Methods of treatment of patients with skeletal forms of distal occlusion using dental alveolar compensation. The role of digital technologies and the approach to treatment

Abstract

Improving the effectiveness of complex treatment in patients with distal occlusion of the dentition during the period of active skeletal growth. 202 patients with skeletal distal occlusion were examined and treated. Patients are divided into three subgroups depending on the position/size of the jaw bones and the main link of pathogenesis. The parameters of TRG and CBCT sections were measured before and after treatment. Various parameters were used for the analysis: skeletal (SNA, SNB, ANB, etc.), dental (II/SN, II/ii, APog-I, APog-i, etc.), skeletal profile and soft tissue parameters. Various orthodontic techniques have been applied, including FNTA, the Damon bracket system, the Biederman apparatus and others. In the retention period, non-removable retainers in the frontal section and removable night retention devices of various structures were used. Patients were monitored for up to 15 years after the completion of the active orthodontic treatment stage. The analysis of the X-ray examination data indicates the normalization of the mutual position of the jaw bones in relation to the base of the skull, optimization of the ratios of the bone elements of the TMJ. An algorithm has been developed for the treatment of patients with dental anomalies in the sagittal plane, with narrowing of the upper jaw during the bite of permanent teeth. Comprehensive treatment of patients with distal occlusion during the period of active skeletal growth makes it possible to achieve significant improvements in dentition, position and closure of teeth, as well as skeletal parameters of X-ray examinations. The results indicate the importance of early intervention using modern orthodontic techniques. Long-term follow-up in the retention period shows the stability of the results and the effectiveness of the treatment.