Treatment of Class III is a current problem in orthodontics that requires constant improvement of its methods, development of new or modifications of known methods and techniques. We have developed and studied the modification of removable functionally-directing orthodontic appliances for treatment of Class III, which consists of a plastic base, vestibular arc, retaining clasps, ramp, which is connected with the base by means of two torsion springs. Its usage ensures a prolonged contact of ramp with the teeth. We studied two types of club-shaped springs (torsion springs): one spring, which create an amortization effect during the action of the ramp, but do not change its inclination angle and second one-spring that seek to increase the angle of the ramp inclination due to the disclosure of its curl.

Background Tooth impaction is a common problem in orthodontic practice and in some cases accompanied by pain and pathological changes of surrounding teeth. Understanding the cellular and molecular mechanisms underlying tooth impaction allows finding the most effective orthodontic treatment for patients with impacted teeth (IT). RANK (receptor activator of NF-κB) / RANKL (RANK ligand) / OPG (osteoprotegerin) signaling pathway controls bone resorption and may be involved in the regulation of tooth eruption. The study aimed to evaluate bone remodeling based on the assessment of the RANKL/RANK/OPG status in patients with IT. Methods Bone samples from 18 patients (mean age 25.27 ± 3.34) were divided into 3 groups: 1 – bone tissue of healthy persons (control group); 2 – bone tissue, that was taken near the healthy tooth in patients with tooth impaction; 3 – bone tissue, that was collected near the IT. Levels of RANKL, RANK, OPG, osteocalcin (OC), NF-κB p65 subunit, NFATc1, and caspase-3 were determined by western blotting. The difference between groups was assessed using ANOVA followed by Tukey’s post-hoc test. P-value ≤0.05 was considered statistically significant. Results We established a 1.73-fold elevation of RANK level in the IT area vs. control, indicating the recruitment of preosteoclasts. An increase in RANKL, OPG, and OC content was demonstrated (1.46-, 1.48-, and 1.42-fold respectively), reflecting the high activity of osteoblasts near the IT. Despite the activation of the RANKL/RANK/OPG system in the impaction area, NF-κB and NFATc1 levels did not change compared vs. control, indicating a blocked/delayed process of osteoclastogenesis. We found a decrease in the content of procaspase-3 (1.28-fold), while the level of its active form p17 increased by 2.26 folds near the healthy tooth in patients with IT compared with control. In the area of ​​IT, we observed an increase in procaspase-3 and p17 levels (1.32 and 1.78 folds). This reflects impairments of caspase-3 activation and accumulation of its inactive form in the IT area that may contribute to the tooth eruption failure. Conclusions Tooth impaction may be associated with the disturbances in the caspase-3 cascade activation and the imbalance in the RANKL/RANK/OPG system, and as a result, blocked bone resorption.

For many years, malocclusions have remained one of the most common dental pathologies in the world. Malocclusions are found in every second child and teenager in the world, and their prevalence does not change depending on the stage of the bite. Having polyetiological causes, malocclusions affect most body systems, which are closely related to the functions of respiration, chewing, swallowing, and speech. Our goal was to obtain up-to-date data on the prevalence of malocclusion in children during the period of mixed and early permanent occlusion. In this study, we examined 674 children aged from 6 to 13 years (with the mean age of 9.2). The examined patients' occlusion was assessed in three planes: sagittal, vertical, and transverse. In the sagittal plane, the occlusion was assessed according to Angle’s classification, children were divided into three groups according to this criterion: class I, class II, class III. The overbite was estimated in the vertical plane. Children were divided into three groups: normal group, overbite, open bite. The overlap in the lateral areas was estimated in the transverse plane. Children were divided into three groups according to this criterion: normal group, bilateral crossbite, unilateral crossbite. In 94.51% of all children aged from 6 to 13 years, living in the city of Kyiv and Kyiv region, there was a malocclusion in one of the three planes, regardless of the gender. Only 5.49% of children did not have a malocclusion. Among the total number of children examined, class I was observed in 324 children, class II in 296 children, class III in 54 children. Among all examined children aged from 6 to 13 years, overbite was diagnosed in 57.27% (386 children). The open bite was determined least often, with the incidence rate of 9.64% (65 children) among the examined 674 children. Unilateral crossbite was observed in 58 children (8.61%) among 674 subjects. In most cases, namely, in 43 children (74.14%) out of 58 children, unilateral crossbite was accompanied by the midline displacement. Bilateral crossbite was detected in 163 children (24.18%) among the total number of respondents. Bite anomalies in sagittal and vertical planes were observed in 444 children (65.88%), 91 children (13.5%) in the sagittal and transverse planes, 43 children (6.38%) in the vertical and transverse planes, and 59 children (8.75%) in all planes. Developing a strategy for early prevention and treatment of malocclusion in children, as well as eliminating bad habits are important factors in combating the growing number of patients with orthodontic pathologies. Our data indicate a high prevalence of malocclusion among children and teenagers and the need to review the prevention management and early treatment of children of this age group.

