COMPLETE REHABILITATION OF ORTHODONTIC PATIENTS AND PREVENTION OF RECURRENCES

Abstract

Emotional instability of children leads to the development of oral habits or adaptive type of swallowing. They are ways of adaptation to existing chronic stress. Oral habits play an important role in the appearance of number of orthodontic anomalies of the occlusion or worsen the conditions of treatment of such a patient. The purpose of the study. Improving the effectiveness of the complex treatment of maxillomandibular anomalies among the patients with pathological occlusion, with primary swallowing and oral habits is important. Only an etiological approach to such clinical cases gives the desired result. Materials and methods. The article is based on a clinical and laboratory study conducted among patients aged 12-15 years who have oral habits (sucking fingers or other objects, breathing through the mouth, resting the head on the hands, sleeping in an uncomfortable position, having a primary swallowing). 15 people of the comparison group without maxillomandibular anomalies, oral habits, with normal swallowing and 60 patients with acquired maxillomandibular anomalies were examined. An important point of the clinical examination was the external oral examination with determination of the way of swallowing and breathing, determination of the condition of the TMJ. The patients were given the STAI testify, a secret questionnaire in order to identify stress factors that affect the body, and the relationship between the presence of a stress factor and the appearance of changes in the maxillofacial area was studied. We studied and analyzed the data of computed tomograms of 60 patients with acquired maxillomandibular anomalies, deformities, 15 tomograms of persons of the norm group. X-ray methods included examination of the patient on a spiral computed tomography scan TOSHIBA Aquilion PRIME 160-slices MODEL TSX-302A / 1C. The scan was performed according to a specially developed protocol. The results of the cephalometric study before and after the treatment were evaluated, and they were compared with the results of the clinical examination. Results. The obtained results of the STAI testify to the state of chronic tension of patients, a feeling of emotional relief during the period of using an oral habit. The results of the examination and photo report confirm pronounced changes in the symmetry and proportionality of the face, where there is an oral habit. Patients had complex treatment with non-removable Appliance (Hyrex, MARPE), braces systems in combination with myogymnastics. If there was a primary swallowing or hidden mouth breathing, the treatment began with labial therapy with FroggyMouth Appliance (France). The results of a cephalometric study confirm the presence of an acquired rather than a congenital deformation of the facial skeleton. Adaptive changes on the part of the maxillomandibular and the muscular system indicate the long-term effect of oral habits on the maxillofacial area and confirm the existence of a functional facial matrix. Conclusions. Constant systematic struggle with oral habits and atipical swallowing in the complex treatment of patients with maxillomandibular anomalies is an important and necessary stage. Only elimination effect of the etiological factor can prevent a relapse of a disease. The long-term results of the treatment indicate that after the treatment, the clinical and cephalometric characteristics of the maxillomandibular bones and the muscular apparatus normalize in patients.