ABSTRACT
OBJECTIVE: Aim of the work is to increase the effectiveness of complex treatment in patients with mesial occlusion during active skeletal growth. mproving the effectiveness of complex treatment of patients with mesial occlusion during active skeletal growth. MATERIAL AND METHODS: Clinical and radiological examination and comprehensive treatment of 30 patients with skeletal anomalies according to sagittale were carried out (average age 15 years). Orthodontic treatment of patients was performed using the Damon self-ligating bracket system («Ormco¼, USA), H4 («OC Orthodontics¼ USA) with a sequential change of arches. According to the indications, orthodontic mini screws, removable, non-removable dilators, a facial mask, occlusal pads for disconnecting the bite, in the retention period, non-removable retainers in the anterior part of the dentition, a removable retention device at night «Corrector¼, or removable plate devices were used. RESULTS: Rapid palatal expansion was performed according to the traditional method, based on the stages of formation of the median palatine suture (the first algorithm is the stage of formation of the palatine suture A-B). In patients with narrowing of the HF with the stage of formation of the median palatine suture C, the beginning of stage D, the use of the proposed expansion scheme with the use of piezocorticotomy to eliminate the buttresses of the upper jaw, the use of laser corticotomy and the protocol of activation and deactivation of the screw to relax the bone and achieve skeletal expansion of the upper jaw was effective. The change in the dental alveolar height, normalization of the incisor overlap height improved harmony in the gnatic part of the facial skull of patients. In the process of orthodontic treatment, the inclination of the occlusal plane was normalized, the profile of the face improved. Changes in the soft tissues of the profile consisted in an increase in the thickness of the upper lip by 2.27±0.48 mm (p<0.05) and its length by 1.45±0.39 mm (p<0.05), the total length of the lower lip and chin by 3.16±0.45 mm (p<0.05). The position of the lips relative to the aesthetic plane has changed most significantly. An algorithm was developed for the treatment of patients with dental anomalies in the sagittal plane, with a narrowing of the upper jaw during the bite of permanent teeth 12-17 years. CONCLUSION: The method of complex treatment is designed to increase the effectiveness of orthodontic treatment of patients with skeletal abnormalities during active skeletal growth and is aimed at changing skeletal growth, as well as to prevent the development of skeletal malocclusion during permanent bite, which is necessary to prevent the development of more pronounced skeletal deformity at the stage of complete skeletal maturation.
Subject(s)
Malocclusion, Angle Class III , Humans , Adolescent , Malocclusion, Angle Class III/therapy , Malocclusion, Angle Class III/surgery , Male , Female , Orthodontics, Corrective/methods , Orthodontic BracketsABSTRACT
OBJECTIVE: Prevention of the development of pronounced skeletal abnormalities in patients with mesial occlusion. MATERIALS AND METHODS: Biometric analysis of control and diagnostic models of dentition was performed in 60 patients with dental anomalies before and after treatment in 3 mutually perpendicular planes to identify violations in the formation of dental arches by sagittal and transversal dimensions, and alveolar processes - by vertical dimensions (methods of A. Pont, G. Korkhaus). Measurements of 23 parameters of TRG and sections of CBCT were carried out using the modified Nad-Ars technique with analysis of skeletal parameters before and after treatment. Treatment was carried out using dilators for the upper jaw in combination with a facial mask and further dynamic observation using active retention devices. RESULTS: The results of treatment showed an increase in the length of the anterior segment of the upper dental arch by 2.8±0.55 mm (p<0.05 mm); expansion in the area of temporary molars by 2.85±0.65 mm (p<0.05); in the area of permanent molars by 2.75±0.55 mm (p<0.05); in the area of the apical basis of HF by 3.82±0.45 mm (p<0.05). The length of the lower dental arch in the anterior segment has not changed. Analysis of TRG parameters showed a significant increase in the values of Subject(s)
Dental Arch
, Humans
, Child
, Male
, Female
, Dental Arch/diagnostic imaging
, Malocclusion/therapy
, Palatal Expansion Technique/instrumentation
, Bone Screws
, Dental Occlusion
, Orthodontic Anchorage Procedures/instrumentation
, Orthodontic Anchorage Procedures/methods
, Adolescent
, Orthodontic Appliances, Fixed
ABSTRACT
