Human teeth are the only organs that cannot be restored; their condition plays an important role in the digestive process.
Bad habits accelerate the destruction process and become a reason for frequent visits to a specialist.
When coming to an appointment, the patient often cannot understand what the doctor is talking about, since dentistry widely uses formulas designed to name each type of teeth.
Types of teeth
The human dental system belongs to the heterodont type. According to the norm, there are 32 teeth, but their number can be 28. Each has its own purpose. Dental formulas help distribute molar processes into groups based on their shape, location, and purpose.
Such numbering greatly facilitates the work of specialists. For constants, various conditional expressions (formulas) have been created, slightly similar in the systematics of construction.
Understanding a dentist is not so difficult; it is enough to understand the dental formula and remember its diagram.
Rows of dental crowns are arches located on the upper and lower jaw, consisting of:
- 4 (2 side, 2 central);
- 6 (possibly 4).
If we talk about molars, their number can be four, which corresponds to the norm. Molar wisdom teeth are considered a defect and are removed. As dentists say, this is a relic of the past. For ancient people, they were indispensable for grinding hard food; the shape of the jaw allowed them to cut through without problems.
Video about dental anatomy:
Until the age of three or four, children have a limited number of teeth to twenty. They start from about six months.
The functions performed are identical to the permanent ones, while the teeth differ in their characteristic features:
- they are much smaller in size, have a delicate, bluish tint;
- dentin is not so developed, and the pulp is noticeably enlarged;
- the content of mineral compounds in enamel is much less.
To calculate the required number of teeth in babies of different ages a separate formula has been created:
N – required number of teeth
n – child’s age in months
For example, 14 - 4 = 10 - in a year and two months the child will have 10 teeth. This system has a significant drawback - it has a limited period of use; after the child reaches two years of age, it is no longer suitable.
Children's arches number ten teeth:
- 4 incisors – 2 lateral, 2 central;
- 2 fangs;
- 4 premolars.
Types of dental formulas
When diagnosing diseases and carrying out treatment in dentistry, special numberings and designations of the radical processes are used to simplify the work of a specialist.
In such formulas, teeth can be indicated by numbers, symbols or letters.
The following systems are practiced:
- universal ordinal, its other name is American alphanumeric;
- Zsigmondy-Palmer;
- Viola;
- Haderupa.
All of them are relevant, have their differences and are successfully practiced by specialists.
Universal (US alphanumeric)
The formula is understandable to any average person; you don’t need to have a deep understanding of medicine to decipher it.
Marking is done in capital letters, their number on the upper and lower arc is displayed next to it.
The numbers are located below and above, respectively:
- I - incisors, 8 pieces in total;
- C — fangs, 4 pieces;
- P - premolars, 8 pieces;
- M - major molars.
The children's formula is depicted according to the above notations.
For a child, the calculation is identical. The only difference is the absence of three pairs of molars, resulting in ten on one arch.
Zsigmondy-Palmer formula
It was created back in 1876, but is still widely used in dental practice today. It is quite easy to read, its second name is square-digital. Bone formations are marked with a sequence of numbers from one to eight.
There are 32 teeth; for simplicity, two conventional lines are drawn vertically and horizontally in the diagram.
Each number denotes four molar processes located parallel to each other on different sides axles:
- 1- central incisors;
- 2 – lateral incisors;
- 3 – fangs;
- 4 and 5 – first, second premolars, respectively;
- 6, 7, 8 – first, second, third molars, respectively.
To distinguish the location of the crowns, symbols are used - corners.
For dairy products, Roman numerals are used. The principle remains the same, the only difference is the absence of molars.
Viola system
It has been practiced since 71 of the last century, recommended by WHO for practice in specialized educational institutions.
Each process is marked with two numbers. The first is the square of the location of the teeth, there are only four of them. Counting begins from left to right and right to left, starting from the top arc.
