Dentoalveolar Anomalies Research Articles

ГИБРИДНОЕ ОРТОДОНТИЧЕСКОЕ ЛЕЧЕНИЕ С ПРИМЕНЕНИЕМ ТРИЛОН-Б ЭЛЕКТРОФОРЕЗА. КЛИНИЧЕСКИЙ СЛУЧАЙ

The purpose of the study is to optimize the treatment of patients with dentofacial anomalies and deformities using complex orthodontic treatment using Trilon-B electrophoresis. The article presents a clinical example of hybrid orthodontic treatment using Trilon-B electrophoresis of a patient aged 37 years with a diagnosis of “distal occlusion, skeletal class 2”. Materials and methods. A comprehensive diagnosis of the condition of the patient’s dental system was carried out: clinical examination; photometry; anthropometry of dentition on models obtained using 3D scanning; X-ray examination methods (OPTG, CBCT); measurement of bone tissue density before treatment in the Picasso Viewer program. The next stage was making a diagnosis and drawing up a treatment plan, consisting of pre-orthodontic preparation of bone structures using Trilon-B electrophoresis and direct orthodontic treatment. Results. After the combined treatment, an optimal functional and aesthetic result was achieved. The proposed method of orthodontic treatment using Trilon-B electrophoresis made it possible to shorten the active period of treatment and reduce the risk of possible complications due to short-term wearing of orthodontic equipment, and was also successfully used in the complex treatment of 23 patients with dentoalveolar anomalies and deformities.

LOCAL RISK FACTORS IN THE DEVELOPMENT OF PERIODONTAL DISEASES IN CHILDREN AND ADOLESCENTS

Purpose: To estimate the prevalence of gingivitis associated with dental biofilm and to investigate the influence of local risk factors on the development of inflammatory process in the gums in children and adolescents. Materials and Methods: 117 children and adolescents aged 12 to 17 years at the Dental Medical Centre of the Bogomolets National Medical University were examined. All participants were examined for periodontal status, state of oral hygiene, and local risk factors for periodontal diseases. Results: A high prevalence of gingivitis associated with dental plaque (89.7%) was found in children and adolescents aged 12-17 years. The overwhelming majority of them (71.4%) had gingivitis caused by dental biofilm and local risk factors. The prevalence of malocclusions and anomalies of individual teeth was 60%. Carious tooth lesions and poor-quality proximal restorations were detected in 37.1% of participants. Violations of the rules of individual hygienic care of the oral cavity were observed in 54.3% of patients. Conclusion: Local risk factors lead to a significant deterioration in periodontal health in childhood and adolescence, especially in the case of their combined adverse effects. Significant predictors of gingivitis include the accumulation of microbial biofilm and tartar due to poor oral hygiene, dentoalveolar anomalies, carious cavities and proximal restorations, irregular toothbrushing and poor interdental hygiene. The high prevalence of gingivitis necessitates the priority development of primary prevention of inflammatory periodontal diseases in children and adolescents.

ANALYSIS OF THE BIOELECTRICAL ACTIVITY OF THE MASTICATORY MUSCLES, DEFINED ACCORDING TO BERNOULLI'S PRINCIPLE AS "STRONG" OR "FAST", FOR THE PREDICTION OF PATHOLOGICAL TOOTH ABRASION (ACCORDING TO MAGNETIC RESONANCE IMAGING AND ELECTROMYOGRAPHIC STUDIES)

