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مقالات ارتودنسی

تاریخ انتشار: دوشنبه 11 آبان 1394

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به گزارش برترین ها؛ نامنظم بودن دندان‌ها و عدم‌تقارن فک‌ها در دهان از جمله اختلالاتی است که موجب از دست‌رفتن ظاهر زیبا و آراسته مردان و زنان بسیاری در سراسر جهان شده است. اگر داشتن ظاهری آراسته، زیبا و پرنشاط برایتان مهم است، اگر دوست دارید در جمع دوستان و محیط کار با لبخندی زیبا پذیرای مهمانان و همکاران‌تان باشید، پیشنهاد می‌کنیم با ما همراه باشید و توصیه‌های کاربردی دکتر رامین جعفرزاده، متخصص ارتودنسی را در این زمینه جدی بگیرید.

ارتودنسی به چه معناست؟

ارتودنسی به‌طور کلی به معنای ردیف‌بودن و منظم قرارگرفتن دندان‌ها در دهان است. البته این نظم شامل حال فک‌ها نیز می‌شود به این معنی که گاهی ممکن است فک بالا یا پایین در جایگاه مناسب خود قرار نگرفته باشند و به‌اصطلاح جلوتر یا عقب‌تر از جایگاه اصلی خود باشند و حالتی نامتقارن داشته باشند. به‌این‌ترتیب این عدم‌تقارن یا بی‌انضباطی در قرارگرفتن دندان‌ها موجب می‌شود تا فرد رضایت کافی را از ظاهرش نداشته باشد.

علاوه‌براین مسئله که می‌تواند زیبایی فرد را تحت‌تاثیر قرار دهد،  نامنظم بودن دندان‌ها و نامتقارن بودن فک‌ها می‌تواند مشکلاتی در جویدن، بلعیدن موادغذایی و حتی صحبت‌کردن فرد به‌وجود آورد. در این حالت درمانگر با کمک ارتودنس به اصلاح رابطه فک‌ها و رابطه دندان‌ها کمک می‌کند و درعین حال به اصلاح الگوی بلع، نحوه صحبت‌کردن، تلفظ کلمات، اصلاح تنفس دهانی و درمان خروپف بیمار نیز می‌پردازد، بنابراین ما از ارتودنسی برای درمان‌های دندانی، فکی، عضلانی و عادتی استفاده می‌کنیم.

این شیوه برای کدام گروه سنی مناسب است؟

درحال حاضر ارتودنسی برای تمام گروه‌های سنی قابل اجراست. به این معنی که افراد در سنین مختلف با داشتن هر یک از مشکلات دندانی، فکی، عضلانی یا عادتی می‌توانند با مراجعه به متخصص ماهر برای درمان مشکل‌شان اقدام کنند. اما باید به این نکته توجه کرد که برخی از مشکلاتی که مربوط به فک‌ها می‌شود، باید در سنین کمتر و پیش از بلوغ استخوانی یعنی در سنین 9 تا 11 سالگی انجام شود. درباره مشکلات دندانی نیز بهترین سن برای شروع درمان، 11 سالگی به بعد است و در مورد مشکلات عادتی مثل مکیدن انگشتان یا جویدن ناخن‌ها که به تغییر شکل و فرم دهان و دندان منجر می‌شود، باید از سن کمتر یعنی از 6 تا 8 سالگی شروع کرد. با وجود این نباید از درمان این اختلال‌ها در سنین بالاتر مایوس شد. زیرا امروز با پیشرفت‌هایی که این علم کرده است حتی افراد 60 ساله هم می‌توانند از آن برای درمان استفاده کنند با این تفاوت که درصد بهبود در سنین بالا کمی کاهش می‌یابد.