Glaucoma and cataract continue to be the leading causes of visual deficits, especially in older age groups, but the association of visual deficits with cognitive impairments has not been sufficiently studied. The aim of this study is to study visual impairment as a marker of cognitive impairment in patients with cataracts and glaucoma. The study included 326 elderly patients with cataracts and 318 elderly patients with primary open-angle glaucoma. The degree of cognitive impairment was determined using the Mini-Mental State Examination (MMSE) scale. Visual deficit was assessed by visual acuity without correction and maximum corrected visual acuity, and the severity of visual deficit was assessed by the scale we proposed. It was found that with low visual deficit (visual acuity without correction 0,51-0,60 and over 0,61) in the examined patients, the average score on the MMSE scale varied from 28,4±0,6 to 28,7±0,8 points (p>0,05), corresponding to subjective cognitive disorders. However, with a pronounced visual deficit (visual acuity without correction to 0,20 and 0,21-0,30), the average score is 13,9±0,3 and 16,5±0,4 (p<0,001), which indicates moderate dementia. Practically similar patterns about the association of cognitive impairments with the magnitude of visual deficit were also obtained when assessing visual deficit by maximum corrected visual acuity. The associativity of cognitive impairment with visual defect in patients with cataract and glaucoma was confirmed by the correlation method, according to which the correlation coefficient with visual acuity without correction is r=+0,428 (p<0,05), and with maximum corrected visual acuity - r=+0,385 (p<0,05). The results of the study allow us to consider visual deficit as a marker of cognitive impairment.
Subject(s)
Cataract , Cognition Disorders , Cognitive Dysfunction , Glaucoma, Open-Angle , Glaucoma , Humans , Aged , Cognitive Dysfunction/etiology , Cognitive Dysfunction/complications , Cognition Disorders/diagnosis , Glaucoma/complications , Cataract/complications , Cataract/diagnosis , Vision Disorders/diagnosis , Vision Disorders/etiologyABSTRACT
A case of treatment of a 35-year-old patient with a retroposition of the lower jaw, distal occlusion of the posterior teeth, deep incisal overlap, narrowing of the deformity of the dentoalveolar arches, protrusion of the lower incisors, crowded position of the teeth, mismatch between the incisor lines, absence due to extraction of tooth 3.6, with impacted dystopic tooth 3.8 is presented. Fixed individual orthodontic appliances of the WIN («DW Lingual Systems GmbH¼ Germany) were used. It was found that the use of the Herbst apparatus in combination with the WIN lingual bracket system in adult patients helps to achieve optimal functional and aesthetic results. The use of a distal bite correction device is an additional support for the mesialization of the molars of the lower jaw.
Subject(s)
Mandible , Tongue , Humans , Adult , Cuspid , Dental Occlusion , IncisorABSTRACT
The review addresses debatable issues of myocardial revascularization in chronic forms of ischemic heart disease, shows major differences between percutaneous coronary intervention and coronary artery bypass grafting in terms of long-term prognosis, and the dependence of the results on the clinical profile of the disease. The review of current publications demonstrates advantages of open surgery in long-term survival and prevention of adverse outcomes in target groups of patients.
Subject(s)
Coronary Artery Disease , Myocardial Ischemia , Percutaneous Coronary Intervention , Humans , Coronary Artery Disease/diagnosis , Coronary Artery Disease/surgery , Coronary Artery Disease/etiology , Treatment Outcome , Myocardial Revascularization/adverse effects , Myocardial Ischemia/diagnosis , Myocardial Ischemia/surgery , Coronary Artery Bypass/adverse effects , Percutaneous Coronary Intervention/adverse effectsABSTRACT
OBJECTIVE: The aim of the study. To improve the effectiveness of patients' treatment with narrow upper jaw by improving the stability of intraosseous devices. MATERIALS AND METHODS: 40 patients with the narrow upper jaw, from 12 to 40 years old, were treated. 50 self-drilling orthodontic miniscrews of each manufacturer, i.e. «BioRay¼, Taiwan, «Turbo¼, Russia, a total of 100 items, were inserted into a palate. RESULTS: The greatest thickness of the cortical bone relative to the sagittal plane was observed at a distance of 6 mm from the incisor canal, which averages 6.32 mm. Relative to the transversal plane, the greatest bone thickness was observed 3 mm laterally from the median palatine suture and averages 7.62 mm. The smallest thickness of the mucous membrane of the hard palate is noted 6 mm distal from the incisor canal and 3 mm laterally from the palatine suture is on average 4.56 mm. CONCLUSION: The protocol for determining the individual position of the miniscrew for each patient, taking into account all his anatomical features, is a necessary tool for clinical success.
