:

visual examination of the patient's oral condition;
survey - the doctor should inquire about the lifestyle, clarify the presence or absence of metabolic disorders, hereditary diseases, ask questions about the specifics of work;
electroodontodiagnostics;
x-ray;
if necessary, to identify serious illnesses palpation is often performed;
additional consultation of narrow specialists, including a neuropathologist, may be required.

Treatment of the disease

You should be prepared for the fact that the process of treating tooth abrasion will be laborious, take a lot of time and require frequent visits to the doctor. You may have to visit not only the dentist, but also other specialists. Everything will depend on the characteristics of the course of the disease and the reasons that provoked it. In general, the stages of treatment of pathological abrasion of teeth will look like this:

stop the process of tooth decay;
elimination of the causes of increased abrasion;
restoration of the protective layer of enamel;
return of the initial level of the crown part of the teeth;
if necessary, replacement of the prosthesis;
adaptation to the updated position of the jaw.

Restoration of the dentition can be carried out using various devices and techniques. The dentist will select the best option based on the individual characteristics of the structure of the patient's jaw, as well as on the course of the disease. These can be braces, dentures (temporary), caps, inlays or other structures.

The initial height of the restored crown is higher than that to which the patient is accustomed. For this reason, he is given several weeks to adapt. If the patient complains of pain that does not subside, the crown is ground down a couple of millimeters. The adaptation period is counted from the moment the pain is eliminated.

The prosthesis, which the patient will use constantly, is selected by the doctor only after the work of the masticatory muscles has been adjusted, and the jaw has “accustomed” to its new position. Fixed prostheses are considered the best option. When installing a removable structure, the patient often takes it out and puts it in, which can disrupt the course of the therapeutic process.

The selection of an optimally suitable prosthesis is a task for a qualified and experienced doctor, since many factors must be taken into account: from the state of opposing dental elements to the facts of the presence of concomitant pathologies. For example, with constant high loads on the dentition, metal structures are more suitable, and when it comes to chewing elements, it is not recommended to use plastic.

Prevention of excessive grinding of teeth

The main preventive measures aimed at the prevention and early diagnosis of dental diseases remain the observance of hygiene rules. oral cavity and regular check-ups with a specialist. In order to reduce the likelihood of developing pathological abrasion of teeth, it is also recommended to follow the recommendations listed below:

giving up bad habits (if possible);
soda rinses for people who work with harsh chemicals;
balanced diet;
regular intake of vitamin and mineral complexes;
protection of teeth with special devices - for those who work in conditions of high vibration or in hazardous industries;
treatment of bruxism (for patients suffering from this disease);
urgent restoration of teeth lost for any reason;
correction of bite defects.

A beautiful smile has always been considered a sign of success and health. The first impression of a person depends on it. This is why dental services have become so popular.

Restoration consists of a complex of dental actions aimed at restoring the shape and functionality of damaged teeth.

Restoration along with other plastic surgeries helps to improve the appearance and feel more confident. There are many ways to restore the correct appearance of teeth and restore the beauty of a smile.

In addition, they can break or fall out completely due to injuries, poor nutrition, stressful situations, and poor ecology. Changes in the teeth become noticeable - cracks, fractures, darkening. For any of these symptoms, you should contact your dentist for timely treatment. It's not worth the hassle with this. With further tooth decay, health hazards can arise.

The reason for restoration is their curvature and malocclusion. The tooth surface is erased over time and acquires the desired shape for the usual closing of the jaw. After straightening a row with braces, restoration of worn teeth is required.

Dental restoration procedure

First of all, you should contact your dentist. He will examine the condition of the teeth, assess the degree of destruction and give a forecast for further prospects for the development of the situation. Based on the results of the examination of the condition of the dentition and the forecasts of the further condition, the doctor will offer several treatment options.

Which of these methods to use, only the patient decides based on their financial capabilities and priorities. The dentist can only give recommendations and talk in detail about each of the methods of restoration.

The whole recovery procedure consists of several stages:

professional ultrasonic cleaning;
treatment of all identified pathologies - caries, inflammation of the gums;
coordination with the patient of the method of restoration;
preparation of materials;
the extension procedure itself;
recovery period.

The work of recreating the natural state of a smile is very painstaking. The doctor needs not only to improve appearance smiles, but also the functional ability of the jaw.

Restoration can:

change shape;
remove chips and irregularities;
restore enamel;
hide the gap
straighten and restore teeth.

Recovery Methods

Tooth decay occurs for many reasons and each individual case requires its own approach in recreating the original appearance, how are they restored? Dental clinics offer a wide range of methods of treatment and restoration of the dentition.

There are two types of recovery:

direct. When all the main actions are carried out in the oral cavity and the whole process takes one visit to the dentist.
indirect. When the main part of the work is carried out outside the patient's oral cavity, and the whole process takes some time.

filling

One of the most common and relatively cheap methods of restoration is filling. It is mainly used after caries treatment. After the restoration, the filling practically does not differ in color from the enamel of the neighboring ones. The procedure is very fast. It is impossible to remove the reconstructed part, otherwise the crown will be very badly destroyed.

pin restoration

It can be used for all teeth - both lateral and anterior. This method allows you to restore them at any degree of destruction. The pin is a needle inserted into the root canal. Two pins are used for the side pins, one for the front ones. Part of the pin remains on top and serves as the basis for recreating a denture using a crown.

This method is also very fast and is carried out in one visit to the doctor. This is ideal if you need to quickly insert an anterior incisor in one day. The advantages of the method are the strength of reconstruction, the possibility of extracting the pin, and the aesthetic appearance. The disadvantages are the long recovery period and the high cost of the procedure.

Crowns

The establishment of a crown is practically a micro-prosthetics operation. This method is used in case of destruction, when a part of the teeth still remains above the gum and it is possible to attach a crown.

The dentist prepares the tooth surface, cleans it of caries, then makes an impression.

Within a few days, a crown is made, which will completely recreate the original appearance, match the color of the entire dentition.

The advantages of the method include a beautiful appearance and strength. The disadvantages are high trauma, enamel grinding is required, it is difficult to achieve the correct shrinkage the first time.

The following materials can be used to make crowns:

metal - gold, silver, steel, titanium;
plastic, ceramics;
cermet, metal-plastic.

permanent dentures

At total absence permanent prosthetics with bridges are used. Dental bridges are several crowns that are connected into one structure.

In this case, the remaining ones serve as a support. Extreme crowns are put on healthy incisors, and the middle ones replace the lost ones.

This method has many disadvantages. When installing prostheses, a very strong grinding of healthy teeth is required, and when replacing a prosthesis, they will also need to be restored.

