PROSTHETIC TREATMENT OF PATIENTS WITH DISTAL OCCLUSION USING A DEPROGRAMMER (CLINICAL CASE)
Abstract and keywords
Abstract (English):
Introduction. An actual problem of modern dentistry is the anomalies of the position of the lower jaw. The share of these diseases in the structure of requests for dental care can reach up to 27%. The most common pathology is distal occlusion, which accounts for 25 to 37% of all occlusion abnormalities. The aim of this work was to describe and demonstrate on a clinical example the method of orthopedic treatment of patients with distal occlusion proposed by the authors. Material and methods of research. The paper presents a new method of orthopedic treatment of patients with distal occlusion using a deprogrammer of the original design. Orthopedic treatment of patients was carried out on the basis of a multidisciplinary clinic of Postnikov in the city of Samara. Using the method proposed by the authors, orthopaedic treatment was performed in 36 patients with distal occlusion. For clarity, the article considers an original clinical case of treatment of a patient with distal occlusion, who was made a deprogrammer of the author's design, with a detailed analysis of each stage of diagnosis and orthopedic treatment. To confirm the effectiveness of the proposed technique, a CT scan of the patient's temporomandibular joint was performed before and after orthopedic treatment. As a result of the treatment, the patient has a decrease in the hypertonicity of the masticatory muscles, which made it possible to position the lower jaw in the position of the central ratio, which is confirmed by CT data. Conclusion. The use of a deprogrammer-mouthguard, the proposed design allows for deprogramming of the masticatory muscles and correctly determining the central ratio of the jaws, and can be used in the treatment of patients with distal occlusion.

Keywords:
distal occlusion, deprogrammer, kappa, central jaw ratio, temporomandibular joint CT
References

1. Davydov B.N., Domenyuk D.A., Dmitrienko S.V. i dr. Matematicheskoe modelirovanie formy i razmerov zubnyh dug dlya vybora taktiki i ob'ema ortodonticheskogo lecheniya u pacientov s anomaliyami zubochelyustnoy sistemy. Medicinskiy alfavit. 2018;2;8(345):7-13. [B.N. Davydov, D.A. Domenyuk, S.V. Dmitrienko et al. Mathematical modeling of the shape and size of the dental arches for choice of tactics and volume of orthodontic treatment in patients with anomalies of the dentition. Medical alphabet. 2018;2;8(345):7-13. (In Russ.)].

2. Anikienko A.A., Pankratova N.V., Persin L.S. i dr. Fundamental'nye osnovy ortodontii. Monografiya. Moskva : Ofort. 2014:201. [A.A. Anikienko, N.V. Pankratova, L.S. Persin et al. Fundamental foundations of orthodontics. Monograph. Moscow : Etch. 2014:201. (In Russ.)].

3. Kucenko A.M., Postnikov M.A., Trunin D.A. i dr. Reabilitaciya pacientov s polnym otsutstviem zubov v sochetanii s zubochelyustno-licevymi anomaliyami na protivopolozhnoy chelyusti. Sovremennye problemy nauki i obrazovaniya. 2018;4:201. [A.M. Kutsenko, M.A. Postnikov, D.A. Trunin et al. Rehabilitation of patients with complete absence of teeth in combination with dentofacial anomalies on the opposite jaw. Modern problems of science and education. 2018;4:201. (In Russ.)].

4. Dmitrienko S.V., Zelenskiy V.A., Shkarin V.V. i dr. Algoritm opredeleniya sootvetstviya tipov lica osnovnym anatomicheskim variantam zubnyh dug pri diagnostike i lechenii ortodonticheskih bol'nyh. Sovremennaya ortopedicheskaya stomatologiya. 2017;28:62-65. [S.V. Dmitrienko, V.A. Zelensky, V.V. Shkarin et al. Algorithm for determining the correspondence of facial types to the main anatomical variants of dental arches in the diagnosis and treatment of orthodontic patients. Modern orthopedic dentistry. 2017;28:62-65. (In Russ.)]. https://elibrary.ru/item.asp?id=35312573

5. Shadlinskaya R.V., Gasymova Z.V., Gasymov O.F. Sravnitel'naya harakteristika chelyustno-licevyh parametrov pacientov s bol'shoy β-talassemiey i distal'noy okklyuziey. Klinicheskaya stomatologiya. 2019;1:46-50. [R.V. Shadlinskaya, Z.V. Gasymova, O.F. Gasymov. Comparative characteristics of maxillofacial parameters of patients with large β-thalassemia and distal occlusion. Clinical dentistry. 2019;1:46-50. (In Russ.)]. https://elibrary.ru/item.asp?id=37128728

6. Domenyuk D.A., Dmitrienko S.V., Vedeshina E.G. Korrelyaciya razmerov zubov s parametrami zubochelyustnyh dug i chelyustno-licevoy oblasti po rezul'tatam issledovaniya nativnyh preparatov cherepov. Kubanskiy nauchnyy medicinskiy vestnik. 2016;2(157):71-79. [D.A. Domenyuk, S.V. Dmitrienko, E.G. Vedeshina. Correlation of the size of teeth with the parameters of the dentoalveolar arches and the maxillofacial region according to the results of the study of native preparations of skulls. Kuban Scientific medical Bulletin. 2016;2(157):71-79. (In Russ.)].