Subject(s)
Cortical Bone , Palate, Hard , Palate, Hard/surgery , Humans , Male , Female , Child , Adolescent , Young Adult , Adult , Orthodontic Appliances , Bone ScrewsABSTRACT
OBJECTIVE: To improving the effectiveness of complex treatment of adult patients with the absence of individual teeth. MATERIAL AND METHODS: Clinical and radiological examination and comprehensive treatment of 37 patients with dental anomalies and the absence of individual teeth were carried out, 24 of them were women (average age 35 years), 13 men (average age 38 years). The patients were divided into two groups: the 1st group - 22 patients with distal occlusion; the 2nd group - 15 patients with mesial occlusion. RESULTS: The results of the developed algorithms for the complex treatment of patients with dental anomalies and the absence of individual teeth during the bite of permanent teeth are presented on a clinical example. The complex treatment included orthodontic treatment using a bracket system, functional fixed telescopic appliance, orthodontic mini screws for bone support and further rational prosthetics. After conducting a clinical and radiological examination and analyzing the data obtained, an individual patient treatment plan was developed, which included orthodontic and orthopedic stages. Orthodontic treatment made it possible to normalize the position of the teeth, the shape of the dental alveolar arches, occlusal planes, improve the bite, which made it possible to prepare the patient for rational prosthetics. The chosen treatment plan was optimal and correct for this patient: all the tasks were solved with changes not only at the dental alveolar level, a stable dental ratio was achieved and not only dental, but also facial parameters were improved. CONCLUSION: Orthodontic preparation of adult patients before orthopedic treatment significantly improves the quality of orthopedic treatment and allows to achieve the most stable functional and aesthetic results.
Subject(s)
Dental Occlusion , Tooth , Male , Adult , Humans , Female , Dentition, PermanentABSTRACT
OBJECTIVE: The aim of the study is to evaluation of the quality of orthodontic treatment by comparing the severity of signs of distal occlusion before the start of orthodontic treatment and after its completion. MATERIAL AND METHODS: Quantitative assessment of the severity of distal occlusion in 83 patients aged 17 to 30 years before and after orthodontic treatment. Depending on the chosen treatment algorithms, the patients were divided into 3 groups. The first group - 34 people - treatment included the use of a functional non-removable orthodontic device (FNT). The second group - 21 people - the treatment was accompanied by the removal of individual teeth of the upper jaw and the retraction of a group of front teeth of the upper jaw. Patients of the 3rd group - 28 people - underwent combined orthodonto-surgical treatment. The severity of distal occlusion was assessed using 3D cephalometric analysis data. To obtain a subjective assessment of the quality of orthodontic treatment, patients were asked to fill out questionnaires before and after orthodontic treatment. RESULTS: The severity of distal occlusion decreased as much as possible as a result of treatment of the first group in 23.07% of patients and the third group (16.63%), which is interpreted by the formulation «significant improvement¼ of the dental anomaly. Patients of the first and third groups had a high degree of satisfaction with the result of treatment, according to the quantitative assessment of the questionnaire. The severity of distal occlusion in the second group was reduced to a lesser extent (55.5%), compared with the first and third groups, which is interpreted as «moderately improved¼. Patients noted an average degree of satisfaction with the result of treatment, as the implemented treatment plan did not meet their expectations in the aesthetic aspect. CONCLUSION: The use of FNT for the extension and normalization of the position of the lower jaw is justified in the case of refusal of patients from combined orthodonto-surgical treatment, as it allows to fully solve the functional, aesthetic and psychological problems of patients, which contributes to improving their quality of life.