Under the prosthesis, atrophy will continue. Over time, the gum will settle and a gap will appear. Not only will this ruin the whole look of your smile, but it will also become a place for food debris to accumulate. As a result, there is a chance of losing the rest.

Removable dentures

Removable dentures are the most accessible and fast method prosthetics. These prostheses are a plastic gum on which the prostheses are fixed. You can put a prosthesis and replace all the teeth with it if they are not.

With their help, you can replace the entire dentition, then the prosthesis is put on the gum. Or several, then the prosthesis is attached with hooks to healthy tooth surfaces. Due to the relatively low cost, such prostheses are not of high quality.

Very often there are difficulties such as rubbing of the gums, poor fastening and slipping of the prosthesis from the mouth. Appearance also leaves much to be desired. Removable dentures look very unnatural. They need to be constantly removed and washed. Atrophy of tissues under prostheses continues and after some time will be reflected in facial features.

Microprosthetics

This method is the installation of an insignificant prosthesis, with the help of which its appearance changes. Such prostheses look like a very thin plate and are made mainly of ceramic or composite material.

Among such prostheses, veneers, lumineers, and inlays can be distinguished. Veneers and lumineers are used for aesthetic defects in color and shape, they can be used to make even teeth in one day. Inserts are used for partial destruction.

They are made individually for each of the teeth. Before prosthetics, enamel grinding is required, depending on the thickness of the prosthesis and the required restoration parameters. The method has established itself as a fairly high-quality restoration of the appearance of a smile, but it takes time to make prostheses and is quite expensive.

Restoration

Restoration with the help of composite materials is actually a filling on several layers. No preparation is required. If a seal was previously installed, then it is advisable to remove it and replace it with a new one.

The seal is installed on the outside. Two small grooves are made along the edges, which are the border of the restoration. The enamel remains intact. A degreasing and disinfecting composition is applied, then the main filling. Each layer is carefully dried with a lamp. The number of layers depends on the size of the defects.

The procedure is painless and safe. The restoration copes well with minor defects in color and shape, but is intended only for the anterior teeth.

Implants

Implantation has been practiced in dentistry for more than half a century. This is a rather complicated and painful method. Best suited for restoring 1 or 2 teeth. It is the most extreme measure.

The process takes a long time. The main stages of implantation:

a complete examination, which includes the delivery of tests, x-rays of the jaw;
selection of a suitable implant;
preparatory procedures, if necessary, building bone tissue on the jaw;
implant placement is performed under anesthesia, a rather complicated operation and requires a long recovery period.

After the procedure, you should visit the doctor periodically to check how the implant takes root.

Fiberglass

It's pretty new method restoration. Due to its strength and safety, fiberglass has become widely used in dentistry. In its properties, it is similar to dentin, stronger than metal, and matches the color of enamel.

Fiberglass is combined with the installation of pins. Once the post is in place, the denture is reshaped using fiberglass.

Photopolymers

Photopolymers are widely used in filling, restoration and crowning. Modern photopolymer materials are very durable, have a color palette for every shade of enamel.

The material is applied to the prepared tooth surface, the doctor gives the desired shape and dries with a special lamp.

Then the photopolymers are ground and turned to give the desired shape. At the end, a protective composition is applied, which retains the color of the composite for a long time.

Glassspan technology

This technology is also a novelty in the field of dentistry. The method consists of placing a flexible ceramic bond on the lateral and anterior incisors. Used for both temporary and permanent prosthetics. It can be used to restore damaged and missing teeth.

The technology is painless, does not require recovery period. It is possible to use any dental material for restoration.

Functional recovery

Very often, after inflammatory processes as a result of caries or damage, patients need to restore functionality. This process is to recreate the exact anatomical shape.

This is a very complex and careful work, which takes into account both the position in the row and the correspondence of the teeth of the opposite row.

Cosmetic restoration

This procedure is aimed at changing the color of the enamel and filling microcracks.

It is carried out in a specialized clinic using composite and filling materials.

The procedure does not take long. After the session, the doctor gives recommendations for maintaining the whiteness of the enamel.

The price depends on the bleaching materials and the complexity of the work.

Enamel restoration

Enamel is the protector of teeth from external influences. When it is thinned or damaged, the enamel is negatively affected and begins to break down. If the teeth are worn out, it is important to undergo the enamel restoration procedure as soon as possible.

Ways to restore enamel:

filling small cracks;
fluoridation - application of a solution of fluorine, which perfectly strengthens and restores enamel;
remineralization - application of a mixture of fluorine and calcium;
the use of veneers;
application of overlays.

Restoration technologies are constantly being improved, new methods and materials are emerging. Dentists every year offer safer and less painful ways to recreate beautiful smile. At the same time, methods are becoming more and more qualitative, and the result is preserved for many years.

Prostheses are practically no different from natural ones, all their functional abilities are preserved even in the most difficult cases.

How to restore teeth at home

At home, it is possible to independently restore the enamel for free and make it whiter. The main work is to follow the rules of personal oral hygiene. It's not just about cleaning, but about using special pastes.

Dental products with a high fluorine content contribute to the restoration and maintenance of the health of the oral cavity and enamel. Rinses, mouth guards and pastes restore the mineral composition of the enamel and strengthen it.

Self-massage of the gums, a balanced diet rich in vitamins and minerals, the right brush and paste, daily brushing - all this will help maintain healthy teeth.

There are many options for replacing teeth. Each of them is effective in its own way. Which of the methods of restoration to use depends on the degree of destruction, the financial capabilities of the patient and his priorities.

The most effective way is to prevent caries at home with the help of proper nutrition and oral hygiene.

The procedure for building teeth is done in almost every dental clinic. With its help, you can restore the dentition, eliminate cosmetic defects or correct the bite. Clinics provide their clients with various restoration methods, including pinning, inlays and fillings. How the front teeth are built up will be discussed in this article.

How to build up front teeth

Extension - what is it?

A dental procedure that allows you to restore tooth enamel and the tooth itself. This term also includes the artistic restoration of the dentition. What is the reason for this name? The fact is that when building up the front teeth, the main task of the dentist is not only to proper recovery tooth, but also in giving it a natural appearance.

At the dentist

High-quality artistic restoration of a tooth requires a true master of his craft, with the skills of a sculptor and excellent artistic taste. All this comes with time, when doctors gain experience in practice.

Indications and contraindications

If building up is called the restoration of the dentition (regardless of the location of the teeth), then the same procedure, but only with the front teeth, is a restoration (although many do not see much difference between these concepts). With the help of restoration, it is possible not only to eliminate the defect that has arisen, but also to give the tooth maximum naturalness so that it does not stand out from the others.

