SPECIAL ASPECTS OF COMPREHENSIVE DIAGNOSTICS IN PATIENTS WITH DENTOFACIAL ANOMALIES COMPLICATED BY TEETH CROWDING

Dmytrenko M. I.

DENTISTRY

Scentific article

Comprehensive diagnostics is a prerequisite for successful ethiopathogenetic treatment and its control. Diagnostic orthodontic errors often cause prolonged treatment, complications and recurrences of disease. The proportion of patients with dentofacial anomalies, complicated by teeth crowding at orthodontic appointment amounts to 70-80%. The aim of the study is to suggest and implement into clinical practice systematized algorithms of diagnostic measures in patients with dentofacial anomalies, complicated by teeth crowding. Examination and comprehensive orthodontic treatment of various dentofacial anomalies, complicated by teeth crowding was carried out in 169 patients aged from 4 to 42 years. Clinical diagnostics, electromyography, odontometry, morphometry, radiography and computer methods were applied. Clinical examination allowed to analyze complaints, identify risk factors for anomaly development, to define characteristic changes of the face and oral cavity, functional disorders and develop the further examination plan. Objective research was started with physique examination. When examining, the facial profile, shape and size of the chin were measured. The face shape, proportionality of the upper, middle and lower parts and symmetry of the left and right halves were determined. The proportional development of jaws, mandible position, lip-seal type, the severity of nasolabial and labiomental folds were examined carefully. Significant attention was focused on specifying the functions of the oral cavity and identification of harmful habits. The type of the mandible movements during opening and closing of the mouth, presence of mandibular displacement were also determined. The final diagnosis was stated after additional examination. The occlusion type was represented in three dimensions, special attention was paid to examination of the front teeth placement. Aesthetic abnormalities based on the findings of photometric examination were revealed. Direction of the jaw bone growth was determined according to the size of mandibular angles. Identification of gnathological and cranial disorders degree, which was determined by the teleroentgenography method is an integral part of orthodontic diagnostics. Examination of the functional state of temporal, actually masticatory muscles and circular muscle of the mouth was carried out using electromyography method and electromyographic indexes were also calculated. Analysis of the given research results enables to develop an algorithmic scheme of diagnostic measures in patients with dentofacial anomalies, complicated by teeth crowding: clinical methods; additional methods that should be used when planning orthodontic treatment for the patients. Thus, objective systematic approach, that relates facial aesthetics, occlusion state, the skull structure, muscle function of maxillofacial area and temporo-mandibular joint, periodontal tissues, teeth is of great importance in dentofacial anomalies diagnostics, complicated by teeth crowding.

dentofacial anomalies, dental crowding, orthodontic diagnostics

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