Аннотация. В статье проводится обзор и сравнительный анализ существующих видов и методов диагностики зубочелюстных аномалий на этапе подготовки и планирования ортодонтического лечения. Определяется и доказывается целесообразность проведения комплексной диагностики на ранних этапах подготовки к проведению ортодонтического лечения. Устанавлива-ется связь между методами различных видов диагностики и процентом рецидивов в ретенционном периоде, делается вывод об отсутствии единой методики проведения диагностики, недосточной ее полноте, что в свою очередь оказывает существен-ное влияние на ход лечения, а впоследствии на возникновения рецидивов. В рамках определения и анализа установленных взаимосвязей предлагаются подходы к снижению процента рецидивов на основе оптимизации процессов и методов долечеб-ной диагностики. Ключевые слова: зубочелюстные аномалии, виды диагностики, лучевая диагностика, ортодонтическое лечение, ретенцион-ный период, рецидивы, компьютерная томография.В настоящее время в структуре стоматологических заболеваний аномалии положения зубов занимают тре-тье место после кариеса зубов и болезней пародонта и имеют тенденцию к росту. Среди обследованного населения, аномалии положения зубов отмечены, по данным разных авторов в 38,0 − 75,0% случаев [1].Согласно статистике, сегодня среди всех зубоче-люстных аномалий около 35% составляют аномалии положения отдельных зубов. Скученное положение зу-бов, по данным ряда авторов, колеблется от 5,5% до 47,7%. Особенно важным является тот факт, что со-гласно данным после проведенного ортодонтического лечения у 18,9 % взрослых и у 36,8% детей наблюда-ется развитие рецидива [2]. В качестве решения данной проблемы сегодня предлагается проводить длитель-ную ретенцию для стабилизации достигнутого резуль-тата. Однако это не всегда гарантирует достижение по-ставленной задачи по сохранению результата ортодон-тического лечения у пациента.Зубочелюстные аномалии чаще выявляются в смен-ном прикусе и старших возрастных группах детей. Преимущественно формируются во фронтальном от-деле верхнего и нижнего зубного ряда. В результате чего возникают проблемы различного характера: ску-ченное положение резцов верхней и нижней челюсти, нарушение линии улыбки, асимметрия лица, (эстети-ческие жалобы), так же отмечаются функциональные нарушения − нарушение захвата и откусывания пищи, звукообразования и другие.Разнообразие зубочелюстных аномалий очень ве-лико и большое значение приобретает их классифика-ция, использование которой помогает в краткой фор-мулировке охарактеризовать сущность патологии. Классификация необходима для учета отклонений от нормы, систематизации, выбора плана лечения, меж-дународного общения. В нашей стране и большинстве стран мира ортодонты используют классификацию Всемирной организации здравоохранения, которую было принято использовать на X Съезде ортодонтов России.Классификация аномалий зубов Всемирной ор-ганизации здравоохранения (ВОЗ)1. Аномалии формы зуба. 2. Аномалии структуры твердых тканей зуба. 3. Аномалии цвета зуба. 4. Аномалии размера зуба (высоты, ширины, ...
Aim. The thickness of bone tissue in patients with pathological dental inclinations planning orthodontic treatment with fixed equipment.Materials and methods. The CBCT scans of patients with pathological dental inclinations was studied, bone tissue deficiency was described, a universal table was given that helps to calculate the necessary thickness of bone tissue at various levels of root length at the stage of treatment planning when the torc of the frontal teeth changes.Results. Bone tissue deficiency is described in two study groups, however, in patients with retrusion, the deficiency is most pronounced in the cervical third from the vestibular side, in the group with protrusion, the deficiency is described in the cervical third from the oral surface in the cervical third.Conclusions. The article describes a clinical case of orthodontic treatment using a universal table. The principle of operation of the universal table is shown, as well as its own clinical results proving the effectiveness of the universal table are described.
Cone Beam Computed Tomography (CBCT) is the preferred imaging method for a comprehensive orthodontic examination. Thanks to the development of this technique, clinicians today can make most accurate measurements without fear of errors associated with projection distortion or localization of landmarks on radiographs. The quality of CBCT images gives to orthodontists the ability to analyze bone structures, teeth (even impacted teeth), and soft tissue in three dimensions. The accuracy of measurements of hard and soft tissues from CBCT images determines the accuracy of diagnosis and treatment planning. A fundamentally new approach has been proposed, which makes it possible to thoroughly study the bone tissue surrounding the tooth at the stages of planning orthodontic treatment. Аnalysis of radiation studies of patients with dentoalveolar anomalies was carried out to select the optimal treatment tactics and to control its effectiveness.
The aim of this study was to carry out a comparative analysis of the volume of dental intervention under conditions of combined endotracheal anesthesia and inhalation anesthesia of nitrous oxide in pediatric dentistry.Materials and methods. Within the framework of this study, the results of oral cavity sanitation were analyzed in 300 patients aged 2 to 5 years. The median age was 3.7 years. The participants were divided into 2 equal samples: 150 patients underwent sanitation under general anesthesia (anesthesia group), 150 under conditions of inhalation anesthesia of nitrous oxide (sedation group). In the sedation group, there were 83 (55.3%) boys and 67 (44.7%) girls, in the anesthesia group – 89 participants (59.3%) were male, and 61 (40.7%) were female. The patients included in this study had comparable dental status. Also, when performing dental interventions in both groups, according to indications, local anesthesia was performed: children under 4 years old – lidocaine, children over 4 years old – articaine.Results. Based on the results of the analysis of the data obtained, it was found that the number of visits required for full-fledged dental treatment was statistically significantly lower in the anesthesia group compared to the sedation group: thus, all patients who underwent combined endotracheal anesthesia required only one visit to the clinic for necessary treatment. But it was also found that the total time of dental treatment differed depending on the anesthetic aid used: in the anesthesia group, it usually took from 1 to 2 hours (in 98% of patients), during this time a complete sanitation of the oral cavity was carried out, and in the sedation group varied more widely, with half of the patients in the range from 30 minutes to 1 hour (14% and 36.7% of children, respectively), but the number of visits for complete oral cavity sanitation increased to 8.Conclusions. In the present work, it was revealed that dental treatment under general anesthesia in children was more effective than the same treatment under conditions of inhalation anesthesia of nitrous oxide with preserved consciousness. The use of combined endotracheal anesthesia allows to reduce the number of visits to the clinic and avoid refusals from further dental treatment. General anesthesia was also more effective than sedation in terms of the number of cured teeth with caries, chronic pulpitis and extracted teeth. Nitrous oxide inhalation anesthesia provides partial retention of consciousness, is more manageable and better tolerated by children.
The introduction of cone beam computed tomography (CBCT) methods allow to most accurately visualize the bone structures of the maxillofacial region, which enables the specialist to obtain a detailed 3D model of the jaws and teeth with a fairly high resolution. This article provides the use of computed beam tomography method in orthodontic practice to analyze the initial thickness of bone tissue at various levels of the root length of the frontal group of teeth during their retrusion and protrusion. The calculation results allow us to draw conclusions about the volume of bone tissue and the possibility of orthodontic manipulations. The results of the study significantly improve the diagnosis and planning of orthodontic treatment for pathology in the frontal jaw.
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