Feem ntau ntawm cov keeb kwm caj ces, kev kho hniav agenesis yog qhov tsis muaj kev tsim ntawm ib lossis ntau cov hniav. Ntau dua lossis tsawg dua, nws qee zaum muaj qhov cuam tshuam tseem ceeb thiab zoo nkauj, nrog rau kev puas siab puas ntsws tseem ceeb. Kev tshuaj xyuas orthodontic ua rau nws muaj peev xwm kwv yees seb cov khoom siv kho hniav puas muaj txiaj ntsig zoo.

Lus txhais

Kev kho hniav agenesis yog tus cwj pwm los ntawm qhov tsis muaj ib lossis ntau cov hniav, vim lawv tsis tau tsim. Qhov kev tsis txaus ntseeg no tuaj yeem cuam tshuam rau tus menyuam cov hniav (cov menyuam tsis muaj cov hniav) tab sis cuam tshuam cov hniav mus tas li ntau zaus. 

Muaj cov qauv nruab nrab lossis hnyav ntawm kev kho hniav agenesis:

• Thaum tsuas yog ob peb cov hniav koom nrog, peb hais txog hypodontia (ib rau rau ntawm cov hniav uas ploj lawm). 
• Oligodontia hais txog qhov tsis muaj ntau tshaj rau ntawm cov hniav. Feem ntau nrog malformations cuam tshuam rau lwm yam kabmob, nws tuaj yeem cuam tshuam nrog cov tsos mob sib txawv.
• Thaum kawg, anodontia yog hais txog tag nrho cov hniav uas tsis muaj hniav, uas yog nrog los ntawm lwm yam kabmob txawv txav.

Ua rau

Kev kho hniav agenesis feem ntau yog congenital. Feem ntau ntawm cov neeg mob, nws yog keeb kwm ntawm caj ces (genetic genetic anomaly los yog sporadic tsos ntawm tus neeg), tab sis ib puag ncig tej yam kuj yuav cuam tshuam.

Yam caj ces

Cov kev hloov pauv sib txawv uas tsom cov noob koom nrog hauv kev tsim cov hniav tuaj yeem koom nrog.

• Peb hais txog kev sib cais ntawm kev kho hniav agenesis thaum cov caj ces tsis xws luag tsuas yog cuam tshuam kev kho hniav.
• Syndromic dental agenesis yog txuas mus rau caj ces txawv txav uas tseem cuam tshuam rau kev loj hlob ntawm lwm cov ntaub so ntswg. Qhov tsis muaj hniav feem ntau yog thawj cov tsos mob. Muaj nyob ib ncig ntawm 150 ntawm cov mob no: ectodermal dysplasia, Down syndrome, Van der Woude syndrome, thiab lwm yam.

Ib puag ncig yam

Kev nthuav tawm ntawm tus menyuam hauv plab rau qee yam ib puag ncig cuam tshuam rau kev tsim cov kab mob hniav. Lawv tuaj yeem yog tus neeg sawv cev ntawm lub cev (ionizing hluav taws xob) lossis tshuaj lom neeg (cov tshuaj noj los ntawm leej niam), tab sis kuj muaj cov kab mob sib kis ntawm niam txiv (syphilis, tuberculosis, rubella ...).

Kev kho mob qog noj ntshav hauv menyuam yaus los ntawm kev siv tshuaj khomob lossis kev kho mob hluav taws xob tuaj yeem ua rau muaj ntau yam agenesis, ntau dua lossis tsawg dua qhov hnyav nyob ntawm lub hnub nyoog ntawm kev kho mob thiab cov koob tshuaj.

Thaum kawg, kev raug mob craniofacial tseem ceeb tuaj yeem ua lub luag haujlwm rau kev kho hniav.

diagnostic

Kev kuaj mob thiab panoramic X-ray yog qhov tseem ceeb ntawm kev kuaj mob. Ib qho retro-alveolar x-ray - classic intraoral x-ray feem ntau ua hauv chaw kho hniav - qee zaum ua tiav.