It deciphers like this:
- Upper left part – 1, right – 2;
- Lower right part – 3; left – 4.
The second digit is the serial number of the tooth, counting from one to eight. For example, if the 4th molar hurts upper jaw on the right, its number corresponds to 24. The similar tooth located on the left has the number 14.
The formula used for children is similar, but the values of the quadrants begin with five.
Using this scheme, it is important to know the basic principles:
- From the age of 6, the child’s upper and lower incisors, located in the center, change from numbers 51.61 and 81.71 to numbers 11.21 and 41.31.
- Closer to 9 years, the lateral incisors change - 52, 62 and 82.72 to 12.22 and 42.32.
- By the age of 10, fangs grow on the lower arch.
- At the age of 11, the upper fours are replaced.
- By the age of 12, the upper canines, fives, and lower fours must be replaced, and premolars appear.
- The age of 12-13 years is marked as adolescence, by this time the primary molars completely fall out, and permanent molars grow in their place.
Haderup formula
Developed on the basis of the Zsigmondy-Palmer system, the difference lies in the designation of the upper arc with the “+” symbol and the lower arc with the “-” symbol, respectively. Next, indicate the number of the process from one to eight.
The location of the “+” and “-” signs may vary depending on the side of the teeth (left or right, respectively). The designations for children are slightly different; a zero is written before the serial number.
The presented systems have their differences, advantages and disadvantages. For example, the universal formula is inconvenient for determining the left and right sides; this often leads to errors in the treatment process.
A similar problem can arise when using the Handerup system. The Zsigmondy-Palmer formula is also used for operations of the maxillofacial part of various complexities. In routine diagnosis and treatment, there is a high chance of errors occurring.
The best option is the Viola system. It is indispensable in diagnosis various diseases and their treatment.
There are several schemes for determining the identity of a tooth. In our country the scheme is used Zigmondy And FDI circuit
Scheme Zigmondy denotes the permanent dentition teeth in Arabic numerals along the four quadrants of the jaws, starting from the midline of the face. Thus, the formula of permanent teeth will look like:
8 7 6 5 4 3 2 1 1 2 3 4 5 6 7 8
8 7 6 5 4 3 2 1 1 2 3 4 5 6 7 8
Primary teeth are designated by Roman numerals according to the quadrants of the jaws. The formula of the primary teeth will look like this:
V IV III II I I II III IV V V IV III II I I II III IV V
Scheme FDI (International Federation Dentists) And WHO. According to this scheme, each tooth has a two-digit designation: the first number indicates the quadrant number (starting from the upper right side), and the second number of the tooth in each quadrant (starting from the midline).
Permanent teeth
|
Right side |
Left side |
|
quadrant 1 quadrant 2 |
|
|
18 17 16 15 14 13 12 11 21 22 23 24 25 26 27 28 |
|
quadrant 4 quadrant 3
Temporary teeth
Right Left side side
Quadrant 1 (5) Quadrant 2(6)
55 54 53 52 51 61 62 63 64 65
85 84 83 82 81 71 72 73 74 75
quadrant 4(8) quadrant 3(7)
The numbering of teeth in each quadrant begins with the central incisor and ends with the third molar. Also, each quadrant of the upper and lower jaw has a digital designation, which increases clockwise. Temporary teeth are numbered in quadrants 5,6,7,8.
The results of the examination of the dentition are recorded in the formula, starting with the last molar of the upper jaw on the right, and ending with the last molar of the lower jaw on the right, i.e. in the same direction as the examination of the dentition.
To record the results of an examination of the dentition and an individual tooth, there are notations:
« ABOUT" – missing tooth, " WITH" - caries, " P" - seal, " R» –
pulpitis, " Pt" – periodontitis, " R" - root, " TO" – crown, " AND»
artificial tooth, " I, II, III» – degree of tooth mobility
Control questions:
What is percussion? Comparative percussion?
How is palpation performed?
Dental formula according to WHO.