Subject(s)
Malocclusion , Quality of Life , Cephalometry , Dental Occlusion , Humans , Malocclusion/surgery , MaxillaABSTRACT
THE AIM OF THE STUDY: Improving the effectiveness of complex orthodontic treatment of patients with constriction and deformation of the upper jaw during the period of replacement and permanent bite based on the analysis of cone-beam computed tomography (CBCT) data. MATERIALS AND METHODS: The results of complex treatment of 70 patients with constriction and deformation of the upper jaw during the period of temporary and permanent bite are presented. The patients were divided into groups according to the stage of formation of the midpalatal suture: 1st group - 40 patients with stage «A¼ and «B¼ (average age 11.5 years); 2nd group - 15 patients with stage «C¼ (average age 20.5 years); 3rd group - 15 patients with stage «D¼ and «E¼ (average age 24.5 years). Orthodontic treatment was carried out using palatine expanders with a dental and intraosseous type of fixation. The complex treatment consisted of: orthodontic treatment using a bracket system, transgingival laser corticotomy, piezocorticotomy, surgically assisted rapid palatal expansion, orthodontic appliances for the expansion of the upper jaw. After conducting a clinical X-ray examination of all patients and analyzing the data obtained, we developed algorithms for therapeutic measures. RESULTS: As a result of the diagnosis and treatment planning, the expansion of the upper jaw was achieved both at the dental alveolar and skeletal levels. Detailed algorithms of complex treatment were developed based on the analysis of CBCT data, the stage of formation of the midpalatal suture individually for each patient. CONCLUSION: It was found that the analysis of CBCT data makes it possible to choose the optimal treatment method for patients with skeletal deformities of the dentition complex, thereby increasing the effectiveness of orthodontic treatment.
Subject(s)
Cranial Sutures , Palatal Expansion Technique , Adult , Algorithms , Child , Constriction , Humans , Sutures , Young AdultABSTRACT
The effects of Cu, Ni, and Cd on the Pinus sylvestris metabolome was studied in experimental conditions by gas chromatography-mass spectrometry (GC-MS). Structural changes in plant metabolite network became detectable on day 6 of exposure to the metals, 3-6 days earlier than visual signs of toxicity developed. Differences at the metabolome level arose earlier in a control group of plants, and specific effects of particular metals on the plant metabolome became distinct on day 9. Both nature and concentration of a metal equally contributed to the plant metabolome clustering. Plant responses (changes in concentrations of individual metabolites) to metal exposure substantially differed depending on the metal concentration (1 or 5 mM) and nature. The effects of Cd and Cu were generally similar, while the effect of Ni was often different. Dynamic changes visualized in plant metabolite matrix reflected the changes in its correlation structure, rather than depending on the set of particular compounds.
Subject(s)
Metals, Heavy , Pinaceae , Pinus sylvestris , Soil Pollutants , Pinus sylvestris/metabolism , Cadmium/pharmacology , Pinaceae/metabolism , Metals, Heavy/toxicity , Metals, Heavy/analysis , Metabolome , Soil Pollutants/analysis , Soil Pollutants/chemistry , Soil Pollutants/metabolismABSTRACT
This article describes a case report of the patient with mandibular retrognathia, class II malocclusion, constriction and deformation of dental arches and bimaxillary protrusion. Due to the patient's refuse to undergo the orthognathic surgery, after diagnostic, it was decided to carry out the orthodontic dentoalveolar compensation. The combined use of the functional fixed telescopic appliance (FFTA), bracket system and orthodontic miniscrews made it possible to effectively normalize the mandibular position, achieve orthognathic occlusion, eliminate bimaxillary protrusion and improve the face profile. This method significantly reduced invasiveness and time of orthodontic treatment.
Subject(s)
Malocclusion, Angle Class II , Malocclusion , Retrognathia , Adult , Cephalometry , Humans , Malocclusion, Angle Class II/diagnostic imaging , Malocclusion, Angle Class II/therapy , Mandible/surgery , Retrognathia/diagnostic imaging , Retrognathia/surgeryABSTRACT
Dentofacial anomalies occupy one of the leading places among dental diseases in people of different age groups. Analysis of epidemiological data on the prevalence of dentoalveolar anomalies indicates that there is no tendency to decrease it in Russia and abroad countries. The demand for orthodontic treatment is increasing with the development of new technologies and materials, the development of modern methods of treatment in the field of dentistry. This trend is accompanied by increased requirements for the quality of orthodontic care. The patient's dissatisfaction with the result of treatment most often arises because of a discrepancy between his subjective assessment of treatment and the objective anatomical, functional and aesthetic state of occlusion. The use of methods for quantitative assessment of dentoalveolar anomalies and the quality of orthodontic treatment makes it possible to objectively substantiate the choice of tactics of orthodontic care and increase its effectiveness. At the same time, the patient's subjective assessment of the quality of orthodontic treatment allows one to see how the proposed (implemented) treatment plan reflects the patient's main complaints and to assess the degree of his satisfaction with the achieved result. That`s why, the issue of using methods of objective and subjective assessment of the quality and effectiveness of orthodontic treatment is relevant today. The purpose of the literature review is to consider the development and implementation of criteria for an objective and subjective assessment of the outcome of orthodontic treatment.
