Wyniki analizy cefalometrycznej w ocenie dynamiki leczenia chorych z zaburzeniami zgryzu w płaszczyźnie poprzecznej

Anzhelika V. Yakymets1, Myroslava S. Drohomyretska1, Olena M. Doroshenko1, Sergii M. Hermanchuk1,
Maryna K. Bilous1, Olga A. Omelianenko1, Volodymyr I. Struk2

1SHUPYK NATIONAL MEDICAL ACADEMY OF POSTGRADUATE EDUCATION, KYIV, UKRAINE

2PUBLIC MEDICAL ESTABLISHMENT “MUNICIPAL STOMATOLOGICAL POLYCLINIC”, CHERNIVTSI, UKRAINE

 

ABSTRACT

Introduction: This article discusses the problems of the current issue of modern orthodontics aimed at increasing the effectiveness of diagnosis and treatment of transversal anomalies of occlusion in patients in periods of alternating and permanent bites by using standard orthodontic equipment in combination with orthopedic treatment by physical rehabilitation methods. In this work, the features of cephalometric indices in patients with transversal anomalies of occlusion have been studied, which make it possible to approach the choice of orthodontic treatment method in a comprehensive way.

The aim was to prove the efficiency of the combination of standard orthodontic equipment with orthopedic treatment by physical rehabilitation methods.

Materials and methods: In order to study the characteristics of cephalometric indices in 9-15 years old patients with transversal anomalies of occlusion and to determine the criteria for the treatment effectiveness. Depending on the method of treatment, the patients were further divided into 2 subgroups: A and B. The method of treatment of subgroup A consisted of orthodontic treatment, which was carried out simultaneously with osteopathic correction of postural muscle imbalance by physical rehabilitation methods. Patients of subgroup B were treated exclusively by orthodontic treatment. The analysis of teleradiograms in the frontal projection was carried out using Dolphin software.

Results: The effectiveness of the proposed regimens was carried out with the help of clinical and cephalometric indices which were studied before and after the orthodontic intervention. Clinical effectiveness of the performed orthodontic treatment was established in the absence of aesthetic disorders of facial features, normalisation and synchronisation of the sizes of the upper and lower dentition, physiological positioning of the mandible, restoration of nasal breathing, disappearance of difficulties while chewing.

Conclusions: When using proposed method (complex orthodontic treatment combined with physical rehabilitation methods) of orthodontic treatment, cephalometric analysis indices showed better dynamics, especially with unilateral cross-bite.

 

Wiad Lek 2018, 71, 7, -1213

 

Introduction

Despite the rapid development of orthodontics, the problem of quality of treatment of individuals with transversal anomalies of occlusion remains unresolved [1-3]. In this pathology, there is a discrepancy in occlusal contact between pairs of teeth-antagonists in the horizontal plane. It leads to a disorder in the functioning of dentition [4-6]. In recent years the connection between the position of the lower jaw, the state of the masticatory apparatus and the functioning of the organism as a whole have been studied. New methods for examining patients are being developed, and cooperation opportunities for specialists in different fields of medicine are expanding [7-11].

In this research, the complex method of treatment of transversal anomalies of occlusion was developed. The aim was to combine the use of standard orthodontic equipment with orthopedic treatment by physical rehabilitation methods. This allowed to significantly shorten the treatment period for patients and achieve full normalization of all clinical and functional indices immediately after the orthodontic treatment was completed.

In this work, the features of cephalometric indices in patients with transversal anomalies of occlusion have been studied, which make it possible to approach the choice of orthodontic treatment method in a comprehensive way.

A comparative assessment of the effectiveness of the use of the developed treatment methods with the conventional methods of treatment of transversal anomalies of occlusion is carried out.

 From the practical point of view, it is important to clinically confirm the necessity of introducing in the standard of medical care for patients with musculoskeletal disorders the obligatory consultation of an orthodontist in order to detect pathogenetic factors in the dento-facial system.

The Aim

To establish the diagnosis of transversal anomalies of the occlusion and to determine the effectiveness of the treatment performed, the need for a cephalometric study in a direct projection has been proved [12-15].

