DISTAL OCCLUSION AND DENTAL CROWDING: TREATMENT STRATEGY

  • L.V. Smagliuk Ukrainian Medical Stomatological Academy (Poltava)
  • M.I. Dmytrenko Ukrainian Medical Stomatological Academy (Poltava)
Keywords: distal occlusion, dental crowding, orthodontic treatment.

Abstract

Dental anomalies are the leading ones among dental diseases in the period of mixed (79,96%) and permanent (84,33%) dentition. According to the results of our studies, frequency of distal occlusion (up to 40%) and dental crowding (up to 65%) are the largest in structure of orthodontic pathology.

The aim of the study is to analyze and summarize knowledge about ways of enhancement of treatment and prophylaxis efficiency in patients with distal occlusion and dental crowding.

Genetic predisposition, early childhood diseases (including upper respiratory tract infections), children's bad habits, pathological state of teeth (adentia, impaction, micro-, macrodentia), micro-, macrognathia, functional disorders of maxillofacial area contribute a high percentage in structure of "risk factors" which lead to formation of distal occlusion with dental crowding. For each particular patient distal occlusion, complicated by dental crowding, is formed under the influence of combination of several "risk factors", where the first place belongs to disturbances of dental area: breathing, closing of lips, swallowing, chewing, speech.

Today it is well known that the first step in correction of distal occlusion of dentitions is to evaluate the patient's potential growth. Treatment in the period of mixed dentition is important with relation to protection of palate from trauma by mandibular incisors with a large sagittal gap, prophylaxis of dysfunction of temporomandibular joint, psychological rehabilitation of children during speech formation, as well as to improve the prognosis of treatment in older age. The best period of treatment is a peak of growth and development. Growth is the most important factor in planning treatment of distal occlusion, since dramatic changes in correction are related to growth rather than teeth movement. Orthodontists forbear from recommendations for teeth extraction in growing patients, as they believe that it leads to worsening of face profile and does not allow to achieve optimal relationships of jaw and occlusion.

In adult patients, complete conservative correction of distal occlusion is possible only in the absence of skeletal disorders. Combined method, namely combination of orthodontic treatment and orthognathic surgery, is an alternative for adults treatment.

Adequate individual approach to orthodontic treatment in patients with distal occlusion complicated by dental crowding is based on a comprehensive clinical examination, scientific analysis and results interpretation of additional examination methods. Full functional occlusion is possible if all elements of dentition: occlusion, periodontal tissues, temporomandibular joints, muscles and nervous system, are considered. Stable results and positive prognosis are provided by normalization of physiological state of masticatory and mimic muscles.