Subject(s)
Dental Occlusion , Malocclusion , Dental Care , Humans , Malocclusion/therapy , Personal Satisfaction , RussiaABSTRACT
THE AIM OF THE STUDY: Was to analyze the effectiveness of the use of Pitts Broad and early elastics in the treatment of patients with narrowing and deformation in dentition. MATERIALS AND METHODS: The results of orthodontic treatment of 46 adult patients with narrowing and deformation in dentition are presented. Patients were separated in 2 groups, depending on the algorithm of treatment: group 1 - using the braces of passive self-ligation, Pitts Broad and early short elastics; group 2 - using ligature braces and archwires Orthos. RESULTS: Biometric analysis of the diagnostic models of the 1st group after treatment showed a significant increase in the area of the premolars on the upper (between premolars - 39.8±0.4 mm, between molars - 48.3±0.5 mm) and lower (between premolars - 37.1±0.5 mm, between molars - 46.3±0.6 mm) jaws compared to the data before treatment. Biometric analysis of the diagnostic models of the 2d group showed that expansion in the area of the molars was achieved in a much smaller volume in the upper and lower jaws, compared with the 1st group (upper jaw: between premolars - 35.7±0.4 mm, between molars - 43.5±0.5 mm; lower jaw: between premolars - 33.2±0.3 mm, between molars - 42.3±0.5 mm). CONCLUSION: The passive self-ligation system in combination with protocol of Pitts Broad already contributes the expansion of dentition in aesthetically significant areas (distal regions) in the early stages of treatment. Using of early light elastics provides an early control of the lateral tooth torque, which allows achieving a harmonious and wide smile at the end of treatment.
Subject(s)
Dental Arch , Orthodontic Brackets , Adult , Bicuspid , Humans , Mandible , Molar , Tooth Movement TechniquesABSTRACT
BACKGROUND: The aim of this research is the experimental study measuring stability of the orthodontic miniscrews «Turbo¼ designed in Russia in comparison with its foreign analogues, namely, «Vector Tas¼ (USA) and «BioRay¼ (Taiwan). MATERIAL AND METHODS: Four self-drilling orthodontic miniscrews of each manufacturer, i.e. «Vector Tas¼, USA, (10-mm length, 2-mm diameter), «BioRay¼, Taiwan, (10-mm length, 2-mm diameter), «Turbo¼, Russia, (9-mm length, 2-mm diameter), a total of 12 items, were inserted into native pig mandible sample. Their stability was estimated by torques using a dynamometer (Zahoransky AG, Germany) and «Periotest¼ device («Periotest M¼, Germany). This experiment was conducted in native pig mandible sample immediately after the screws' placement and in 7 days after loading at an angle 70°. RESULTS: After application of a load, the decreased torque values and increased Periotest values were registered in all orthodontic miniscrews. CONCLUSION: Orthodontic miniscrews «Turbo¼ designed in Russia are slightly inferior to «VectorTas¼ miniscrews and superior to «BioRay¼ miniscrews in primary stability and stability after 7 days under loading.