Materials and Methods

In order to study the characteristics of cephalometric indices in 9-15 years old patients with transversal anomalies of occlusion and to determine the criteria for the treatment effectiveness, 116 patients with transversal anomalies of occlusion aged 9 to 18 years underwent orthodontic treatment and were divided into 2 groups: I group included 236 people aged 9 to 12 years with a mixed dentition, and II group included 107 people aged 13 to 18 years with a permanent dentition. Depending on the method of treatment, the patients were further divided into 2 subgroups: A and B. The method of treatment of subgroup A consisted of orthodontic treatment, which was carried out simultaneously with osteopathic correction of postural muscle imbalance by physical rehabilitation methods. Patients of subgroup B were treated exclusively by orthodontic treatment. Standard devices with occlusal onlay were used as the orthodontic technique, and in II group they were combined with the use of fixed orthodontic appliances – the Roth system (bracket system Sprint 22 Forestadent slots).

The cephalometry of the study was conducted in a direct projection using Dolphin software. The study of lateral linear indices of the facial part of the skull was carried out with the obligatory observance of the symmetry of the location of the points on the left and on the right relatively to the anatomical landmarks.

The symmetry of the width of both sides of the upper jaw in relation to the median line was estimated by measuring the length of the perpendicular, lowered from the point J (intersection of the upper jaw and zygomatic buttress) to the MSR (mid-sagittal ridge) to the right and to the left (mm).

The symmetry indices of the width of the sides of the middle third of the face were determined according to the indices of Porion-MSR right (mm) and Porion-MSR left (mm).

The angular indices of the deviation of the lowest point of the mandibular symphysis (Me) relatively to the mid-sagittal ridge (MSR) was determined according to the index A-Me-MSR (º).

The symmetry of the width of both sides of the lower jaw in relation to the mid-sagittal ridge (MSR) was estimated on the basis of measurements of the length indices AG (antegonial notch, lateral-lower edge of the antegonion) – MSR (mm) to the right and GA-MSR (mm) to the left.

The deviation of the contact point of the upper U1 and lower L1 incisors from the mid-sagittal ridge (MSR) was determined by the Denture midline discrepancy (mm).

The inclination of the lower molars to the base of the lower jaw on the right (Lower molar 1 to Ag-Ag right) and on the left (Lower molar 1 to Ag-Ag left) was determined from the angle by the ratio of the points L6 (point on the buccal surface of the crown of the lower first molar) in relation to the body of the mandible Ag-ag.

The rotation index of the occlusal plane was estimated according to the angle of the ratio of the occlusal plane to the mid-sagittal ridge (<OcL / MSR (º)).

Results

The effectiveness of the proposed regimens was rpoven with the help of clinical and cephalometric indices which were studied before and after the orthodontic intervention.

Clinical effectiveness of the performed orthodontic treatment was established in the absence of aesthetic disorders of facial features, normalization and synchronization of the sizes of the upper and lower dentition, physiological positioning of the mandible, restoration of nasal breathing, disappearance of difficulties while chewing.

Using the proposed method in the first age group, transversal anomalies of occlusion were eliminated in 71.4% of individuals in a period from 6 to 9 months; only in 7.4% of patients with anomalies in the position of individual teeth or groups of teeth it was eliminated during the period up to 6 months; and more than 9 months needed 21.2% of patients, mainly with a unilateral crossbite.

At the same time, when using the standard method, 29.2% of patients ended treatment in a period from 6 to 9 months, and 70.8% of patients – from 9 to 12 months. The longest elimination of the anomaly of bite when using both methods is determined at a unilateral cross bite. Instead, treatment of anomalies in the position of individual teeth or groups of teeth was effective in 78.6% of individuals in the period from 6 to 9 months.

In II group, the term of the bite pathology elimination in most (57.4%) patients was from 6 to 9 months. The treatment was ended within 9 months when applying the proposed methodology with anomalies in the position of individual teeth or groups of teeth. The treatment that exceeded 9 months was observed mainly (28.6%) in people with a unilateral cross bite.

The effectiveness of treatment in II group according to the standard method is determined in 87.0% in the period from 9 to 12 months.