شایع‌ترین علت تغییر فرم دندان‌ها و فک چیست؟

عوامل ژنتیک، عادات، پوسیدگی و از دست‌دادن دندان‌های شیری زودتر ازموعد، عدم‌هماهنگی سایز دندان‌ها با سایزفک، ضربه، کمبود فضا، رویش دندان‌های عقل، بیماری‌های لثه، بعضی از بیماری‌های بافت نرم و استخوان، تنفس دهانی ناشی از کیپ‌بودن بینی، رژیم‌های غذایی است که در کنار آنها عادات غلط در حیطه دهان مانند عادت مکیدن انگشت، جویدن ناخن یا مداد از جمله شایع‌ترین عوامل است. در این حالت فرد به‌طور ناخودآگاه دندان‌های پایینی را با انگشت شست خود به سمت عقب و دندان‌های بالایی را به سمت جلو هل می‌دهد. این روند درصورتی که تا سن 4 سالگی ادامه داشته باشد، عادی است اما تداوم آن موجب تغییر شکل و فرم قوس دندان‌ها می‌شود و اگر تا پایان7-6 سالگی تداوم پیدا کند به مرور موجب تغییر شکل استخوان فک نیز می‌شود. در این حالت فرد به اختلال open bite مبتلا می‌شود به این معنی که فک‌ها در قسمت جلو به‌هم نمی‌رسند و  موقع بلع غذا زبان و گاهی آب دهان بچه بیرون می‌آید و این اختلال درصورتی که به موقع درمان نشود در بزرگسالی نیز با او باقی می‌ماند. علاو ه‌بر جویدن انگشت، ناخن و مداد، شکستن بیش از حد تخمه نیز می‌تواند مشکلات مشابهی برای افراد به‌وجود آورد.

ژنتیک در بروز اختلال‌های دندانی و فکی چقدر نقش دارد؟

البته فرم صورت و فک افراد هر جامعه‌ای از ژنتیک آن منطقه تبعیت می‌کند. به‌عنوان مثال در کشور ما جلو بودن فک بالا و بینی در میان مردم بسیار شایع است. در حقیقت تعداد افرادی که فک بالای آنها جلوتر است در مقایسه با افرادی که فک پایین آنها جلوتر است بسیار زیادتر است. برای درمان این اختلال‌ها بهتر است از سنین کودکی اقدام کرد. برای درمان جلوبودن فک بالا از 10سالگی و برای درمان جلوبودن فک پایین از 8 سالگی باید اقدام کرد تا به نتیجه مطلوب رسید.

نامنظم بودن دندان‌ها چه عوارضی همراه دارد؟

بیشتر افرادی که به من مراجعه می‌کنند از نامنظم بودن دندان‌هایشان شکایت دارند. نامنظم بودن دندان‌ها موجب می‌شود تا فرد نتواند به‌خوبی غذا را بجود و این مسئله موجب می‌شود تا قطعات بزرگ غذا را ببلعد و به‌این‌ترتیب فشار زیادی را به دستگاه گوارش وارد کند. علاوه‌براین نامنظم بودن دندان‌ها موجب بروز مشکلاتی در لثه فرد شده و ممکن است خونریزی نیز به همراه داشته باشد. حتی بوی بدن دهان نیز یکی دیگر از عوارض نامنظم بودن دندان‌هاست. در کنار این مسئله فرد لبخند زیبایی نخواهد داشت و این مسئله ممکن است عادت‌هایی مانند منقبض‌کردن لب یا پوشاندن دهان با کمک دست را همراه داشته باشد. زیرا فرد نسبت به فرم دندان‌هایش احساس خوبی ندارد و به‌این‌ترتیب اعتماد به نفسش را نیز به مرور از دست می‌دهد.

طول درمان در این شیوه چقدر است؟

طول درمان در این شیوه بستگی به‌شدت ناهنجاری‌های دندان یا فک‌ها دارد. در مواردی که آغاز درمان در سن مناسب صورت بگیرد، ممکن است 12 ماه به طول بینجامد و این مسئله موجب می‌شود تا فرد نیاز به درمان در سنین بالاتر نداشته باشد. زیرا در سنین بالاتر طول درمان از 6 ماه و بیشتر افزایش می‌یابد اما به‌طور کلی و در حالت طبیعی و در سن مناسب، بیشتر افرادی که مشکلاتی دندانی دارند، می‌توانند در فاصله زمانی 12 تا 18 ماه نتیجه درمانی خوبی بگیرند اما طول درمان در شرایطی که فرد در سن مناسب قرار ندارد بین 18 تا 24 ماه به طول می‌انجامد. فراموش نکنید که در مشکلات استخوانی به‌دلیل پیچیدگی‌هایی که دارد طول درمان بین 6 تا 12 ماه به‌مدت زمان ذکر شده اضافه می‌شود.