Pathological abrasion is a well-known disease, but it is topical issue of hard dental tissues. The principle of D. Bernoulli and its numerical expression in the form of the coefficient “k” were used. It is calculated by the formula , where k is the calculated coefficient; l is the length of the muscle in this case, the masseter separately on the right and left; s is the cross-sectional area of the muscle. The masseter muscles' length, width, and thickness were determined using SIEMENS MAGNETOM Skyra 3T magnetic resonance imager, 2018.
 The classical method was used for the electromyographic study of the masseter muscles. We analysed 64 MRI scan results, of which 15 were control subjects with intact dentitions, and 49 were patients with varying degrees of tooth abrasion. After determining the physical parameters as length, width, and thickness of the masseter muscles on the right and left sides, the cross-sectional area of the muscles was determined and the author's coefficient of the numerical expression of the Bernoulli principle for each masseter was proposed.
 Electromyograms of the masseter muscles in the mode of free chewing were recorded for all subjects with subsequent software analysis. Extrapolation of the obtained coefficients of the numerical expression of the Bernoulli principle of the left and right masseter muscles to the values of quantitative and qualitative indicators of electromyograms of the same muscles revealed a direct dependence of the bioelectrical activity of muscles on the ratio of muscle length to cross-sectional area. Higher values of this coefficient correspond to higher values of bioelectrical bursts of muscle activity, faster contraction and relaxation, shorter chewing time, and longer resting time of the muscle, which is a sign of the biomechanical property "speed". Masseter muscles with such properties are observed in individuals without pathological tooth abrasion. In the groups of patients with pathological tooth abrasion, a decrease in the ratio of the length of the masseter to its crosssectional area is observed in proportion to the increase in the severity of the pathological process. The amplitude of muscle bioelectrical activity bursts decreases, the speed of excitation and relaxation processes decreases, the chewing time is prolonged, and the resting time is reduced, which indicates that the muscle acquires the biomechanical property of "strength". "Fast" masseter muscles do not cause pathological tooth abrasion, while "strong" muscles contribute to the development of pathological tooth abrasion. Employing both Bernoulli's principle and MRI studies on the muscles responsible for mandibular movements will enable a comprehensive investigation into the progression of localized pathological tooth abrasion and provide a more intricate understanding of the muscles' impact on the development of dentoalveolar anomalies.

Cephalometrics in Obstructive Sleep Apnea Patients with Mixed Dentition

Distal occlusion is one of the most common dentoalveolar anomalies and can be the reason for the obstructive sleep apnea (OSA) syndrome development among children. The aim of the study was to investigate the relationship between cephalometric and OSA parameters in the pediatric population. Methods: The cohort study included 39 children with OSA symptoms. Orthodontic examination consisted of a cephalometric analysis of 39 linear and angular variables. Patients underwent a sleep diagnostic study. Statistical analysis was performed using SPSS 19.0.0. Results: Of the general sample, 53.8% were mouth breathers and 46.2% had a mixed type of breathing. Moreover, 30.8% of patients had bruxism. The mean apnea-hypopnea index and oxygen desaturation index were 4.6/h and 3.9/h, respectively. A 1.06 times increase in the SNA index indicated the anterior position of the upper jaw. The MnPLSN° exceeded the norm by 1.3 times, which indicated the posterior position of the lower jaw and vertical type of the growth. An increase in ANSPNSSPT° by 1.1 times indicated an inclination of the upper jaw in the posterior position and a narrowing of the nasal passages. Patients with pediatric OSA had a significantly smaller lower airway space and MPH parameter. Conclusion: Systematic orthodontic monitoring of children with pediatric OSA is important for diagnosis and timely treatment.

Experience with double transposition flaps and intravelar veloplasty for closure of wide cleft palates

ABSTRACT Background: Repairing a wide cleft palate is a challenging task for surgeons. The goals of cleft palate repair such as achieving anatomical closure of the defect, complete velopharyngeal closure, speech development, and to minimize dentoalveolar anomalies are difficult to achieve in wide and massive cleft palates. Several methods have been described for the same. We performed double transposition flaps combined with intravelar veloplasty in our patients. In this article, we share our experience with the same. Materials and Methods: We reviewed 9 cases, in which double transposition flaps with intravelar veloplasty were performed. Patient demographics, clinical data, and outcomes were analyzed. Functional status including nasal resonance and palatal mobility were assessed with nasal endoscopy. Results: The average age at the time of surgery was 17 months. Four patients had associated diseases. The mean operative time was 55.7 min. The mean follow-up period is 23.7 months. Only posterior palatal closure was done in all the cases and patients were managed temporarily with obturators and are planned for delayed closure later. Conclusion: Double transposition flap is a safe, effective, and technically less demanding procedure. It has no wound complications and can avoid the need for osteotomy to correct maxillary retrusion. The main drawback of the procedure is the creation of an anterior palatal fistula that needs closure later.

