Progenia is a disease of the jaw. In this case, this is misaligned (dysgnathia). Characteristic of a progenia is a reverse overbite of the incisors (so-called frontal crossbite).
What is progenia?
In dentistry, the term progenia is used to describe a massive malocclusion of the jaw. Since the term is increasingly perceived as misleading because it merely describes a protruding chin, the term dysgnathia is primarily used in the new literature. Progenia is classified as a subset of the various dysgnathias. Characteristic for this jaw malposition is an inverted overbite (also called frontal crossbite). Here, especially the incisors are in an unusual position. The progenia is usually not limited to the teeth, but extends to the entire jaw. Consequently, various impairments of functionality can result from a progenia. Damage to other parts of the lower cranial region is also conceivable.
Causes
A progeny usually cannot be attributed to a monocausal cause. This means that it usually has more than one cause. However, the dental literature attributes a major role to genetics. According to this, dysgnathia can be dominantly inherited. In addition, other developmental stimuli are also identified that can lead to the development of a jaw malposition such as progenia. These include, for example, functional disorders of the tongue (so-called dyskinesias) or deviations from the regular physique (morphological anomalies). Morphological anomalies that can lead to the development of a progeny are, for example, an enlarged tongue or a severely restricted breathing capacity of the nose, which leads to almost complete breathing through the mouth. These are all factors that can cause a lack of growth of the jaw, leading to a progeny. In addition, cleft lip and palate should be considered. The scars caused by these can cause inhibition of jaw growth. In summary, the most common causes of progeny are thus heredity (genetics), tongue dysfunction (dyskinesias), morphologic abnormalities (for example, decreased nasal breathing ability), and scars that are the result of cleft lip and palate.
Symptoms, complaints, and signs
A progeny has primarily visual effects. This means the misalignment of the jaw is visible (often to the layperson) to the naked eye. Often, the jaw shifts forward so that the lips cannot be fully closed. The lower lips are shifted forward compared to the upper lip. The facial areas of many affected persons appear concave and the nasolabial fold is conspicuously deepened. Complaints caused by progeny (dysgnathia) include (among others): difficulty chewing or speaking, pain throughout the jaw, and decreased ability of the nose to breathe.
Diagnosis and course of the disease
Dentists make the diagnosis of a progeny purely visually. The typical features of the face are viewed and evaluated. This is used to determine the degree or severity of the malocclusion. Since a distinction is made in maxillofacial surgery between true and real progenia, a diagnosis often involves a precise differentiation between the two manifestations. While true progenia is characterized by an overdevelopment of the lower jaw, false progenia is characterized by an underdeveloped upper jaw. Underdevelopment of the middle face is also attributed to inauthentic progenia. Mixed forms are also possible. Therefore, X-rays can also be taken for precise differentiation. This allows a more detailed observation.
When should one go to the doctor?
If irregularities in the position of the teeth or jaws become apparent during the child’s growth and development process, a doctor should be consulted. Characteristic of progenia is an overbite of the teeth in the frontal region. If the incisors of the upper and lower jaw do not overlap correctly, the observations can be discussed with a doctor. In principle, however, a regular check-up visit with a doctor should take place in advance. This enables quick intervention if changes and abnormalities in the area of the jaws become apparent.If there are serious disturbances in the development, a quick correction can be initiated in these cases already within the growth process. Therefore, parents and children should visit a dentist at least twice a year for a check-up. If there are problems with the chewing process or if there is a disturbance in speech due to the impairment, a doctor should be consulted. Pain, swelling or disturbances in the swallowing process should be examined and treated. Affected persons who do not perceive any impairments despite the progeny should decide for themselves whether the displacements are cause for a visit to the doctor. In some cases, it is an optical blemish that does not require any medical action. Unless the affected person or guardian wishes to receive explicit treatment, no further steps need to be taken.
Treatment and therapy
Jaw malpositions such as progenia or dysgnathia can be treated in different ways. Following a comprehensive diagnosis, which differentiates between real and unreal dysgnathia, the possible forms of treatment are discussed. Depending on the age of the patient or the severity of the disease, various treatment options are available. One possibility is the use of special appliances that must be worn continuously over a long period of time. This can improve the malocclusion of the jaw by up to five millimeters by conservative means. However, this method is considered to be quite lengthy and painful. Another conservative method of treatment is the use of specially made braces. These shift the lower rows of teeth (dental compensation of the lower jaw). Especially in difficult cases, surgery is also a possibility. In this case, the upper and lower jaws are surgically adjusted. Often, corrections of the lateral view of the face are also made. The costs are covered by health insurance companies if there is an indication.
Prevention
Jaw malocclusions are best prevented by early detection of morphologic abnormalities. Thus, much can still be achieved in childhood by conservative means. The development of a complete progeny or dysgnathia can possibly still be prevented in this way. This can make dental compensation of the mandible or surgical treatment unnecessary. It is therefore advisable to take children to dental examinations at an early age. This is because the treating dentist will notice malocclusions of the jaw, so that conservative therapy can be started early.
Aftercare
In the case of a progenia, those affected usually have only a few and usually also only limited measures of aftercare available to them. Affected individuals should therefore seek medical attention at the first symptoms of this condition to prevent complications or other medical conditions from developing as the condition progresses. Early diagnosis with subsequent treatment usually has a very positive effect on the further course of the disease. Most patients with progeny require surgical intervention, which can permanently alleviate the symptoms. After such an operation, strict bed rest should be maintained, and patients should also refrain from exertion or from physical and stressful activities. In general, a healthy lifestyle with a healthy diet can have a very positive effect on the further course of the disease. Even after a successful surgical procedure, regular checkups and examinations by a doctor are very important to monitor the current state of the progeny. As a rule, this disease does not reduce the life expectancy of the patient. The further course depends strongly on the time of diagnosis, so that a general prediction is usually not possible in this case.
What you can do yourself
People who suffer from a misalignment of the jaws should carefully examine whether a change is medically necessary or whether it is merely an optical blemish. If the displacement of the jaws is minimal and the chewing process is not affected, often no correction is needed. This means that the affected person should build up his self-confidence in order not to experience any emotional irregularities in everyday life. In the case of a developed progenia, there are conspicuous features of the voice.The pronunciation is unclean and can be trained by the patient on his own responsibility. In therapy, various exercises are practiced to improve phonation. These exercises can be repeated independently several times a day to achieve an improvement. If the food cannot be sufficiently ground due to the malocclusions and distances between the teeth, the food intake must be changed. The components of the meals should be ground into smaller pieces even before they are fed into the mouth. This avoids complications and supports the act of swallowing. Swallowing and digestive disorders should thus be avoided. Despite the disease, adequate daily dental cleaning should be performed. This is more difficult for patients with braces. Nevertheless, care should be taken to remove food twice daily and to avoid the formation of deposits on the tongue