Relevance of research. Under complex correction of speech disorders in existing orthodontic pathology, it is important to establish the causative factor, because incorrect tongue articulation, infantile type of swallowing and other bad habits can be the cause of dental and maxillary pathologies and, at the same time, speech disorders. The cause-and-effect relationship between dentoalveolar and speech disorders has been proved. Anomalies and deformations of the dentoalveolar apparatus prevent the sounds from being pronounced normally, contribute to strengthening the habits of improper articulation and complicate logopedic correction. The problem of logopedic correction of sound pronunciation should be addressed comprehensively in collaboration with an orthodontist. The purpose of the research. To treat patients with anomalies of bite and speech disorders according to the proposed algorithm. Materials and methods. To achieve study objectives, 82 patients with severe orthodontic pathology and speech disorders, with normal hearing and intellect, were accepted for treatment. Clinical examination according to the generally accepted scheme, extraoral and intraoral photographs, anthropometry, myography, cephalometry, and logopedic diagnostics of all aspects of speech were conducted. After establishing the diagnosis, determining the treatment plan, orthodontic treatment was performed simultaneously with speech therapy correction. Results and discussion. The first step in the algorithm of successful treatment (correction) of speech disorders and dentoalveolar anomalies was the explanation of its necessity. The second stage of the algorithm was a clinical examination, which included medical history taking and objective methods of examination. The speech therapy part of the algorithm provided for speech therapy diagnosis of all aspects of speech: sound pronunciation, vocabulary, grammar, phonetics. Additional methods of examination were performed for the preparation of the plan, the choice of method and tactics of treatment: extraoral and intraoral photographs, anthropometry, myography, cephalometry, which is an integral part of the second stage of the treatment algorithm for patients with abnormalities and deformations of the dentoalveolar device in conjunction with correction of speech disorders. The third stage of the algorithm was direct orthodontic treatment and speech correction. The retention period is the final stage of the algorithm for treating patients with abnormalities and deformations of the dental apparatus in combination with the correction of speech disorders. Conclusion. The algorithm for treating patients with anomalies of bite and speech disorders consists of the following blocks: motivation, detailed diagnosis, treatment planning and tactics, the active period of orthodontic treatment simultaneously with speech correction and patient management in the retention period.

