Dysgnathia

Under malocclusion ( Greek. : Δύς dys miss -, fail -; Γνάθος Gnathos pine ) refers to a grouping of aberrations of the teeth, the jaw and / or of the masticatory system . The anomalies can affect the position of the teeth, the teeth ( occlusion ), the shape of the jaws, the position of the jaws in relation to one another or the way the jaws are built into the skull and, as a result, cause aesthetic and functional impairments. There are smooth transitions between dysgnathia and eugnathia - the balanced and well-developed teeth.

Misalignments

Dentoalveolar misalignments are to be treated orthodontically even after the end of growth . The skeletal anomalies can only be corrected surgically after growth has ended. These can only be treated to a limited extent during growth; at most, growth can only have a modifying effect.

Deciding whether to correct a skeletal abnormality conservatively, i.e. H. Orthodontic treatment alone or whether combined orthodontic-surgical therapy is appropriate will be decided on a case-by-case basis.

A distinction is made between hereditary and acquired jaw anomalies, whereby it is mostly a combination of acquired misalignments and genetic readiness.

Congenital abnormalities

In congenital anomalies, the upper and lower jaws are disproportionate to one another in terms of size or position, or aplasias occur , i.e. H. "Non-abutment" of the teeth, which often leads to asymmetrical tooth positions.

Acquired anomalies

The acquired misalignments are due to so-called habits (bad habits) such as thumb sucking , sucking pacifiers for too long or pressing the tongue.

consequences

In the case of pronounced dysgnathia, numerous important tasks cannot be carried out properly; thorough chewing is made difficult or impossible because the contact between the teeth and the opposing jaw is insufficient or nonexistent.

The optimal digestion is impaired in this way and the teeth holding apparatus is overstrained by the misalignment, which leads to periodontitis and in the worst case to premature tooth loss.

If the lips are not closed, mouth breathing increases , which means that the nasopharynx is insufficiently developed due to the lack of tongue deposition. The result is often language disorders and a higher susceptibility to colds and throat diseases as well as damage to the tooth substance .

If the teeth are too narrow, dirt niches arise in which tooth decay and periodontitis can form.

Reclining or narrowing of the jaw also causes constrictions in the upper airways, which lead to snoring and obstructive sleep apnea.

Indications for treatment

Treatment must be considered particularly if the following functional complaints are present:

TMJ discomfort
Insufficient bite function ( incorrect bite , open bite , cross bite, etc.)

strong tooth nesting

insufficient lip closure

Obstructed nasal breathing, chronic tonsillitis, and speech disorders (e.g., lisp)

migraine headache

snoring

Sleep apnea

Gastrointestinal disorders

Neck and back pain .

The error axes of the jaws can be in the transversal (width of the jaw), in the sagittal (too far forwards or backwards) or in the vertical (too high or too deep) as well as combined.

Most common forms of dysgnathia

A distinction is made between the following forms of dysgnathia.

Transverse dysgnathia

Maxillary crowding, lower jaw crowding

Sagittal dysgnathias

mandibular retrognathy (micrognathy, "bird's face"), maxillary retrognathy , mandibular prognathy , maxillary prognathy

Vertical dysgnathias

Frontal open bite , side open bite, elongated midface, deep bite

Dysgnathia operations

Dysgnathia operations are jaw repositioning operations. The procedure is performed under general anesthesia. To secure the temporomandibular joint position, the correct position of the lower jaw branches supporting the joints is set and these are fixed to the upper jaw. Then the jaw arch supporting the teeth is cut off, adjusted to the planned correct position and fastened to the upper jaw by means of a wire lacing. Then it is firmly screwed back to the joint-bearing jaw branches.

Web links

Wiktionary: Dysgnathia - explanations of meanings, word origins, synonyms, translations

literature

Schahram Schamsawary: Dysgnathias: interdisciplinary therapy concepts from planning to surgery. Elsevier, Urban and Fischer, Munich 2007, ISBN 978-3-437-05620-8 .

Individual evidence

↑ Norbert Schwenzer: Special surgery: 41 tables . Georg Thieme, 2002, ISBN 978-3-13-593503-4 , p. 235- ( google.com ).
↑ Can obstructive sleep apnea (OSAS) be inherited? In: SeegartenKlinik Heidelberg. October 21, 2019, accessed on July 3, 2020 (German).
↑ Wolfgang Bigenzahn: Orofacial dysfunctions in childhood: basics, clinic, etiology, diagnostics and therapy; 5 tables . Georg Thieme, 2003, ISBN 978-3-13-100592-2 , p. 16– ( google.com ).
↑ Wolfgang Stelzenmüller, Jan Wiesner: Therapy of temporomandibular joint pain: a treatment concept for dentists, orthodontists and physiotherapists; 94 tables . Georg Thieme, 2010, ISBN 978-3-13-131382-9 , p. 487 ff . ( google.com ).

[1] Norbert Schwenzer: Special surgery: 41 tables . Georg Thieme, 2002, ISBN 978-3-13-593503-4 , p. 235- ( google.com ).

[2] Can obstructive sleep apnea (OSAS) be inherited? In: SeegartenKlinik Heidelberg. October 21, 2019, accessed on July 3, 2020 (German).

[3] Wolfgang Bigenzahn: Orofacial dysfunctions in childhood: basics, clinic, etiology, diagnostics and therapy; 5 tables . Georg Thieme, 2003, ISBN 978-3-13-100592-2 , p. 16– ( google.com ).

[4] Wolfgang Stelzenmüller, Jan Wiesner: Therapy of temporomandibular joint pain: a treatment concept for dentists, orthodontists and physiotherapists; 94 tables . Georg Thieme, 2010, ISBN 978-3-13-131382-9 , p. 487 ff . ( google.com ).