[Efficiency of orthodontic treatment in combination with surgically assisted rapid palatal expansion]

[Algorithms for orthodontic treatment of patients with maxillary constriction based on the stages of formation of the palatal suture]

THE AIM OF THE STUDY

Improving the effectiveness of complex orthodontic treatment of patients with constriction and deformation of the upper jaw during the period of replacement and permanent bite based on the analysis of cone-beam computed tomography (CBCT) data.

MATERIALS AND METHODS

The results of complex treatment of 70 patients with constriction and deformation of the upper jaw during the period of temporary and permanent bite are presented. The patients were divided into groups according to the stage of formation of the midpalatal suture: 1st group - 40 patients with stage «A» and «B» (average age 11.5 years); 2nd group - 15 patients with stage «C» (average age 20.5 years); 3rd group - 15 patients with stage «D» and «E» (average age 24.5 years). Orthodontic treatment was carried out using palatine expanders with a dental and intraosseous type of fixation. The complex treatment consisted of: orthodontic treatment using a bracket system, transgingival laser corticotomy, piezocorticotomy, surgically assisted rapid palatal expansion, orthodontic appliances for the expansion of the upper jaw. After conducting a clinical X-ray examination of all patients and analyzing the data obtained, we developed algorithms for therapeutic measures.

RESULTS

As a result of the diagnosis and treatment planning, the expansion of the upper jaw was achieved both at the dental alveolar and skeletal levels. Detailed algorithms of complex treatment were developed based on the analysis of CBCT data, the stage of formation of the midpalatal suture individually for each patient.

CONCLUSION

It was found that the analysis of CBCT data makes it possible to choose the optimal treatment method for patients with skeletal deformities of the dentition complex, thereby increasing the effectiveness of orthodontic treatment.

[Improving the effectiveness of treatment of the adult patients with dentoalveolar anomalies and deformities using Er,Cr:YSGG laser: a clinical study]

THE AIM

Of the work is to develop and substantiate the method of minimally invasive complex orthodontic treatment of patients with constriction and deformation of the upper jaw in the period of permanent bite with the combined use of a bracket system, orthodontic devices for the expansion of the upper jaw and fractional photothermolysis to improve the effectiveness of complex treatment.

MATERIALS AND METHODS

The results of complex treatment of patients with the deficiency of the upper jaw in the period of permanent bite are presented. Complex treatment consisted of orthodontic treatment using a bracket system, laser corticotomy, orthodontic devices for the expansion of the upper jaw. Ultrasound examination before and after the procedure was performed to obtain reliable results of laser impact on bone tissue.

RESULTS

After conducting a clinical and radiological examination (using cone-beam computed tomography) of all patients and analyzing the data obtained, we have developed algorithms for therapeutic measures. As a result of orthodontic treatment aimed at the expansion of the upper jaw patients who underwent fractional photothermolysis procedure achieved the expansion of the upper jaw at both the dentoalveolar and skeletal levels.

CONCLUSION

It was found that a comprehensive approach with minimally invasive effects can improve the effectiveness of treatment of patients with constriction and deformation of the upper jaw during the period of permanent bite and achieve stable treatment results.

[Tongue position assessment in patients before and after maxilla expansion]

The aim of this research is to increase the accuracy of determining the position of the tongue, the amount of space occupied by the tongue and space, free from tongue, increase of efficiency of diagnostics of dentofacial anomalies in patients based on CBCT analysis-the study of the skull conducted in transversal, sagittal and coronal planes. Clinical and x-ray examination and orthodontic treatment were carried out in 120 patients with anomalies of the dentition complex. Patients were divided into three groups. Group 1 - 30 patients aged 5 to 11 years. Group 2 - 50 patients aged 12 to 17 years. Group 3 - 40 patients aged 18 to 40 years. All patients underwent CT examination of the skull before treatment, and during the retention period of treatment. After a diagnostic examination of the proposed method for diagnosing the anatomical and functional state of the dentition complex and drawing up a treatment plan, all patients underwent orthodontic treatment, which consisted in the expansion of the upper jaw using various orthodontic appliances for expansion. This method allows to identify anomalies in the position of the tongue before and after orthodontic treatment, to assess the quality of orthodontic treatment, based on the analysis of not only the tongue filling the space of the dome of the palate, but also the position of the bone structures of the skull in three planes. The high quality of the study allows us to give a reliable assessment of the state of maxillofacial structures: the position of the upper and lower jaws, inclination of teeth, the stage of formation of the patient's growth, airway lumen and the influence of tongue on these structures at different stages of development of the maxillofacial skull. When comparing the results of the study, not all patients carried out recovered the anatomical and functional balance of the maxillofacial complex after orthodontic treatment, suggesting the need for more myogymnastics of the tongue before, during, and after treatment.

[Complex orthodontic-surgical rehabilitation of adults with malocclusions and deformations in dentition]

The aim of the study was the development and substantiation of the method of orthodontic treatment of patients with malocclusions and deformities of dentoalveolar arches with the combined use of braces, orthodontic miniscrew, piezo-surgical corticotomy or laser corticotomy to improve the efficiency and reduce the time of complex treatment. The results of complex rehabilitation of 80 adult patients with dentoalveolar anomalies and deformities of dentition are presented. As a result of the orthodontic treatment of patients who underwent piezo-surgical corticotomy the bodily movement of the posterior teeth in the area of the previously removed tooth was achieved. After piezo-surgical or laser corticotomy the rate of tooth protraction remained elevated for 3 to 5 months (on average 0.3±0.5 mm/month), then gradually decreased. Piezo-surgical corticotomy led to a decrease in bone density, which was measured on the Hounsfield scale. As a result of orthodontic treatment in patients who underwent laser corticotomy an expansion of the upper jaw and normalization of occlusion in the transversal and sagittal directions was achieved: in the region of the hard palate by 7.1±0.4 mm; in the region of the alveolar bone by 6.5±0.5 mm; in the region of the roots of molars by 6.4±0.9 mm; in the area of crowns of molars by 8.3±0.7 mm. It was found that the combined use of piezo-surgical corticotomy and orthodontic miniscrews improve the efficiency and reduce the duration of orthodontic treatment by 3 to 6 months.