Subject(s)
Orthodontic Anchorage Procedures , Animals , Bone Screws , Orthodontic Appliance Design , Russia , Swine , TorqueABSTRACT
The aim of this study is to develop algorithms for the treatment of patients with class II malocclusion and incisor protrusion using the combination of bracket system, functional fixed telescopic appliance (FFTA) and skeletal anchorage, which allows to achieve effective dentoalveolar compensation of skeletal forms of class II malocclusion. MATERIALS AND METHODS: Orthodontic treatment of 60 patients with class II malocclusion at the age of 18 to 44 years, using the bracket system, FFTA and orthodontic miniscrews was performed. In order to assess the results of treatment, cone-beam computed tomography were obtained at the beginning and at the end of treatment. RESULTS: As a result of the treatment normalization of lower jaw position, dental position and occlusion were achieved, the lower incisors protrusion was eliminated and the facial profile was improved, reliably confirmed by lateral cephalograms. CONCLUSION: The proposed treatment algorithm proved to be effective for stable correction of skeletal class II malocclusion in patients rejecting orthognathic surgery.
Subject(s)
Malocclusion, Angle Class II , Orthognathic Surgery , Adolescent , Adult , Algorithms , Cephalometry , Humans , Malocclusion, Angle Class II/diagnostic imaging , Malocclusion, Angle Class II/surgery , Mandible/diagnostic imaging , Mandible/surgery , Young AdultABSTRACT
THE AIM: Of the work is to develop and substantiate the method of minimally invasive complex orthodontic treatment of patients with constriction and deformation of the upper jaw in the period of permanent bite with the combined use of a bracket system, orthodontic devices for the expansion of the upper jaw and fractional photothermolysis to improve the effectiveness of complex treatment. MATERIALS AND METHODS: The results of complex treatment of patients with the deficiency of the upper jaw in the period of permanent bite are presented. Complex treatment consisted of orthodontic treatment using a bracket system, laser corticotomy, orthodontic devices for the expansion of the upper jaw. Ultrasound examination before and after the procedure was performed to obtain reliable results of laser impact on bone tissue. RESULTS: After conducting a clinical and radiological examination (using cone-beam computed tomography) of all patients and analyzing the data obtained, we have developed algorithms for therapeutic measures. As a result of orthodontic treatment aimed at the expansion of the upper jaw patients who underwent fractional photothermolysis procedure achieved the expansion of the upper jaw at both the dentoalveolar and skeletal levels. CONCLUSION: It was found that a comprehensive approach with minimally invasive effects can improve the effectiveness of treatment of patients with constriction and deformation of the upper jaw during the period of permanent bite and achieve stable treatment results.
Subject(s)
Lasers, Solid-State , Adult , Cone-Beam Computed Tomography , Dental Occlusion , Humans , Maxilla , Treatment OutcomeABSTRACT
The aim of this research is to increase the accuracy of determining the position of the tongue, the amount of space occupied by the tongue and space, free from tongue, increase of efficiency of diagnostics of dentofacial anomalies in patients based on CBCT analysis-the study of the skull conducted in transversal, sagittal and coronal planes. Clinical and x-ray examination and orthodontic treatment were carried out in 120 patients with anomalies of the dentition complex. Patients were divided into three groups. Group 1 - 30 patients aged 5 to 11 years. Group 2 - 50 patients aged 12 to 17 years. Group 3 - 40 patients aged 18 to 40 years. All patients underwent CT examination of the skull before treatment, and during the retention period of treatment. After a diagnostic examination of the proposed method for diagnosing the anatomical and functional state of the dentition complex and drawing up a treatment plan, all patients underwent orthodontic treatment, which consisted in the expansion of the upper jaw using various orthodontic appliances for expansion. This method allows to identify anomalies in the position of the tongue before and after orthodontic treatment, to assess the quality of orthodontic treatment, based on the analysis of not only the tongue filling the space of the dome of the palate, but also the position of the bone structures of the skull in three planes. The high quality of the study allows us to give a reliable assessment of the state of maxillofacial structures: the position of the upper and lower jaws, inclination of teeth, the stage of formation of the patient's growth, airway lumen and the influence of tongue on these structures at different stages of development of the maxillofacial skull. When comparing the results of the study, not all patients carried out recovered the anatomical and functional balance of the maxillofacial complex after orthodontic treatment, suggesting the need for more myogymnastics of the tongue before, during, and after treatment.
