As manifested atrophy of the alveolar process and modern methods of its correction

According to specialists, atrophy of the alveolar process begins immediately after tooth extraction.

The alveolar process is the portion of the jawbone that forms the "socket", or the tooth bed, completely repeating its shape. At the core of the structure of this process is the spongy bone, which is more friable than the other bone tissue and is nested by nerve fibers and small vessels. The height of the appendage can fluctuate, mainly it depends on the person's age, the presence of inflammatory diseases or removed teeth.

After extraction or loss of the tooth, the hole first decreases by one third of its height, and then the process slows down somewhat, but does not stop, but progresses. The process of destruction is not equally pronounced. It depends on the order of removal, the cause and characteristics of the operation.

Developmental abnormalities can also affect the shape and structure of the alveolar processes, but this does not occur as a result of atrophic changes.

The most pronounced atrophy of the alveolar process results from the deep application of the forceps, which guarantees the most efficient and complete removal, but leads to the formation of uneven edges of the alveoli. This result not only speeds up destructive processes, but also greatly complicates the subsequent prosthetics.

Sometimes a patient does not even suspect that he has atrophic changes, since the process lasts a long time. After the extraction of the tooth can take many years, and only after contacting the dentist about the prosthesis, the patient can learn about this pathology.

Atrophy is based on examination of the oral cavity and is confirmed by X-ray examination.

Classification

In the absence of a tooth, the tooth row is gradually shifting. Uneven distribution of the load leads to the fact that the alveolus begins to break down. For subsequent treatment tactics, it is extremely important to understand the degree of atrophic changes and the condition of the alveolar process. Therefore, on these grounds classification of atrophy of the alveolar process is based.

According to the Schroeder-Kurlyansky there is a degree of atrophy:

1. Light. The most favorable option for prosthetics. Main anatomical structures are preserved and the height of the process is not changed.
2. Average. There is thinning of the mucosa, the diameter of the bone bed decreases. Preliminary preparation is necessary for further action.
3. Heavy, or full. The outgrowth of the alveoli is practically absent. The tooth surface of the jaw is smoothed.

Keplerian classification:

1. Mild dystrophy. There is a different degree of mucosal changes, but with preservation of the alveolar process. It is considered favorable.
2. Severe dystrophy.
3. Uneven hypoplasia. The pathological process is most pronounced on the part of incisors and less - in the region of molars.
4. Uneven hypoplasia. Atrophic changes are more pronounced in the side of the painters, and less in the area of ​​the front teeth.

Osman classification:

• Almost absent atrophy of the alveolar process of the upper jaw with pronounced mandibular hypoplasia.
• The same situation is described, only the other way around.
• Uniform dystrophic change of all alveolar processes.
• Uneven destructive changes.

Reasons for atrophy of

All the reasons for the development of atrophic changes can be divided into:

• Inflammatory. Damage to tissues when exposed to mediators of inflammatory reaction with gingivitis and periodontitis. Often the destruction leads to a cervical caries or osteomyelitis.
• Non-inflammatory. These include trauma and tooth extraction, as well as periodontitis.

Treatment of

Treatment of atrophy of the alveolar process consists in an increase in its height due to a number of surgical techniques.

Slight atrophy of the alveolar ridge or some defects that can occur during surgery, osteomyelitis, removal of the tumor process, correction of the alveolar process is performed. After carrying out this type of intervention, in the first week the patient wears a special periodontal bandage, then he is offered to wear a mouthguard, and only six months later implants are placed in the fully formed process, and soft tissues are sutured.

The lower jaw can develop a process of destruction, in which the height of the bone edge is lower than 10 mm from the lower-nerve nerve. In such cases, the nerve is moved downward( transposition).The operation is done under local anesthesia, and the skill and experience of the doctor is a guarantee of the absence of complications.

With a pronounced and neglected process, the patient is prepared to plant a transplant. It can be alloplastic, autoplastic, or explant. In the latter variant, a framework of intact metal is implanted under the periosteal, from which several pins are removed from the lumen of the jaw to fit the upper or lower removable prosthesis.

In order to increase the level of the shoot, cadaveric cartilage, polymeric resin materials are also used. When adding a bone, all the surplus, inconvenient overhanging edges are removed, and also the excision of the strands is performed.

With pronounced periodontitis, gingival-osteoplasty is now widely used.

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