THE STABILIZATION EFFECTIVENESS OF UPPER JAW SUPPORTING TEETH IN ORTHODONTIC TREATMENT WITH FIRST PREMOLARS EXTRACTION

Kobtseva O. A.

CONTENTS

Scentific article

Introduction. An important step in the distal movement of the upper permanent canines during orthodontic treatment with extraction of the upper first premolars is a control of the abutment teeth’ position. The aim of the study. Assess the stability of position of the supporting first permanent molars of the upper jaw in orthodontic treatment with nonremovable technique considering ways to reinforcement of anchorage, particularly in using the designed stabilizing appliance. The object and methods. The first group of studies (basic) – 30 supporting molars, patients’ age – 22,7±0,7 years. The second group (control) – 34 supporting molars, patients’ age – 21,6±0,8 years. The position stabili-zation of the supporting upper teeth in the patients of the basic group was carried out using a removable palate plate (own design). In this plate there were mounted plastic artificial teeth, which were placed in created spaces after the extraction of the upper first premolars. Thus, the place of removed 14 and 24 teeth were closed with plastic teeth that stabilized the position of the first permanent molars and second premolars during orthodontic treatment. Mesial surface of the artificial teeth gradually grounded off according to the size of the distal move-ment of the upper permanent canines. Therefore, the space between the second premolars and canines gradu-ally decreased due to the closure of the distal shift of canines. The position stabilization of the supporting upper teeth in the patients of the control group was performed using the ligature binding of the first molars’ and second premolars’ brackets. Stability of the supporting molars was assessed by the following indicators: change of rota-tion angles and angulation angles, a value of sagittal bodily shift of supporting molars. In the study V. Tuharin’s, R. Ziegler’s, J. S. Weber’s methods, photo analysis method were used. Assessment of rotation molar angles, value of the bodily mesial shift of first upper molars was performed from photographs of upper jaw models. The resulting value of the bodily mesial shift of first upper molars was evaluated according to the author’s quantita-tive classification of orthodontic support of the upper jaw. Registration of the angulation angle of first upper molars was carried out at the initial and final panoramic X-ray of patients. Analysis of the results was performed by statistical methods. Results and discussion. Comparison of data in the study groups suggests that the change of the position of the supporting first permanent molars of the upper jaw was lower in patients of the main group for the value of the bodily mesial shift of first upper molars (p‪0,001), the angular parameters of mesial axial inclination (p‪0,001) and mesial rotation (p‪0,01). In 100% of cases in the basic group the value of mesial shift of abutment teeth did not exceed the digital indicators of requirements for maximum anchorage (0-1,9 mm). While 82,4±9,2% supporting teeth in the control group’s patients had mesial shift of molars corresponding to the digital values of moderate anchorage, and only in 5,9±5,7% of cases the stability of the abutment teeth was maximum. Conclusions. The maxillary removable plate for upper jaw abutment teeth stabilization was developed and clinically tested. It was proved that clinical use of this appliance improves the efficiency of orthodontic treatment with fixed appliances and first upper premolar extraction by preventing complications of treatment such as the anchorage loss of supporting upper teeth.

stabilization, supporting teeth, orthodontic treatment

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