Dental and alveolar pathologies of the Early Iron Age population of the Upper Ob region based on the materials of the Bystrovka-3 burial ground)

The study is focused on the analysis of distribution of the dentoalveolar pathologies (caries, calculus, periodontitis, dental fluorosis, antemortem enamel chips, alveolar abscess, antemortem loss of teeth), which are generally used for revealing the diet component composition of ancient groups and as the markers of the stress episodes (enamel hypoplasia, child dental caries). In addition, several anomalies in the structure of the dentition (dystopia, crowding, hypo- and hyperdentia) are considered. The study is based on the anthropological materials of the Bolsherechenskaya culture of the Bystrovka-3 burial ground, dated to the second half of the 1st millennium BC. The series consist of 130 skulls: 46 male, 34 female, 26 infants and 24 individuals whose gender could not be determined. The frequencies of the pathologies of the Bystrovka-3 sample were compared with those of the Neolithic and Bronze Ages populations of Western Siberia. The results of the study reveals that diet of the Bystrovka-3 people included both animal and plant products. The presence of endemic fluorosis on the teeth of four people (two female and two infants) may indicate the migration of a small group of people from outer regions with high fluoride content in soil and water to the Bolsherechye area. It was also found that the representatives of the study group experienced significant stress caused by adverse environment event. In addition, in the main group several rather rare dentoalveolar anomalies were identified, which, according to some researchers, are hereditary. Comparative analysis of frequencies of dentoalveolar pathology of the study group and the Neolithic-Bronze Age population of the south of Western Siberia revealed that the component composition of the diet of Bolsherechye people had significant differences from that of the Bronze Age pastoralists and is more similar to the Neolithic and pre-Andronovo bronze populations of Baraba forest-steppe, which had similar economy structure based on fishing, gathering and hunting.

Dentoalveolar anomalies and modern views on the mechanisms of local stress-modeling effect of orthodontic appliances on the periodontal tissues (a literature review)

The aim of the study was to highlight the results of modern scientific developments in tracing the mechanisms of local stress-modeling effect of orthodontic appliances on the oral cavity and periodontal tissues during the active period of orthodontic treatment. Materials and methods. The research methodology was implemented in the collection and analysis of scientific results on the stress-modeling effect of orthodontic appliances in patients with dentoalveolar anomalies obtained from the processed sources – published full-text articles of original and fundamental research by national and foreign authors based on the evidential databases MEDLINE / PubMed, PMC, Scopus, Web of Science, Cochrane, Google Scholar, ResearchGate and other scientific and practical resources. Results. The main components of the stress-modeling effect of fixed orthodontic appliances on the oral cavity, and particularly on the periodontal tissues, were analyzed. The proportion of various complications is quite high and ranges from 32.7 % to 50.0 % of all cases. The development of oxidative stress during orthodontic treatment is potentiated by microcirculatory disorders and hypoxia of the periodontal tissues. The peculiarities of the periodontal cellular complex reaction, which has the ability to bear stress generated in the actin cytoskeleton by direct mechanical stimulation, to extracellular matrix proteins, affecting the three-dimensional organization of the extracellular matrix and its remodeling, have been traced. The role of lipid peroxidation, antioxidant system and enzymatic reaction of oral and crevicular fluids was also defined. Conclusions. The development of oxidative stress during orthodontic treatment can be caused by local and systemic exposure to metals, corrosion processes in particular; by inflammation of periodontal tissues due to poor oral hygiene and activation of periodontal pathogenic microflora; by aseptic inflammation in the periodontal ligament due to the use of mechanical force. Certain enzymes of the oral fluid, in particular lactate dehydrogenase, can act as a sensitive marker of changes in the periodontal ligament metabolism during orthodontic teeth movement. The localization and nature of free radical pathology are largely caused by the nature of an exogenous inducer of lipid peroxidation and the genotypic characteristics of antioxidant system. It is this ratio that determines the initiation and further chain branching of free radical reactions. Without normalization of all pathogenetic links, successful treatment of inflammatory and dystrophic-inflammatory diseases of the periodontal tissues, in particular in orthodontic patients, is impossible.

