RELATIONSHIP BETWEEN THE POSITION OF HEADS OF TEMPOROMANDIBULAR JOINT AND UPPER RESPIRATORY TRACT IN MALOCCLUSION CLASS I AND II

Abstract

The respiratory organs and the maxillofacial apparatus are quite closely related to each other. Reducing the size of the upper respiratory tract is a factor that contributes to the development and formation of bite pathology and even dysfunction of the temporomandibular joint (TMJ). In recent years, there has been an increase in the prevalence of maxillofacial anomalies among children. The aim of the study Is to determine and to compare the position of the TMJ heads and the anatomical dimensions (anterior-posterior dimensions) of the upper respiratory tract in patients with malocclusion class I and II bite based on cone beam computed tomography findings. The analysis of 39 cone-beam computer tomograms of patients was carried out. According to the ANB angle, all patients were divided into two groups based on the type of malocclusion: group I included patients with malocclusion class I, and group II included patients with malocclusion class II. Measurement and interpretation of cone-beam computer tomography was carried out according to the method of N.A. Rabukhina and the McNamara’s method. The dimensions of the joint space of the temporomandibular joint in three sections (front, top and back both on the right and on the left) had no statistically significant differences. The average value of the joint space on the left and right in the patients of the first group in the front section was 2.5±0.27mm, in the patients of the second group – 3.01±0.35. In the upper part these indicators in patients of the first group were 2.76±0.37 mm, in the second group - 2.65±0.32 mm. In the posterior part the average value of the joint’s gap was 3.06±0.01 mm in patients of the first group and 2.28±0.27 mm in the second group. Measurements of the oropharyngeal area on cone-beam computed tomography were (according to the McNamara’s method): the width of the upper part of the pharynx in the first group - 17.41±0.44 mm, and in the second group averaged 15.82±0.61 mm with statistical significance (р˂0.05). In patients with bite pathology of both classed, according to the McNamara’s method, the lower part of the pharynx is narrowed compared to the norm. The study demonstrated the patients of the II group have a statistically significant difference in the reduction of the pharyngeal upper part width compared to I group and the displacement of the TMJ heads upwards and backwards.