IMPACT OF MALOCCLUSIONS ONTO TONGUE MOTION IN PATIENTS WITH NEUROLOGICAL IMPAIRMENTS
Abstract. Polyetiology of the tongue movement disorders are widely demonstrated in various scientific publications. At the same time the cause of such disorders is often falls within the competence of multiple medical specialties, i.e., rheumatologists, oncologists, endocrinologists, traumatologists, dentists, etc. Data concerning to neurological etiological factors are limited. Mobile component of the pathology has not been fully elucidated. Currently, the tongue movement disorders remain unstudied and issues of its diagnosis and therapy have not been fully demonstrated in scientific publications. The aim of the study is to define the degree of impact of malocclusions onto tongue movement disorders.
The objective of the research. The objective of the research is to define the degree of the influence of occlusal disturbances on the mobility of the tongue.
The task of the research.
- To define the prevalence of occlusive disorders for patients with evidence of tongue motility pathology.
- To define and classify the occlusive disorders that cause lingual mobile anomalies.
The subject of the research. The subject of the research is tongue motility disorders of patients who consulted the prosthodontist with the aim of receiving prostheses.
The object of the research was the correlation of occlusive disorders in the form of dentition defects and tongue motility defects.
The clinical group included 50 patients who had evidence of lingual mobility disorders and occlusal defects, who consulted the Department of Prosthodontics and Implantology of the HSEE of Ukraine "UMSA".
The average age of the patients was 51 years.
The control group included 50 persons, who had no occlusal and somatic disorders. The average age was 21 years.
The results of the research. The results of the clinical observations of the patients who sought dental help from the Department of Prosthodontics and Implantology of the HSEE of Ukraine "UMSA" indicated, that tongue motility disorders can be caused by a variety of occlusal factors.
We have isolated five main groups of occlusive disorders, occurring in patients with impaired tongue motility:
- Carious destruction of teeth crowns, causing the appearance of sharp edges of the enamel, as well as poor therapeutic treatment of these disorders.
- Loss of teeth caused by chronic inflammatory and degenerative processes in periodontal tissue and rarely - by trauma of the coronal part of a tooth.
- Pathological dental abrasion.
- Breakage of the coronal part of teeth caused by non-carious lesions.
- Orthopedic structures that do not meet the clinical and laboratory requirements.
Discussion of the results.
The obtained results demonstrate following, the most common symptom of tongue motility disorders in patients with occlusive pathology is dysarthria - sounds pronunciation disorder (84%). Less frequently we detected dysphonia
- voice sonority disorder (42%) and dysphagia - swallowing difficulties (36%). Relatively rarely we have met symptoms of bradylalia - pronunciation lethargy (20%). The data above reveals that patients with occlusive pathology often have a combination of multiple symptoms of tongue motility disorder.
From the distinguished occlusal disorders, which are the factors of tongue motility disorders, orthopedic structures, which do not meet the clinical and laboratory requirements, proved to be the most widely spread (44%), which we suppose is due to the specifics of doctors` treatment process and the patients` age (mean age - 51 years).
At the same time, a relatively common factor of tongue motility pathology has been identified as carious lesions of teeth which led to appearance of sharp edges of enamel and their poor therapeutic treatment (30%). Less frequently we observed pathological dental abrasions, teeth loss and non-carious lesions of dentin and enamel (24%). The data above show that in this group a combination of several factors of occlusive pathology, that disrupt tongue motility, has not been observed.
Conclusions. The data above make it possible to conclude that the overwhelming majority of subjects were diagnosed with symptoms of tongue motility, among which pronunciation disorder is the most frequent (84%). A combination of tongue motility disorder symptoms is typical in subjects. Occlusal pathology in the subjects is very diverse and therefore needed splitting into groups, the most frequent occlusal factors of tongue motility disorder are low-quality or- thopedic structures, low quality of therapeutic treatment and lack of proper dental treatment.
2. Цыганок А. В. Диагностика нарушений моторики языка у пациентов с неврологической патологией различной этиологии / А. В. Цыганок, В. М. Новиков // Український медичний альманах. – 2014. – №2. – С. 61–63.
3. Post-stroke dysphagia in chronic stage treated with magnetic-ball sticking therapy at the auricular points: a randomized controlled trial / H. P. Jin, Q. Y. Wu, W. Zhang [еt аl.] // Zhongguo Zhen Jiu. – 2014. – №34. – С. 9–14.
4.Outcomes of tongue-pressure strength and accuracy training for dysphagia following acquired brain injury / C. M. Steele, G. L. Bailey, R. E. Polacco [еt аl.] // Int. J. Speech. Lang. Pathol. – 2013. – №15. – С. 492–502.
5. Elhammady M. S. Surgical management of adult intrinsic brainstem tumors / M. S. Elhammady // C.Neurosurgery. – 2013. – №60. – С. 131–138.
6. Ryan P. Acute tongue swelling, the only initial manifestation of carotid artery dissection: a case report with differentiation of clinical picture / P. Ryan, S. Rehman, S. Prince // Ann. Vasc. Surg. – 2015. – №29. – С. 17–18.
7. Delil S. Re-emergent Tongue Tremor as the Presenting Symptom of Parkinson's Disease / S. Delil, F. Bolukbas?, N. Yeni // K?z?ltan G.Balkan Med. J. – 2015. – №32. – С. 127–128.
8. Oral motor movements and swallowing in patients with myotonic dystrophy type 1 / B. Ercolin, F. C. Sassi, L. D. Mangilli [еt аl.] // Dysphagia. – 2013. – №28. – С. 446–454.
9. Myotonia-like symptoms in a patient with spinal and bulbar muscular atrophy / K. Araki, H. Nakanishi, T. Nakamura [еt аl.] // Neuromuscul Disord. – 2015. – №25. – С. 913–915.
10. Мультидисциплинарная концепция в диагностике и лечении больных с заболеваниями слизистой оболочки полости рта / П. Н. Скрипников, Т. П. Скрипникова, Л. Я. Богашова [и др.] // Український стоматологічний альманах. – 2012. – №5. – С. 16- 20.
11. Дичко Є. Н. Больовий та парестетичний феномен слизової оболонки порожнини рота / Є. Н. Дичко, А. В. Вербицька, С. О. Карнаух // Медичні перспективи. – 2013. – №1. – С. 20-24.