ANALYSIS OF MORPHOMETRIC INDICES OF THE MANDIBLE’S DEVELOPMENT IN THE PATIENTS WITH CROSS BITE ACCORDING TO ORTHOPANTOMOGRAMS’ DATA
About the author:
Smagluk L. V., Kulish N. V., Voronkova H. V., Karasiunok A. Y.
Type of article:
Significant morphological and aesthetic disabilities of the face, observed during the formation of a cross bite in combination with the displacement of the mandible, prompt the doctors – orthodontists to study carefully the morphogenesis of this anomaly. A significant number of clinical manifestations of malocclusion in the transversal plane causes doctors to seek new methods of treatment, especially in adult patients, the number of which has recently increased. The lower jaw has certain autonomy of development, due to the greater influence of the action of functional factors and is more prone to asymmetric deformations. The displacement of the mandible in the transversal direction is possible due to several factors: discoordination of the masticatory muscles, incorrect occlusal contacts, joint displacement, and skeletal asymmetries of congenital genesis. In according this, we selected one of the possible etiologic factors for study – the morphogenesis of the mandible. The purpose of the study: analysis of the mandible structure in patients with a cross bite and lower jaw displacement based on the analysis of orthopantomograms. Object and methods of research: for this study, the orthodontic examination of 20 patients, 18-22 years old, was made they complained about facial asymmetry, displacement of the lower jaw and a violation of the cosmetic centers. A diagnosis of the buccal cross bite form in combination with the displacement of the lower jaw was put according to the Uzhumeckiene classification. All patients underwent complete clinical and paraclinical examination according to treatment protocols (2005). With the purpose of analyzing the development of the mandible as the main component of the dento-alveolar complex, which directly affects the aesthetics of the face, an orthopantomogram analysis was carried out for all patients using the method of B. Ospanova and N.A. Rabukhina (2008). The parameters of the length of the body, the height of the branch, the right and left angle of the mandible are analyzed. The width of the mandibular branches in the upper and lower sections is determined. The tooth-alveolar height of the lateral segments, the angle of inclination of the canines and the first permanent molars to the basal arch of the lower jaw, symmetry of the lateral segments are estimated. The results of the study and their discussion: the analysis of the obtained data indicates that the angle of the mandible has more variable (p ≤ 0,05). Go120,8º and 125,1º. Significant of the angles of the canines according to the basal arch of the lower jaw of 102,8º and 105,4º (p≤0.01) and the angle of inclination of the first permanent molars of 89,6º and 91,4º, respectively (p≤0.01). So we can say that one of the factors that causes the displacement of the lower jaw in the transversal plane is a unilateral increase of angle, and this is a manifestation of skeletal disorders, which accordingly affects the symmetry of the face. The change of the canines, and the first permanent molars inclination is, in our opinion, compensation for the formation of optimal occlusal contacts. The data obtained should be taken into account when planning orthodontic treatment. Conclusions: the obtained data indicate that there is no clear correlation between changes in the studied parameters and the localization of anomalies (left-sided, right-sided). Indicators of the angle of the lower jaw are significantly altered from the opposite direction of its displacement. The change in the angles of inclination of the canine and the first permanent molars, as occlusive compensation, is determined reliably. The more the angle of the mandible changes, the more the lower jaw moves in the transversal direction. Perhaps this is due to the asymmetric tone of masticatory muscles. Therefore, the prospect of further research requires an electromyography study in these patients to determine the symmetrical activity of the muscles. Perhaps timely coordination of muscle function will prevent significant morphological changes in the formation of the mandible and improve the conditions for aesthetic development of the face.
cross bite, lower jaw, morphometric, orthopantomograms
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Publication of the article:
«Bulletin of problems biology and medicine» Issue 4 part 1 (146), 2018 year, 307-310 pages, index UDK 616.716.4–06:616.314.2–007.26–073.75