Rules for recording an examination in a dental formula.
What is a dental patient record?
Literature
Propaedeutic dentistry: Textbook for medical universities / edited by E.A. Bazikyan. – M: GEOTAR-Media, 2008. – P. 3
Therapeutic dentistry: A textbook for students of medical universities / ed. HER. Borovsky. – M: Medical Information Agency, 2006. – S.
Practical therapeutic dentistry: Textbook / A.I. Nikolaev, L.M. Tsepov. – 6th ed., revised. and additional – M.: MED press-inform, 2007. – P.
ADDITIONAL NITE LH NEW M E TODS AND SSL FOOD A Research Institute: RE NTG E LEG R A FIA, U ZI, EDI, MIOG R A FIA, CT, M R T , T E PLO VIZY OG R A FIA.
Target: study additional methods of examining a dental patient: radiography, thermometry, EDI.
Thermome T Riya – The method is based on the reaction of the tooth pulp to temperature stimuli: cold and heat. Thermometry can be carried out using cold or warm water or air. Pluggers can be used to heat gutta-percha to determine reaction to heat.
X-ray examination:
Dense tissues absorb X-rays, soft tissues transmit them.
Types of X-ray examination:
targeted dental (intraoral) radiographs (Fig. 109);
Figure 109 Sighted intraoral radiographs
panoramic radiographs;
orthopantomogram (Fig. 110);
Figure 110 Orthopantomogram
radiovisiorgaf (Fig. 111) (less dose, but less sensor resolution).
Figure 111 Radiovisiograph
Ren T genogra f ical m no odes of research allow you to determine:
Condition of teeth: position, condition of hard dental tissues, root canals, roots, degree of formation
Condition of the peri-apical tissues
State bone tissue
Condition of the temporomandibular joint
Sinus condition
Presence of neoplasms, sequestration of bone tissue
EXTERNAL EXAMINATION OF THE MAXILLOFACIAL AREA
Educational elements
Purpose of the lesson: Learn the method of external examination of the maxillofacial area (MFA) of a child, recording the dental formula.
Key terms: anamnesis, visual inspection, examination of the maxillofacial area, dental formula.
Topic study plan:
- Control of the initial level of knowledge
- Interview on the topic of the lesson:
a) medical history;
b) external examination and external examination of the maxillofacial area;
c) recording the dental formula (graphic-digital and international two-digit systems);
- Control of knowledge acquisition.
Presentation educational material
Anamnesis is a set of information about the development of the disease, living conditions, previous diseases and other things collected for the purpose of their use for diagnosis, prognosis, treatment, prevention (BME, 1984).
1. LIFE HISTORY:
Antenatal (prenatal, intrauterine) period is key in human life. In the antenatal period, the formation and formation of organs and systems, including the dentofacial, occurs. The presence of risk factors at this stage can lead to disruption of the processes of formation and histogenesis of teeth and cause the occurrence of multiple caries and non-carious lesions in the future.
Main risk factors in the antenatal period:
Short intervals between births;
Maternal diseases (histoses, infectious diseases, exacerbation of chronic somatic pathology);
Reception medicines;
Unbalanced and poor quality nutrition;
Bad habits.
Postnatal period is divided into: the neonatal period, infancy, early childhood, preschool, junior school, middle school, senior school. Each age period is characterized by certain risk factors:
Main risk factors of the postnatal period:
Nature of feeding (breastfeeding, artificial);
Diseases and pathological conditions child (dyspepsia, rickets, hypovitaminosis, infectious diseases, allergic conditions, chronic diseases);
The nature of the child’s diet (food consistency, frequent intake of simple sugars, insufficient consumption of dairy products);
Not regular and poor quality oral care.
Genetic predisposition(the presence of caries in parents is a predisposing factor for the development of caries in a child).
Place and living conditions(fluoride concentration in drinking water, social conditions, social status parents, etc.)