RETENTION OF MANDIBULAR MOLARS: ETIOLOGICAL FACTORS, CURRENT DIAGNOSTIC APPROACHES, AND TREATMENT OPTIONS

The problem of tooth eruption is a common issue affecting nearly 20% of the population. Along with this, there is a growing trend of increased dentoalveolar anomalies in children and adults. One of such anomalies is the retention of the mandibular molars, which has always been a complex dentoalveolar pathology posing clinical challenges for orthodontists and oral surgeons. The aim of this study is to review and analyze relevant literature sources regarding the current etiological factors, diagnostic methods and treatment options for the retention of the mandibular molars. Tooth eruption is a complex and highly regulated process, which is currently the subject of research by many authors. There are various theories about the process of tooth eruption, often contradicting each other. Retention of molars should be considered as a pathological phenomenon with a multifactorial aetiology. Consequently, the approach to the diagnosis and treatment of this pathology cannot be standardized or unified. Therefore, there is a tendency to personalized approach both in the diagnosis and treatment of patients with dentoalveolar anomalies. In most cases, the diagnosis of molar retention is based on a clinical and x-ray examination. Notably, decision-making and treatment strategy selection rely on constantly evolving methods. Unfortunately, the acceleration and early completion of bone tissue maturation increase the frequency of tooth retention, pushing clinicians towards the early intervention. This, in turn, requires a revision of existing recommendations and protocols. The development of technology and the modern possibilities of digital planning open up new horizons and provide tools for addressing complex challenges; however, they require a multidisciplinary approach to implementing non-standard treatment methods involving both orthodontists and oral surgeons. Apparently, all novel techniques require careful analysis, which provides researchers with space for further investigations.

Some features of prevention of demineralization of hard tissues of teeth during orthodontic treatment of children with dental anomalies

Aim. To study the effectiveness of remineralization and hygienic measures in the prevention of demineralization of hard tissues of teeth when using a fixed orthodontic structure in children and teenagers with dentoalveolar anomalies. Materials and methods. We examined 150 children and adolescents with anomalies of the dentition at the age of 12 to 16 years with fixed orthodontic structures. When starting orthodontic treatment of anomalies of the dentoalveolar system in children, we proceeded from the fact that the treatment and prophylactic methods of education consisted of two stages: 1st stage – general, where they explained in detail how to carry out an individual hygienic procedure in the oral cavity with controlled brushing of the teeth; Stage 2 – specialized, which includes the features of oral care in children with orthodontic appliances in these specific conditions, in accordance with the new dental clinical situation of the oral cavity. Results. The data obtained necessitate the conditions for successful prevention of orthodontic complications during corrective therapy of dentoalveolar anomalies are remineralizing therapy, the correct choice of methods and means of individual oral hygiene.

ЗУБОЧЕЛЮСТНЫЕ АНОМАЛИИ У ДЕТЕЙ ДОШКОЛЬНОГО ВОЗРАСТА В ЗАВИСИМОСТИОТ ТИПА СЕМЬИ И МОРФОФУНКЦИОНАЛЬНОГО РАЗВИТИЯ РЕБЕНКА

Introduction. Dentоfacial deformities in preschool children do not show any downtrend. Studying how various factors affect their occurrence and development is of undoubted interest. Our aim was to study the impact of family types on the prevalence and nosology of dental system diseases. Materials and Methods. 2,556 children were examined, aged one to six years, of both genders, and from families of different types. To statistically process the study findings, descriptive statistics methods were used. Integrity was assessed in the compared groups by averaging and computing error in mean, using Student’s t-test. Results and Discussion. Prevalence of dental abnormalities among preschool children was higher among boys of all ages (63.6±1.353%), as compared to girls (57.5± 1.376%). It was found that children from substitute families were most susceptible to dental abnormalities. Prevalence of dentoalveolar deformities was in 100% of cases in all age groups in children from adoptive families. High prevalence of dentoalveolar anomalies was also recorded in preschool children living in incomplete families, i.e., in 82±2.78% of cases. The lowest prevalence of dentoalveolar deformities was found in children living in full families, i.e., in 56.1±1.129% of cases, and in extended families, i.e., in 59.2±3.367% of cases. In children living in reconstituted families, dentoalveolar abnormalities are found less frequently (78.9±3.167%) than in children living in substitute and one-parent families, but more frequently than in children living in nuclear and extended families. When analyzing the structure of dentoalveolar anomalies, it was found that most often there were bite pathologies (prognatic and deep bites), as well as abnormalities of dental arches. The least common pathology of the jawbone system in the examined children turned out to be the cross-bite pathology. Older age group children (aged 4.6-6 years) are most susceptible to dentoalveolar abnormalities as compared to other ages of preschool children. Conclusions. Data presented in this article are of practical importance for implementing and developing preventive measures, considering the type of family and the morphofunctional development of the child.

