Butskaya YM

Bashkir State Medical University, Ufa, Russia

THE ORAL HEALTH OF PATIENTS UNDERGOING ORTHODONTIC TREATMENT

In recent years, an increasing number of adult patient visits to the dentist, orthodontist, while in patients at the age from 18 to 40 years, the clinical picture of dentoalveolar anomalies and deformations is characterized by the greater severity and intensity than in children and adolescents. This is because anomalies in adults is often complicated by partial loss of teeth, deformation of occlusal and functional overload of the periodontium, and the presence of different prosthetic constructions [1, 2]. On the basis of clinical stomatologic examination of 1398 students of higher educational institutions of Ufa at the age from 16 to 22 years found that the prevalence of dentoalveolar anomalies is 83,12%. The high prevalence of dentofacial anomalies requires improving the complex of treatment and preventive measures in this category. [2] in individuals undergoing orthodontic treatment, the prevalence and intensity of major dental diseases is significantly greater than that of those without orthodontic design [10]. After removing the braces, 55% of the tooth surfaces have foci of demineralization, which is manifested in the form of white spots and stripes, following the contours of the bases of the braces. Demineralization are also subject to the molars, which are the supporting teeth throughout the orthodontic treatment [3]. It is believed that one of the most important pathogenetic factors in the development of caries is the condition of hard dental tissues directly and acid resistance of enamel [1, 9], and the nature of food intake, namely excessive consumption of carbohydrate and dental plaque [10]. Signs of demineralization under the use NOT are identified within 4 weeks of starting treatment and spread to a depth of 100 µm. In 75% of patients developing decalcification of dental enamel [9]. Gevorgyan, T. V. [5] notes that the plaque index by Quigley and Hein Turesky modification in patients with SOT increased from 1.02±0,24 to 1.23±0.15 in the first month of treatment c and then decreased to 1.22±0,2 after 6 months and stabilization at the level of 1.15±0,23 12 months from the start of orthodontic treatment.

In recent years, increasingly popular method of treatment dentoalveolar anomalies and deformities with the use of aligners. According to Gevorgyan, T. V. [5] of the patients who underwent orthodontic treatment using aligners, DMF index increased from 6.83±5,18 to 6.93±5,24. The authors attribute this to the fact that the long period of time (20-22 hours per day), the enamel was stripped of the impact of natural protective factors of the oral fluid. Removable aligners-aligners are more hygienic compared to classic braces. Due to the fact that they are removable, the patient is easier to carry out individual hygiene of the oral cavity and on the surface of teeth fewer retention points and, as a consequence, a lower level of accumulation of plaque [6].

Levenec A. A. et al. [11] investigated the state of humoral and cellular immunity in patients undergoing orthodontic treatment and found that in the treatment process develops, the immune deficient status, while also reducing the level of lymphocytes СD3, immunoglobulin A and altered immunoregulatory index increases the concentration of anti-inflammatory cytokines (IL 1β and IL 4) on the 7th day after fixation of the NOTES by 64.1 and 4.2 %, respectively. Are suppressed by the factors of local immunity with a decrease of lysozyme activity and the concentration of sIgA in the mixed saliva within 3 months after fixation of the NOT, resulting in frequent development of these patients is complications in the form of inflammatory processes in the periodontium (20-38% and above), requiring the participation of specialists of related professions (periodontist, immunologist, endocrinologist, hematologist, gastroenterologist, etc.). Therefore, the necessary objective assessment of the periodontal tissues to treatment and therapy for the prevention or relief already developed inflammatory complications [4, 7, 8].

[3] notes that in 75% of patients undergoing treatment with lingual braces, a pathology of the periodontium, caused by orthodontic appliances. The presence of dentofacial anomalies and orthodontic appliances lead to a significant deterioration of the hygienic condition of the oral cavity. This is due to the deterioration of natural cleaning of the teeth due to poor access to vestibular, lingual and buccal surfaces, where fixed orthodontic apparatus. Most authors note that the orthodontic apparatus is complicated individual hygiene, is conducive to the deposition of soft plaque and food retention of residues, changes in microbiological status, increasing the total microbial mass [7,10,11]

Thus, according to the literature it was found that the prevalence and intensity of caries, periodontal disease patients with NOT higher than patients with SOT, and the bracket system to a greater extent adversely impact on the fabric of the marginal periodontal and hygienic condition of the mouth, injury of the oral mucous membrane than the removable device, which dictates the need for a comprehensive approach to the selection of preventive measures, training, rational hygiene and quality control, professional oral hygiene, the selection of tools and objects for personal hygiene of the oral cavity.

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., Зубарева А.В. Оценка уровня качества жизни у пациентов с зубочелюстными аномалиями // Современные проблемы науки и образования .2015 №4 с. 308

3. Беньковский В.В. Клиническая оценка гигиены полости рта пациентов, пользующихся ортодонтическими аппаратами: Автореф. дис. к. м. н. - СПб, 2011. - 22 с.

4.Воспалительные заболевания слизистой оболочки полости рта при использовании съемной и несъемной ортодонтической аппаратуры / С. Н. Гонтарев [и др.] // Научные ведомости БелГУ. - 2013. - № 11-1(154). - С. 15-18.

5.Геворкян, Т.В. Состояние органов и тканей полости рта при коррекции зубоальвеолярных аномалий и деформаций с использованием стоматологических капп: Автореф. дис. канд. мед. наук. - Москва, 2014. - 24 с.

6.Гянджали, Н.Т. Брекет-техника или элайнеры? // Бюллетень медицинских интернет-конференций. - 2014. - Т. 4, № 4. - С. 370.

7. Герасимова Л.П., Гуляева О.А., Чемикосова Т.С., Тухватуллина Д.Н., Дубова О.М. Эффективость метода Perio-Flow в комплексе поддерживающей пародонтальной терапии у пациентов с воспалительными заболеваниями пародонта при ортодонтическом лечении// Пародонтология 2016 №3 – С.-72-77.

8. Гуляева О.А. Способ профилактики воспалительных заболеваний пародонта у пациентов с несъемной ортодонтической техникой с применением инъекционной формы аутологичной тромбоцитарной плазмы/ патент на изобретение RUS 2626825 08.11.2016

9.Децык О.Р. Оценка кариесогенной ситуации в динамике лечения зубочелюстных аномалий несъемной ортодонтической аппаратурой: Автореф. дис. канд. мед. наук. - Пермь, 2010. - 22 с.

10.Кабачек, М.В. Профилактика развития осложнений при ортодонтическом лечении несъемной техникой: Автореф. дис. канд. мед. наук. - Москва, 2004. - 26 с.

11.Левенец, А.А. Состояние системы иммунитета у детей на этапах ортодонтического лечения / А.А. Левенец, Е.А. Бриль, Т.А. Кожевникова // Институт стоматологии. - 2005. - No3. - С. 44-45.