Restoration of teeth

Indications for extension look something like this:

the occurrence of interdental gaps;
the development of caries, due to which part of the tooth was lost;
age-related wear of incisors;
discoloration of tooth enamel, if no cleaning or whitening procedures help to correct the situation;
curvature of the teeth;
malocclusion;
mechanical damage, as a result of which the bone tissue was damaged;
the formation of cracks on the surface of the tooth;
the appearance of a chip.

On a note! The extension procedure, or rather, its appearance, is a serious step in the development of modern dentistry. It (the procedure) allows you to eliminate the aesthetic problems that have arisen with the restoration of teeth.

Dental restoration - before and after

The main contraindications to building:

patient health problems and poor health. In this case, it is not recommended to carry out restoration - you first need to cure the body, and only after that you can carry out the procedure;
the presence of caries or other cause of the defect. Must be eliminated before extension main reason Problems. The same applies to inflammation of the gums, in the presence of which doctors do not undertake restoration. After the problem is completely eliminated, you can start building;
in the treatment of children, certain methods of building up teeth cannot be used - for example, using pins. Therefore, if the doctor said that he would install a pin for your child, it is better to contact another specialist;
Tooth on pin
bruxism (teeth grinding). The procedure can be carried out only after getting rid of bruxism. Otherwise, the likelihood of a recurrence of the defect increases. Fortunately, there are many methods to eliminate this unpleasant habit, including special exercises and protective thermoformed splints for the teeth;
if it is impossible to protect the necessary area in the mouth from contact with moisture (in this case, with saliva), the procedure cannot be performed for technical reasons. This is due to the fact that upon contact with moisture, the composite substance used in dentistry will not be able to dry out and finally fix.

Indirect restoration

In order to avoid unnecessary costs and problems, it is necessary to consult a doctor before performing an extension. The correct and competent approach will not only save money, but also save the health and nerves of the patient. If a child sits on the dentist's chair, then his parents are simply obliged to first find out all the nuances of the upcoming operation.

Front teeth extension methods

Depending on the materials used or the degree of damage to the teeth, the extension procedure can be performed in one visit to the doctor's office, or in several. Below are the main ways to build up the front teeth, as well as their features.

Table. The main methods of restoring the anterior dentition.

pinning	This method is used only in cases where the nerve is still alive, although the tooth itself has been completely destroyed. Most often this happens due to injuries. The pin allows you to strengthen the base of the tooth root, install fillings and crowns in the patient's mouth. The extension procedure begins with images of the root, after which a pin made of a transparent material is screwed into the root itself, and a special substance is applied on top. To dry the tooth, a device is used that illuminates it with ultraviolet rays for 1.5-2 hours. A fully restored tooth is treated with a protective agent, thanks to which no soda, coffee or other sweets are no longer afraid of it.
	This is the perfect combination of aesthetic properties and therapeutic effect. Veneers are translucent thin plates made of porcelain or ceramic. In addition to a noticeable cosmetic effect, veneers also restore the wrong bite. When creating veneers, a cast of the patient's teeth, made in the laboratory, is taken as the basis. Due to the wide variety of shades of this product, the doctor can choose the most suitable color for the veneer, which will not differ from the background of real teeth.
Photopolymer restoration	If the teeth have worn out over time or are affected by caries, then a photopolymer restoration is used. Using composite materials, the doctor restores partially or completely destroyed patient's teeth - in both cases, the method is very effective. With the help of an ultraviolet lamp, the composition quickly hardens (no more than 45 minutes). This is provided that the ultraviolet beam is directed exclusively at the restored tooth. With the development of the inflammatory process, it is impossible to carry out restoration by this method.
filling	High-quality and fast tooth extension can also be carried out using various means for filling. At the same time, the restored tooth has good aesthetic properties, and the filling material outwardly corresponds to the dental bone tissue. The compositions used for this differ in that they do not darken over time and always have a color similar to enamel. Thanks to fluorine, which is contained in the dental composition for filling, it is possible to build up a tooth not only in the presence of minor defects, but also in case of serious damage. The main advantages of the method are the preservation of the dental nerve, the speed of the procedure and the tight adhesion of the material to the dental tissues, resulting in a single structure.
dental crowns	With a serious destruction of the dental crown part of the tooth, doctors recommend building up with dental crowns. This applies not only to the back, but also to the front teeth. In such cases, damaged teeth usually have already lost their nerve, therefore, in order to prevent a fracture under the dental crown, reinforcement is carried out with special inlays made of ceramic or metal. To install crowns, the tooth root must be intact and intact - this is the main condition for the operation. Otherwise, if there are granulomas or cysts in the root, the placed crowns will not be able to last long enough.

Restoration of teeth with filling materials

Step 1. First, an impression of the front teeth is made, according to which the build-up with composite materials will be carried out. After that, the doctor, using special equipment, grinds the teeth to a certain level.

Create an impression

ground teeth

Step 2 Having protected the rest of the teeth, the dentist treats the already ground down liquid composition, after which it hardens under the influence of ultraviolet rays.

Treatment of worn teeth with a liquid composition

Step 3 A cast is applied to the teeth so that the shape of the tooth can be recreated from it. The procedure is performed extremely carefully, the doctor closes the lateral part of the restored tooth with special dental overlays. During the filling process, an ultraviolet lamp is periodically used to solidify the composition used.

An impression is applied

Step 4 When the tooth is almost ready, its surface is treated with a protective substance that can protect the extended tooth from harmful factors (such as food, drinks, smoking, and so on).

Applying a protective compound

Step 5 As a result, the patient leaves the dentist's office with a new snow-white smile. Moreover, this does not take much time - just one visit is enough to fully build up the front teeth.

Teeth after restoration

Pros and cons of extensions

All modern methods of building teeth used in dental practice have positive qualities, in particular:

restoration of the tooth can be carried out even in the most inaccessible places;
the restored tooth practically does not differ externally from the natural one;
compared to prosthetics, the extension procedure is much cheaper;
doctors use only anti-allergic fillings;
in most cases, one visit to the doctor's office is enough for the complete restoration of one or more teeth;
extensions are resorted to even with the complete destruction of the patient's tooth. This makes the procedure indispensable for high-quality and fast recovery;
there is a maximum preservation of the tissues of the damaged tooth during extension;
high-strength modern materials used in fillings are in no way inferior in their properties to human bone tissue, so the restored front teeth serve their carriers for many years.

Beautiful teeth

On a note! When building up, there is no need to install prostheses, which greatly facilitates the restoration process.

The peculiarity of the extension also lies in the fact that in some patients the restored tooth can be damaged already 10-12 months after the procedure, while in others it lasts more than 8 years.

The duration of the operational period can be affected by certain factors, including the presence of bad habits, diet, compliance with the rules of oral hygiene, the experience of the doctor, and so on. Even if the patient skips one tooth brushing a day, all the work of the doctor and the money spent on the procedure will be in vain.