Long-term results of early orthodontic treatment of children aged 3–5 years

Background. The frequency of dentoalveolar anomalies and the severity of dentoalveolar disorders in children increases with age. Early orthodontic treatment allows to take advantage of the growth and eruption of teeth and stop pathological development before significant compensatory deformities of the dentition occur, which are more difficult to treat.
 Aim. To study the long-term results of early orthodontic treatment of children aged 35 years.
 Material and methods. A prospective study of the long-term results of orthodontic treatment in 50 children aged 35 years was carried out. The state of the dentoalveolar system of children was analyzed: the magnitude of the disproportion in the sagittal, transversal and vertical directions; direction and magnitude of displacement of the lower jaw; the presence of anomalies in the development of teeth before and 3.5 years after treatment. Statistical analysis was carried out using the program Statistica 13.3. The ShapiroWilk and KolmogorovSmirnov tests, asymmetry and kurtosis indicators, and the Student's test were used.
 Results. A high frequency (52%) of cases of severe occlusion disorders was revealed (occlusion disorders in two planes 44%, in three 8%). Often there was a displacement of the lower jaw 72%. These disorders require early orthodontic treatment. When analyzing the results of early orthodontic treatment after 3.5 years, physiological occlusion was established in 86% of cases: a decrease in the size of the direct sagittal fissure (before treatment 3.92.5, after treatment 1.11.5; p=0.000005); elimination of the reverse sagittal fissure (before treatment 0.80.5, after treatment 0.030.1; p=0.000000); decrease in the depth of vertical overlap (before treatment 4.60.6, after treatment 2.21.1; p=0.000043); elimination of the vertical gap (before treatment 3.121.3, after treatment 1.02.0; p=0.05011); elimination of exocclusion (before treatment 4.92.3, after treatment 0.30.9, p=0.000000); elimination of endocclusion (before treatment 5.50.7, after treatment 0.70.3, p=0.033475); elimination of the displacement of the lower jaw. In 14% of cases in children, the occlusion was not ideal, while the physiological development of the dentition was noted.
 Conclusion. Early orthodontic treatment of children aged 35 years can eliminate severe disorders and, in most cases, create conditions for the physiological development of the dentoalveolar system.

ASSESSING THE STATE OF THE ALVEILAR MORPHOTYPE IN PLANNING AND CARRYING OUT ORTHODONTIC TREATMENT OF PATIENT WITH INFLAMMATORY PERIODONTAL DISEAS ES

Aim: to assess the state of periodontal tissues when planning and performing controlled orthodontic movement of crowns and roots of teeth using the overlay of computed tomography on 3-D visualization of the process of movement of dentition in patients with inflammatory periodontal diseases.
 Methods: Based on the inclusion and non-inclusion criteria, the study involved 80 patients aged 25-35 years, who were divided into 2 groups - control (with clinically healthy periodontium) and main (with chronic generalized periodontitis) for orthodontic treatment of dentoalveolar anomalies. Orthodontic equipment for the comparison groups was identical (aligners, vestibular and lingual braces with passive self-ligation). Prior to the start of the orthodontic program, the alveolar morphotype was determined by CT of patients superimposed on the program for digital modeling of the future result; the optical density of the alveolar bone was estimated in Hounsfield units (HU). Clinical indicators for assessing the condition of periodontal tissues and after completion of the orthodontic program in the comparison groups.
 Results: After the completion of orthodontic treatment, patients of group 1 had a lower number of periodontal complications - 42% versus 54% in group 2, with initially normal periodontium with a thin alveolar morphotype; 18% and 23% - with a thick alveolar morphotype. The best results were noted in the aligners subgroup - 16% and 18% for groups 1 and 2, respectively; the worst - in the subgroup with lingually fixed braces - 50% and 55%, respectively. The most common periodontal complication was tissue recession. Thanks to the predictive planning of the assessment of patients' computed tomograms superimposed on the program of digital modeling of the final result after the displacement of teeth, a positive result of orthodontic treatment was obtained and the risk of negative impact of the orthodontic program on both intact periodontal tissues and damaged periodontium was minimized.
 Conclusions: The new ability to control the state of the alveolar ridge bone using 3-D visualization of tooth movement with CT overlay increases the efficiency of orthodontic treatment planning by 40%, ensuring a minimum of side effects and complications.

