Особенности оказания ортодонтической помощи детям с различным уровнем соматического здоровья

Abstract

INTRODUCTION: Today, not all groups of the child population can receive full orthodontic care. This is typical for children with disabilities who have mental and neuromotor development disorders. To ensure optimal quality of orthodontic care in these cases, it is necessary to involve related specialists, the availability of modern equipment, and the psychological readiness of the doctor to work with children. The combination of these conditions will make it possible to fully provide orthodontic care to children with disabilities. AIM: To study features of rendering orthodontic care to children with different somatic health level MATERIALS AND METHODS: Orthodontic treatment of 50 children aged 7 to 16 years was carried out. The patients were divided into 3 groups based on the general somatic health status: children with anomalies of the position of teeth and bite, without burdening pathology; children with anomalies of the position of teeth and bite, with concomitant disorders of the respiratory, musculoskeletal and other systems; children with disabilities. Besides, the patients were classified by types of dental anomalies. Orthodontic treatment of patients from group 2 started after consultation with specialists. Patients from group 3 had a conclusion about the underlying disease and were referred to related specialists for consultation if necessary. RESULTS: The treatment of group 1 patients was without peculiarities. Removable and non-removable devices were used to correct dental anomalies. In all cases, a satisfactory result of treatment was obtained. In the treatment of group 2 patients, it was necessary to eliminate the concomitant pathology. Therapeutic measures aimed at restoring natural respiration and normalizing the function of the musculoskeletal system were recommended. As a result, anomalies of the dental system were corrected in 17 cases. In 3 cases, it was impossible to achieve correction of the distal bite due to the late start of treatment. In 1 patient, it was impossible to restore the function of the respiratory system. In 3 cases, the disorders in functioning of the musculoskeletal system were not completely corrected, which required further observation. The impossibility to restore the function of the respiratory system affected the result of treatment in 1 patient. Treatment of children from group 3 caused the greatest difficulty. A good clinical result was achieved in 3 cases, and in the rest ones the result was an improvement of the existing condition, but due to the peculiarities of the mental state of children, the treatment could not be fully completed. CONCLUSIONS: An effective algorithm for providing orthodontic care to children with disabilities has been developed. Before treatment, it is necessary to correct the concomitant pathology with participation of related specialists. It is recommended simple devices be used with good fixation in the oral cavity. The positive changes in the dental status obtained permit to further improve the overall health condition.