Upon completion of orthodontic treatment, regardless of the age group and the method applied, the indices of teleradiography came to normal in all patients. But it is necessary to point out that the normalization of the teleradiography indices coincided with the term of elimination of the bite pathology. The longest period of treatment was needed for patients aged 13-18 years with a unilateral cross bite when using the standard technique, while the shortest period was in 9-12 years old children with bilateral transversal pathology of occlusion and anomalies of individual teeth or groups of teeth. When applying the proposed methodology, the duration of treatment was significantly shorter in both I and II study groups.

As can be seen from Table I, before the start of the treatment, in children of the I group, significant deviations in teleradiography indices were identified: a significant disorder of the symmetry of the width of both sides of the upper jaw with left-sided and right-sided unilateral cross bite ( J to MSR 30.9 ± 2 mm and 26.9 ± 2 mm, respectively) and the width of the sides of the middle third of the face (in case of left sided – decrease of Porion-MSR left up to 52.1 ± 3 mm vs 56.1 ± 3 mm of control) (p≤0 , 05) with the constant value of Porion-MSR right; in case of right sided, on the contrary, there was a decrease of Porion-MSR right (51.4 ± 2 mm vs. 56.4 ± 2 mm of control) (p ≤ 0.05) with constant values of Porion-MSR left). Displacement of the lower jaw is detected in all children.

After the completion of the treatment with the proposed method, the symmetry of the width of the sides of the upper jaw and the middle third of the face corresponded to the control indices ( J to MSR 31.2 ± 3 mm and 30.6 ± 2 mm in accordance with the left and right sided unilateral cross bite) vs. 31.1 ± 3 mm of control indices (p≥0.05). There was also a complete normalization of the position of the lower jaw in all patients with both left-sided and right-sided unilateral cross bite (-0.9 ± 0.4º and + 1,2 ± 0,3 ° in accordance with the left sided and right sided unilateral cross bite vs. 0 ± 2º indices of the control subgroup (p≥0,05).

Also, with the use of complex treatment, we noted a complete absence of inclination of the lower molars to the base of the lower jaw in patients with both left sided and right sided unilateral cross bite and alignment of the occlusal plane (in case of right-side occlusion <OcL / MSR was + 1.1 ± 3º; in case of left sided occlusion – 1,2 ± 1,3º vs. the indices of the control – 0 ± 2º (р р≥0,05).

Thus, after completing the complex treatment of children of the first group with unilateral cross bite according to the proposed method, along with the normalization of the clinical picture, a complete normalization of all teleradiography indices was observed (Table I).

In patients with bilateral cross bite and anomalies of individual teeth or groups of teeth, the symmetrical width of the sides of the upper jaw and the sides of the middle third of the face was almost preserved before the start of the treatment, no displacement of the lower jaw was present, no changes were found after the end of the treatment.

Unlike children who were treated with complex treatment, using the standard method, the teleradiography indices showed a somewhat worse dynamics, especially with unilateral cross bite, but at the end of the treatment they also practically corresponded to indices of the control subgroup (Table II).

Worst of all, the teleradiography indices were normalized with unilateral cross bite, while with bilateral cross bite and anomalies of individual teeth or groups of teeth, teleradiography indices quickly returned to normal (Table II).

Similar results were observed in the patients of the II group of 13-18 years, but treatment of transversal anomalies of occlusion, by both the proposed and standard methods, was longer and more complicated according to the data of teleradiography indices. It should be noted that before the start of the treatment, they had worse results and differed significantly from both the indices of the control subgroup and the indices of I group (Table III, IV).

After the end of orthodontic treatment according to the proposed method, the indices of teleradiography came to the norm both in unilateral and bilateral cross bite and in the anomalies of the position of individual teeth or groups of teeth, despite a much more complicated picture before the treatment.

Similar characteristic was found with the use of the standard method of orthodontic treatment in patients of the second group, after the end of the treatment the teleradiography indices were almost normal in all patients (Table IV). However, it should be noted that the term of normalization of the teleradiography indices coincided with the term of orthodontic treatment. The longest period of orthodontic treatment was found in elderly patients of the second group with unilateral cross bite using the standard method, while the shortest period for elimination of transversal anomalies of occlusion was needed for the patients of the first age group with bilateral transversal pathology of occlusion and anomalies of individual teeth or groups of teeth. It should be emphasized that when using the proposed method, the duration of treatment was significantly shorter both in the I and the II study groups.