Prevalence of dental malocclusion and its gender distribution among dental students at Kabul university of medical science

The current study aims to provide quantitative and qualitative information about the prevalence of dental malocclusions among dental students of Kabul University of Medical Sciences (KUMS) in the orthodontics department of Ali Abad Teaching Dental Clinic that evaluates the relationship of malocclusion between gender and the major causes of malocclusion in society among genders and the tendency of the community toward the treatment of dentoalveolar anomalies. This study was a cross-sectional survey that was done randomly among 133 students, 68 male (51.12%) and 65 female (48.87%), in an age range of 18–25 years old at Kabul University of Medical Sciences, Ali Abad teaching dental clinic faculty of dentistry. show the dental malocclusion classes due to “angle" classification in females in Class I (53.48%), Class II (21.4%), and Class III (23.07%), while in males in Class I (48.33%), Class II (6.66%), and Class III (43.33%). The prevalence rate of crowding was 33% in males and 43% in females. It has been studied and analyzed separately that the most common oral problems in females were dental caries (53.84%). According to our survey (65 female participants), no one had periodontitis, while in males, plaque was at a rate of 28.97%, and the least common was gingivitis (6%), respectively. The occurrence of dental trauma in boys and heredity in girls may be the most important factors for dental malocclusion. Girls were more interested in orthodontic treatments, which may be because they pay more attention to beauty than boys. Moreover, crowding had the highest rate among participants, followed by deep, open bites and edge-to-edge bites.

PECULIARITIES OF TEETH ERUPTION IN THE PERIOD OF MIXED DENTITION IN CHILDREN WITH DENTAL ALVEOLAR ANOMALIES FROM POLTAVA REGION

The prevalence of dento-alveolar anomalies in the structure of dental morbidity ranks the third position following dental caries and periodontal diseases. Signs of normal teething are the following: timeliness, sequence in relation to certain groups of teeth, evenness, eruption of teeth first in the lower jaw and then in the upper jaw. The timing of the eruption for deciduous and permanent teeth can shift in one direction or another. There is a distinction between premature and delayed teething. According to the literature, there are two options for the eruption of canines and premolars: premolars appear first (at the age of 7-11 years) followed by canines, or canines can erupt first (at the age 8 to 12 years) then followed by premolars. Both patterns are independent of gender and race. The purpose of this study is to determine the timing and sequence of eruption for permanent canines and premolars in children of Poltava Region and to establish the influence of eruption timing on the development of dental alveolar anomalies.
 The results of our research have demonstrated that the most common pathology is the anomaly of the position of individual teeth, or Class I according to Angle, which is diagnosed in 77.6% (615 cases) of patients over the period of tooth change. Class II malocclusion according to Angle, or distal bite is found in 150 patients (18.9%), in 68 patients in the first period of the mixed dentition and in 82 in the second period. Mesial bite, or class III according to Angle is diagnosed in 3.4% (27) of study subjects.
 Pathology in the vertical plane, namely, a deep bite is diagnosed in 153 people, 19.31% of them have open bite, and 6.56% (52 cases) have close bite, 2.77% (22) of patients have cross bite.
 Thus, the commonest orthodontic pathology in the mixed dentition of patients with of dento-alveolar anomalies from the Poltava region is the abnormality of the position of individual teeth, or Class I pathology according to Angle. The number of patients having this diagnosis is 77.6% of all children who searched for orthodontic care at this age.
 We have not found any special relationship between the nature of teeth eruption, gender and type of dental alveolar anomaly in orthodontic patients of Poltava region during the period of tooth change.

