Aşırı Derin Kapanış ve Alt Kesici Dişlerde Pulpa Nekrozu Birlikteliği: Olgu Serisi

Abstract

In this article, a unique disease pattern in 9 patients involving the simultaneous presence of excessive deep-bite malocclusion (≥50% vertical overlap) and the necrosis of multiple mandibular incisor teeth with large periradicular radiolucency is described. The mandibular central incisors were always implicated and were sometimes joined by the lateral incisors. In the examination, no other significant factor that could contribute to the pathology was found. During centric occlusion, the incisal edges of the incisors either occluded into the palatal gingival crevices of the maxillary teeth (Akerly Class II) or abraded the palatal surfaces of maxillary incisors (Akerly Class IV). Additionally, during protrusive and lateral jaw movements, the necrotic mandibular incisors often contacted their antagonists. Mild to severe attrition was found in the affected mandibular incisors. Changes in the stomatognathic equilibrium, due to the deep-bite malocclusion and the elicited chronic trauma, are assumed to be the underlying factors in this pathology.