Discussion

The results of an examination of 1835 American children [16] of an average age 8.5 showed incidence of cross bite in 10%. The same prevalence was noted by E. Bratu [17] when examining 500 Romanian children 6-8 years old.

P.V. Ishmurzin [18] during the examination of 53 patients with transversal anomalies of occlusion in 15 patients (28.3%) determined the discrepancy between the median line between antagonist incisors, and in 45 (84.9%) disorder of dental occlusion in the transversal direction in the lateral sections.

The cause of multiple anomalies of occlusion, including cross bite, is a hereditary factor. E.F. Harris, R.J. Smith [19] found that in 60% of patients the size and shape of dentitions and, as a consequence, the type of occlusion are due to the genetic factor.

W. Schmid, F. Mongini, A. Felisio [20] observed a group of patients with gnathic forms of asymmetry without genetic or congenital factors in the etiology, traumas, tumors and infections in the anamnesis and concluded that the reason for the asymmetry was the change in the position of the mandible in lateral direction through occlusal contacts. If these patients remain untreated, changes can progress.

J. Skolnick et al. [21], when examining patients with the cross bite, identified the relationship between the radiographic indices of asymmetry of the mandible and the prepubertal trauma of the maxillofacial area in the anamnesis. Also, the authors believe that the asymmetry of the maxillofacial area is formed under the influence of genetic and muscular-functional factors.

B. Gaard et al. [22], during the examination of 3 years old Norwegian and Swedish children, determined that sucking a finger increases the likelihood of cross bite, but the leading etiological factor was sucking the nipple, which within 2 years leads to a significant narrowing of the upper dentition. Sucking nipples for 3 years significantly enlarges the lower dentition, causing cross bite in the lateral sections.

K. Lopatiene et al. [23], Antonino Marco Cucciaa; Maurizio Lottib Domenico Caradonnac studied the etiological role of nasal respiratory disorder in the pathogenesis of dento-facial anomalies and noted that 71.43% of patients with cross bite had nasal breathing disorder. However, R.D. Sheats, J. Rebellato [24], when comparing children with physiological and cross bite, noted that nasal breathing disorder occurred in both groups – in 29% of patients with cross bite and in 25% with physiological one.

A fairly common cause of transversal anomalies of occlusion in the anterior and lateral sections is the trauma of the maxillofacial area.

Teleradiography is one of the integral parts of the diagnosis of maxillofacial anomalies in orthodontics. One of the first studies was conducted by A. Schueller in 1905[25] and later, in 1949, by V. Merrill[26]. They described the diagnosis of anomalies according to the data of the head teleradiograms in the basilar projection. In 1964[27], N. Berger’s works on the study of teleradiograms were published not only in the basilar, but also in the lateral and frontal projections. The studies were conducted according to the Frankfurt plane. Subsequently, a large number of analyzes of teleradiogram were available, in which new landmarks, planes and indices were offered.

Back in 1990, only 13.3% of practicing orthodontists in the US used the frontal projection of the teleradiogram (Gottlieb E.L., Nelson A.N., Vogels D.S., [28]). The frontal projection of teleradiogram is irreplaceable in the case of three-dimensional head analysis, diagnosis and differential diagnosis of transversal anomalies of occlusion.

One of the founders of the description of the head teleradiogram in direct projection was R.M. Ricketts [29], who not only offered to use his own method of teleradiogram analyses, but also calculated the average values of the norm.

W. Schmid, F. Mongini, A. Felisio [20] used teleradiogram in the frontal projection to diagnose gnathic forms of asymmetry. As a mid-sagittal ridge, the line between the apex of the crista galli and the point of intersection of the bottom of the anterior cranial fossa and the ethmoid bone was used. The construction was made using a computer program.

W. Schmid, F. Mongini, A. Felisio [20] deciphered the frontal teleradiography using computer programs. Points were used: menton, gonion or antegonion, articular, the point of the frontal-zygomatic suture, the point of intersection of the perpendicular of the plate of the ethmoid bone with the bottom of the anterior cranial fossa and anterior nasal spine. The authors considered three sites which were constructed using the indicated points (mandibular, upper cranial and cranio-mandibular). The vertical axis went through the top of the crista galli and the point of intersection of the bottom of the anterior cranial fossa and the ethmoid bone.

