Adentia is the complete or partial absence of teeth. It is classified as complete primary, partial primary, partial secondary and complete secondary.
Complete primary adentia – is very rare. It is a severe anomaly accompanied by both the absence of permanent tooth buds and underdevelopment of the facial skeleton. Associated signs include underdeveloped alveolar ridges of the jaws and a dry, pale oral mucosa.
Primary partial adentia in the baby teeth.
It is characterized by the absence of several baby teeth, and X-rays show no baby tooth buds. Gaps (diastemas between teeth) are seen between the erupted teeth. A significant lack of baby teeth is accompanied by underdevelopment of the jaws. Treatment aims to increase jaw size and ensure timely eruption of the permanent teeth.
Treatment of primary adentia:
- A pre-orthodontic trainer, depending on age
- Regular follow-up monitoring
Primary partial adentia in the permanent teeth.
It has the same features as adentia of the baby teeth. On examination, several teeth are missing from the dental arch, and neighboring and opposing teeth have shifted into the gap (the Popov-Godon phenomenon).
In childhood, treatment aims to prevent deformation and ensure correct eruption of the permanent teeth – just as with adentia of the baby teeth.
After the permanent second molar has erupted, replacing the missing teeth can be considered. As a rule, this is preceded by complete orthodontic treatment, followed by replacement of the missing tooth.
Restoration methods:
- Implantation of the missing tooth.
- Adhesive bridge
- Prosthetics with metal-ceramic and zirconia-ceramic crowns and inlays.
This treatment method is generally used for a one-sided defect (one missing tooth).
Let’s look at another situation: the canines are missing in the upper jaw, and the defect is symmetrical. In this case, the orthodontist may suggest moving the first premolars into the place of the canines, restoring the continuity of the dental arch, while a general dentist reshapes the tooth into the shape of a canine with a light-cured restoration. However, this method requires well-coordinated work and extensive experience from both the orthodontist and the dentist.
There are cases when a patient is missing 3 premolars: 2 at the top and one at the bottom on the right side. In this situation, it makes sense to remove the lower left premolar to restore the symmetry of the dental arch and carry out orthodontic treatment, thereby avoiding prosthetics.
Complete secondary adentia – there are no teeth in either the upper or lower jaw. Treatment: prosthetics only, using complete removable dentures, implant-supported dentures, etc.
Secondary partial adentia – partial absence of teeth in both the upper and lower jaw. In dentistry, this topic is called orthodontic preparation of the patient for prosthetics. The question arises: “Why can’t we start prosthetics straight away?” We can, but there are cases where, due to the Popov-Godon phenomenon mentioned above and periodontitis, the teeth have spread, shifted, etc. It is important to understand that a perfect, beautiful smile is impossible without adequate orthodontic preparation.
Look for… it is painstaking work; an understanding patient will realize that they need to help the doctor achieve the ideal result.
