ASSESSMENT OF EFFECTIVENESS IN APPLYING MULTIDISCIPLINARY EXPERIMENTALLY-BASED APPROACH IN CHOOSING THERAPY FOR PATIENTS WITH FUNCTIONAL MAXILLOFACIAL DISORDERS IN COMBINATION WITH PRIMARY DEEP BITE

Abstract

Introduction. In recent years, the percentage of adults seeking orthodontic care has been increasing. The management of such a group of patients poses a number of challenges the orthodontists have to solve. One of the common problems that arise during the bite correction with fixed orthodontic appliances is debonding. The highest percentage, 43%, of adhesion disruption is observed in patients with a deep overlap. There is also an increase in the number of dental patients presenting with manifestations of the development of functional occlusion disorders caused by reconstructive prosthetic restorations under the existing bite pathology. Materials and methods. A comparison of electromyography indicators in patients before and after the treatment was carried out. The study included 51 patients aged 18-45 years (average age was 29.6±6.1 years). The selection was made on the basis of inclusion / exclusion criteria. The first group involved 24 patients (9 men, 15 women) with a deep bite, occlusal disorders with unexpressed architecture of the occlusal surface of reconstructive restorations mainly made of composite and polymer materials; the participants presented no pronounced pain symptoms, but presented complaints about the masticatory muscles (discomfort, trismus, contracture of the lateral pterygoid muscle, bruxism, etc.). Patients of this group were characterized by multiple direct restorations and short-length orthopaedic structures. The second group included 27 patients (10 men, 17 women) with a deep bite, occlusal disorders, pronounced architecture of the occlusal surface of reconstructive prosthetic restorations and existing pain manifestations from the masticatory muscles, which appeared after their functional overload. In order to compare the effectiveness of treatment, each of the clinical groups was divided into 2 subgroups, test and control. Results. The findings obtained demonstrated the normalization of bioelectric activity indicators after the treatment, both in the control group and in the test group (p<0.05). For patients of clinical group 1, the level of the bioelectrical activity after the treatment in the test group was statistically significantly (p=0.0049) lower than in the control group. The same was observed for the patients from 2 clinical groups (p<0.001) Conclusions. The scheme of the proposed algorithm for the fixation of orthodontic appliances and measures aimed at normalizing the work of masticatory muscles significantly improves the indicators of functional research methods, in particular, the indicators of bioelectric activity during electromyography in patients of all study groups.