Malocclusions and jaw anomalies

Interconnection of the dentofacial system and ENT organs

The anatomical proximity of the nasal cavity, paranasal sinuses, ear, and jaws determines their mutual influence. Persistent nasal breathing obstruction forces the patient to breathe through the mouth, which triggers a pathological cascade:

1. The oral mucosa dries out.
2. Natural clearance from food debris worsens, and enamel nourishment is disrupted.
3. The microbial landscape changes, which provokes the development of caries, stomatitis, and gingivitis.

In addition, mouth breathing alters the mechanics of the chewing act. Periodontal tissues and teeth do not receive adequate functional load, which directly leads to tooth malposition and malocclusion. The reverse process is also possible: orthodontic problems can develop against the background of chronic nasal congestion.

Due to shared sensory innervation, cross-localization of pain frequently occurs. Dental problems (such as temporomandibular joint arthritis or glossitis) may radiate to the ear or throat, and inflammatory processes in the maxillary sinus often mimic toothache.

The role of the dentofacial system in speech production

Speech is a higher mental function that depends on the integrity of oral structures. The process of speech production is divided into three links:

• Energy link — the respiratory apparatus, which creates an expiratory air stream.
• Generator link — the vocal folds of the larynx, which form the primary sound (phonation).
• Resonator-articulatory link — the lips, tongue, soft and hard palate, and teeth, which form specific sounds.

Dental arches serve as a crucial support for the tongue in the pronunciation of sibilants and fricative consonants, forming a slit for airflow. The hard palate is essential for the articulation of anterior tongue sounds. The absence of anterior teeth or the presence of congenital defects (cleft lip and palate) results in distorted sounds and rhinolalia.

This is why any prosthodontic treatment must restore not only masticatory but also phonetic function, which is verified in the clinic using special phonetic tests. Orthodontic treatment of malocclusions is also often accompanied by improved speech articulation.

Treatment methods and biomechanics of tooth movement

A comprehensive approach is used to correct dentofacial anomalies. The doctor may use interdental separation, grinding of deciduous tooth cusps, therapeutic exercises, and cranial therapy. For hard tissue pathology, dental arch defects, or jawbone defects, prosthetics are indicated.

Orthodontic treatment is based on directed biomechanical tooth movement. The main types of such movement include:

• Intrusion — the movement of a tooth into its socket.
• Extrusion — the eruption of a tooth.
• Torsion — the rotation of a tooth around its longitudinal axis.

To achieve the result, preventive, retention, and fixed appliances are used (including bracket systems consisting of specific structural elements). In some clinical situations, orthodontic indications require the extraction of certain permanent teeth. Treatment of congenital malformations is always carried out in conjunction with an otolaryngologist to ensure the restoration of nasal functions.

Class and exam questions

What else to study on this topic

• Endogenous and exogenous prenatal causes of dentofacial anomalies.
• Distinctive physiological signs of primary and mixed dentitions.
• Classification of dental and jaw anomalies by MSMSU and L.S. Persin's sagittal classification.
• Modern theories explaining the biomechanics of tooth movement.
• Structural elements of fixed orthodontic appliances (bracket systems).

Other topics in the "Additional Topics" section

Prepared by WhiteCoat Pro faculty in accordance with the medical school curriculum. For educational purposes only.