Missing tooth

It is a known fact that a healthy human has 32 teeth each one located at a specific place. When all teeth are present and are properly positioned, they are in a steady state, which optimally resist masticatory forces which are necessary for the chewing of food. It is scientifically proven that chewing forces exerted on the teeth are about 30 kg/cm2 for front teeth and up to 80 kg/cm2 for molars. This is an enormous load which must be neutralized by the teeth and the supporting bone, and this is possible only if all teeth are available and are located in the right places. When a single tooth is removed, the balance of the dental arches in the mouth is violated and if no prosthetic device is placed within reasonable time limits, irreversible processes of moving of the teeth known as “Phenomenon of Godona” commences. This phenomenon occurs continually, initially affecting adjacent teeth to one that has been removed, and then progressing to the whole dental segment. What happens with the Phenomenon of Godona is that the teeth move in such a direction as to fill the empty space in the tooth row. The adjacent teeth on the left and right side of the missing tooth, tilt towards the empty space, and the opposing tooth grows freely in the direction of the missing tooth. The movement of the teeth leads to a disturbance of the balance of the masticatory apparatus, which in turn causes new problems. These are – chewing problems, difficulty in cleaning, loss of interdental contacts, incorrect loading of teeth leading to their loosening, loss of supporting bone, damage to the nerve of the tooth.
It is difficult to chew where the tooth is missing and the patient starts to chew on the opposite side, leading to overload, which initiates problems there.
Due to displacement of the teeth, cleaning in the area is more difficult, leading to increased accumulation of dental plaque and tartar, which in turn lead to the development of caries and periodontal diseases.
The loss of interdental contact leads to increased mobility of the teeth and development of gingivitis. Increased mobility with improper loading of teeth when chewing leads to their loosening and melting of the supporting bone.
The loss of bone leads to an inability to chew and gradual loss of healthy adjacent teeth. Besides the bone around the adjacent teeth, the bone in the place of the missing tooth melts as well, which further hinders treatment in these cases. This process leads to the principle of the closed circuit, which eventually leads to a gradual loss of all teeth and melting of alveolar bone. Prevention of the development of the phenomenon of Godona is achieved through different methods of prosthetic dentistry. If there is a single or a couple of missing teeth, implants or conventional metal-ceramic bridge devices can applied. In case of one or two missing teeth, dental bridges without filing can be used. In the case of several missing teeth and inability to use bridge devices, partial dentures are used, and where there is absence of all teeth – whole dentures.

4 Rayko Aleksiev Str., zh.k. Iztok, Sofia

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