The relevance of research. When examining patients with dentoalveolar anomalies, children with speech disorders can often be observed. For orthodontists, it is important to diagnose the etiologic component of these disorders, namely, whether they are the cause of diseases of the ENT-organs and whether they are directly related to orthodontic pathology. In order to study the impact of the pathology of the ENT-organs on the formation of speech disorders, clinical and additional examination methods were carried out. In case of respiratory tract narrowing due to the deviated septum, hypertrophic or allergic rhinitis, adenoid vegetations, hypertrophy of the tonsils, speech pathology may be observed. Specified pathologies are subject to treatment before the logopedic and orthodontic correction. According to our clinical study in children of the main group and of the comparison group, the apparent pathology of the nose and oropharynx was not detected. Subjective and objective methods of hearing examination also did not reveal deviations from the norm. For a more detailed study of the condition of the upper respiratory tract, it is advisable to use computer tomography of the skull and magnetic resonance therapy of the head. The purpose of research is to eliminate the influence of otorhinolaryngologic pathologies on the formation of speech disorders. Materials and methods. We examined 124 patients. Patients were divided into two groups: control and comparison. The control group consisted of 82 patients with anomalies and deformations of dentognathic apparatus and speech disorders. The comparison group consisted of 42 patients without orthodontic pathology who applied to otolaryngologists for a diagnostic examination. The examination did not show the expressed pathology of ENT-organs in the presence of speech impairment and 5 children (aged from 6 to 12 years) with ENT pathology and speech impairment were not included in the main comparison groups. To make clinical and additional diagnosis such methods as rhinoscopy, pharyngoscopy, otoscopy were used. Results and discussion. During the rhinoscopy of all the examined patients of control and comparison groups, it was found: the nasal passages were free, the nasal shells were of the usual size, the nasal membrane was in the medial position, pathological contents in the nasal cavity were not detected. During pharyngoscopy, attention was mainly paid to the size of palatine tonsils. Thus, 62 children (50%) had the 1st and 2nd stage of development, 42 (33.87%) - 2nd stage and 20 (16.13%) - II-III degree. Adenoids (nasopharyngeal tonsil) of the 1st and 2nd degree were established in 86 children (69.35%), 28 children (22.58%) - second degree and 10 (8.06%) - II-III degree, but in all children of the main and comparison groups, nasal breathing function was not noted. In 124 subjects (100%), there was no adenoid type of facial skeleton. Conclusion. With the narrowing of the respiratory tract due to a curvature of the nasal septum, hypertrophic or allergic rhinitis, adenoid vegetation, hypertrophy of the palatine tonsils, speech impairments can be observed. The specified pathologies are subject to treatment before the logopedic and orthodontic correction. According to our clinical examination of children of the main group and the groups of comparison, evident pathology of the nose and oropharynx was not detected. Subjective and objective methods of hearing examination also did not reveal deviations from the norm. For a more detailed study of the condition of the upper respiratory tract, it is advisable to use computer tomography of the skull and magnetic resonance therapy of the head.

Background: Tooth impaction is a common problem in orthodontic practice and in some cases accompanied by pain and pathological changes of surrounding teeth. Understanding the cellular and molecular mechanisms underlying tooth impaction allows finding the most effective orthodontic treatment for patients with impacted teeth (IT). RANK (receptor activator of NF-κB) / RANKL (RANK ligand) / OPG (osteoprotegerin) signaling pathway controls bone resorption and may be involved in the regulation of tooth eruption. The study aimed to evaluate bone remodeling based on the assessment of the RANKL/RANK/OPG status in patients with IT. Methods: Bone samples from 18 patients (mean age 25.27±3.34) were divided into 3 groups: 1 – bone tissue of healthy persons (control group); 2 – bone tissue, that was taken near the healthy tooth in patients with tooth impaction; 3 – bone tissue, that was collected near the IT. Levels of RANKL, RANK, OPG, osteocalcin (OC), NF-κB p65 subunit, NFATc1, and caspase-3 were determined by western blotting. The difference between groups was assessed using ANOVA followed by Tukey’s post-hoc test. P-value ≤ 0.05 was considered statistically significant.Results: We established a 1.73-fold elevation of RANK level in the IT area vs. control, indicating the recruitment of preosteoclasts. An increase in RANKL, OPG, and OC content was demonstrated (1.46-, 1.48-, and 1.42-fold respectively), reflecting the high activity of osteoblasts near the IT. Despite the activation of the RANKL/RANK/OPG system in the impaction area, NF-κB and NFATc1 levels did not change compared vs. control, indicating a blocked/delayed process of osteoclastogenesis. We found a decrease in the content of procaspase-3 (1.28-fold), while the level of its active form p17 increased by 2.26 folds near the healthy tooth in patients with IT compared with control. In the area of ​​IT, we observed an increase in procaspase-3 and p17 levels (1.32 and 1.78 folds). This reflects impairments of caspase-3 activation and accumulation of its inactive form in the IT area that may contribute to the tooth eruption failure.Conclusions: Tooth impaction may be associated with the disturbances in the caspase-3 cascade activation and the imbalance in the RANKL/RANK/OPG system, and as a result, blocked bone resorption.