Teeth cleaning

Therefore, before deciding on the choice of a method for building up a tooth, ask yourself: can you force yourself to lead a correct lifestyle and observe basic oral hygiene? In any case, this is the decision of the patient and only.

Video - Aesthetic restoration of the anterior teeth

V modern world people pay great attention to their appearance. Plastic surgery, rejuvenation and other services are very popular today. No less popular is the restoration of teeth. After all, a smile is a person's calling card. Much depends on her at the first meeting. Therefore, people are so reverent about dental organs and when they are chipped, deformed or destroyed, they immediately look for ways to correct the situation.

When is it necessary to restore a tooth?

Collapse front and chewing teeth may be for various reasons.

One of these reasons is caries. It occurs due to the acids produced by carbohydrates during their fermentation. For this reason, sweet teeth are most susceptible to such an ailment, since sugar is the main carbohydrate.

Externally, caries can be determined if there is dark spots and further tooth decay. The disease can develop into pulpitis and periodontitis. But its most terrible consequence is the harm brought hard tissues. The disease can lead to the destruction of most of the tooth, for the treatment of which it will be necessary to remove absolutely all damaged areas.

It is also necessary to restore the tooth due to jaw injuries. The anterior teeth are especially susceptible to this effect. Treatment aims to restore not only the functionality of the tooth, but also the aesthetics of the smile. Here it is important to carry out the restoration as soon as possible, because the imperfection of a smile is perceived by each patient quite painfully.

It is also necessary to restore teeth:

on enamel that has chips, cracks, unbleached spots, or the surface has completely worn off;
between which there are gaps that look unaesthetic;
with malocclusion.

Restoration of tooth functionality

Patients often turn to dentistry with a request to restore the functionality of the tooth. The need for this procedure is usually caused by problems resulting from the inflammatory process, mechanical damage or caries. Restoring such a dental organ, the specialist recreates its anatomical shape. And this work is very painstaking.

It is important to take into account the position of the dental organ during its functional restoration. The difficulty extends to both working with molars and incisors. It is very difficult to create an aesthetic appearance of the teeth in the smile area, because they should not differ from the real ones.

What method the restoration will take place, what materials and technology will be used, the doctor decides individually for each patient.

Correction Methods

There are cases when it is important to restore not only the functionality of the tooth, but primarily its aesthetic appearance. Then, for restoration, the use of lumineers, veneers, inlays, crowns and other structures is practiced.

Depending on the complexity of the situation, restoration methods can be as follows:

Minor chips and other imperfections of the front and other teeth can be easily masked with veneers. They also perfectly protect the dental organs from destruction. The disadvantage of such devices is that their attachment requires preliminary grinding of healthy teeth. But the result is excellent. The patient receives a highly aesthetic dentition.
In the case when the tooth can no longer be sealed, but it is still possible to save it, linings are used.
Crowns are the most popular restoration method. Their types are diverse, which makes it possible for each patient to choose the most suitable one.
Restoration with composite materials is also quite common, especially when it comes to treating caries and restoring enamel. New techniques for their creation contribute to obtaining very durable and aesthetic fillings. Due to the large number of shades, they can be matched as accurately as possible to the color of natural tooth enamel, which will make the filling even in the smile zone completely invisible to others. In addition to high aesthetics and the preservation of more healthy tooth tissues, the advantage of this method is the speed of treatment.
To avoid prosthetics, when the tooth is slightly damaged, it is possible through artistic restoration. The result depends on the ability of the dentist to make this kind of restoration, the specialist must have artistic skills.
If the tooth organ is broken, it is either restored using a crown, or, if the damage is minor, a composite material is used.
Even if the tooth is more than 50% destroyed, it can be restored using a pin. For this, it is important what condition the root of the dental organ is in, and high-quality preparation for the procedure is also required. To prolong the service life of the oral cavity restored in this way, a crown is placed on the pin.
With a strong destruction of the crown part of the dental organ due to various diseases, stump tabs are used. Designs are reliable and high-precision. With the help of an individually made structure inserted into the tooth root, the dental crown is fixed. The crown can be ceramic, platinum, gold, etc.
In addition to the composite material, enamel can also be restored with ceramic microprostheses. Their price is not low, but the result is excellent. For minor lesions, remineralizing compounds are used, which are quite affordable.
Implantation is used to restore the bone tissue of the teeth. After the tooth is removed, an implant is placed in place of its root, on which a new tooth is built up. So he gets a second life.
If the molar is completely lost, prosthetics are used. This procedure has almost no contraindications, and it gives a fairly high-quality result.

Fiberglass

Restoration of dental organs using fiberglass is a new way. Thanks to him, the destroyed organ is restored and made more durable. Fiberglass has become used in dentistry due to its strength and perfect safety for the human body.

Comparing it with other materials used to restore teeth, it should be noted that fiberglass is not inferior in almost all respects, and in some cases even wins. Great strength allows it to be used for prostheses and implants. Teeth after restoration with fiberglass look natural, thanks to the quality and aesthetics of the material.

Glassspan technology

The use of Glassspan technology to restore a tooth is also one of the modern methods. The technology itself is a flexible ceramic bond used to restore anterior and posterior teeth. This technology makes it possible to use any kind of dental material.

Glassspan technology is used when it is necessary to replace or restore a dental organ. She has proven herself excellently in the manufacture of bridges, both temporary and intermediate, and adhesive. Using this method, the position of the affected dental organs is also stabilized.

The technology does not cause complications, and the rehabilitation time when using it is less than when the tooth is restored with a pin or crown.

Cosmetic restoration

To restore a tooth cosmetically means to restore its color or whiteness. This also includes microprosthetics of cracks formed on the enamel. A dentist-cosmetologist performs procedures, using composite and filling materials.

Having restored the teeth cosmetically, the specialist gives the patient recommendations on how to shorten the duration of the rehabilitation period and maintain the attractiveness of the dentition for as long as possible.

The price of such a procedure depends on the complexity of the work being done. It is advisable to carry out the cosmetic restoration procedure in a specialized clinic.

Restoration with photopolymers

Restoration of teeth using polymers allows not only to get rid of cracks and stains on the tooth enamel, but to restore the tooth, restoring its desired color, shape and functionality.

At the beginning of the procedure, the tooth is processed to give it the desired shape. Then the missing areas are built up with photopolymers, recreating the desired size and shape. The result obtained is fixed by the action of a special lamp.

The cured material is polished so that it does not change its shade when exposed to coloring products. After that, in order to preserve the color, the surface of the tooth is covered with a special compound.

