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LA DYSHARMONIE DENTO-MAXILLAIRE PAR MANQUE DE PLACE: TROUBLE DE LA CROISSANCE MAXILLO-FACIALE ET MALADIE DE CIVILISATION (2eme partie)

par Dandoit, Richard
Référence Acta Stomatologica Belgica, 75, 4, page (261-296)
Publication Publié, 1978

Article révisé par les pairs

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Résumé :

The author traces the development of dento-maxillary disharmony (term used in French to designate the crowding of the teeth) since the beginning of our era in Western Europe and reviews the different hypotheses given to explain this phenomenon. It seems that dental overlapping is a real civilization disease, since it only appears with the western life style, as technology becomes more highly developed. Moreover, this is so not only in Europe, but throughout the world: crowding of the teeth sets in, in the human being, as soon as our civilization reaches him. How can we approach the causes of this phenomenon as objectively as possible? Since permanent teeth have only very slightly increased in volume since the latter Middle Ages, overlapping can only be due to a reduction in the maxillary bases holding them. Dento-maxillary disharmony is therefore none other than the clinical expression of a quantitative insufficiency maxillary-facial growth in the buccal sphere. This all happens as if 'something' were slowing down the normal development of maxillary structures or rather as if we currently lack one or several factors which favour the growth of the buccal cavity. Based on this premise, the author's deductions are as follows. The environmental factors alone can explain the rapidity of the appearance of this phenomenon in primitive man who is becoming civilized. These environmental influences can only be local since the buccal sphere seems to be the only one to undergo this type of atrophia. Factors which are both environmental and local can only be of a functional type. Among the functions carried out by the human cavity and its annexes, there are two which operate differently in primitive man or our ancestors, and in civilized man: mastication (since the dental wear almost no longer exists) and alimentary sucking which has almost disappeared from the life of the modern baby. However, the first clinical and radiographic signs of crowding are present during the first years of the life of a child (notably the non-existence of physiological diastemas separating the milk teeth), at the time when it could no longer fully carry out its masticating function. If we follow the author's reasoning, only one working hypothesis can be put forward: the disappearance of alimentary sucking of the modern child must constitute a primordial etiological factor in dental overlapping. There are evidently three steps to be taken. While there is still time, to study the quentitative and chronological differences which may exist in the maxillary-facial growth of the primitive child and the modern child. To emphasize the role of suckling and particularly the sucking of the breast in the growth of the buccal cavity. To determine by which process it carries out this function: it may be that the MOSS functional matrix theory will provide a great contribution.