7. Zelenskiy V.A., Baturin M.V., Zelenskiy I.V. i dr. Integral'nyy pokazatel' kontrolya kachestva ortodonticheskoy pomoschi. Medicinskiy vestnik Severnogo Kavkaza. 2014;9;1(33):80-83. [V.A. Zelensky, M.V. Baturin, I.V. Zelensky et al. Integral indicator of the quality control of orthodontic care. The Medical Bulletin of the North Caucasus. 2014;9;1(33):80-83. (In Russ.)]. https://elibrary.ru/item.asp?id=21486375

8. Douson P.E. Funkcional'naya okklyuziya: ot visochnonizhnechelyustnogo sustava do planirovaniya ulybki. Moskva : Prakticheskaya medicina. 2016:592. [P.E. Dawson. Functional occlusion: from the temporomandibular joint to the planning of the smile. Moscow: Practical Medicine. 2016:592. (In Russ.)].

9. Fischev S.B., Puzdyryova M.N., Dmitrienko S.V. Morphological features of dentofacial area in peoples with dental arch issues combined with occlusion anomalies // Archiv EuroMedica. - 2019;9;1:162-163.

10. Markov N.M. Stabilometriya kak diagnosticheskiy metod v ortodontii. Klinicheskaya stomatologiya. 2013;2:18-21. [N.M. Markov. Stabilometry as a diagnostic method in orthodontics. Clinical dentistry. 2013;2:18-21. (In Russ.)]. https://elibrary.ru/item.asp?id=22474108

11. Korobkeev A.A., Shkarin V.V., Dmitrienko S.V. i dr. Anatomicheskie osobennosti vzaimozavisimosti osnovnyh parametrov zubnyh dug verhney i nizhney chelyustey cheloveka. Medicinskiy vestnik Severnogo Kavkaza. 2018;13;1-1:66-69. [A.A. Korobkeev, V.V. Shkarin, S.V. Dmitrienko. Anatomical features of the interdependence of the main parameters of the dental arches of the upper and lower jaws of the person. The Medical Bulletin of the North Caucasus. 2018;13;1-1:66-69. (In Russ.)]. https://elibrary.ru/item.asp?id=35378007

12. Postnikov M.A., Nesterov A.M., Trunin D.A. i dr. Vozmozhnosti diagnostiki i kompleksnogo lecheniya pacientov s disfunkciyami visochno-nizhnechelyustnogo sustava. Klinicheskaya stomatologiya. 2020;1:60-63. [M.A. Postnikov, A.M. Nesterov, D.A. Trunin. Possibilities of diagnostics and complex treatment of patients with dysfunction of the temporomandibular joint. Clinical dentistry. 2020;1:60-63. (In Russ.)]. https://elibrary.ru/item.asp?id=42846269

13. Dmitrienko S.V., Lepilin A.V., Domenyuk D.A. Clinical meaning of methods for identifying variability of mental prominence location // Archiv EuroMedica. - 2019;9;1:45-46.

14. Shkarin V.V., Domenyuk D.A., Dmitrienko S.V. i dr. Sovremennye podhody k opredeleniyu ugla inklinacii zubov pri diagnostike i planirovanii ortodonticheskogo lecheniya. Kubanskiy nauchnyy medicinskiy vestnik. 2018;25;2:156-165. [V.V. Shkarin, D.A. Domenyuk, S.V. Dmitrienko. Modern approaches to determining the angle of inclination of teeth in the diagnosis and planning of orthodontic treatment. Kuban Scientific medical Bulletin. 2018;25;2:156-165. (In Russ.)].

15. Gauer R.L., Semidey M.J. Diagnosis and treatment of temporomandibular disorders. // Am Fam Physician. - 2015;91(6):378-386.

16. Skármeta N.P., Pesce M.C., Saldivia J., Espinoza-Mellado P., Montini F., Sotomayor C. Changes in understanding of painful temporomandibular disorders: the history of a transformation // Quintessence Int. - 2019;50(8):662-669.