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References

1. Smaglyuk LV, Kulish NV. Analiz rezultatov lecheniya patsientov s patologiey prikusa II 1 v zavisimosti ot vozrasta i taktiki lecheniya (s udaleniem ili bez udaleniya pervyih premolyarov na verhney chelyusti. Covremennaya ortodontiya. 2011; 3: 25-28. (Russian).
2. Dmytrenko MI, Nesterenko ON. Results of follow-up study of occlusion state in Ukrainian schoolchildren. J of Stomatology (Poland). 2016; 6(69): 725-728.
3. Kutsevlyak VI, Starikova SL. Vliyanie sostoyaniya oporno-dvigatelnogo apparata na formirovanie distalnogo prikusa. Novitni tekhnolohii v ortodontii : zb. nauk. pr. Pershoho ukrainskoho ortodontychnoho konhressa (Kyiv). 2013: 56–58. (Russian).
4. Sharma R, Muralidharan CG, Verma M, Pannu S, Patrikar S. MRI Changes in the temporomandibular joint after mandibular advancement. J Oral Maxillofac. 2020;7: S0278-2391(20)30001-X. doi: 10.1016/j.joms.2019.12.028.
5. Smahliuk LV, Salakh Abduzhalil Elburav Mezio-dystalni parametry rozmiriv zubiv patsiientiv iz riznymy formamy dystalnoi okliuzii. Suchasna ortodontiia – shliakh profesiinoho rozvytku: materialy nauk.-prakt. konf. z mizhnarodnoiu uchastiu (Kyiv). 2012: 150-153. (Ukrainian).
6. Smahliuk LV. Stratehiia i taktyka pidhotovky patsiientiv iz dystalnoiu okliuziieiu zubnykh riadiv vikom starshe 18 rokiv do aktyvnoho ortodontychnoho likuvannia breket-tekhnikoiu. Problemy ekolohii ta medytsyny. 2011;T. 15, № 3-4 (dodatok 1): 144-145. (Ukrainian).
7. Drohomyretska MS, Hrechnova YuV. Osoblyvosti rezultativ elektromio-hrafichnoho obstezhennia patsiientiv z dystalnoiu okliuziieiu zubnykh riadiv u zminnomu prykusi. Suchasna ortodontiia – shliakh profesiinoho rozvytku: materialy nauk.-prakt. konferentsii z mizhnar. uchastiu ( Kyiv). 2012: 52–55. (Ukrainian).
8. Dmytrenko MI. Analysis of electromyographic indexes of temporal and masticatory muscles in patients with distal occlusion complicated by dental crowding.Wiadomości Lekarskie. 2018; tom LXXI, nr 2 cz II: 295-298.
9. Smahliuk LV, Lei Zhun, Sydorenko AIu. Elektromiohrafichna kharakterystyka kolovoho miazu rota u patsiientiv 6-9 rokiv iz dystalnoiu okliuziieiu zubnykh riadiv. Visnyk problem biolohii i medytsyny. 2014; Vyp. 3, T. 2 (111): 384-388. (Ukrainian).
10. Polma LV, Markova MV, Oboro-tistov NYu. Distalnaya okklyuziya zubnyih ryadov: odno- ili dvuhetapnoe lechenie? Ortodontiya. 2013; 2: 14–24.
11. Smaglyuk L, Sheshukov D, Bilous A. Constitutional and typological features of body structure in patients with malocclusion. Abstract 90th Congress of the European Orthodontic Society, Warsaw, Poland – 18-22 june 2014: SP 352. http://eos2014.com/abstracts/?showabs =1&id=914.
12. Rocha AD, Casteluci CEVF, Ferreira FPC, Conti AC, Almeida MR, Almeida-Pedrin RR. Esthetic perception of facial profile changes after extraction and nonextraction Class II treatment. Braz Oral Res. 2020; 31;34:e003. doi: 10.1590/1807-3107bor-2020.vol34.0003.
13. Mezomo MB, Guerino P, Matje PRB, De Lima EMS Uprighting Severely Impacted Lower Second Molars Prior to Class II Correction with Upper Second-Molar Extractions. J Clin Orthod. 2019;53(9):539-549.
14. Antonarakis GS, Kiliaridis S. Predictive value of masseter muscle thickness and bite force on Class II functional appliance treatment: a prospective controlled study. Eur. J. Orthod. 2015; 37(6): 570-577.
15. Franchi L., Pavoni C., Faltin K. Jr, McNamara JAJr, Cozza P. Long-term skeletal and dental effects and treatment timing for functional appliances in Class II malocclusion.Angle Orthod. 2013; 83(2): 334-340.