Kev sab laj tshwj xeeb

Cov neeg mob uas raug kev txom nyem los ntawm oligodontia raug xa mus rau kev sib tham tshwj xeeb, uas yuav muab kev ntsuam xyuas tag nrho rau lawv thiab koom tes nrog kev saib xyuas ntau yam.

Indispensable nyob rau hauv cov ntaub ntawv ntawm oligodontia, qhov kev ntsuam xyuas orthodontic yog nyob rau hauv tshwj xeeb tshaj yog nyob rau hauv lub lateral teleradiography ntawm lub pob txha taub hau, kab teeb (CBCT), cov txheej txheem radiography siab tso cai rau cov 3D rov tsim dua tshiab, ntawm cov duab exo- thiab intraoral thiab ntawm orthodontic casts.

Kev tawm tswv yim txog caj ces yuav pab qhia meej seb puas yog oligodontia yog qhov sib txawv thiab sib tham txog cov teeb meem tshwm sim.

Cov neeg txhawj xeeb

Kev Kho Hniav Agenesis yog ib qho ntawm feem ntau cov hniav txawv txav nyob rau hauv tib neeg, tab sis nyob rau hauv feem ntau ntawm cov mob tsuas yog ib los yog ob tug hniav uas ploj lawm. Agenesis ntawm kev txawj ntse cov hniav yog qhov ntau tshaj plaws thiab cuam tshuam txog li 20 lossis 30% ntawm cov pejxeem.

Oligondotia, ntawm qhov tod tes, suav hais tias yog kab mob tsis tshua muaj (ntau zaus tsawg dua 0,1% hauv ntau yam kev tshawb fawb). Qhov tsis muaj tag nrho cov hniav yog 

tsawg kawg nkaus.

Zuag qhia tag nrho, cov poj niam feem ntau cuam tshuam ntau dua li cov txiv neej, tab sis qhov kev sib txawv no zoo li rov qab yog tias peb xav txog tsuas yog cov ntaub ntawv uas muaj cov hniav ploj lawm ntau tshaj plaws.

Qhov zaus ntawm agenesis nrog rau hom ntawm cov hniav uas ploj lawm kuj txawv raws li pawg neeg. Yog li, Caucasian-hom Europeans tsis tshua muajkim tshaj cov Suav.

Kev kho hniav

Hauv cov ntaub ntawv me me (hypodontia), cov hniav ntse feem ntau ploj lawm. Lateral incisors thiab premolars kuj tseem yuav tsis tuaj.

Nyob rau hauv cov ntaub ntawv hnyav dua (oligodontia), cov canines, thawj thiab thib ob molars los yog sab hauv nruab nrab incisors kuj yuav muaj kev txhawj xeeb. Thaum oligodontics txhawj xeeb txog cov hniav mus tas li, cov hniav cov hniav tuaj yeem mob siab tshaj qhov qub hnub nyoog.

Oligodontia tuaj yeem nrog ntau yam txawv txav cuam tshuam rau lwm cov hniav thiab lub puab tsaig xws li:

• cov hniav me,
• conical los yog txawv txav cov hniav,
• enamel defects,
• hniav ntawm kev zoo siab,
• lig tawg,
• alveolar pob txha hypotrophy.

Associated syndromic abnormalities

Kev kho hniav agenesis yog txuam nrog cleft di ncauj thiab palate nyob rau hauv tej yam mob xws li Van der Woude syndrome.

Oligodontia tuaj yeem cuam tshuam nrog kev tsis txaus ntawm salivary secretion, plaub hau lossis ntsia thawv txawv txav, hws qog ua haujlwm tsis zoo, thiab lwm yam.

Ntau yam kab mob agenesis

Ntau tus hniav agenesis tuaj yeem ua rau tsis txaus ntawm lub puab tsaig (hypoplasia). Tsis txhawb los ntawm zom, cov pob txha zoo li yaj.

