PRACA POGLĄDOWA

REVIEW ARTICLE

INTERDISCIPLINARY APPROACH TO DIAGNOSTICS OF MALOCCLUSIONS (REVIEW)

Lyubov V. Smaglyuk, Hanna V. Voronkova, Anna Y. Karasiunok, Anastasiia V. Liakhovska, Kseniia O. Solovei

Ukrainian Medical Stomatological Academy, Poltava, Ukraine

ABSTRACT

Introduction: The main task of modern orthodontics is to create a balanced, morphologically stable occlusion in harmony with facial aesthetics and functional adaptation.

The aim of the study is to investigate the relationship between dentofacial anomalies and somatic pathology.

Materials and methods: A literary study was conducted using the Medline database and the Google Scholar database.

Review: The human body is a biological system consisting of interconnected and subordinate elements. Any abnormalities in the operation of this system may lead to functional impairment in a single organ. This is fully applicable to dento-facial anomalies and deformations; their development is closely related to other diseases.

Conclusions: The diagnostics, treatment tactics and prevention of dento-facial anomalies and deformations should be considered in the context of the integrity of the child’s unformed organism, the interdependence of the form and functions of its organs and systems.

KEY WORDS: diagnostics, dento-facial anomalies, malocclusions

Wiad Lek 2019, 72, 5 cz. I, 918-922

Introduction

The main task of modern orthodontics is to create a balanced, morphologically stable occlusion in harmony with facial aesthetics and functional adaptation [1, 2, 3]. During the last decade, there is a clear tendency in the prevalence of dento-facial anomalies, which, according to the data of modern domestic and foreign scientific literature, reaches 80% [4, 5, 6], and sometimes exceeds this figure. Thus, according to R. E. Villanuela-Arriaga [7], only 8.2% of those examined have a physiological bite which makes orthodontic treatment a problem of social importance. Researchers [8] note a constant and statistically significant correlation between the permanent occlusion pathology and the state of somatic health in adolescence. These include diseases of the respiratory, musculoskeletal, endocrine systems, and the psycho-emotional status of the patient. From the data of modern literature, the interconnection between the presence of anomaly of the bite and posture abnormalities due to the dento-facial system as one of the postural sensors that provide harmony and balance of the human body in space [9, 10, 11]. The most important changes in the structural and functional state of the bone tissue are observed during puberty, the course of which affects the further formation and condition of the bone tissue throughout life [12]. Only taking into account the somatic status and the psycho-emotional state of the patient in orthodontic treatment allows choosing the optimal treatment [13]. Therefore, the interdisciplinary approach is one of the most urgent tasks of modern orthodontics and a constant object of searching for new methods of diagnosis and treatment [14].

The aim

The aim of the study is to investigate the relationship between dento-facial anomalies and somatic pathology.

Materials and methods

A literary study was conducted using the Medline database and the Google Scholar database. Keywords used in the search were: malocclusions, growth and development, orthodontic diagnostic and treatment.

Review and Discussion

The human body is a biological system consisting of interconnected and subordinate elements. The peculiarities of their structure and relations are subordinated to their functioning as part of a single integral mechanism. Therefore, any abnormalities in the operation of this system may lead to functional impairment in a single organ. This is fully applicable to dento-facial anomalies and deformations; their development is closely related to other diseases [15]. Genetic, congenital and acquired factors are commonly identified as the main etiological factors in the development of dento-facial anomalies [16]. Most authors note the existence of a direct interconnection between the general somatic pathology and anomalies of the dento-facial system [16, 17, 18, 19]. When analysing the literature data, several major groups of diseases that have the greatest impact on the development of the dento-facial system are clearly distinguished: diseases of the ENT organs, the gastrointestinal tract, endocrine and musculoskeletal systems. At present, scientists have substantiated the concept of commonality of factors that shape both dental status and state of somatic health [20, 21, 22, 23, 24]. The morphological basis of the unity of the characteristics of dental and somatic health is the commonality of the embryonic origin of the facial part of the skull, skin, its derivatives, musculoskeletal system, heart valves, and blood vessels [25, 26]. Thus, based on the analysis of the interconnection between parameters of electrocardiogram and electromyography, the intersystem integration of the functional state of the dento-facial and autonomic nervous systems, as well as the cardiovascular and respiratory systems has been proved [27]. An increase in the frequency of dento-facial anomalies and deformations in 1,6-2,3 times is noted in disorder of the musculoskeletal system [28]. In this category of children, deep incisor occlusion, distal occlusion and neutral occlusion with anomalies of individual teeth predominate. It has been revealed that with the increase in the severity of disorders of the musculoskeletal system (from the posture abnormalities to scoliosis II-IV degree of severity) the prevalence of distal occlusion increases [29]. In children with scoliosis, 72.9-84.3% of cases are diagnosed with dento-facial anomalies and deformations [30].

