Порівняльна характеристика морфо-функціонального стану зубощелепної ділянки у пацієнтів в період раннього та пізнього змінного прикусу

Abstract

Проведене порівняння особливостей морфо-функціонального стану зубощелепної ділянки у дітей в період раннього та пізнього змінного прикусу виявило відмінності у структурі ЗЩА та функціональних порушень. З віком відмічено збільшення кількості аномалій прикусу ІІ класу за Енглем та вертикальних аномалій прикусу. В обох вікових групах визначено великий відсоток комбінацій функціональних порушень, пов’язаних із неправильним положенням язика (ковтання, мовлення), які з віком доповнюються порушенням функції жування; Проведенное сравнение особенностей морфо-функционального состояния зубочелюстной области у детей в период раннего и позднего сменного прикуса выявило различия в структуре зубочелюстных аномалий и функциональных нарушений. С возрастом отмечено увеличение количества аномалий прикуса II класса по Энглю и вертикальных аномалий прикуса. В обеих возрастных группах определен большой процент комбинаций функциональных нарушений, связанных с неправильным положением языка (глотания, речи), которые с возрастом дополняются нарушением функции жевания; To compare the features of patients` morpho-functional status in different mixed dentition periodsclinical examination of 1045 children 6-12 years old was conducted (510 children 6-9 years old – the first group, and 535 children 10-12 years old – the second group). The diagnosis is established by Angle and Grigorieva classification. Functional state of maxillofacial region by clinical functional tests was assessed. As a result of the research in both age groups physiological occlusion was diagnosed in nearly equal numbers: the 1-st group – 24.9%, and 2-nd group – 24.7%. Malocclusions and deformations in both age children groups in 87.3% and 75.3% was founded respectively. The I class by Angle in 47.6% of 1-st group was diagnosed, in 2-nd group was increasing to 39.7%. II class in the 1-st group – 39.4% was observed, 2-nd group – 42.7%. Other changes were observed in the study of the prevalence of class III Engle: the 1-st group – 3.1%, the 2-nd group – 2.2%. Vertical bite abnormalities in the 1-st age group accounted for 7.9%, and in the second age group the number increased to 12.2%. Transversal occlusion in 2% of children 1-st group observed. In the 2-nd group – 3.2%. Functional disorders of maxilla-facial region in the first age group in 75.1%, in the second group – in 56.5% was founded. In determining the functional state of the dental area in 6-9 years old children with malocclusion (445 children) dysfunction of swallowing, speaking, breathing, closing of the lips and chewing in 334 cases (75.1%) was diagnosed. Single functional violation (one of them) met only in 38.3%. Among them, swallowing dysfunction encountered in 17.6%, the dysfunction of speech – at 14.4%, chewing dysfunction – in 4.8%, the closing of the lips – at 1.5%. It should be noted that we have not observed any cases of a single breath dysfunction. The dysfunction of breath always combined with other functionality maxilla-facial region problems. In 206 children 6-9 years old was noted combination of functional disorders, representing 61.7%. Combinations of swallowing and speech disorders in 26.6% identified; swallowing, speech and closing of the lips – at 12.6%; breathing, speaking, chewing and closing of the lips – at 8.1%; breathing in conjunction with closing of the lips violation – 6.3%. The combination of swallowing, breathing, speaking, closing the lips, chewing dysfunction in 4.5% was detected; swallowing, breathing, speech and chewing disorders – in 3.6%. For the 2-nd group, dysfunction of swallowing, speaking, breathing, closing of the lips and chewing in 302 cases (87.7%) was diagnosed. Single functional violation (one of them) met in 12.3%. Among them, the greatest number of cases was noted dysfunction of chewing in 7%. Violation of speech and swallowing was representing in 3.3% and 2%. It should be noted that in this age group did not observe single disorders of breathing and swallowing. The combination of functional impairment in children 10-12 years old were found in 87.7%. Among the combinations of dysfunctions in children of this age group in the largest number of cases was noted combination of swallowing, speaking, chewing and closing of the lips disorders – 41.7%. In a sufficiently large number of surveyed noted a combination of swallowing, speaking, chewing and swallowing, speaking, chewing, breathing and closing of the lips disorders representing in 25.5% and 13.2% respectively. Violation of breathing, speaking, chewing and lip closure functions in 5.6% was diagnosed and the least number of cases combination swallowing disorders of speech, chewing and breathing –in 2% were identified. Such combinations of functional disorders: swallowing, speech; swallowing, speaking, closing of the lips; and breathing, closing of the lips in 2-nd group we have not been observed in any case. Comparison of morpho-functional state features of maxilla-facial region in both age groups differences in the structure malocclusions and functional disorders was revealed. The number of II class and vertical malocclusion increased with age. In both age groups a large percentage of functional disorder combinations related to the incorrect position of the tongue (swallowing, speech) was identified. They are complemented of chewing dysfunction by age.