Профілактика захворювань порожнини рота в дітей з бульозним епідермолізом: опис клінічного випадку та огляд стану проблеми

Today, more than 300 million people worldwide suffer from one or more rare diseases. Epidermolysis bullosa (EB) is a heterogeneous group of hereditary diseases characterized by a genetic predisposition to a hypersensitive body reaction to minor skin damage, characterized by the formation of blisters and erosions on the skin and mucous membranes, followed by scarring. It is one of the most severe hereditary dermatoses. In EB, pathological conditions also occur in the oral cavity. Thus, patients with EB require a special “atraumatic” approach to medical procedures, hygienic care, professional oral hygiene, etc. Purpose - to systematize clinical recommendations for oral care for patients with BE on the basis of a clinical case. Clinical case. We present a clinical case of a patient with a dystrophic EB and a diagnosis of acute chronic granulating periodontitis. Examination of the oral cavity revealed microstomia, multiple caries, erosions and ulcers on the oral mucosa, signs of chronic catarrhal gingivitis, as well as dentoalveolar anomalies. After achieving a satisfactory degree of mouth opening using a set of exercises for the maxillofacial muscles, treatment of the acute chronic granulating periodontitis of the tooth 23 was performed. As a result of the clinical observation and analysis of the literature, we systematized practical recommendations aimed at facilitating the treatment of oral diseases in patients with EB. Conclusions. Treatment of oral diseases in patients with EB is primarily aimed at preventing pain and preventing secondary infection of affected areas. Treatment of dental caries contributes to the correct position of the tongue, improved swallowing and phonetics, as well as to improvement in nutritional status and aesthetic appearance. Oral hygiene reduces the risk of injury to the oral and pharyngeal mucosa. In the treatment of patients with EB, it is important to use a multidisciplinary approach with the involvement of specialists of different specialties. Implementation of simple but effective recommendations made by pediatric dentists will increase the effectiveness of prevention of oral diseases in these children. The study was conducted in accordance with the principles of the Declaration of Helsinki. Informed consent of parents and child was obtained for the study. No conflict of interests was declared by the authors.

Orthodontic status of children of Bukovina region in the age aspect

There are three groups of patients with abnormalities of magnesium homoeostasis. The first one include patients with magnesium deficiency (low total body magnesium content) and a resultant hypomagnesaemia (low serum magnesium concentration). Patients with hypomagnesaemia (serum magnesium concentration <0.75 mmol/L) in the absence of magnesium deficiency (i.e., a normal total body magnesium content) consist the second group. The third group include patients with magnesium deficiency (low total body magnesium content) but no evidence of hypomagnesaemia (i.e., a normal serum magnesium concentration). Magnesium deficiency can be caused by decreased magnesium intake from the diet, decreased magnesium absorption, or increased renal magnesium excretion (renal magnesium wasting). The narrative review examines the causes, clinical and laboratory signs of magnesium deficiency in the body, and the effect of magnesium supplementation on health indices. Groups of people who are more likely to suffer from magnesium deficiency are outlined. Emphasis is placed on the use of questionnaires to identify individuals with possible magnesium deficiency. The changes on the electrocardiograms that are characteristic of the initial magnesium deficiency and that occur in case of its increase are given. The effect of additional intake of magnesium salts on blood pressure changes in individuals with and without baseline hypertension is discussed in detail. Factors that make it difficult to assess the relationship between magnesium intake and abnormalities in lipid and carbohydrate metabolism are listed. An association between increased dietary magnesium intake and reduced risk of certain cardiovascular diseases, diabetes mellitus, and overall mortality has been demonstrated. Keywords: children, dentoalveolar anomalies, prevalence, primary dentition, changing dentition, permanent dentition.

Prevalence of Dental Malocclusion and Its Gender Distribution Among Dental Students at Kabul University of Medical Science

Aim: The current study aims to provide quantitative and qualitative information about the prevalence of dental malocclusions among dental students of Kabul University of Medical Sciences (KUMS) in the orthodontics department of Ali Abad Teaching Dental Clinic that evaluates the relationship of malocclusion between gender and the major causes of malocclusion in society among genders and the tendency of the community toward the treatment of dentoalveolar anomalies. Methodology: This study was a cross-sectional survey which has been done randomly among 133 students, 68 male (51.12%) and 65 female (48.87%); in an age range of (18-25) years old at Kabul University of Medical Sciences, Ali Abad teaching dental clinic faculty of Dentistry. Results: It displays the different "Angle" grades of dental malocclusion for males and girls. For men, the classifications are Class I (48.33%) Class II (6.66%) Class III (43.33%). Males experienced crowding at a rate of 33% while females experienced it at a rate of 43%. Dental caries (53.84%) was shown to be the most prevalent oral condition in females after extensive research and analysis. No one in our survey (65 female participants) reported having periodontitis, compared to men who had dental plaque at rates of 28.97% and 6%, respectively, and gingivitis. Conclusions: The most significant contributing factor to dental malocclusion in boys may be dental trauma, while in girls it may be inheritance. Because girls tend to value beauty more than boys do, they were more interested in orthodontic procedures. Moreover, participants' rates of crowding, deep, open bites, and edge-to-edge bites were highest.

