Читать книгу Fundamentals of Fixed Prosthodontics - James C. Kessler - Страница 104

The need to replace missing teeth is obvious to the patient when the edentulous space is in the anterior segment of the mouth, but it is equally important in the posterior region. It is tempting to think of the dental arch as a static entity, but that is certainly not the case. It is in a state of dynamic equilibrium, with the teeth supporting each other (Fig 7-1). When a tooth is lost, the structural integrity of the dental arch is disrupted, and there is a subsequent realignment of teeth as a new state of equilibrium is achieved. Teeth adjacent to or opposing the edentulous space frequently move into it (Fig 7-2). Adjacent teeth, especially those distal to the space, may drift bodily, although a tilting movement is a far more common occurrence.

If an opposing tooth intrudes severely into the edentulous space, it is not enough just to replace the missing tooth (Fig 7-3). To restore the mouth to complete function, free of interferences, it is often necessary to restore the tooth opposing the edentulous space (Fig 7-4). In severe cases, this may necessitate the devitalization of the supererupted opposing tooth to permit enough shortening to correct the plane of occlusion; in extreme cases, extraction of the opposing tooth may be required.