S.F. Snodell, R.S. Nanda, G.F. Currier [30] used computer analysis of frontal teleradiography to analyze vertical and lateral growth. The transversal group of indices included the width of the face in the region of the extreme points of the skull, zygomatic arches, upper jaw, nose, lower jaw, and also the intermolar sizes of the upper and lower dentitions. Vertical indices were defined as the general, upper and lower height of the face, the height of the mandibular branches to the right and to the left. The authors suggest using a horizontal line drawn through the points at the intersection of the small wing of the sphenoid bone with the medial edge of the orbit to determine the location of the mid-sagittal plane.

J. Skolnick, B. Iranpour, P-L. Westesson, S. Adair [21], analyzing the frontal teleradiography of the head, used the mid-sagittal ridge between the crista galli and the anterior nasal spine. Symmetry of the lower jaw was determined by the symmetry of the tangents to the edge of the lower jaw on the right and on the left. The difference in size more than 3.0 mm was interpreted as an asymmetry.

V. Trpkova, P. Major, B. Nebbe [31] in the study of the interrelationships between changes in cranio-facial structures and temporo-mandibular joints used the method of analysis of frontal teleradiography, offered by P.W. Major in 1994. The tangent to the upper edges of the orbits was used as a horizontal reference line. The vertical line was drawn as a perpendicular to the horizontal line through the middle of the segment between the points of intersection of the edges of the orbits and the protruding wing of the sphenoid bone. The deviations were determined according to the size of the perpendiculars from the bone points to the horizontal and vertical reference planes.

O.G. da Silva Filho, L.A. Montes, L.F. Torelly [32] controlled the process of rapid palatal enlargement of the frontal projection of the teleradiography. The width of the skull, face and dentition, including increasing distance between the central incisors were studied.

B. Ingervall, P. Gollner, U. Gebauer, K. Fröhlich [33] in order to control the position of molars in the treatment of cross bite by Goshgarian apparatus determined their inclination on the frontal teleradiography in relation to the line of intersection of the contour of the skull base (oblique orbital line) and the lateral contour of orbits from both sides.

S.N. Larionov [34] in the analysis of transversal anomalies of occlusion studied the degree of rotation of horizontal planes on the teleradiography in direct projection.

S.E. Bishara [35] identifies in an X-ray study of the asymmetry of teleradiography in a direct projection: they are reliable at equal distances from the radiator to the right and left sides, which makes it easy to compare the sides and determine the localization of the mid-sagittal ridge; radiograph can be made both with the closed mouth and with open, which allows to diagnose functional displacement of the mandible. Teleradiography in a direct projection is obtained with the help of: conventional radiograph, tomogram, computed tomogram, arthroscopy, video fluoroscopy, magnetic resonance tomography and radionuclide research.

M. Delamaire and D. Rollet [36] for the diagnosis of maxillofacial anomalies in the transverse direction used the frontal projection of teleradiography and its analysis according to C.F. Gugino.

Conclusions

In the first age group, transversal anomalies of occlusion were eliminated using the proposed method (complex orthodontic treatment combined with physical rehabilitation methods), mainly in the period from 6 to 9 months (71.4%), up to 6 months – only in 7.4% of children with anomalies in the position of individual teeth or groups of teeth, and more than 9 months – in 21.2%, mainly with unilateral cross bite. The use of the standard method has shown that 29.2% of patients completed treatment within 6 to 9 months, and 70.8% of patients in the period from 9 to 12 months. The longest elimination of an anomaly of occlusion when using both methods is defined at a unilateral cross bite. Instead, with anomalies in the position of individual teeth or groups of teeth was effective in 78.6% of individuals in the period from 6 to 9 months. In the II group, in most (57.4%) patients, the term for the elimination of bite pathology was in the period from 6 to 9 months. When using the proposed method in case of anomalies in the position of individual teeth or groups of teeth, treatment was ended within 9 months. Treatment that exceeded 9 months was observed mainly in (28.6%) patients with a unilateral cross bite. The effectiveness of the treatment in the II group according to the standard method was estimated in 87.0% of patient in the period from 9 to 12 months.