According to recent studies, the dento-facial system plays an important role in the postural balance of a person, that is, its condition affects the stability of the human body in space. Decrease in the occlusal vertical dimension occurs in such pathological conditions of the dento-facial system as dentition defects, anomalies of bite, dysfunction of the TMJ, pathological abrasion of teeth. It affects the functioning of not only the dento-facial system, but also the human body as a whole [31, 32, 33]. Delaire argued that the position of the upper and lower jaws relative to each other is determined by the ratio of the tone of the posterior group of the neck muscles and the mass of the skull [34]. The position of the jaws has an effect on the spatial orientation of the head, and this in turn affects the position of other structures of the body. When the contact between the occlusal surfaces of the teeth on one or two sides is impaired, the patient’s postural status changes, which may lead to pain in the neck or shoulder, changes in the spine, disorders in the body position, and incorrect posture [9]. Some researchers point to the “anterior” position of the head of patients with dysfunction of the temporomandibular joints associated with the shortening of the extensors of the sternocleidomastoid muscles. This confirms the effect of dysfunction of the temporomandibular joints on posture. A high frequency, up to 90%, of dento-facial anomalies in children with allergic pathology has been established [35]. Research showed that in 89,3% of cases, children with bronchial asthma have dento-facial anomalies. The impairment in the activity of the glands of the internal secretion has a negative impact on the formation of the child’s organism in general and on the growth and development of the dento-maxillofacial complex, in particular [36, 37, 38, 39]. Adolescence is one of the critical periods of human life, since it is precisely in adolescence that the neuroendocrine system begins to function, and sex hormones which affect the development of many body systems and the formation of reproductive health are produced. Under the action of steroid hormones, an active development of the musculoskeletal system occurs, which is manifested by the acceleration of total body growth and dento-maxillofacial growth. Insufficient secretion of estrogen leads to impaired bone mineralization and may cause abnormalities in the maxillofacial area [40, 41, 42]. Research results show that sex hormones are one of the key factors that determine the growth and development of the mandible. A delay in the sagittal growth of the mandible, disturbance of its architectonics, and disproportional development of the facial part of the skull were observed with changes in the level of sex hormones [43]. In case of hypogonadism there are anomalies of bite, the deformation of the facial skeleton, changes in the structures of the TMJ. Thus, an examination of one hundred and twenty-two patients suffering from b-thalassemia, which is accompanied by hypogonadism, revealed a disproportional development of the facial part of the skull [44]. Impaired growth and development of the dento-facial system was detected in case of juvenile rheumatoid arthritis [45]. In juvenile idiopathic arthritis, one third of the patients examined were diagnosed with the skeletal pathology of the Angle I class, as well as impaired functional state of the TMJ [46]. Thyroid hormone, thyroxin, stimulates growth in the sphenoid-occipital synchondrosis, nasal cartilage, and the growth of the upper jaw in the area of bone sutures, thereby determining the size and position of the upper jaw. As a result of a decrease in thyroxin level, there is a delay in craniofacial growth, disproportional development, retroposition of the upper jaw, and decrease in the length of the mandible [47]. According to O.T. Supiieva in children living in foci of iodine deficiency, the frequency of dento-facial anomalies is 39.1%, and the frequency of endemic goiter it is 61.1% [48]. In case of pituitary insufficiency associated with a decrease in the secretion of all the hormones produced in the anterior lobe of the pituitary gland, disturbances in the dento-facial system were detected [49]. The study by B. Kawala, T. Mathews-Brzozowska et al. [50] showed that in children with growth hormone deficiency, the difference between chronological, dental and bone age is determined. With insufficiency of the growth hormone, due to the proportional delay in craniofacial growth, there is a decrease in all craniometric and gnathometric linear parameters, with the most pronounced changes in the length of the upper jaw, and the length of the anterior part of the skull base [51, 52]. Hypersecretion leads to gigantism in young people and to acromegaly in adults, which is usually caused by pituitary adenoma. Cephalometric studies with gigantism indicate a large size of the anterior facial height. Growth of the lower jaw occurs gradually and according to research data a cross-bite is often formed. Enlargement of the tongue is noted. An increase in the mandible in case of acromegaly is the result of both appositional growth and hypertrophic changes in the cartilaginous joint. Skeletal anomalies were identified in the experimental study of the role of parathyroid hormones in the maxillofacial development, Accelerated differentiation of chondrocytes and endochondral bone formation in the posterior part of the anterior section of the skull base and in synchondrosis, as well as abnormal bone modelling were observed [53]. Skeletal forms of the Angle Class II anomalies are the dominant pathology in secondary hyperparathyroidism due to chronic renal failure – Sagliker syndrome. Under the experimental conditions, it was found that corticosteroid hormones have a significant inhibitory effect on the proliferative activity and differentiation of chondrocytes in the temporomandibular joint, and therefore, adversely affect the normal process of endochondral bone formation in the mandible growth zone. The growth of the inhibitory effect of corticosteroids is partially due to a decrease in the reaction of cartilage cells to insulin-like growth factor-1 (IGF-1) [54]. When studying craniofacial morphology in children with obesity, an increase in the length of the mandible, prognathia of the jaws, and a decrease in the anterior height of the face were recorded [55]. However, the analysis of literature data revealed that it is necessary to specify the prevalence of clinical forms of anomalies and deformations of the dento-facial system in children with endocrine pathology. A. Silvestrini-Biavati et al. prove in their study that the pathological condition in one part of the body affects other areas. Skeletal muscles play a crucial role in the coincidence of various disorders, since they have a continuous anatomical and functional “chain” between the skull, lower jaw, spine, limbs and pelvis [56, 57]. Therefore, when a strong muscle tension occurs in one of the links in this chain, it is immediately transmitted to another part of the body. As a result, the body loses its equilibrium state, generating compensatory mechanisms, for example, muscle tension in other antagonistic parts of the body. Thus, dento-facial anomalies with disturbance of the mandibular position are associated with one of the links in the muscle chain, which leads to an excessive contraction of the masticatory muscles [58]. This tension causes the rest of the body to react, creating postural modifications caused by contractions of other muscles of the chain.