Photopolymers do not help in cases of:

With a very weakened root.
In the presence of inflammation in the root system.
Pathological mobility of the fourth stage.
When restoring two adjacent teeth.

Features of building on a pin

The pin is a special design that plays the role of a base that provides the tooth with reliability during chewing. They are made from alloys of gold, palladium, titanium, stainless steel, as well as ceramics, carbon fiber and fiberglass. The pins are different in shape, composition and size.

The main types of pins:

Standard conical or cylindrical design. They are used when tooth decay is insignificant.
Individual designs. They are made taking into account the relief of the root system. These pins are very reliable and hold firmly in the root canals.
Metal rods are used for significant tooth decay, when most of it is missing. With its help, the tooth can withstand heavy loads during chewing.
Anchor pins are made from titanium alloys.
Fiberglass structures are very flexible. Fiberglass does not react with saliva and oral tissues.
Carbon fiber pins are the most modern material. They are very durable and distribute the load on the dental organ evenly.

Today, fiberglass pins are most commonly used. With their help, you can completely fill root canals. Also, fiberglass interacts well with composite materials, which makes it possible to restore a tooth without a crown.

When choosing a pin, it is important to consider the following nuances:

How badly the root is destroyed, what is the thickness of its walls, how deep can the pin be placed.
At what level relative to the gums the tooth collapsed.
What load will the tooth be subjected to. Will it be a support for the bridge or is it freestanding.
When choosing a material, it is important to take into account the characteristics of the patient, the possibility of an allergic reaction to a particular material.

Pin installation is contraindicated in the following cases:

disruption of the central nervous system;
blood disease;
periodontal;
the thickness of the root walls is less than two millimeters;
complete absence of the crown part in the frontal part of the tooth.

Stages of building on a pin

Preparation of tooth canals with special tools. Their cleaning and processing.
Inserting the pin into the channels so that it enters the bone.
Fixation of the product with filling material.
Fixation of the crown, if its fixation is provided.

Enamel restoration

Strong enamel is the foundation of a healthy tooth. When it is weakened and damaged, the tooth can be affected by caries, infections and dental deposits.

Consider the main ways to restore enamel:

The use of filling materials for the restoration of cracks and chips.
One of effective ways restore enamel - fluoridation. A composition saturated with fluorine is applied to the tooth, which restores and strengthens the enamel.
Remineralization is the saturation of the tooth with fluorine and calcium, which are very useful for the dental organs.
The use of veneers.
Application method - the use of overlays filled with a special composition.

Restoration of teeth with minor damage

Cracks in tooth enamel, its thinning, the presence of interdental spaces and chips are minor damage. Composite materials are used to mask them. So the restoration can be done by visiting the clinic once, as the process is quite fast.

Modern materials for restoration take any shape, quickly harden, have a highly aesthetic appearance and are absolutely compatible with the tissues of the oral cavity. Their structure is as close as possible to the structure of tooth enamel, and the oral mucosa is not damaged during chewing.

The advantages of this recovery method:

Pulp preservation.
The speed of the procedure.
Maximum similarity with tooth enamel.
The ability to adjust the shape and size.
The ability to hide minor defects, such as stains.

Stages of the procedure for restoring teeth with extension:

Professional cleaning of plaque and stone, in order to enhance the effect of fixing the filling material.
Selection of the shade of the photocomposite.
Local anesthesia if necessary.
Drilling with a boron machine areas damaged by caries and darkened fillings.
Isolation of the tooth from saliva by means of a latex lining, because moisture can greatly reduce the effectiveness of the treatment.
Using a pin when more than half of the tooth is destroyed. It is used to normally withstand the load of the crown during chewing.
Application of filling material in layers.
Polishing and grinding.

New technologies

Modern technologies for restoring teeth are changing, improving every day, and new types of them are also appearing. The restoration process with their help is fast, painless, high-quality, while giving an effective and durable result.

On a note: The main feature of the new restoration methods is the use of modern materials. Composite materials used for reconstruction are very durable and safe.

Prostheses made using new technologies are of the highest quality, in addition, they perfectly match the living dental organs in color, repeating their individual features. New technologies make it possible to restore a lost tooth from scratch, when there are no remnants of bone tissue.

Should decayed teeth be saved?

When a small piece is chipped from a tooth or when a crack appears on it, it should of course be restored. But if there is more serious damage, you should think about the need to restore this organ.

Restoring with composites and inlays is safe enough. Enamel during their installation is processed slightly. After removing them, the patient can continue their usual life activities. What can not be said about the use of veneers. Their removal makes the teeth vulnerable, because there is no protection, enamel and ceramic plate are missing. The tooth will become as sensitive as possible to any irritants. Also, his appearance will suffer greatly. In addition, in order to replace veneers, the teeth are grinded again each time, which eventually leads to their thinning, making them unusable and requiring crowns to hide the defect.

And crowns are already a denture, not restoring, but replacing a tooth. Crowns are quite strong and will last much longer than veneers. Also, their use will be more profitable in relation to cost.

Therefore, it is important to think about the use of ceramic plates.

If the tooth is no longer restored, what should I do?

When a tooth can no longer be restored, a crown is used. But this solution may not work in all cases. If the tooth root is also destroyed, even the installation of a pin will not save you. After all, the crown will be very difficult for him, and the tooth will have to be ground off to install it, depriving the pin of the external support.

The best way out in case of loss of a tooth along with the root is to install a prosthesis on an implant. Despite the complexity of implantation, it gives a highly effective result. A metal rod is implanted into the bone, which replaces the root of the tooth and serves as a support for the crown. Most implants come with a warranty of about twenty years, but if properly maintained, they can last much longer.

Characteristic signs for pathological abrasion of dental tissues (PSA) are an accelerated decrease in the volume of dentin and enamel, a reduction in the size of crowns on some or all teeth.

In addition to changes in the anatomical outlines of the teeth, the pathology is characterized by disruption of the temporomandibular joint, improper occlusion and excessive sensitivity in hard surfaces.

PSZ is associated with a progressive decrease in the volume of enamel and dentin, various disorders of the morphological, functional and aesthetic nature. This is one of the known non-carious lesions leading to tooth loss.

In dentistry, a similar pathology is detected in 12% of people, among whom about 60% are males. The increase in symptoms of the disease occurs at the age of 40-45 years.

Basically, the chewing tubercles of premolars with molars, the cutting parts of the frontal teeth, are exposed to increased abrasion of teeth.

The doctor reveals a violation of dental tissues during the examination of the patient, conducting electroodontodiagnostics, aiming, orthopantomography and electromyography.

The defect can be eliminated by selecting , or .

