Gibadullina Z. G.

Bashkir State Medical University, Ufa, Russia

Combined treatment of vertical tool disocclusion

Today in the structure of dental diseases dental-maxillary disorders (DMD) is one of the leading places [1, 2, 3, 4,]. Open bite or vertical cutting disocclusion, is one of the most severe and difficult to treat abnormalities of occlusion [4; 9]. The complexity of the problem stems from the multifactorial nature of the development of this anomaly, it is imperative an integrated approach to the diagnosis, treatment and rehabilitation, and also with a high recurrence rate [2, 3]. The presence of the vertical incisor disocclusion disrupts the function of mastication, swallowing and speech, contributes to the diseases of the gastrointestinal tract and the development of dissatisfaction with appearance [1; 5,8].

Given all the above, it seems quite justifiable to apply the combined method of orthodontic treatment which involves pre-surgical interventions to reduce the mechanical properties of the hard tissues of the jaws, including surgical procedures: compactsteam(lattice, linear, tunnel), osteotomy and osteectomy [7], with subsequent orthodontic treatment fixed equipment.

The purpose of the study - improving the efficiency of treatment of patients with vertical tool disocclusions through the development and implementation of combined techniques (the surgical sky and orthodontic) treatment.

In the course of treatment were examined 18 patients 14-35years (7 male and 11 female, average age 24,851 ±0.3 mm) with a vertical tool disocclusions. The patients were divided into two groups:(I) – main group (9 patients) who underwent combined treatment with modelirovaniem bones and the use of orthodontic treatment bracket system;(II) control group (9 patients) who underwent orthodontic treatment using braces.

To determine the extent of the surgery in the main group, we conducted a clinical and radiographic evaluation of the position of incisors of maxilla and mandible, as bone tissue, determined the placement of the surgical injury of the jaw bones. On models of the jaws in the studied groups measured the height of the dentoalveolar, sagittal gap between the incisors and the simulated path of orthodontic tooth movement. Measuring dentoalveolar height of the Central incisors, first premolars and first molars upper and lower jaw, the indicators were compared with the measurements, dentoalveolar heights when accepted as the norm orthognathic occlusion determining dentoalveolar protrusion dentoalveolar shortening or elongation [5, 6].

In the combined treatment of vertical incisor disocclusion main group strictly followed the stages of treatment: preduralsky stage of treatment (installation of braces, leveling of the teeth in the dental arch), surgical stage (modelirovanie bone), active orthodontic phase of treatment (vertical dentoalveolar movement of the cutters), the passive stage of orthodontic treatment (functional stabilization of the occlusion and the height of the bite), the retentive phase (retention).

In the active period of orthodontic treatment patients in the control group, orthognathic ratio of teeth in the frontal portion is reached in 8-12 months. In the active period of orthodontic treatment of patients of the main group under the force of the vertical elastic rods, held dentoalveolar lengthening in the region of incisors of maxilla and mandible, and dental alveolar shortening in the area of first premolars and first molars of the jaws. Thus, after 3 months of active treatment achieved orthognathic ratio of teeth in the frontal portion. After the completion of active orthodontic treatment, functional occlusion and stabilization of the bite height in the retention period of treatment performed orthopantomography of the jaws and teeth to control osteoplastic regenerative and recovery processes of bone tissue. The combined treatment of vertical incisor disocclusion normalized ratio of teeth in the vertical plane, improved aesthetics of the smile and facial features, normalized functions of chewing, swallowing and speech.

List of used literature:

1. Аверьянов С.В., Авраамова О.Г., Акатьева Г.Г., и др. Детская терапевтическая стоматология. Национальное руководство. Москва, 2017.

2. Аверьянов С.В., Авраамова О.Г., Акатьева Г.Г., и др. Детская терапевтическая стоматология Национальное руководство / Ассоциация медицинских обществ по качеству (АСМОК); Под ред. В.К. Леонтьева, Л.П. Кисельниковой. Научный редактор: Маслак Е.Е.. Москва, 2010.

3. Аверьянов С.В. Концепция этиологии, патогенеза и профилактики зубочелюстной аномалии у детского населения, проживающие в зоне экологического неблагополучия. - автореферат дисс. доктора мед. наук- Пермь, 2010г- 46с.

4. Аверьянов С.В., Зубарева А.В., Мингазева А.З., Ромейко И.В. Оптимизация методов лечения ретенированных клыков у студентов вузов города Уфы //Современная клиническая медицина: изучение этиологии и патогенеза заболеваний, разработка методов их профилактики, диагностики и лечения сборник материалов международной научной конференции. 2013. С. 251-255.

5. Аверьянов С.В., Зубарева А.В. Комплексный метод лечения ретенированных зубов //Ортодонтия. 2016. № 2 (74). С. 32.

6. Арсенина О.И., Лукашин В.В., Матвеева Е.А. Клинико-функциональное состояние зубочелюстной системы в зависимости от вида и степени дизокклюзии зубных рядов // Ин-т стоматол.-2003.-№4.-С. 55-56.

7. Давыдов Б. Н., Бессонов С. Н. Костно-пластические операции в комплексном лечении деформаций верхней челюсти. // Стоматология.- №2.-2004.-С. 46-50

8. Персин Л.С. Ортодонтия. Современные методы диагностики зубочелюстно-лицевых аномалий: Рук-во для врачей.-М: Информкнига.-2007. -248 с.

9. Habirova E.R., Averyanov S.V., Gulyaeva O.A.
the choice of braces in the treatment of dentofacial anomalies // Приднепровский научный вестник. 2017. Т. 4. № -3. С. 011-013.