Impaired respiratory function has a direct effect on the formation of the dento-facial area. According to A. Y. Gungora [59], the volume of air passing through the nose and nasopharynx is limited by its shape and diameter. Continuous flow induces a constant stimulus for transversal growth of the upper jaw and proper formation of the palate. Maximum morphological differences were observed between patients with and without respiratory tract problems, showing a potential etiological role in the interaction between the respiratory function and the maxillary growth: shortening and narrowing of the upper jaw, increasing the length and thickness of the soft palate, V-shaped dental arch, high palate and protrusion of incisors.

According to L.V. Polma et al. [60, 61, 62], when planning a treatment, it is mandatory to take into account patients’ motivation. A.M. Dybov, H.B. Ospanova emphasize the need to take into account the needs and expectations of the patient [63]. The level of aesthetic component, according to I. Grzywacz [64], reflects the subjective need for dental aesthetics and orthodontic treatment. I.N. Minaieva [65] notes that it is the aesthetic component that is essential for the image of success. U. Klages [66] points out that there is an interconnection between physical attractiveness, on the one hand, and social success and high self-esteem, on the other. The author also found that, unlike subjects with higher level of teeth aesthetics, respondents with a low level of aesthetics showed a higher social interest in their own appearance. Thus, taking into account the psycho-emotional state of patients must be necessarily supplemented by clinical diagnostic methods [67].

Conclusions

Thus, the interaction of local disorders of the dental-maxillofacial area in children and adolescents with common diseases allows to consider dento-facial anomalies and deformations as a multiorgan, socially significant pathology. Consequently, the diagnostic, treatment tactics and prevention of dento-facial anomalies and deformations should be considered in the context of the integrity of the child’s unformed organism, the interdependence of the form and functions of its organs and systems.

References

1. Gerasimov S.N. Ortodonticheskoye lecheniye vzroslykh patsiyentov. Lingval’naya ortodonticheskaya tekhnika [Orthodontic treatment of adult patients]. SPb,: Piter: 2004, 136s. (RU)

2. Kuroyedova V.D. Osnovy tekhniki pryamoy dugi [Fundamentals of a direct arc technique] In: N.V. Kulish. Poltava: Verstka; 2008, 108 s. (RU)

3. Alexander R. G. ‘Wick’ Quintessence Publishing Co Inc.,U.S., 2013, 1740 р.

4. Dyen’ha O.V., Mirchuk B.M., Horokhivs’kyy V.N. etal. Poshyrenist’ zuboshchelepnykh anomaliy ta stan porozhnyny rota u ditey m. Dnipropetrovs’ka [Prevalence of tooth-abdominal anomalies and the state of the cavity of mouth in children of Dnipropetrovsk]. Visnyk stomatolohiyi. 2004;2:74-76. (UA)