2. ANAMNESIS OF THE DISEASE allows you to obtain preliminary information necessary for making a diagnosis, drawing up a treatment plan and prognosis.
Key medical history questions:
The appearance of the first signs of pathology;
Dynamics of the disease;
First visit to the dentist;
Nature and effectiveness of treatment;
Subsequent appeals;
COMMUNICATION is a must and the most important element dental examination, allowing FOR THE DOCTOR TO HEAR THE PATIENT. During communication with the child or his parents (guardians), the doctor receives the information necessary for making a diagnosis, planning effective treatment. Neglecting conversation in many cases leads to medical errors and conflict situations.
SEQUENCE OF EXTERNAL DENTAL
EXAMINATIONS OF THE CHILD
| Examination stages | Variant of the norm | Pathology variant | |
| 1. | Complaints | No complaints | Complains of pain discomfort during meals, tooth decay, bleeding gums, oral mucosa injury, malocclusion, aesthetic defects, etc. |
| History of illness, life | See above | ||
| Psycho-emotional state. | Calm. The child is friendly, active, cheerful | Alarming. The child is scared, capricious, aggressive, inhibited | |
| Indicators of physical development | Age appropriate | Acceleration, retardation. Body weight decreased, increased | |
| Posture, gait | Direct, energetic | Slouched, lethargic. Incorrect posture affects the growth of the bones of the facial skeleton, the position of the lower jaw and causes the development of malocclusions | |
| Head position | Direct | Lowered, thrown back | |
| Symmetrical face and neck | Symmetrical | Asymmetrical, neck curved or shortened | |
| Breathing pattern | Nasal | Oral (narrow nostrils, mouth slightly open, dry lips, wide bridge of the nose) | |
| Swallowing pattern | Somatic: free swallowing, movements of facial muscles are invisible. The tongue is located in top floor, rests on the hard palate behind the upper incisors | Infantile type of swallowing: tension of the facial muscles and neck muscles “thimble symptom”, protrusion of the lips, increase in the height of the lower third of the face (the tongue is located in the lower part, rests on the lips, cheeks) | |
| The nature of speech production | The child pronounces all sounds (age-appropriate) correctly | The pronunciation of a number of sounds is impaired | |
| The size of the mouth gap, lip closure | The oral fissure is limited by perpendiculars lowered from the pupils when looking directly. The lips are closed, muscle tension is not visually or palpably determined, the nasolabial and chin folds are moderately pronounced | Oral fissure of smaller or larger sizes(macro, microstomia). The lips are open, when closing, tension in the facial muscles is noted, the nasolabial folds are smoothed | |
| Condition of the masticatory muscles (determined by palpation or visually) | On palpation of the masticatory and temporal muscles, no pain is detected; when closing the teeth, the muscles are tense | Pain on palpation is determined, muscle tension is weak or at rest. | |
| TMJ function (determined by bimanual palpation) | The movement of the head in the joint is free in all directions, smooth. The amplitude of movement vertically is 40-50 mm, horizontally – 30 mm | The range of movements of the lower jaw is limited or excessive, pain. On palpation there is a crunching or clicking sound | |
| Condition of the lymphatic system of the maxillofacial area | Movable lymph nodes are not palpable or can be detected, painless, with elastic consistency on palpation | Lymph nodes are enlarged in size, painful on palpation, dense or rocky in consistency, adherent to tissues | |
| State skin | Pink color, moderate humidity and turgor | Pale or bright pink. Turgor is reduced, there are elements of rash (spots, papules, crusts, scratches, pustules, peeling, scars, blisters) | |
| Condition of the red border of the lips | Bright pink, wet, clean | Paleness, dryness, peeling, crusts, cracks, blisters |
Recording the dental formula:
Graphic-digital system(Zsigmond-Palmer, 1861) - the formula is written using a coordinate system. Permanent teeth are designated by Arabic numerals, and baby teeth are designated by Roman numerals.
