The article presents an overview of modern approaches to the identification and justification of the choice of management tactics for patients with malocclusion and crowding of teeth. The questions of the etiology and pathogenesis of malocclusion that occurred both in early childhood and in older age are highlighted. There is a high prevalence of malocclusion in the population, which creates a number of medical problems (tooth erasability and mobility, changes in the upper-mandibular joint, abnormalities of the biomechanics of the lower jaw), but also a number of aesthetic and psychological problems. The classification of malocclusion anomalies is given. The article describes the currently relevant visualization methods for diagnosing malocclusion, which allow us to assess the severity of changes and adequately select the optimal method of correction, including orthopantomography and telerentgenography. The application of the calculation method is justified, which allows to establish the fact of a lack of space in the dental arch and to identify the need for its increase in case of crowding of teeth. Indications for extraction of teeth for correction of malocclusion have been determined. The factors determining the success of corrective treatment and the stability of the achieved results are listed.
Currently, hereditary connective tissue disorders (HCTD) are divided into hereditary syndromes - rare diseases that are diagnosed according to internationally agreed criteria (Marfan, Ehlers-Danlos, Stickler, Loeys-Dietz syndromes, and others), and a number of dysplastic phenotypes (marfanoid habitus, marfan-like and Ehlers-like phenotypes, benign joint hypermobility). The involvement of the bone system in the dysplastic process is typical for most HCTD. The bone signs of dysembriogenesis include malocclusion and dental growth disorders. The article presents an overview of current recommendations for a number of HCTD, assesses the role of facial signs of dysembriogenesis in the diagnostic algorithms for these diseases. A rather low prognostic value of such signs as malocclusion and dental growth disorders in the detection of hereditary syndromes and dysplastic phenotypes is shown. The clinical manifestations of HCTD in the maxillofacial region are analyzed - the frequent detection of different types of the malocclusion and dental growth disorders in HCTD is demonstrated. The difficulties of orthodontic treatment of patients with hereditary syndromes are substantiated.
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