The tooth crown has a multi-faceted configuration that provides complete grinding and chewing of solid food. The division of the tooth into sections is used to describe the relief of the dental arch and various pathological processes occurring on the surface of each tooth. The upper dentition is located in the form of a semi-ellipse, the lower - an ellipse. Due to the contact of the elements with each other, a single row is created. Let's take a closer look at the main forms of the surface of the teeth.
Tooth crown surfaces
The proximal surface of a tooth is the areas adjacent to adjacent teeth. And it happens in one row. It is conditionally divided into mesial, directed towards the middle part of the dental arch, and distal, located from its center.
Vestibularthe surface is directed to the vestibule of the mouth. There are two subspecies: labial (at the front teeth, in contact with the lips), and buccal (at the back, located near the cheeks).
The occlusal surface is available only for premolars and molars. It is located towards the opposite dentition.
The lingual surface is turned in the oral cavity towards the tongue. In the region of the upper jaw, it is called the palatine. The alveoli and root walls directed into the oral cavity received the same name.
Features of the proximal surface
The proximal surface is also called the contact surface. This is the surface of contact with the tooth located behind. Its configuration affects the unity of the dentition, its aesthetic appearance. The interdental distance depends on the points of contact of the lateral walls of the teeth, the structure of the incisal edge and the inclination of the tooth. Between rectangular adjacent teeth, the smallest space is formed, and between triangular - wide. Proper contact of the contact surfaces in the dentition allows you to distribute the chewing load. When it is violated, the teeth move in any direction during chewing.
Nuances of dental arch aesthetics
In the gap between the approximal surfaces of adjacent teeth of the front row, there is a gingival papilla that fills the pyramidal cavity between them. In triangular teeth, the papilla is large, while in rectangular teeth it may be absent due to the tight contact of the walls. Papilla atrophy in oval and triangular teeth leads tothe formation of a black empty space between the teeth. This pathology is not a disease. You need to thoroughly clean your teeth with dental floss. The proximal surface of the tooth is a place for the development of latent caries in the future with inadequate hygiene.
Development of approximal caries
Minor lesions on the contact areas are not always detectable by visual inspection. The most difficult thing is to diagnose them at the points of contact of molars and premolars by classical research methods. The first signs of the onset of pathology is a change in the color of the enamel. Best of all, chalky spots are visible along the periphery of the distal surface of the tooth. It may take several years from the first signs to the appearance of visible defects.
Important! The appearance of carious areas for the patient is asymptomatic. The patient learns about the problem when the pathology becomes impressive.
Diagnosis of pathology
The most accurate result is obtained when determining caries on the front teeth. In the beam of transmitted light, defective areas are visible in the form of brown hemispheres. They are clearly separated from a he althy surface. For the diagnosis of caries on the contact cavities of chewing teeth is carried out:
- thermal test - a heated tool is applied to the tooth or a specialized coolant is applied on a cotton swab under the influence of a jet of water; in the presence of defects, a pain reaction occurs, which quickly passes;
- sounding- using a dental probe, tissues are examined for sensitivity, integrity and consistency; ineffective in hidden carious processes;
- drying - he althy hard tissues are shiny and smooth, affected - rough and soft;
- electroodontodiagnostics - assessment of the degree of electrical resistance of tissues when applying direct or alternating current;
- laser diagnostics - the supply of active light by a laser and a photodiode to the cavity of the tooth, followed by an assessment of the fluorescent glow.
The best method for detecting carious defects on the proximal surfaces of the tooth is transillumination. It is based on the transmission of a beam of cold light crowns. X-rays are used in situations where other methods are ineffective. It makes it possible to assess the depth of the focus of pathology, the thickness of the dentin and the interaction with neighboring tissues. The results are approximate, the exact size of carious cavities cannot be determined by x-ray.
Features of treatment of approximal caries
Treatment is done in stages. Carious cavities are opened and expanded. Necrotic hard tissue is removed. Restoration of the proximal surface of the tooth is the formation of a new cavity and tooth edge. If there are natural or pathological discrepancies between the teeth, it is not advisable to create new contact points. With extensive lesions and significant destruction, the defect is closed with a crown.
Restoration of the anatomical structure of the teeth at the edges is carried out using special matrices. The matrix holds the material in the cavity, forms the correct contour of the proximal surface, and improves the adaptation of the filling in the gum area. The alignment of the filling occurs safely on either side of the dental crown. The matrix eliminates the ingress of air inclusions into the material, mixing with blood, saliva.
Photopolymerization takes place without air access. The quality of the filling is checked by introducing floss into the interdental space. It should slide over the surface and be removed from the cavity with a click. A defect on the proximal surfaces is indicated by floss tearing or its getting stuck between the teeth. Such deficiencies must be corrected.
