the pathology of dental crowding in mixed dentition period is one of the most common in orthodontic practice. Its prevalence, according to various worldwide scientific sources, reaches 77% and occurs at all stages of the formation of the dentognathic system, sometimes complicating the existing malocclusion. The purpose of our study is to create a rational treatment protocol for patients with dental crowding according to the facial skeleton growth pattern, as well as to conduct a comparative analysis of the effectiveness of dental crowding treatment according to standard and suggested protocol. A three-year study at NMU O.O. Bogomolets Medical Center of patients with dental crowding in mixed dentition period(164 people).A total of 328 CBCT slices before and after treatment of patients with crowded teeth were submitted to the overall analysis. The results and conclusions of treatment efficiency analysis were carried out using the proposed treatment protocol with different facial skeleton growth patterns indicate an increase in the quality of treatment of this pathology and a reduction in treatment terms to achieve the result. The results obtained after 16 months in patients with a horizontal type of growth indicate that the effectiveness of the treatment of CG II patients reached 68.1±1.3%;after 17 months, in patients with a vertical and neutral growth patterns, the effectiveness of treatment of CG III reached 76.7±1.6%, CG I – up to 62.3±0.7%. The algorithm proposed by us allows to shorten the treatment period by 3-4 months.
Dental crowding in mixed dentition is one of the most common orthodontic pathologies nowadays. According to modern literature database it’s prevalence reaches 77% and present at all occlusion periods, which is a significant sign of malocclusion’s severity. The aim of our research is to develop rational treatment protocol of patients with dental crowding during mixed dentition period according to facial skeleton growth patterns and also to make comparative analysis of treatment efficiency by using traditional and suggested protocol. Patients in mixed dentition period with dental crowding (n=164) were examined over a period of last three years at the base of NMU O.O. Bogomolets Dental Center, Kyiv. A total of 328 CBCT sections of facial skeleton (medium FOV) before and after treatment were submitted to the general analysis. The results and conclusions of treatment efficiency analysis were carried out by using the suggested protocol of dental crowding treatment with different facial skeleton growth patterns. Results indicated an improvement in treatment efficiency of this pathology and significant treatment time shortening. The results obtained after 16 months in patients with a horizontal growth pattern indicate that treatment efficiency value of clinical group (CG) II patients was 58.1±1.3%; after 17 months in patients with vertical and neutral growth patterns, treatment efficiency value of CG III was 66.7±1.6%, CG I - was 52.3±0.9%. The algorithm proposed by us allows to shorten treatment duration by 3-4 months.
The purpose of the study was to study and comparatively analyze the nature and degree of changes in electromyographic activity of the main and auxiliary chewing muscles in patients with temporomandibular joint dysfunction before and after the use of treatment with myorelaxant splints. Materials and methods. Five-year study on the basis of Stomatological Medical Center of Bogomolets National Medical University of patients with temporomandibular joint dysfunction (274 people) was conduscted. The general analysis provided 1024 detailed electromyograms before, after and at the stages of treatment of patients with temporomandibular joint dysfunction. Results and discussion. The results and conclusions of the analysis of the effectiveness of the treatment with the use of myorelaxant splints in the treatment of temporomandibular joint dysfunction indicate an increase in the quality of treatment of this pathology in patients and a reduction in the period of achievement of the result. The results obtained after 12 months indicate that the effectiveness of treatment of patients of control group I (with the lowest intensity of symptoms of temporomandibular joint dysfunction) reached 89.1±1.3%; control group II – up to 78.3±1.3%; control group III – 77.3±1.3%. In general, a study of the state of temporomandibular joint, complex clinical and paraclinic diagnosis, modern orthopedic treatment and prevention of musculoskeletal dysfunction of the temporomandibular joints were carried out. Based on the obtained data, the effectiveness of this algorithm of complex diagnosis, treatment and prevention of musculoskeletal dysfunction of temporomandibular joint was developed, clinically implemented and evaluated. Also, the data obtained as a result of the study by the authors were the basis for finding and correcting new methods and algorithms for diagnosing and treating pathology. The original author's concept of the pathogenesis of muscular-articular dysfunction of temporomandibular joint, used in the study and scientifically substantiated by the authors, united all existing theories of the development of this disease. The multifactorial analysis revealed an increase (p <0.001) of the risk of not achieving the effect of treatment by reducing pain syndrome with an increase in scores on the Bayers scale before treatment, odds ratio = 1.6 (95% of BI 1.4–1.9) for each point of growth score (when standardizing on three other risk factors). An increase (p=0.002) of the risk of not achieving the effect of treatment by reducing pain syndrome with an increase in the asymmetry of the indicator J_MM_A_max, Index Bayers (visual analogue scale) = 1.08 (95% BI 1.03–1.12) for each point exceeding the value of the indicator for the left half above the right (when standardizing on three other risk factors). Also, an increase (p= 0.049) of the risk of not achieving the effect of treatment for a decrease in pain syndrome with an increase in the asymmetry of the J_MM_A_mean indicator, odds ratio = 1.28 (95% of BI 1.00–1.65) for each point exceeding the value of the indicator for the left side above the right side (when standardizing on three other risk factors) was found. Conclusion. Such a thorough approach to the implemented model of diagnosis and treatment of patients with temporomandibular joint dysfunction and a synchronized complex of studies and treatment of this pathology, developed in accordance with it, provided an opportunity to assess qualitative and quantitative changes in the link of the chewing apparatus and the central link of the corresponding functional biosystem that ensure the formation and implementation of the main functions of the temporomandibular joint
Annotation. Pathology of dental crowding during mixed dentition is one of the most common and difficult in the practice of dentist-orthodontist. Its prevalence, according to modern scientific data reaches 77% and occurs in all pathologies of occlusion (malocclusions). The aim of our study is to establish the relationship between the formation of dental crowding and the growth patterns of facial skeleton during mixed dentition in order to improve the effectiveness of orthodontic treatment. We used 42 pairs of plaster models and 42 slices of cone-beam computed tomography images (CBCT) for patients aged 7 to 11 years. Randomization of patients into study groups was performed according to the facial skeleton growth patterns and the Little index value. The analysis was performed by the method of variation statistics taking into account the mean values (mode, median, arithmetic mean) and mean error (M) with the assessment of reliable values by Student’s t-test, as well as determining the correlation coefficient using the Pearson pairwise method to detect connections between the obtained indicators at the minimum probability threshold p<0.05 using the statistical package EZR v. 1.35. According to the results of the examined patients: 30 people (71.4%) had a severe degree of dental crowding on both maxilla and mandible (LII> 8 mm.), more often it was associated with the neutral type of growth – 82% (with vertical – 60%). Statistically significant correlations were found between severe degree of dental crowding and vertical and neutral facial skeleton growth patterns (p<0.05). The results of the CBCT study showed that narrowing of the upper pharyngeal airway (UP) according to McNamara was more common in patients with neutral (85%) and vertical (80%) growth patterns with skeletal II and I class malocclusions according to Engle, which were 55% and 35%, respectively. The study revealed that the vast majority of children with dental crowding with different facial skeleton growth patterns had clinically significant disorders of the development of both maxillary and mandibular apical bases and airways which required immediate interceptive orthodontic treatment.
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