Optimization of the clinical diagnostic examination algorithm of patients with a cross bite complicated by cranio-mandibular dysfunction and postural disorder.

OBJECTIVE: Aim: Optimization of the clinical and diagnostic examination algorithm of patients with cross bite, aggravated by cranio-mandibular dysfunction and postural disorders. PATIENTS AND METHODS: Materials and Methods: 22 patients aged 13-16 years with cross bite with displacement of the lower jaw were examined. The first group consisted of 15 people with a right-sided displacement of the lower jaw, the second - 7 patients with a left-sided one. The condition of the musculoskeletal system was assessed by the position of the head, shoulders, shoulder blades, back (curvature of the spine), legs, chest shape, and abdomen. To determine the state of stability of the body in space, posturological and kinesiological tests were performed. The location of TMJ elements was evaluated on orthopantomograms. Statistical processing of the material was carried out with the help of the "Excel" license package. RESULTS: Results: 63.64% of patients with a cross bite have disorders of the musculoskeletal system: scoliotic posture - 40.91% and scoliosis - 22.73%. TMJ dysfunction was detected in all examined patients. It was established that the anatomical and topographic features of the joint elements depend on the side of the lower jaw displacement. CONCLUSION: Conclusions: The functional imbalance of all structural elements of the musculoskeletal system and the cranio-mandibular complex determined during the research proved the need to optimize the clinical-diagnostic algorithm: consultation of a traumatologist-orthopedic doctor, X-ray examination of TMJ, conducting posturological tests.

X-ray analysis of the mandible in patients with crossbite and mandibular displacement.

OBJECTIVE: Introduction: Significant morphological and aesthetic disabilities of the face, observed during the formation of a cross bite in combination with the displacement of the mandible, prompt the doctors - orthodontists to study carefully the morphogenesis of this anomaly. The aim: Analysis of the mandible structure in patients with a cross bite and lower jaw displac ement based on the analysis of orthopantomograms. PATIENTS AND METHODS: Materials and methods: For this study, the orthodontic examination of 20 patients, 18-22 years old, was made they complained about facial asymmetry, displacement of the lower jaw and a violation of the cosmetic centers. A diagnosis of the buccal cross bite form in combination with the displacement of the lower jaw was put according to the Uzhumeckiene classification. The methods used do not contradict the conclusions of the ethics commission. RESULTS: Results: The analysis of the obtained data indicates that the angle of the mandible has more variable (p ≤ 0,05). Go120,8º and 125,1º. Significant of the angles of the canines according to the basal arch of the lower jaw of 102,8º and 105,4º (p≤0.01) and the angle of inclination of the first permanent molars of 89,6º and 91,4º, respectively (p≤0.01). CONCLUSION: Conclusions: The obtained data indicate that there is no clear correlation between changes in the studied parameters and the localization of anomalies (left-sided, right-sided). Indicators of the angle of the lower jaw are significantly altered from the opposite direction of its displacement. The change in the angles of inclination of the canine and the first permanent molars, as occlusive compensation, is determined reliably. The more the angle of the mandible changes, the more the lower jaw moves in the transversal direction. Perhaps this is due to the asymmetric tone of masticatory muscles.