When using the standard method of orthodontic treatment, teleradiography indices showed somewhat worse dynamics, especially with unilateral cross bite, but after the end of treatment they also practically corresponded to the indices of the control subgroup. In the II group, the trends were similar, but the treatment of anomalies of occlusion, both according to the proposed and standard methods, was longer and more complicated according to the data of the teleradiography indices.

Thus, despite the age group and the method of orthodontic treatment after the end of the treatment, cephalometric indices in all patients almost matched the indices of healthy children of the corresponding age.

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27. Delameire M, Rollet D. Zero Base orthodontic philosophy. Lecture, Moscow. 2003; 15p.

 

Topic of the research: «Development and testing of basic methods of diagnostics, treatment and prevention of tooth-jaw anomalies». Beginning 01.2016 Finishing 12.2020.

National Medical Academy named after P.L. Shupik Institute of Dentistry, Health Ministry of Ukraine, universal decimal classification [616.314+616.716.1/.4]-007-07-08

Authors’ contributions:

According to the order of the Authorship

Conflict of interest:

The Authors declare no conflict of interest

CORRESPONDING AUTHOR

AnjelikaYakymets

Mezhigirska str. 26/24, flat 26, Kyiv, Ukraine

tel: +380501321999

e-mail: anjelika.yakymets@gmail.com

Received: 13.07.2018

Accepted: 28.09.2018

Table I. The results of the study of telerentgenography indices after the treatment of patients of I group according to the proposed method of treatment

Index

Control group

(n=15)

Unilateral croossbite (n=45)

Bilateral crossbite

(n=20)

Anomalies of occlusion of individual teeth or groups of teeth (n=16)

Right sided

Left sided

Before the treatment

After the treatment

Before the treatment

After the treatment

Before the treatment

After the treatment

Before the treatment

After the treatment

J to MSR

right (mm)

31,1±٣

26,6±2*

30,6±2 “

30,9±2

31,2±3 “

27,9±3

29,8±3

29,6±2

31,2±2

J to MSR

left (mm)

31,1±3

30,8±3

30,9±2

26,9±2*

31,1±2 “

30,0±2

31,2±2

30,7±1

31,0±1

Porion-MSR right (mm)

56,1±3

51,4±2*

56,2±3 “

56±2

56,2±3

51,2±2*

56,2±2 “

56,0±3

56,1±2

Porion-MSR left (mm)

56,1±3

55,9±2

56,3±2

52,1±3*

55,4±2

52,7±3*

56,1±3 “

57,2±2

57,2±2

A-Me-MSR (º)

0±2

+3,6±0,5*

+1,2±0,3 “

-4±0,9*

-0,9±0,4 “

1,6±0,2*

1,4±1

2,0±3*

1,8±0,7

AG-MSR (mm)

39,8±3

36,9±3*

38,9±3

42,1±2*

42,0±2

36,9±1*

39,1±3 “

40,1±2

40,1±2

GA-MSR (mm)

39,8±3

42,3±2*

42,2±3

35,5±2*

41,7±3 “

37,2±2*

39,2±2 “

39,8±1,5

39,9±2

Denture midline discrepancy (mm)

0±1,5

+2,4±1,3*

+0,1±3 “

-2,2±1*

-1,1±3 “

0±2*

0±2

2,2±2*

1,5±2 “

Lower molar 1 to Ag-Ag right(mm)

12,3±2

7,0±2*

12,1±3 “

10,8±1*

12,0±3 “

9,1±2*

11,5±2 “

10,9±1*

12,0±3 “

Lower molar 1 to Ag-Ag Left(mm)

12,1±2

9,9±2*

12,3±2 “

6,3±2*

11,7±3 “

9,0±3*

11,8±3 “

10,6±1*

11,7±2 “

<OcL/MSR (º)

0 ±2

+2,4±1,3*

+1,1±3 “

-2,3±1*

-1,2±1,3 “

0±2

0±2

1,7±1,2

0,1±2

Note: * – p ≤ 0.05 is the reliability of the differences compared to the control subgroup