Causes that provoke the development of PSZ

According to dentists, there are 3 groups of factors that provoke tooth grinding:

Classification and stages of development of pathology

According to the degree of localization, pathological tooth wear is divided into horizontal, vertical and mixed forms:

vertical a form of the pathological process with normal overlap on the front teeth, can be detected on the palatal part of the labial and upper surface of the lower teeth.
For horizontal The form is characterized by a reduction in the volume of hard tissues of the teeth in the same plane with the appearance of abrasion on the chewing or cutting facets. Basically, horizontal abrasion is characterized by spreading to the lower and upper rows of teeth.
With mixed In the form of PSZ, pathology can spread in a vertical and horizontal position.
Also allocate faceted, stepped, cellular and patterned PSZ form.

In the course of the process, generalized (with spread to all tissues) or localized (appearance of PSZ in certain areas) abrasion is distinguished.

Erasure of teeth can occur in several stages:

First(25-30 years old) is characterized by abrasion of the cutting edge on the canines and incisors, smoothing of the molar and premolar tubercles. There is abrasion of the enamel layer and a partial part of the dentin.
Second(45-50 years) is associated with the erasure of tooth enamel without the appearance of a cavity.
Third(over 50 years) is associated with grinding of hard surfaces to the enamel-dental edges with partial violation of the dentin and translucence of the tooth cavity.
Fourth stage- characterized by grinding over 2/3 of the parts of hard dental tissues.

How to identify the problem in time?

In addition to external signs (decrease in interalveolar height, change in the anatomy of the crown, periodontal disturbance, facial adjustment), physiological disturbances may occur.

It's connected with constant pain head, facial muscles, temporomandibular joint, a possible violation of the auditory and visual organs, a change in salivation, a crunch in the jaw joint.

Hyperesthesia may appear from mechanical, chemical or thermal effects. Often, due to sharp dental edges, the mucous membrane on the lips and cheeks is injured.

With the progression of the pathological process, malocclusion intensifies, the height of the lower part of the face decreases, chin and nasolabial folds appear, and the corners of the mouth drop.

The decrease in the height of the crown of the tooth is associated with the degree of PTZ; in severe stages, the process can reach the neck. Abraded surfaces are polished, smooth, may have a faceted, cellular, stepped or patterned shape.

Carrying out diagnostic studies

Before prescribing any treatment, it is imperative to conduct a correct diagnosis with the interpretation of the existing problem.

The correct diagnosis is determined on the basis of a complete clinical and instrumental examination. The doctor interrogates the patient, analyzes his complaints, determines the etiology of the process. During examination, attention is paid to the outlines of the face, the form of occlusion, the stage of development of the pathology.

The specialist conducts a study of the TMJ and masticatory muscles using radiography, tomography and electromyography. Effective therapy and assessment of the involvement of the dental tubules is done after performing radiography, electroodontodiagnostics and orthopantomography.

Thanks to the analysis of diagnostic jaw models, the specialist specifies the shape, type, level of PSZ.

What to do to restore the enamel of affected teeth

Therapy for abrasion of tooth enamel and dentin is chosen based on the nature and type of violation, as well as based on the professionalism of the doctor.

An important factor is the correct examination, correction of problems and rehabilitation treatment using methods of indirect and direct restoration with the restoration of aesthetics, functionality and forms of the oral cavity.

Elimination, restoration of bite, etc. may be required.

To eliminate the causes of the pathological process, mineral metabolism is corrected, endocrine problems are treated, bad habits must be abandoned, prostheses are changed or put in place.

Hyperesthesia of the teeth is eliminated (a complex of vitamins with minerals, electrophoresis, applications of fluorine-containing products are prescribed).

The specialist polishes the sharp edges of the teeth, which can damage the mucous membranes in the oral cavity. For terminal violations in the dentition, and are used. Bruxism is eliminated by use during sleep.

In the pathological process of 2 and 3 degrees, the use of simple stamped crowns is not allowed due to possible complications with trauma to the marginal periodontal crown.

Therefore, with contraindications for the use of artificial crowns, stamped caps, cast crowns, and stump crowns can be used. When choosing materials, wear resistance is taken into account.

Preventive actions

With an increased effect of acid on tooth enamel, it is possible.

To prevent enamel wear, normalization of the diet, elimination of bad habits, and periodic visits to the dentist are required.

The specialist must carry out timely correction of the bite, elimination of adentia, bruxism, normalization of metabolic processes and adjustment of working conditions.

Increased abrasion of teeth is a pathological process of accelerated grinding of the upper layers of hard tissues, that is, enamel. It is worth noting that this process is normal and it begins immediately after teething, the degree of its severity consists of many factors: heredity, hardness of food, composition of the water that a person consumes. But the teeth should be erased, of course, within reasonable limits - this should not be noticeable. If there is increased abrasion, which, moreover, can be noticed, then this, of course, is a pathology. But let's look at the problem in more detail.

Physiological abrasion

Erasing of hard tissues of teeth is normal - a natural process that is designed to help adapt to the load. It is uniform, no local overload is observed when it comes to the normal structure of the dentition. The result of erasure is a gradual change in the contacts of the antagonist teeth, a change in the angle of inclination so that the occlusion is correct.

Important! Physiological abrasion is distinguished mainly by the fact that it affects only the enamel - normally, the dentin is not exposed, and the areas of enamel in the area of the contact planes of the teeth are subject to abrasion.

Milk teeth are also subject to partial abrasion. So, by the age of 3-4, the teeth of the incisors and the tubercles of the canines and molars are erased, and by the age of 6, erasing to the dentin is allowed. Its erasure can be up to 13-14 years, that is, until a complete change. They speak of increased abrasion when the cavity is translucent or the crown is lost almost completely, that is, there are 4 and 5 degrees of abrasion.

Causes of pathological abrasion

The causes of the disease often lie in the presence of bad habits - when a person gnaws objects (nails, pens, pencils) or holds them in his mouth, loves nuts and seeds, and also prefers products with hyperacidity. In addition, the disease may be the result of bruxism and other violations of the tone of the masticatory muscles.

The disease can also be provoked by the constant intake of certain medicines, diseases of the gastrointestinal tract, accompanied by reflux of gastric acid or frequent vomiting, diseases of the heart and blood vessels, nervous and endocrine systems.

And finally, inappropriate or poor-quality orthopedic constructions, crowding of teeth or other bite defects can lead to abrasion.

Symptoms of pathology

Symptoms of pathological abrasion include a number of disorders:

change in the anatomy of the crown, i.e. decrease in height
hyperesthesia - hypersensitivity to temperature, mechanical, chemical influences,
damage, ulcers of the mucous membrane - this is due to the presence of sharp edges of the teeth,
malocclusion, as a result - the loss of hard tissues due to improper distribution of chewing load,
decrease in the height of the lower third of the face - omission of the corners of the mouth, clearly marked nasolabial, chin folds,
pain of a different nature in the temporomandibular joint, facial muscles, neck muscles - if there is dysfunction of the temporomandibular joint.