Проблеми організації ортодонтичної допомоги дітям, які проживають у м. Ужгород

Introduction. In the structure of the prevalence of dental diseases, children with dentoalveolar anomalies (DAA) take the third place after the dental caries and periodontal tissue diseases. According to the WHO, the prevalence of DAA is 50% on average. However, the dental care provided does not always meet existing needs, and patients need to expand its volume and improve its quality. Purpose: to study the problems of organizing orthodontic care for children living in Uzhhorod. Materials and methods. In order to evaluate the effectiveness of dynamic observation and rehabilitation of children at the orthodontist, an in-depth study of the observation method was conducted in comparison with the appointment on demand. Planned treatment and preventive measures covered 432 elementary school students, and 228 students of the same age in Uzhgorod who received orthodontic care on demand. Statistical data processing was performed on a personal computer using licensed software for the Windows operating system and the standard Statsoft software package. Inc STATISTICA 6.0 2300 East 14th Street Tulsa, OK 74104 USA. Student's t-test values were used to determine the reliability of the difference in results. Results and discussion. Screening of the prevalence of dentoalveolar anomalies in the city of Uzhgorod showed that 54% of children and teenagers have defects that need treatment. In children living in Uzhgorod, the frequency of formed DAA ranges from 32.9 to 33.2%, those which are forming – from 19.7 to 21.3%, those with risk factors for development from 16.9 to 18.3% of the total number of examinees. The vast majority of children (97.7%) have DAA combined with abnormalities of other systems and organs: postural disorders and scoliosis (82.9%), myopia (82.7%). The prevalence of DAA is uneven in different age. In the period of temporary dentition, anomalies occur in 24% of children, in the period of mixed dentition – in 49%, and at the age of 17 (permanent dentition) in 35%. There is an increase in the frequency of DAA between the ages of 6 and 11 years. Conclusions. The high prevalence of dentoalveolar anomalies is a consequence of insufficient coverage of the pediatric population with the necessary orthodontic care. The success of orthodontic treatment depends on the contact of the patient and (or) his parents with the doctor, therefore, an orthodontist needs special psychological training. It is necessary to expand the sanitary and educational work among the population and in the mass media regarding the promotion of a healthy lifestyle, timely detection and treatment of anomalies of the dentomaxillofacial system.

Influence of hygienic status on the activity of the carious process in children with dentoalveolar anomalies and deformities against the background of bronchopulmonary pathology

Influence of hygienic status on the activity of the carious process in children with dentoalveolar anomalies and deformities against the background of bronchopulmonary pathology

Перспективи впровадження навчання по удосконаленню знань, умінь та практичних навиків за фахом «Стоматологія» у сімейних лікарів на кафедрі ортопедичної стоматології НУОЗ України імені П. Л. Шупика

Relevance. Dental diseases, including dentoalveolar anomalies, have a significant prevalence and occupy a leading place in the structure of the general morbidity of the population of Ukraine. In the context of a pandemic and a state of war, the effectiveness of preventive measures has fallen sharply, which negatively affects the dental health of the population. An important role in solving this problem should be taken by family doctors, who are representatives of the primary level of health care. A family doctor should take a leading place in the prevention and detection of diseases, including dental diseases, pay special attention to hygiene education and education of the population, health education. Therefore, much attention has recently been paid to an interdisciplinary approach in dentistry, which will significantly improve the effectiveness of patient treatment. Purpose – scientific and methodological substantiation of the need for continuous professional development of general practitioners in dental care for the population at the dental departments of the National University of Health of Ukraine named after P.L. Shupyk. Results. Priority areas for training general practitioners in the preservation of dental health have been identified. Conclusions. Awareness of the family doctor with preventive dental measures will make it possible to bring primary medical care closer to the population, ensure its quality and accessibility, prevent the development of severe pathology and conduct appropriate comprehensive, including orthopedic treatment. Keywords: family doctor, prevention of dental diseases, primary health care.