16. Dmytrenko MI, Pysarenko EA. Analiz effektivnosti ortodonticheskogo lecheniya detey so skuchennostyu zubov. Wiadomości Lekarskie. 2016; Tom. 69 (2): 252-257. (Russian).
17. Ajami S, Morovvat A, Khademi B, Jafarpour D, Babanouri N. Dentoskeletal effects of class II malocclusion treatment with the modified Twin Block appliance. J Clin Exp Dent. 2019:1; 11(12):e1093-e1098. doi: 10.4317/jced.56241.
18. Al-Khateeb SN., Abu Alhaija ES., Majzoub S. Occlusal bite force change after orthodontic treatment with Andresen functional appliance.Eur. J Orthod. 2015; 37(2): 142-146.
19. Greco M., Fichera G, Caltabiano M, Barbato E, Leonardi R. Short-term effects of the activator in skeletal class II division 1 patients with different vertical skeletal pattern. A retrospective study. Minerva Stomatol.2010; 59(3): 61-74.
20. Nucera R, Lo Giudice A, Rustico L, Matarese G, Papadopoulos MA, Cordasco G. Effectiveness of orthodontic treatment with functional appliances on maxillary growth in the short term: A systematic review and meta-analysis. Am. J Orthod. Dentofacial. Orthop. 2016; 149(5): 600-611.
21. Zhang CX, Shen G, Ning YJ, Liu H, Zhao Y, Liu DX. Effects of Twin-block vs sagittal-guidance Twin-block appliance on alveolar bone around mandibular incisors in growing patients with Class II Division 1 malocclusion. Am J Orthod Dentofacial Orthop. 2020; 157(3):329-339. doi: 10.1016/j.ajodo.2019.04.029.
22. Bock NC, Killat S, Ruf S. Class II:2 malocclusion-prevalence and progression of labial gingival recessions during Herbst-Multibracket appliance treatment. Clin Oral Investig. 2020; 27. doi: 10.1007/s00784-020-03243-2.
23. Pinelli Henriques Fontes F, Bastiani C, Bellini-Pereira SA, Aliaga-Del Castillo A, Castanha Henriques JF, Janson G. Dentoskeletal and soft-tissue changes comparison between the Jasper Jumper and Twin Force Bite Corrector in Class II malocclusion patients: A retrospective study. Int Orthod. 2020; 13. pii: S1761-7227(20)30006-1. doi: 10.1016/j.ortho.2020.01.005.
24. Solomonyuk MM. Distalizatsiya verhnih bokovih zubov u vzroslyih patsientov s distalnoy okklyuziey zubnyih ryadov s primeneniem mikroimplantov. Ortodontiya. 2013; 4: 52–58.
25. Quinzi V, Marchetti E, Guerriero L, Bosco F, Marzo G, Mummolo S. Dentoskeletal Class II Malocclusion: Maxillary Molar Distalization with No-Compliance Fixed Orthodontic Equipment. Dent J (Basel). 2020; 18;8(1). pii: E26. doi: 10.3390/dj8010026.
26. Manni A, Cerruto C, Cozzani M. Herbst Appliance Supported by Four Miniscrews. J Clin Orthod. 2019;53(12):737-744.
27. Bechtold TE, Park YC, Kim KH, Jung H, Kang JY, Choi YJ. Long-term stability of miniscrew anchored maxillary molar distalization in Class II treatment. Angle Orthod. 2020;20. doi: 10.2319/051619-335.1.
28. Gulduren K, Tumer H, Oz U. Effects of micro-osteoperforations on intraoral miniscrew anchored maxillary molar distalization: A randomized clinical trial. J Orofac Orthop. 2020; 81(2):126-141. doi: 10.1007/s00056-019-00207-4.
29. Keim RG. Camouflage or Surgery? J Clin Orthod. 2017; 51(4):195-196.
30. Kuroiedova VD, Dmytrenko MI. Sposib ortodontychnoho likuvannia skupchenosti frontalnykh zubiv u postiinomu prykusi. Reiestr haluzevykh novovveden Ukrainy. 2010;Vyp. 32-33, № 313/33/010: 173-174. (Ukrainian).
31. Smahliuk LV, Solovei KO, Liakhovska AV. EMH-aktyvnist zhuvalnykh miaziv u patsiientiv na pochatku stadii retentsii Bukovynskyi medychnyi visnyk. 2017; T. 21, 3 (83): 91-97. (Ukrainian).
Published
2020-06-26
How to Cite
Smagliuk, L., & Dmytrenko, M. (2020). DISTAL OCCLUSION AND DENTAL CROWDING: TREATMENT STRATEGY. Ukrainian Dental Almanac, (2), 103-108. https://doi.org/10.31718/2409-0255.2.2020.16
Section
ORTHODONTICS