THE SYNDROME OF THE DISTAL MOLAR TOOTH

Authors: V. Burlui, Carmen Stadoleanu, Corina Cristescu

Abstract:

The paper aims at focusing, in the context of the complications occurring in partial edentation, of a special pathology, manifested in lateral intercalated edentation of the arch, namely the distal molar tooth syndrome of the potentially prosthetic space, which shows an interesting behaviour,with several pathological consequences.
The syndrome of the distal molar tooth, more frequently occurring on the mandible than on the maxilla, is a result of teeth natural displacement, as well as of their tendency to mezialization.
Installation of the distal molar tooth syndrome is evident in the molar and neighbouring teeth displacement towards the edentulous space, by extrusion of the antagonistic molar tooth, modifications of the marginal and supporting periodontium, as well as by axis and occlusal side disorders, accompanied by installation of occlusal trauma, and of disfunctional symptoms of articular, muscular, mandible-skull relations, mandibular dynamics, etc.
The present study establishes several correlations between the displacement of the distal molar tooth axis and its dental mobility, depth of the mezial pockets and gingival inflammation, on an experimental group made up of 239 patients, out of which 187 showed lateral reduced intercalated partial edentations on the mandible and 52 on the maxilla. There was also evidenced the presence, within the distal molar tooth syndrome, of symptoms accompanying partial edentation at muscular and articular level, centric and posture relations, mandibular dynamics, etc.
The results obtained lead to the conclusion that the more marked displacement of the distal molar tooth axis is accompanied by its increased mobility, by a higher depth of the mezial parodontal pockets and by more intense gingival inflammation.
The complexity of the clinical manifestations, together with the occurrence of the distal molar tooth syndrome requires therapeutical solutions to be found immediately, in post-edentation initial stages. Immediate prosthesis application, be it conjunct or adjunct, may restore the continuity of the damaged arch, thus preventing the complications of partial edentation.
If such a moment is lost and the distal molar tooth syndrome is already installed, the treatament will be conducted towards the recovery of the morpho-functional integrity of the stomatognate system, by taking care of the muscle-articular complex, mandible-skull repositioning, recovery of the distal molar tooth through orthodontic procedures in young patients, followed by long-term gnato-prosthetic treatments.