Recording the dental formula of permanent dentition
V IV III II I I II III IV V
V IV III II I I II III IV V
Accepted in most countries international digital system , proposed by the International Dental Federation (FDI) and approved by the International Standards Organization (ISO). The upper and lower dental rows are conventionally divided into 2 parts: the upper right quadrant is designated 1, the left - 2, the lower left - 3, the right - 4. To record the formula of a specific tooth, the serial number of this tooth is assigned to this number. For example: left upper permanent canine - 23, lower right permanent first molar - 46.
18 17 16 15 14 13 12 11 | 21 22 23 24 25 26 27 28
48 47 46 45 44 43 42 41 | 31 32 33 3 435 36 37 38
To record the formula of primary teeth, the quadrants are designated 5, 6, 7, 8. For example: the right upper first primary molar is 54, the left lower primary canine is 73.
55 54 53 52 51 | 61 62 63 64 65
85 84 83 82 81 | 71 72 73 74 75
Of the two systems, the more convenient is the international digital teeth designation system, which makes it possible to transmit data by telephone, telegraph, fax, and process it using a computer.
1. Risk factors for caries of primary teeth in the antenatal period:
a) histoses
b) poor oral hygiene in the mother
V) acute infections and chronic maternal diseases
d) gingivitis in pregnant women
d) stressful situations
2. Risk factors for dental caries and periodontal disease after childbirth:
b) child's illness
d) poor nutrition
3. Indicate the sequence of external examination of the child:
a) the condition of the skin of the face and the red border of the lips
b) psycho-emotional state and physical development baby
c) the nature of breathing, swallowing, speech production
d) condition lymph nodes maxillofacial area
e) posture, gait, head and neck position
4. The international digital teeth designation system allows:
a) transfer data by phone
b) transmit data by telegraph
c) transmit data by fax
d) perform computer processing
d) find it difficult to answer
5. Record your teeth in the international digital system:
6. Record the teeth in the graphical-digital system:
7. Causes of dental anomalies in children:
a) mouth breathing
b) somatic swallowing
c) thumb, tongue, cheek sucking
d) poor oral hygiene
d) incorrect posture
8. Violation of the primary mineralization of primary incisors is facilitated by:
a) poor oral hygiene in the mother
c) histoses
d) infectious diseases of the mother
d) poor oral hygiene
9. Violation of primary mineralization of primary molars is facilitated by:
a) histoses
b) chronic diseases of the child
c) nature of feeding
d) toxicosis of the second half of pregnancy
e) poor oral hygiene in a child
10. Violation of secondary mineralization of primary teeth is facilitated by:
b) histoses
c) poor oral hygiene in a child
d) chronic diseases of the child
Literature:
1. Persin L.S., Elizarova V.M., Dyakova S.V. Dentistry childhood. M., 2008. - pp. 71–72
2. Kuzmina E.M. Prevention of dental diseases. - M., 2001. - p. 107–108.
3. Leontyev V.K., Pakhomov G.N. Textbook. Prevention of dental diseases. Moscow, 2006, p. 155–176, 298–301.
CLASS topic.
EXAMINATION OF THE MUCOUS MEMBRANE OF THE ORAL CAVITY AND PERIODONTAL IN CHILDREN.
INDICES FOR REGISTRATION OF THE CONDITION OF PERIODONTAL TISSUE
Educational elements
Purpose of the lesson: Master the methodology for examining the oral mucosa (ORM) and periodontal disease, using the RMA, CPITN, and KPI indices.
Key terms: Oral mucosa, periodontium, periodontal indices
Topic study plan:
4) Control of the initial level of knowledge
5) Interview on the topic of the lesson:
a) assessment of the oral mucosa, frenulum and cords of the mucous membrane, the depth of the vestibule of the oral cavity
b) periodontal assessment, criteria for normal gums
c) Schiller-Pisarev test
d) indices RMA, CPITN, KPI
6) Control of knowledge acquisition
There are several schemes for determining the identity of a tooth.