17. Diyanova S.N., Zhuravleva A.L., Besschastnyy D.S. Metody deprogramirovaniya zhevatel'nyh myshc pri opredelenii central'nogo sootnosheniya chelyustey. Proryvnye nauchnye issledovaniya kak dvigatel' nauki. 2018:192-197. [S.N. Diyanova, A.L. Zhuravleva, D.S. Besschastny. Methods for deprogramming the masticatory muscles in determining the central ratio of the jaws. Breakthrough scientific research as the engine of science. 2018:192-197. (In Russ.)].

18. Korobkeev A.A., Konnov V.V., Vedeshina E.G. i dr. Izmeneniya strukturnyh elementov visochno-nizhnechelyustnogo sustava pri distal'noy okklyuzii. Medicinskiy vestnik Severnogo Kavkaza. 2017;12;1:72-76. [A.A. Korobkeev, V.V. Konnov, E.G. Vedeshina. Changes in the structural elements of the temporomandibular joint with a distal occlusion. The Medical Bulletin of the North Caucasus. 2017;12;1:72-76. (In Russ.)].

19. Konnov V.V., Davydov B.N., Vedeshina E.G. i dr. Morfologiya visochno-nizhnechelyustnogo sustava pri fiziologicheskoy okklyuzii i distal'noy okklyuzii, oslozhnennoy defektami zubnyh ryadov (Chast' I). Institut stomatologii. 2017;1(74):92-94. [V.V. Konnov, B.N. Davydov, E.G. Vedeshina. Morphology of the temporomandibular joint in normal occlusion and distal occlusion complicated by defects of dentition (Part I). Institute of dentistry. 2017;1(74):92-94. (In Russ.)]. https://elibrary.ru/item.asp?id=28965111

20. Petrikas I.V., Zhirkov A.M., Krasnov A.A. Kompleksnyy mezhdisciplinarnyy podhod k profilaktike i lecheniyu disfunkcii VNChS. Problemy stomatologii. 2016;1:97-102. [I.V. Petrikas, A.M. Zhirkov, A.A. Krasnov. Complex interdisciplinary approach to the prevention and treatment of TMJ dysfunction. Actual problems in Dentistry. 2016;1:97-102. (In Russ.)]. https://elibrary.ru/item.asp?id=25781411

21. Ishakov I.R., Mannanova F.F. Ekspress-diagnostika narusheniy okklyuzii i patologii visochno-nizhnechelyustnogo sustava na stomatologicheskom prieme. Problemy stomatologii. 2013;5:39-43. [I.R. Iskhakov, F.F. Mannanova. Express-diagnostics of occlusion disorders and pathology of the temporomandibular joint at the dental reception. Actual problems in Dentistry. 2013;5:39-43. (In Russ.)]. https://elibrary.ru/item.asp?id=21009690

22. Chikunov S.O. Kachestvo zhizni pacientov s priznakami patologii visochno-nizhnechelyustnogo sustava pri provedenii kompleksnoy stomatologicheskoy ortopedicheskoy reabilitacii. Problemy stomatologii. 2020;16;2:144-150. [S.O. Chikunov. Quality of life of patients with signs of pathology of the temporomandibular joint during complex dental orthopedic rehabilitation. Actual problems in Dentistry. 2020;16;2:144-150. (In Russ.)]. https://elibrary.ru/item.asp?id=43783721

23. Kostina I.N., Kochmasheva V.V. Ul'trazvukovaya vizualizaciya visochno-nizhnechelyustnogo sustava v norme. Problemy stomatologii. 2016;2:95-101. [I.N. Kostina, V.V. Kochmasheva. Ultrasound visualization of the temporomandibular joint in the norm. Actual problems in Dentistry. 2016;2:95-101. (In Russ.)]. https://elibrary.ru/item.asp?id=26324579

24. Murphy M.K., MacBarb R.F., Wong M.E., Athanasiou K.A. Temporomandibular disorders: a review of etiology, clinical management, and tissue engineering strategies // Int J Oral Maxillofac Implants. - 2013;28(6):393-414.

25. Ishmurzin P.V., Danilova M.A. Lechenie distal'noy okklyuzii zubnyh ryadov, sochetannoy s disfunkciey visochno-nizhnechelyustnogo sustava. Problemy stomatologii. 2012;1:70-75. [P.V. Ishmurzin, M.A. Danilova. Treatment of distal occlusion of the dentition, combined with dysfunction of the temporomandibular joint. Actual problems in Dentistry. 2012;1:70-75. (In Russ.)]. https://elibrary.ru/item.asp?id=17651443


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