Аналіз вивчення частоти відривів брекетів в залежності від методики їх фіксації при лікуванні пацієнтів із зубощелепними аномаліями в поєднанні із флюорозом зубів

Abstract

Склад і структура емалі зубів, уражених флюорозом відіграють важливу роль при використанні адгезивних технологій, що застосовуються для фіксації брекет-систем при лікуванні ортодонтичних пацієнтів. Запропонована методика підготовки до фіксації брекет-системи на зуби, уражені флюорозом, яка полягає в збільшенні часу протравлювання емалі, сприяє зменшенню кількості випадків незадовільної фіксації брекетів в порівнянні зі стандартною методикою фіксації; Состав и структура эмали зубов, пораженньїх флюорозом имеют важное значение при использовании адгезивних технологий, которьые применяются для фиксации брекет-систем при лечении ортодонтических пациентов. Предложенная методика подготовки для фиксации брекет-системи на зубы, пораженные флюорозом, предполагающая увеличение времени протравливания эмали, способствует уменьшению количества случаев неудовлетворительной фиксации брекетов по сравнению со стандартной методикой фиксации; Abstract. The high prevalence of disorders in maxillodental system is considered as a result of a complex effect of endogenous and exogenous factors. One of exogenous factor is influencing unfavorable environmental conditions, such as a high fluoride levels in drinking water that’s influence on the whole human body and on formation of its organs and systems, including on the formation of maxillodental system.The pathomorphological changes that occur in tissues of tooth with fluorosis are very complicity. The severity of clinical picture of disease is dependence with changes occur in the structure of tooth enamel during mineralization. The composition and structure of tooth enamel affected by fluorosis determine its properties a permeability and solubility, which have an important role for using of adhesive technologies which are using for the fixation bracket system in the treatment of orthodontic patients. The aim of the research was to determine the frequencies of brackets debonding in the treatment patients with maxillodental anomalies conjunction with fluorosis depending on the conditions of preparation of tooth enamel for the fixation bracket system. The patients undergoing orthodontic treatment were divided into 2 groups depending from the methods of fixation brackets: I group - 62 patients (fixation brackets were performed by the standard method, time for 373 etching enamel was - 30 seconds, drying time - 30 seconds); II group - 15 patients (fixation brackets were performed by the proposed method, time for etching enamel was - 50 seconds, drying time - 30 seconds). Fixation of the brackets was conducted by direct method using Transbond TM XT adhesive. Number of fixed brackets were in I group -1298; II group - 314. During the treatment brackets debonding were fixed after 3, 6, 12 months. Greater frequency of brackets debonding was observed during the 12 months in the I group - 343 cases (26.4±1.2%), which is on 19.1 % more than in the II group -7.3±1.5 (p<0.001). Conclusions. In the process of orthodontic treatment in patients with maxillodental anomalies conjunction with fluorosis when we were using a standard technique for fixation brackets, the number of brackets debonding was to 19.1% compared with the group, where was used proposed method for fixation. The greatest number of brackets debonding was observed in first three months after fixation used the standard methods of fixing. Due to the proposed methods of preparing to fixation bracket system on tooth affected by fluorosis, the number of cases of unfavorable fixation was during the first three months after treatment. During treatment using by the standard methods for fixation brackets is prevails amount of brackets debonding on the line enamel - adhesive and using a proposed methods on the line adhesive - bracket.