Many of the signs can be attributed to the consequences and complications of the underlying disease - they form later, as the erasure progresses.

“Abrasion can affect one, several teeth or the entire dentition. It depends on the specific reason. So, if the problem is in the excessive height of the artificial crown, the loss of hard tissues will be observed on one antagonist tooth. If we are talking about crowding on the one hand, the remaining half of the dentition will “suffer”. If there is a malocclusion, all teeth can be subject to abrasion., - notes I. Volovonsky, a dental therapist with more than 17 years of experience.

Classification of increased abrasion, degree and form

The degree of tooth wear is determined by the most common classification by A.G. Moldovanova and L.M. Demner. The researchers took into account the physiological erasure and identified normal rate– up to 0.042 mm/year. According to the age norms, there are three degrees:

by the age of 25-30, bumps and cutting edges are smoothed out,
by the age of 45-50, the enamel is only partially erased,
by 50 or more, the abrasion reaches the border of enamel and dentin.

According to Bracco, the process is classified as follows:

smoothing edges and bumps,
erasing of tubercles completely (on 1/3 of the coronal part), exposure of dentin,
crown height reduction by 70%,
distribution of the process to the neck, i.e. almost to the gum.

According to Grozovsky, 3 forms of increased tooth wear are distinguished:

horizontal,
vertical,
mixed.

According to Courland, it is customary to distinguish 2 more types: localized and generalized pathology. The degrees are presented as follows:

spread to enamel and a small part of dentin,
distribution at the border of the main dentin,
transillumination of the cavity, erasing to the replacement dentin,
erasure of the entire coronal part.

The Bushan classification implies not only the stages of development of the pathology and the depth of the lesion, but also the extent, changes in functions, and the plane of the tooth. The researcher also identified 4 degrees - the first is characterized by exposure of the dentin and a shortening of the crown height by 30%, gradually this figure increases and reaches 80% by the 4th.

Erasure Diagnostics

Diagnosis of the defect is carried out using a comprehensive examination. It includes a verbal survey, clarification of the etiology, a visual assessment of the state of the oral cavity, the shape of the face, the height of its lower third, and bite characteristics.

The doctor can study the state of the masticatory muscles and TMJ using electromyography, tomography of the joint, and an x-ray. In order to draw up a correct treatment plan, it may be necessary to conduct an electroodontodiagnostics, a panoramic x-ray or an x-ray of individual groups of teeth. Based on the results obtained, the specialist specifies the type, form, degree of the disease, determines the characteristics of the bite and offers a method of treatment.

Treatment of pathological abrasion

What to do if the diagnosis is confirmed? The doctor will offer treatment tactics based on the state of the dental system, the complexity of the case, the severity of the disease. There are two treatment options: therapeutic and orthopedic.

Therapeutic treatment of tooth abrasion consists in the application of drugs to strengthen tissues, reduce hyperesthesia (high sensitivity). Such drugs are available in the form of solutions and gels, as well as pastes for application. An auxiliary method is physiotherapy. Widely used pastes and materials that seal the dentinal tubules. The mechanism of action depends on the specific composition: some of them act mechanically, the drug itself seals the tubules and reduces sensitivity. As a rule, we are talking about products in the form of varnish. Others act differently: they block the transmission of a nerve impulse. TO therapeutic methods also applies to restoration - restoration of the surface with the help of composite materials.

Orthopedic treatment consists in the selection and installation of prostheses. However, it is worth considering that in some cases, prosthetics are preceded by other measures to eliminate the cause of abrasion or stop the pathological process. So, with a significant progression of the disease, it is important to restore the bite height with the help of special dental and periodontal trays. Mouthguards will also be required for bruxism, which will slow down the destruction.

Installation of crowns

Metallo ceramic crowns- one of the best options for prosthetics with increased abrasion. They can significantly reduce the load and completely restore the shape and function of the tooth. In this disease, all-ceramic crowns or based on zirconium dioxide are most often used, since they are distinguished by high strength characteristics. Metal ceramics will cost from 7.5 thousand rubles, but constructions based on zirconium dioxide and ceramic crowns will cost about 20-30 thousand.

Stump tabs

Severe tooth decay may require the installation of stump inlays that exactly follow the shape of the dental canals. This is a long-term solution that requires a healthy, preserved root. With healthy peridental tissues, it will last a long time - the strength indicators of such a solution are also very high. The cost of such a solution is from 4500 rubles.

Microprosthetics - veneers, lumineers

Artificial structures - ceramic inlays, veneers - are created in dental laboratories. An inlay is the optimal solution when there is significant loss of dentin. Veneers and lumineers will serve optimal way restore both aesthetics and protect teeth from abrasion.

“For a long time I struggled with crowding of teeth on one side with the help of braces. The dentition was aligned, but on the one hand, the upper incisors were heavily worn out during the time when the crowding was. I decided to install lumineers - and I didn’t have to whiten my teeth, and I solved the problem with different sizes of teeth. ”

Irina M., fragment of a message from the woman.ru forum

The cost of a veneer with installation on one tooth is an average of 20 thousand rubles, lumineers - about 40 thousand.

You can prevent increased abrasion by ensuring the correct bite. It is important to timely pay attention to diseases of the tone of the masticatory muscles, take measures in the presence of crowding of teeth, adentia, and also deal with bad habits. Nutrition also plays an important role - it is necessary to ensure a normal balance of vitamins and minerals.

Related videos

1 Mandra Yu.V., Ron G.I. Ways to improve the effectiveness of treatment of the early stage of increased tooth wear, 2011.

Oral health is a very topical issue for many. From how beautiful and healthy a person's teeth look, one can judge his health, grooming and status. Ecology, stress, neglect of oral problems and not systematic visits to the doctor contribute to the formation of various problems and diseases of the teeth.

Pathological abrasion of teeth is an actual problem. This is a normal physiological process of the body. In people with the correct bite, the tooth enamel of the upper teeth is combed from the inside, and the lower ones, respectively, from the outside. The problem may arise when a person reaches a more mature age and develop into a pathological process.

According to statistical studies, 12% of the world's population is prone to pathological abrasion of teeth (men are at greater risk - 63%). By the age of thirty, a certain layer of enamel is gradually erased, and after fifty, the erasure of the dentin layer is often recorded. If such problems begin to appear at a younger age, we can talk about the pathological nature of this problem.

