Bite and Occlusion Damage: Accrual Process
Damage to the occlusal plane (our bites) can occur at nearly any age and can have a rapid onset or developmental onset.
The pictures outlined below show how developmental issues affecting jawbone structures and shape, plus common occurences of underdeveloped tooth structures which, if left untreated, can initiate and accelerate unhealthy changes in the occlusal plane.
Depending on the delay of recommended treatment, other damage to teeth and occlusal plane can occur for some patients.
Amelogenesis imperfecta is a developmental disorder that can affect the development of teeth. Teeth tend to be abnormally small, discolored, have surface pitting or grooves. Wear and tear, with eventual breakage can be common. This type of genetic disorder can affect baby teeth and secondary (adult) tooth structures.
Treatment possibilities are numerous and can be quite complex, beginning as early as 2-6 years old. During the developmental years, focus would be on maintaining overall dental functional and an acceptable aesthetic. After developmental stages have passed, a wider scope of possibilities including prosthetics, implants, bridgework, dentures, etc., are possible depending on occlusal need and the cosmetic aspirations of the patient.
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 Amelogenesis Imperfecta Mitchell PohlDDS |
| Bilateral Cross Bite (lower jaw is bigger than the upper jaw) also defined as a " jaw size discrepancy". This is most difficult type of treatment as there is a Orthopedic Problem rather than a Orthodontic Problem The jaw size discrepancy is a orthopedic or (jawbone) problem. Additionally, the teeth are crooked, superuped and she has a classic "underbite". Typical solutions are orthodontics and jaw
surgery to make the lower jaw smaller. Jaw surgery becomes necessary if the face is out of proportion. In this case, her face was fine and surgery was eliminated as she chose a complete bite reconstruction with porcelain veneer crowns. |
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 Angular Appearance Dr. S. Muslin |
| Tetracycline Stain, Peg Lateral Incisors, Retained Baby teeth, Defective Enamel,
The teeth were stained with the antibiotic tetracycline during the development of her permanent teeth at about 4 years of age. The lateral incisors were peg shaped and out of proportions with the sizes of the other permanent teeth. The treatment involved non-invasive porcelain veneers and porcelain veneer crowns that required no grinding of her natural teeth. The color of the veneers was able to hide the color as the dentist bonded the stained defective enamel before the veneers were made |
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 Baby Teeth - Peg Laterals Dr. S. Muslin |
| Deep overbite, bite collapse, Congenitally missing lateral incisors, teeth drifting, lost canine guidance, lower anterior teeth superupted, Broken edge of the central incisor |
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 Congenitally Missing Lateral Incisors Dr. S. Muslin |
| Lower teeth superupted, deep overbite, missing congenitally the upper lateral incisors and back molar teeth, gum recession and tooth erosion, teeth are drifting, bite is not stable, tooth abrasion,
bruxism and heavy tooth wear as the angles on the lower front teeth are from clenching and tooth grinding or bruxism |
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 Super Eruption - Missing Incisors Dr. S. Muslin |
| Unusual case of twelve (12) missing teeth. Early treatment for this 40 something patient consisted of wearing a custom partial for most of his life. Normal dental function not possible. Limited in ability to eat different foods. Unusual orthodontic movements due to missing teeth. Treatments can incorporate choice of crowns, implants, bridgework, fixed bridges and standard dentures. |
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 Multiple Missing Teeth Mitchell Pohl, DDS |
| A common cause of missing two laterals but with exaggerated spacing. Flaring of the 4 anterior teeth is quite significant. Delays in treatment promoted an increase in orthodontic issues affecting overall bite. |
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 Missing Teeth Gaps Kristin Petulla, DDS |
Another example of congenital malformations of upper anterior tooth structures (peg laterals) and multiple diastemas. Many patients delay treatment well into their adult years. Compounded occlusal problems may emerge for some patients, depending on the existence of early signs of impending malocclusion. In this case, 4 anterior teeth appear to be "out of occlusion", creating a reverse smile line.
Treatments can include crowns, implants, bridgework, partials, custom porcelain laminates. |
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 Adult Male Peg Laterals Paul Sussman, DMD |
Missing laterals for an adult female. Fortunately, ortho treatment was not performed during early years to move teeth together (not an uncommon practice). The patient was equally fortunate not to acquire other generalized teeth alignment issues.
Treatments can include implants, crowns, partial or bridgework. |
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 Female Missing Laterals Edward Leventhal, DDS |
A young male adult with an unusual genetic defect that caused the eruption of a good sized tooth into an area that created unique bite problems in addition to the cosmetic impactit had on his good looks. Extraction was required but left a gaping diastema that could be treated in several ways.
Recommended procedures could include adult orthodontics, dental implants, bridgework. |
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 Congenital Defect - Extra Anterior Tooth Ara Nazarian, DDS |
An unusual disorder that creates the appearance of bluish green teeth. The congenital defect occurs during infancy whereby biliary atresia occurs, disrupting the draining of bile from the liver to the small intestine. Numerous developmental events can occur, depending on the extent of the condition. Not hereditary and not contagious.
Recommended procedures for treatment could include implants, crowns, bridgework, bone grafting, reconstructive dentistry. Veneers would probably not be sufficient for resurfacing discolored tooth enamel. |
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 Congenital Defect - Biliary Atresia Mitchell Pohl, DDS |
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