” – ≤ 0,05 is reliability of differences compared to the results before the treatment

Тable II. The results of the study of telerentgenography indices after the treatment of patients of I group according to the standard method of treatment

Index

Control group

(n=15)

Unilateral crossbite (n=45)

Bilateral crossbite

(n=20)

Anomalies of occlusion of individual teeth or groups of teeth

(n=16)

Right sided

Left sided

Before the treatment

After the treatment

Before the treatment

After the treatment

Before the treatment

After the treatment

Before the treatment

After the treatment

J to MSR

right (mm)

31,1±٣

26,6±2*

28,8±2

30,9±2

31,0±1

27,9±3

30,4±2″

29,6±2

30,7±2

J to MSR

left (mm)

31,1±3

30,8±3

31,1±1

26,9±2*

30,8±2″

30,0±2

30,2±1

30,7±1

30,8±2

Porion-MSR

right (mm)

56,1±3

51,4±2*

54,1±2

56±2

56,1±2

51,2±2*

54,3±2 “

56,0±3

56,0±3

Porion-MSR

left (mm)

56,1±3

55,9±2

56,2±2

52,1±3*

57,1±2″

52,7±3*

53,8±2

57,2±2

57,2±2

A-Me-MSR (º)

0±2

+3,6±0,5*

+2,1±1

-4±0,9*

-2,2±1,3 “

1,6±0,2*

1,4±1

2,0±3*

-1,9±0,7

AG-MSR (mm)

39,8±3

36,9±3*

37,9±2

42,1±2*

42,1±3

36,9±1*

37,5±2

40,1±2

40,1±2

GA-MSR (mm)

39,8±3

42,3±2*

42,5±1

35,5±2*

37,9±1″

37,2±2*

38,1±2

39,8±1,5

39,8±2

Denture midline discrepancy (mm)

0±1,5

+2,4±1,3*

+2,0±0,7

-2,2±1*

-1,6±1

0±2*

0±2

2,2±2*

1,5±2

Lower molar 1 to Ag-Ag Right mm)

12,3±2

7,0±2*

11,4±2″

10,8±1*

11,6±1″

9,1±2*

11,4±1″

10,9±1*

11,7±1

Lower molar 1 to Ag-Ag

Left (mm)

12,1±2

9,9±2*

11,9±1″

6,3±2*

11,7±1″

9,0±3*

12,0±1″

10,6±1*

11,2±2

<OcL/MSR

(º)

0 ±2

+2,4±1,3*

+1,9±1″

-2,3±1*

-2,1±1

0±2

0±2

1,7±1,2

-1,5±1

Note: * – p ≤ 0,05 is the reliability of the differences compared to the control subgroup

” – ≤ 0,05 is reliability of differences compared to the results before the treatment

Тable III. The results of the study of telerentgenography indices after the treatment of patients
of II group according to the proposed method of treatment

Index

Control group

(n=15)

Unilateral crossbite (n=28)

Bilateral crossbite

(n=14)

Anomalies of occlusion of individual teeth or groups of teeth (n=19)

Right sided

Left sided

Before the treatment

After the treatment

Before the treatment

After the treatment

Before the treatment

After the treatment

Before the treatment

After the treatment

J to MSR

right (mm)

33,1±٢

26,9±3*

33,1±1 “

31,3±3

31,2±2

30,3±2*

32,4±1 “

30,3±3*

31,9±3 “

J to MSR

left (mm)

32,9±3

32,8 ±2

33,0±2

27,0±2*

32,8±1 “

30,2±3

32,7±1

32,0±2

32,3±2

Porion-MSR right (mm)

59,3±2

53,8±3*

58,9±2 “

59,0±2

59,1±1

55,2±2*

58,4±2 “

58,3±2

58,9±1

Porion-MSR left (mm)

59,4±3

58,2±2

59,1±1

54,5±2*

58,7±2 “

55,4±3*

58,6±2 “

57,6±2

58,7±2

A-Me-MSR (º)

0±2

+3±0,9*

+1,5±1 “

-4±1,2*

-2,0±0,7 “

1,2±0,7

1,0±1

2,0±1,0*

1,7±0,5 “

AG-MSR

(mm)