دستگاه‌های ارتودنسی به 2 صورت متحرک و ثابت وجود دارد، از نظر شما کدامیک از این دستگاه‌ها می‌تواند اصلاح ناهنجاری‌ها را دقیق‌تر و در زمان کمتری انجام دهد؟

هر یک از این دستگاه‌ها برای شرایطی خاص درنظر گرفته شده است. همان‌طور که از عنوان دستگاه‌های متحرک بر می‌آید، بیمار می‌تواند خودش این دستگاه را از دهانش خارج کند اما در مورد دستگاه‌های ثابت این امکان وجود ندارد و این دستگاه تنها توسط متخصص از دهان خارج می‌شود.نکته مهم این است که دستگاه‌های متحرک دامنه درمانی بسیار کوچکی دارد و معمولا برای کودکان استفاده می‌شود.

در این حالت اگر کودک همکاری لازم را نداشته باشد و دستگاه را دور از چشم والدین از دهانش خارج کند، روند درمان با شکست روبه‌رو می‌شود. از این‌رو امروزه درمانگران و متخصصان ارتودنسی از دستگاه‌های متحرک به‌عنوان درمان کمکی و غالبا از آن برای پیشگیری استفاده می‌کنند و به کاربردن آن را به‌خصوص برای بزرگسالان غیرمنطقی می‌دانند، بنابراین معتقدم استفاده از دستگاه‌های متحرک که امروزه در جامعه ما زیاد دیده می‌شود نشان‌دهنده ناآشنایی برخی از درمانگران با دستگاه‌های ثابت و فواید درمانی آنهاست.

برخی از مردم از ارتودنسی می‌ترسند، آیا این شیوه دردناک است؟

شکل نازیبای دستگاه‌های ارتودنسی، ترس از کشیدن دندان یا بروز درد احتمالی از جمله مواردی است که موجب می‌شود، مردم نسبت به ارتودنسی احساس ترس داشته باشند. ترسی که کاملا بی‌مورد است و تنها باعث می‌شود تا آنها درمان و اصلاح ناهنجاری‌های دندانی و فکی خود را به تاخیر بیندازند. درحالی‌که امروزه با توجه به پیشرفت تکنولوژی و وجود سیستم‌های مدرن در مراکز و کلینیک‌های ارتودنسی، درمانگر در سریع‌ترین زمان ممکن و بدون درد می‌تواند به درمان ناهنجاری‌های بیمارش کمک کند.

 در مورد ترس بیماران از کشیدن دندان نیز باید به این موضوع اشاره کنم که سیستم‌های جدید درمانی در روش ارتودنسی احتمال کشیدن دندان برای درمان اختلالات و ناهنجاری‌ها را به حداقل ممکن رسانده است بنابراین باید به مردم بگویم آنها درصورتی که به متخصص و درمانگر متبحر و ماهر مراجعه کنند، نباید به هیچ وجه نگرانی نسبت به این موضوع داشته باشند. در مورد ظاهر دستگاه‌های ارتودنسی نیز باید بگویم، امروزه دستگاهی به بازار آمده که کاملا بی‌رنگ است و هنگام نصب روی دندان دیده نمی‌شود یا سیستمی مانند سیستم «لینگوال» وجود دارد که به کمک آن می‌توان اصلاح ناهنجاری‌ها را از پشت دندان انجام داد. به این ترتیب، افراد نباید نگران ظاهرشان باشند و باید بدانند در متدهای جدید و مدرن ارتودنسی جایی برای این نگرانی‌ها وجود ندارد.