Subject(s)
Maxilla , Palatal Expansion Technique , Adolescent , Adult , Cephalometry , Child , Child, Preschool , Humans , Palate , Tongue , Young AdultABSTRACT
The aim of the study was to analyze the effectiveness of elastocorrective therapy in the complex treatment of patients with musculo-articular dysfunction of TMJ. Patients (n=237) underwent a comprehensive examination, including: 1) analysis of control and diagnostic plaster models of the jaws; 2) clinical examination; 3) X-ray examination: panoramic X-ray and TRG in lateral projection, computed tomography (CT) of the temporomandibular joint or X-ray zonography of the temporomandibular joint, and magnetic resonance tomography (MRI) of the temporomandibular joint, 4) electromyography of the chewing muscles, 5) T-Scan occlusion computer analysis; 6) stabilometry. After clinical, X-ray examination and data analysis of functional research methods, an algorithm for diagnostic and therapeutic measures was developed. All patients were prescribed the use of elastocorrector: at night during sleep and during the day for 1.5-2 hours. As a result of the use of elastocorrector in patients with muscle-articular dysfunction of the TMJ the position of the mandible was normalized and the spatial ratio of TMJ elements was optimized, the masticatory muscles function and bioelectric activity was normalized and the overload of muscles of mastication during functional movements is eliminated. «Elastocorrector¼ appliance can be used in patients with TMJ musculo-articular dysfunction both for orthodontic treatment (to eliminate chewing muscle hypertonus, compression of intra-articular structures, premature occlusive contacts) and to prepare for further treatment (orthopedic, therapeutic, etc.).
Subject(s)
Temporomandibular Joint Disorders , Temporomandibular Joint Dysfunction Syndrome , Humans , Mastication , Masticatory Muscles , Temporomandibular JointABSTRACT
The aim of the study was the development and substantiation of the method of orthodontic treatment of patients with malocclusions and deformities of dentoalveolar arches with the combined use of braces, orthodontic miniscrew, piezo-surgical corticotomy or laser corticotomy to improve the efficiency and reduce the time of complex treatment. The results of complex rehabilitation of 80 adult patients with dentoalveolar anomalies and deformities of dentition are presented. As a result of the orthodontic treatment of patients who underwent piezo-surgical corticotomy the bodily movement of the posterior teeth in the area of the previously removed tooth was achieved. After piezo-surgical or laser corticotomy the rate of tooth protraction remained elevated for 3 to 5 months (on average 0.3±0.5 mm/month), then gradually decreased. Piezo-surgical corticotomy led to a decrease in bone density, which was measured on the Hounsfield scale. As a result of orthodontic treatment in patients who underwent laser corticotomy an expansion of the upper jaw and normalization of occlusion in the transversal and sagittal directions was achieved: in the region of the hard palate by 7.1±0.4 mm; in the region of the alveolar bone by 6.5±0.5 mm; in the region of the roots of molars by 6.4±0.9 mm; in the area of crowns of molars by 8.3±0.7 mm. It was found that the combined use of piezo-surgical corticotomy and orthodontic miniscrews improve the efficiency and reduce the duration of orthodontic treatment by 3 to 6 months.
Subject(s)
Dentition , Malocclusion , Adult , Alveolar Process , Humans , Molar , Tooth Movement Techniques , Tooth RootABSTRACT
AIM: To increase the efficiency of diagnosis and orthodontic treatment of patients with temporomandibular joint dysfunction based on the study of the relationship between the features of the position of the heads of the lower jaw and various face types in patients aged 25 to 44 years according to cone beam computed tomography. We examined 100 people who were divided into two main groups (50 males, 50 females). To study the formed groups index method for diagnosing facial types according to Isar was used. The facial indicator was determined: the percentage of physiognomic height to the morphological width of the face. The structural features and relative positions of the TMJ bone structures in patients with TMJ dysfunction in various face types were studied in the Avantis 3D computer program. It was noted that the upper position of the lower jaw heads in women and men with a narrow type of face was observed in 50% and 40% of cases, respectively; the distal position of the lower jaw heads in women and men with a wide type of face was observed in 50% and 42.3% of cases, respectively. The results of the study indicate that there is a relationship between different types of face and the position of the lower jaw heads in the lower jaw, which should be considered in comprehensive treatment planning. The most at risk of temporal dysfunction is the TMJ of a woman with a narrow type of face, in which dominates the upper position of the lower jaw heads and a woman with a wide type of face with the distal position of the lower jaw heads. Before orthodontic treatment it is necessary to investigate the position of the TMJ heads with the help of CBCT and make a mandatory correction before the beginning of orthodontic treatment.