Tsis tas li ntawd, qhov phem occlusion (malocclusion) ntawm qhov ncauj kab noj hniav tuaj yeem ua rau muaj kev cuam tshuam loj heev. Cov menyuam yaus feem ntau raug kev txom nyem los ntawm kev zom thiab nqos, uas tuaj yeem ua rau muaj teeb meem digestive, nrog rau kev loj hlob thiab kev noj qab haus huv. Kev hu xov tooj kuj raug cuam tshuam, thiab kev ncua lus tsis tuaj yeem txiav tawm. Qee zaum muaj kev cuam tshuam qhov cua.

Cov txiaj ntsig ntawm lub neej zoo tsis muaj qhov tsis txaus ntseeg. Qhov cuam tshuam zoo nkauj ntawm ntau yam agenesis feem ntau tsis pom zoo. Thaum cov menyuam loj hlob tuaj, lawv nyiam cais lawv tus kheej thiab tsis txhob luag, luag nyav lossis noj mov ntawm lwm tus. Yog tsis muaj kev kho mob, kev hwm tus kheej thiab kev sib raug zoo lub neej yuav ua rau tsis zoo.

Cov kev kho mob yog tsom rau khaws cia cov hniav nyiaj hniav kub seem, kom rov zoo occlusion ntawm qhov ncauj kab noj hniav thiab txhim kho kev zoo nkauj. Nyob ntawm tus naj npawb thiab qhov chaw ntawm cov hniav uas ploj lawm, kev kho dua tshiab tuaj yeem siv rau prostheses lossis kev cog hniav.

Oligodontics xav tau kev saib xyuas mus sij hawm ntev nrog ntau qhov kev cuam tshuam thaum kev loj hlob tuaj.

Kev kho qhov muag

Orthodontic kev kho mob ua rau nws ua tau, yog tias tsim nyog, hloov kho cov kev sib dhos thiab qhov chaw ntawm cov hniav seem. Nws tuaj yeem siv tshwj xeeb los kaw qhov chaw nruab nrab ntawm ob cov hniav lossis qhov tsis sib xws kom nws loj dua ua ntej hloov cov hniav uas ploj lawm.

Prosthetic kev kho mob

Prosthetic rehabilitation tuaj yeem pib ua ntej hnub nyoog ob xyoos. Nws siv cov hniav uas tshem tau ib nrab ntawm cov hniav los yog cov hniav ruaj khov (veneers, crowns lossis txuas hniav). 

Kev kho mob implant

Thaum ua tau, cov hniav cog hniav muab cov kev daws teeb meem ntev. Lawv feem ntau xav tau pob txha graft ua ntej. Qhov kev tso kawm ntawm 2 (los yog txawm 4) implants ua ntej qhov kawg ntawm kev loj hlob yog ua tau tsuas yog nyob rau hauv lub mandibular anterior cheeb tsam (lub puab tsaig qis). Lwm hom kev cog qoob loo yog muab tso tom qab kev loj hlob tau nres.

Odotonlogie

Tus kws kho hniav tej zaum yuav tau kho cov hniav uas txuam nrog. Composite resins yog siv tshwj xeeb los muab cov hniav zoo nkauj.

Txhawb pab hlwb

Kev soj ntsuam los ntawm tus kws kho kev puas siab puas ntsws tuaj yeem pab tau tus menyuam kom kov yeej nws cov teeb meem.

Tsis muaj peev xwm tiv thaiv cov hniav agenesis. Ntawm qhov tod tes, kev tiv thaiv ntawm cov hniav uas tseem tshuav yog qhov tseem ceeb, tshwj xeeb tshaj yog tias cov enamel defects ua rau muaj kev pheej hmoo ntawm kev lwj, thiab kev kawm tu lub qhov ncauj ua lub luag haujlwm tseem ceeb.