Національний медичний університет імені О.О.Богомольця АНАЛІЗ РЕНТГЕНОЛОГІЧНИХ ОСОБЛИВОСТЕЙ РОЗТАШУВАННЯ РЕТЕНОВАНИХ ЗУБІВ У ОБСТЕЖЕНИХ ПАЦІЄНТІВ Актуальність. У алгоритмі обстеження пацієнтів із ретенованими зубами обов'язковим є встановлення положення вісі ретенованого зуба в щелепі та по відношенню до вісі сусідніх зубів, стан альвеолярної кістки, вік пацієнтів та їх загальносоматичний статус. Успіх лікування залежить безпосередньо від визначення постановки діагнозу та кваліфікації лікаря. Мета дослідження. Проаналізувати рентгенологічні особливості розміщення ретенованих зубів для визначення необхідного комплексу діагностичних та лікувальних заходів у разі виявлення ретенованих зубів. Матеріали та методи. Загалом було обстежено 109 пацієнтів віком від 9 до 35 років. Віковий розподіл відповідає гендерному відсотку населення. Рентгенологічні методи включали дентальну внутрішньоротову рентгенографію, ортопантомографію, комп'ютерну томографію. Результати дослідження та їх обговорення. При визначенні глибини розташування ретенованих зубів (в постійному та змінному прикусі) встановлено, що більшість із них розташовані на І і ІІ рівнях. Виявлено топографічне розташування ретенованих зубів залежно від їх анатомії (щічне або оральне). Так, для ретенованих центральних різців вестибулярне положенння достовірно перевищує піднебінне

Abstract Background: Tooth impaction is a common problem in orthodontic practice and in some cases accompanied by pain and pathological changes of surrounding teeth. Understanding the cellular and molecular mechanisms underlying tooth impaction allows finding the most effective orthodontic treatment for patients with impacted teeth (IT). RANK (receptor activator of NF-κB) / RANKL (RANK ligand) / OPG (osteoprotegerin) signaling pathway controls bone resorption and may be involved in the regulation of tooth eruption. The study aimed to evaluate bone remodeling based on the assessment of the RANKL/RANK/OPG status in patients with IT. Methods: Bone samples from 18 patients (mean age 25.27±3.34) were divided into 3 groups: 1 – bone tissue of healthy persons (control group); 2 – bone tissue, that was taken near the healthy tooth in patients with tooth impaction; 3 – bone tissue, that was collected near the IT. Levels of RANKL, RANK, OPG, osteocalcin (OC), NF-κB p65, NFATc1, and caspase-3 were determined by western blotting. The difference between groups was assessed using ANOVA followed by Tukey’s post-hoc test. P-value ≤ 0.05 was considered statistically significant. Results: We established a 1.73-fold elevation of RANK level in the IT area vs. control, indicating the recruitment of preosteoclasts. An increase in RANKL, OPG, and OC content was demonstrated (1.46-, 1.48-, and 1.42-fold respectively), reflecting the high activity of osteoblasts near the IT. Despite the activation of the RANKL/RANK/OPG system in the impaction area, NF-κB and NFATc1 levels did not change compared vs. control, indicating a blocked/delayed process of osteoclastogenesis. We found a decrease in the content of procaspase-3 (1.28-fold), while the level of its active form p17 increased by 2.26 folds near the healthy tooth in patients with IT compared with control. In the area of ​​IT, we observed an increase in procaspase-3 and p17 levels (1.32- and 1.78-fold). This reflects impairments of caspase-3 activation and accumulation of its inactive form in the IT area that may contribute to the tooth eruption failure. Conclusions: Tooth impaction may be associated with the disturbances in the caspase-3 cascade activation and the imbalance in the RANKL/RANK/OPG system, and as a result, blocked bone resorption.