40,7±2

47,5±3*

40,8±3 “

36,0±2*

40,5±3

39,9±2

40,6±2

41,3±3

41,4±3

GA-MSR

(mm)

40,6±3

35,7±2*

40,2±2 “

47,8±3*

41,3±3 “

40,2±2

40,7±2

40,8±2

40,7±2

Denture midline discrepancy

(mm)

0±1,5

+2,9 ±0,2*

+1,1±0,4 “

-2,6±0,3*

-1,2±0,6 “

0,5±0,3

0±1

2,6±0,5*

1,2±0,3 “

Lower molar 1 to Ag-Ag right (mm)

15,3±2

10,9±1*

14,7±2 “

15,3±1

15,5±2

12,2±2*

15,1±2 “

13,2±3

14,8±1,5

Lower molar 1 to Ag-Ag Left (mm)

15,1±3

14,8±1

15,4±2 “

10,6±2*

14,8±3 “

10,8±2*

15,2±3 “

13,6±2

14,6±2

<OcL/MSR

(º)

0 ±2

+4,2±2*

+2±1 “

-3,7±2*

-1,8±1 “

1±1,5*

0±1 “

2,2±1,7*

0±1,4 “

Note: * – p ≤ 0,05 is the reliability of the differences compared to the control subgroup

” – ≤ 0,05 is reliability of differences compared to the results before the treatment

Тable IV. The results of the study of telerentgenography indices after the treatment of patients
of II group according to the standard method of treatment

Index

Control group

(n=15)

Bilateral crossbite (n=16)

Bilateral crossbite

(n=13)

Anomalies of occlusion of individual teeth or groups of teeth (n=17)

Right sided

Left sided

Before the treatment

After the treatment

Before the treatment

After the treatment

Before the treatment

After the treatment

Before the treatment

After the treatment

J to MSR right (mm)

33,1±٢

26,9±3*

31,6±2 “

31,3±3

32,7±2

30,3±2*

32,4±2

30,3±3

31,8±1

J to MSR left (mm)

32,9±3

32,8 ±2

33,0±2

27,0±2*

31,4±1 “

30,2±3

32,7±2

32,0±2

32,1±1

Porion-MSR right

(mm)

59,3±3

53,8±3*

57,1±2 “

59,0±2

59,5±2

55,2±2*

58,6±1,9 “

58,3±2

58,9±2

Porion-MSR left

(mm)

59,4±3

58,2±2

58,8±2

54,5±2*

57,6±2 “

55,4±3*

59,0±1 “

57,6±2

58,6±1

A-Me-MSR

(º)

0±2

+3±0,9

+1,8±1 “

-4±1,2*

-2±0,6 “

1,2±0,7

0,9±0,7

2,0±1,0*

2,0±-0,5

AG-MSR

(mm)

40,7±2

47,5±3*

42,4±3 “

36,0±2*

41,1±2 “

39,9±2

41,4±2

41,3±3

41,3±3

GA-MSR

(mm)

40,6±3

35,7±2*

40,8±2 “

47,8±3*

42,3±3 “

40,2±2

42,1±2

40,8±2

41,1±2

Denture midline discrepancy

(mm)

0±1,5

+2,9 ±0,2*

+1,0±0,3 “

-2,6±0,3*

-1,6±0,6 “

0,5±0,3*

0±0,5 “

2,6±0,5*

1,9±1

Lower molar 1 to Ag-Ag Right(mm)

15,3±2

10,9±1*

14,1±2 “

15,3±1

15,2±2

12,2±2*

14,7±2

13,2±3

13,9±2

Lower molar 1 to Ag-Ag Left(mm)

15,1±3

14,8±1

14,8±1

10,6±2*

13,9±3

10,8±2*

14,3±2 “

13,6±2

14,2±1,9

<OcL/MSR

(º)

0 ±2

+4,2±2

+1,8±1 “

-3,7±2*

-1,6±1 “

1±1,5*

0,4±1 “

2,2±1,7*

1,0±0,5 “

Note: * – p ≤ 0,05 is the reliability of the differences compared to the control subgroup

” – ≤ 0,05 is reliability of differences compared to the results before the treatment