The main reasons for the appearance

Anatological abrasion of teeth is commonly called the systematic erasure of enamel (in some cases, enamel and dentin) of all or several teeth. Level of neglect this process only a doctor can determine by applying the main methods:

Examination of the model of the jaw on the cast.
Electrodiagnostics.
Electromyography.
Orthopantography.

Causes of dental pathology

Specialists combine the main causes of this anomaly of tooth enamel into two groups, namely:

- Functional lack of hard tissues of teeth:

- Wasting of human teeth due to problems associated with:

loss of teeth (partial);
bad habits, which very often cause systematic injury to a person’s teeth;
the resulting hypertonicity of the masticatory muscles of a person (may be formed due to tense muscles of the face);
foodless chewing.

Classifications of increased tooth wear

The classification of this pathological disease is made depending on the forms and complexity of this disease.

The main degrees of abrasion are distinguished:

Given the level of the erasure plane, the following types are distinguished:

Vertical, most often found in patients with malocclusion. Only the outer side of the tooth enamel is erased.
Horizontal. With the erasure of teeth, the height of the crown decreases.
Mixed. Upon reaching this level of the disease, the erasure of the two previous types is characteristic.

In accordance with the complexity of the process, there are:

local erasure. In this case, one specific area is subject to erasure;
generalized. In this case, the process affects completely all areas of a person's teeth.

Summing up, we can talk about the numerous manifestations of the indicated pathology of the teeth, in which all the enamel can be completely erased or only some part of it, one side - or both at once.

Symptoms of the disease

The symptoms of this disease depend both on the degree of the disease and on its nature.

From the very beginning, the primary appearance of the teeth is disturbed. If you do not take action, the disease develops, due to which the length of the tooth becomes much shorter than before. The chewing function of a person is impaired. Patients note the discomfort that has appeared when taking hot, cold, sweet or sour foods, which indicates the onset of hyperesthesia.

Impaired chewing function is a sign of a disease called increased tooth wear. Tooth enamel is about five times stronger than dentin, therefore, until the enamel is completely worn away, the symptoms are mild, but as soon as the enamel disappears, the symptoms will become more pronounced.

This pathology requires immediate medical attention, while the symptoms indicate the initial stage of the disease. The consequences of the disease, if left untreated, can be deformity of the joints, a change in the lower part of the face, the appearance of severe pain.

Diagnosis of the disease

Diagnosis of pathological abrasion of tooth enamel includes a deep analysis of the symptoms. Due to the wide range of symptoms, only a dentist can diagnose abrasion, taking into account all the factors and the possible presence of other pathologies.

The survey plan includes:

Complete examination and questioning of the patient, study of the history of the disease to determine the forms and stages of pathology.
Inspection of external signs.
Full examination of the oral cavity, the condition of the masticatory muscles of the patient.
Study of the functions of the temporal and mandibular joints.

X-ray, tomography, electromyography can be used to study the picture of the disease.

The initial examination of the patient's face includes the study of the contours of the face, its symmetry and proportionality. Specialists analyze the degree of destruction of the mucous membrane, the level of tooth wear, the condition of hard tissues to determine possible complications during treatment.

Examination of the chewing muscles allows you to study their condition, possible asymmetry and hypertonicity. In this case, electromyography is often used. All this helps to minimize possible complications.

The study of the temporal and mandibular joints allows you to determine different kinds pathologies that can be formed with this type of disease.

Electroodontodiagnostics, or EOD. This type of diagnosis is necessary, since in the pathology of tooth abrasion, pulp death very often occurs, while the patient did not observe any signs of deviation. EDI is prescribed only for the second or third degrees of the disease, since in initial stage symptoms do not appear.

Diagnosis allows you to identify the main causes of the formation of increased abrasion of teeth. In addition to the oral cavity, doctors focus on the condition of the temporal and mandibular joints.

Forms of treatment

The treatment of this problem takes a lot of time, this is due to the huge variety of factors that affect the problem. In addition, it is important to determine the stage of development of the disease, this will help to choose proper treatment and speed up the process.

To cure pathological abrasion of the first and second degrees, doctors first of all stabilize an already running process so that the disease does not develop.

At the initial stage, doctors install temporary prostheses (to start the recovery process and maintain chewing functions). After positive dynamics can be traced, temporary prostheses are changed to permanent ones.

Treatment of more advanced stages of the disease (third and fourth) begins with the restoration of the bite. At this stage, experts strictly prohibit the installation of crowns, as this can cause a malocclusion in the patient. As a result of their establishment, tooth tissues can be violated.

The manufacture of prostheses is an important issue. At the initial levels of the development of this disease, prostheses are most often made of plastic, ceramics, sometimes the choice falls on prostheses made of precious metals. In the case when the disease has gone far, prostheses made of ceramics or metal-ceramics are often used.

When installing prostheses, it is important to remember that the prostheses must be made of the same materials, otherwise you can come to the reverse (repeated) correction of the bite.

If the cause of pathological abrasion of teeth is a strong load or periodic contraction of the masticatory muscles, experts recommend installing prostheses that are not prone to cracks (more durable): made of metal-plastic or metal. Metal ceramics in this case is strictly prohibited.

The main stages of treatment:

By installing temporary prostheses, doctors correct the height of the bite.
Analyze the adaptation of the teeth to the new position.
After positive results, temporary prostheses are replaced with permanent ones.

Restoration of the height of the occlusion at the first stage occurs through the establishment of the so-called plastic caps.

The adaptation period is the adaptation of the patient to other positions of the jaw. Most often, this period is characterized by severe discomfort. The patient must visit the dental office at least twice a week, this is necessary for strict control and research of the results of wearing mouthguards by the dentist. Most often, the average duration of wearing temporary mouthguards takes about two to three weeks. It should also be taken into account that adaptation begins from the moment when the patient stops complaining about discomfort in the area of the temples, the mandibular joint, and also in the area of the masticatory muscles when eating.

The third stage of treatment is the installation of permanent prostheses (final prosthetics). At this stage, special materials are selected in order to achieve the preservation of a correctly set bite. To achieve the best possible results, doctors in the manufacture of prostheses take into account the results obtained when wearing medical mouthguards, which were installed temporarily.

The process of permanent prosthetics can take place both immediately and in stages. Mouthguards help determine the exact occlusal height for the patient. Prostheses for the remaining sections begin to be made after the complete fixation of the first permanent prostheses.

Prevention of tooth wear

To protect yourself from the disease or from the appearance of its re-emergence, you must adhere to the following rules and recommendations:

Treatment prognosis

The prognosis for the treatment of this disease is generally positive. Of course, treatment takes a much shorter period of time if the patient applied for early stages diseases. In addition, younger patients are more likely to recover quickly. However, relapses of the disease of pathological abrasion of teeth often occur, so dentists talk about the need to register patients suffering from such a pathology.