Many people find that their teeth look different from others when they do oral examinations, and there is an extra cusp in the depression of the occlusal surface of the teeth
Guest of this issue
Shi Hongyan, Chief of the Public Health Section of Minhang District Dental Prevention and Treatment Institute
About the deformity ** tip
Deformity ** cusp, also known as dens evaginatus (DE) is a deformity of tooth morphological development, which refers to the protruding conical cusp that appears on the buccal cusp of the ** fossa of the dental occlusal surface ** or close to the ** fossa. Deformity** cusps are more common in premolars, among which the mandibular second premolars are the most common, often occurring symmetrically between left and right, and permanent teeth are more common.
When the malformed** tip is intact, it appears as a small cusp of the tooth maxillofacial ** bulge. When worn gradually, it appears as round or oval black rings,** with pale yellow or brown dentin, which may be accompanied by symptoms of tooth sensitivity.
If it is further broken, it can cause pulpitis or apical periodontitis, which is manifested by tooth pain and dare not bite objects. For young permanent teeth, the infection and necrosis of the pulp will affect the continued development of the tooth root.
The danger of deformity** tip
After the eruption of the malformed** cusp, due to the interference of this cusp during the chewing process, traumatic occlusion is prone to occur, resulting in tooth tilting, twisting, and even malocclusion. In addition, the tip is thin and fragile, and it is easy to wear or break during the occlusion, and bacteria can directly or indirectly enter the pulp through the dentin tubules, thereby causing pulp or apical lesions.
The malformed tip can also affect the physical and mental development of children and adolescents. On the one hand, it destroys the nutritional balance and affects the normal development of the patient's body, and on the other hand, it leads to the patient's tendency to form a hemichewing habit, which in turn leads to malocclusion, temporomandibular joint deformity, and even affects the patient's facial development and aesthetics, resulting in negative depression, anxiety, low self-esteem and other psychology.
How to prevent deformity**Tip breakage
Oral Health Education:
Strengthen health education among primary and secondary school students, parents and teachers. This part of the population generally has little knowledge of relevant knowledge, and most patients with deformity have no obvious self-conscious symptoms in the early stage, resulting in the affected tooth being easily ignored and missing the best time. In addition, many students have poor awareness of oral health care and do not seek medical attention even if the affected tooth has symptoms of pulp or periapical disease**.
Early detection, early detection, early **
Parents should take their children to the hospital regularly for routine dental check-ups. Through the school dental prevention work in the basic public health services, professional doctors will regularly visit the school for oral health examinations, and the deformed ** tip will be included in the key examination scope of oral health of primary and secondary school students.
Clinical interventions
1.Prophylactic**
At present, the commonly used methods are: using composite resin, fluid resin or pit and fissure sealant to reinforce around the tip of the ** to prevent it from breaking. A small amount of deformed cusps can also be used to stimulate and promote restorative dentin formation.
In recent years, the recommended method for malformed and acuid teeth is early one-time grinding of the abrasion, followed by the use of composite resin for preventive filling to eliminate occlusal interference.
2.Pulp infection**
Partial infection of the pulp:In good condition of the root pulp, if the root is not fully developed, preserving the healthy root pulp can promote the continued growth and development of the root. If the root of the tooth has been developed, conventional root canal** can be an option.
Pulp necrosis:For malformed** crusted tooth with pulp necrosis, conventional root canal** removal of the infected pulp is performed if the root of the affected tooth has been developed. If root development is not complete, periapical tissue should be used to induce root development to form a apical barrier after infection control. At present, the most commonly used clinical methods include apical inductionplasty, apical barrier surgery, and pulp vascularization and regeneration.
For malformed** pointed teeth, it should be detected as early as possible. Preventive filling can reduce the occurrence of pulp lesions, and when pulp lesions occur, appropriate drugs and methods should be selected according to the condition of the pulp, the degree of root development, the patient's compliance, economic conditions and other conditions.
Reporter: Wang Tingting.
Editor: Wu Wang Tiancheng (intern).
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