بعد ازانجام ارتودنسی آیا رژیم غذایی خاصی به بیماران توصیه می‌شود؟

بعد از ارتودنسی به بیماران توصیه می‌کنیم در برنامه غذایی روزانه خود از غذاهای نرم استفاده کنند و تا حد امکان از مصرف غذاهایی که سخت هستند و نیاز به جویدن زیاد دارند خودداری کنند. این کار به‌منظور پیشگیری از آسیب دیدن دستگاه ارتودنسی در دهان و اجرای دقیق روند درمانی باید رعایت شود. در کنار آن رعایت بهداشت دهان و دندان نیز از مهم‌ترین نکاتی است که افرادی که دستگاه ارتودنسی در دهان دارند باید بیشتر از گذشته آن را رعایت کنند.

مناسب‌ترین سن برای تشخیص ناهنجاری‌های دهان و فک چه سنی است؟

بهتر است والدین به این نکته توجه کنند اگر کودکشان مشکل ظاهری ندارد برای بررسی فرم و شکل دندان‌ها او را در 8 سالگی نزد متخصص ارتودنسی ببرند و درصورتی که کودکشان مشکل ظاهری و بارز در دندان‌ها و فک او را در 6 سالگی نزد درمانگر و متخصص ببرند تا برای درمان و اصلاح ناهنجاری‌ها از همان سن اقدام شود.  پدر و مادرها بعد از رویش نسبتا کج دندان‌های دائمی فرزندشان دچار نگرانی می‌شوند که معمولا این نگرانی‌ها بی‌مورد است، زیرا با روند رشد کودک، دندان‌ها با فشار زبان و لب به جایگاه و فضای مناسب خود هدایت می‌شوند. اما برای تشخیص دقیق‌تر به والدین پیشنهاد می‌کنم برای بررسی نرمال بودن یا غیرنرمال بودن چینش دندان‌های فرزندشان دست کم یک بار در 8 سالگی او را نزد متخصص ارتودنسی ببرند تا از عدم‌وجود هرگونه اختلال یا ناهنجاری دندانی، فکی، عضلانی یا عادتی مطمئن شوند.

آیا ارتودنسی برای افرادی که لثه‌های بلند دارند و هنگام خندیدن علاوه بر دندان‌ها، لثه‌های آنها نیز نمایان می‌شود، درمانی دارد؟

به این نوع از لبخندها «gummy smile» می‌گویند. در ایران افراد زیادی هستند که از این مسئله نارضایتی دارند. برای درمان این نوع از ناهنجاری‌ها، شیوه‌های مختلفی وجود دارد که از میان آنها می‌توان به لیزر لثه، استفاده از دستگاه‌های ارتودنسی یا تزریق بوتاکس روی لب بالایی اشاره کرد. گاهی با یکی از این روش‌ها مشکل بیمار برطرف می‌شود و گاهی لازم است هر 3 شیوه برای او اجرا شود. در این حالت نیز بیمار می‌تواند در مدت زمان کوتاهی با این ناهنجاری خداحافظی کند و لبخندی زیبا داشته باشد.

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یکشنبه, 03 بهمن,1400
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چهارشنبه, 06 بهمن,1400
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جمعه, 08 بهمن,1400
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یکشنبه, 10 بهمن,1400
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شنبه, 16 بهمن,1400
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دوشنبه, 18 بهمن,1400
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چهارشنبه, 20 بهمن,1400
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جمعه, 22 بهمن,1400
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یکشنبه, 24 بهمن,1400
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چهارشنبه, 27 بهمن,1400
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شنبه, 30 بهمن,1400
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دوشنبه, 02 اسفند,1400
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چهارشنبه, 04 اسفند,1400
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جمعه, 06 اسفند,1400
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یکشنبه, 08 اسفند,1400
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ﺳﻪشنبه, 10 اسفند,1400
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پنجشنبه, 12 اسفند,1400
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شنبه, 14 اسفند,1400
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دوشنبه, 16 اسفند,1400
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چهارشنبه, 18 اسفند,1400
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جمعه, 20 اسفند,1400
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یکشنبه, 22 اسفند,1400
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ﺳﻪشنبه, 24 اسفند,1400
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