Zsigmondy scheme denotes the permanent dentition teeth in Arabic numerals along the four quadrants of the jaws, starting from the midline of the face. So the formula permanent teeth will look like:
American scheme provides for sequential numbering of teeth in a clockwise direction, starting with the upper right wisdom tooth and ending with the lower right wisdom tooth. Thus, the first right molar will be number 3, and the first left molar will be number 14.
FDI (International Dental Federation) and WHO scheme. According to this scheme, each tooth has a two-digit designation: the first number indicates the quadrant number (starting from the upper right side), and the second number of the tooth in each quadrant (starting from the midline).
Permanent teeth
| Right side | Left-hand side |
| quadrant 1 | quadrant 2 |
| 18 17 16 15 14 13 12 11 | 21 22 23 24 25 26 27 28 |
| 48 47 46 45 44 43 42 41 | 31 32 33 34 35 36 37 38 |
| quadrant 4 | quadrant 3 |
Temporary teeth
| Right side | Left-hand side |
| Quadrant 1 (5) | Quadrant 2(6) |
| 55 54 53 52 51 | 61 62 63 64 65 |
| 85 84 83 82 81 | 71 72 73 74 75 |
| quadrant 4(8) | quadrant 3(7) |
The numbering of teeth in each quadrant begins with the central incisor and ends with the third molar. Also, each quadrant of the upper and lower jaw has a digital designation, which increases clockwise. Temporary teeth are numbered in quadrants 5,6,7,8.
The results of the examination of the dentition are recorded in the formula starting with the last molar of the upper jaw on the right, and ending with the last molar of the lower jaw on the right, i.e. in the same direction as the examination of the dentition.
To record the results of dental examination and individual tooth, there are notations:
« ABOUT" – missing tooth, " WITH" - caries, " P" - seal, " R" - pulpitis, " Pt" – periodontitis, " R" - root, " TO" – crown, " AND» – artificial tooth, « I, II, III» – degree of tooth mobility
Control questions:
1. What is percussion? Comparative percussion?
2. How is palpation performed?
3. Dental formula according to WHO.
4. Rules for recording the examination in the dental formula.
5. What is a dental patient record?
Literature
1. Propaedeutic dentistry: Textbook for medical universities / edited by E.A. Bazikyan. – M: GEOTAR-Media, 2008. – P. 3
2. Therapeutic dentistry: Textbook for students of medical universities / ed. HER. Borovsky. – M: Medical Information Agency, 2006. – S.
3. Practical therapeutic dentistry: Tutorial/ A.I. Nikolaev, L.M. Tsepov. – 6th ed., revised. and additional – M.: MED press-inform, 2007. – P.
TOPIC No. 2
ADDITIONAL RESEARCH METHODS: X-ray, ultrasound, EDI, MYOGRAPHY, CT, MRI, THERMAL VISIOGRAPHY.
Target: study additional methods of examining a dental patient: radiography, thermometry, EDI.
Thermometry – The method is based on the reaction of the dental pulp to temperature stimuli: cold and heat. Thermometry can be carried out using cold or warm water, air. Gutta-percha heating pluggers can be used to determine the reaction to hot foods.
X-ray examination:
Dense tissues absorb X-rays, soft ones -
Kinds x-ray examination:
· targeted dental (intraoral) radiographs (Fig. 1);
Picture 1
· panoramic radiographs;
· orthopantomogram (Fig. 2);
Figure 2
· radiovisiorgaf (less dose, but less sensor resolution).
X-ray research methods allow you to determine:
Condition of teeth: position, condition of hard teeth tooth tissue, root canals, roots, degree of formation
Condition around the apical tissues
Condition of bone tissue
Condition of the temporomandibular joint
Sinus condition
· Presence of neoplasms, sequestration
