[Modern concept of treatment of adolescents with Class III malocclusion].

Abstract

Objective: Aim of the work is to increase the effectiveness of complex treatment in patients with mesial occlusion during active skeletal growth. mproving the effectiveness of complex treatment of patients with mesial occlusion during active skeletal growth.

Material and methods: Clinical and radiological examination and comprehensive treatment of 30 patients with skeletal anomalies according to sagittale were carried out (average age 15 years). Orthodontic treatment of patients was performed using the Damon self-ligating bracket system («Ormco», USA), H4 («OC Orthodontics» USA) with a sequential change of arches. According to the indications, orthodontic mini screws, removable, non-removable dilators, a facial mask, occlusal pads for disconnecting the bite, in the retention period, non-removable retainers in the anterior part of the dentition, a removable retention device at night «Corrector», or removable plate devices were used.

Results: Rapid palatal expansion was performed according to the traditional method, based on the stages of formation of the median palatine suture (the first algorithm is the stage of formation of the palatine suture A-B). In patients with narrowing of the HF with the stage of formation of the median palatine suture C, the beginning of stage D, the use of the proposed expansion scheme with the use of piezocorticotomy to eliminate the buttresses of the upper jaw, the use of laser corticotomy and the protocol of activation and deactivation of the screw to relax the bone and achieve skeletal expansion of the upper jaw was effective. The change in the dental alveolar height, normalization of the incisor overlap height improved harmony in the gnatic part of the facial skull of patients. In the process of orthodontic treatment, the inclination of the occlusal plane was normalized, the profile of the face improved. Changes in the soft tissues of the profile consisted in an increase in the thickness of the upper lip by 2.27±0.48 mm (p<0.05) and its length by 1.45±0.39 mm (p<0.05), the total length of the lower lip and chin by 3.16±0.45 mm (p<0.05). The position of the lips relative to the aesthetic plane has changed most significantly. An algorithm was developed for the treatment of patients with dental anomalies in the sagittal plane, with a narrowing of the upper jaw during the bite of permanent teeth 12-17 years.

Conclusion: The method of complex treatment is designed to increase the effectiveness of orthodontic treatment of patients with skeletal abnormalities during active skeletal growth and is aimed at changing skeletal growth, as well as to prevent the development of skeletal malocclusion during permanent bite, which is necessary to prevent the development of more pronounced skeletal deformity at the stage of complete skeletal maturation.