5. Holovko N.V., Halych L.B., Kulish N.V. [ta in.] Poshyrenist’ ZSHCHA v ditey ta pidlitkiv Poltavs’koyi oblasti [Prevalence of malocclusion in children and adolescents of the Poltava region.]. Ukrayins’kyy stomatolohichnyy al’manakh. 2006;5:48-51. (UA)

6. Doroshenko S.I., Kul’hins’kyy YE.A., Iyevlyeva YU.V. [ta in.] Rozpovsyudzhenist’ zuboshchelepnykh anomaliy ta deformatsiy, a takozh defektiv zubiv ta zubnykh ryadiv sered ditey shkil’noho viku m. Kyyeva [Distribution of tooth-jaw abnormalities and deformations, as well as defects in teeth and dentition among children of school age in Kyiv]. Visnyk stomatolohiyi 2009;2:76-81. (UA)

7. Villanueva-Arriaga R.E., Garsia-Lopez S., Masin-Cabrera S. [et al.] Orthodontic treatment needs in schoolchildren in south east Mexico city. European Journal of Orthodontics. 1999;21(5): 627.

8. Levenets S.A., Novokhatskaya S. V., Shelud’ko O. YU. Faktory riska i klinicheskiye osobennosti vtorichnoy oligomenorei u devochek-podrostkov [Risk factors and clinical features of secondary oligomenorrhea in adolescent girls]. Líkars’ka sprava. Vrachebnoye delo.2015;3-4:128-131. (RU)

9. Ivanov V.V., Markov N.M. Vliyaniye zubochelyustnoy sistemy na postural’nyy status patsiyenta [The influence of the dental system on the patient’s postural status]. Manual’naya terapiya.2013;3(51):83-89. (RU)

10. Cuccia A.M. Carola C. The measurement of craniocervical posture: a simple method to evaluate head position. Int J Pediatr Otorhinolaryngol. Int J Pediatr Otorhinolaryngol. 2009;Sep 27. doi: 10.1016/j.orl.2009.09.011. Epub 2009 Sep 27. PubMed PMID: 19786307.

11. Fujino S., Takahashi S, T.,Ueno T. Influence of voluntary teeth clenching on the stabilization of postural stance disturbed by electrical stimulation of unilateral lower limb. Gait Posture. 2010;31 (1):122-125.

12. Lazareva Ye.K., Likhachev V.K., Novikov V.M. Rasprostranennost’ zabolevaniya visochno-nizhnechelyustnogo sustava na fone endokrinnykh narusheniy [Prevalence of temporomandibular joint disease on the background of endocrine disorders]. Ukr. med. al’manakh. 2014;2:37-39. (RU)

13. Degtyareva I.N., Bulyakov R.T. Problema podgotovki patsiyenta k ortodonticheskomu lecheniyu v trudakh otechestvennykh i zarubezhnykh issledovateley [The problem of preparing a patient for orthodontic treatment in the works of domestic and foreign researchers]. Rossiyskaya meditsinskaya akademiya poslediplomnogo obrazovaniya. M.:2005; 214-216. (RU)

14. Zholuyev S.Ye., Grin’kova I.YU. Opyt ispol’zovaniya shkaly klinicheskoy stomatologicheskoy dlya ekspress-diagnostiki psikhoemotsional’nogo sostoyaniya patsiyenta [Experience of using the clinical dental scale for express diagnostics of the patient’s psycho-emotional state]. Stomatolog. 2000;5:10-12. (RU)

15. Shamov S. M. Vzaimosvyaz’ obshchesomaticheskoy patologii i zubochelyustnykh anomaliy u detey i podrostkov Respubliki Dagestan [The relationship between somatic pathology and in children and adolescents in Dagestan]. Kubanskiy nauchnyy meditsinskiy vestnik. 2013;6 (141): 193-195. (RU)

16. Stomatologiya detey i podrostkov: Per. s angl. [Dentistry of children and adolescents: Trans. from English]. M.: Meditsinskoye informatsionnoye agentstvo; 2003:766. (RU)

17. Kim A. A., Karasyunok O. A. Osobennosti prikusa u lits s zabolevaniyami oporno-dvigatel’nogo apparata [Features of bite in persons with diseases of the musculoskeletal system]. Tezisy dokladov. Minsk:2000:34–35. (RU)

18. Daminov T. O., Yakubov R. K., Mavlyanov I. R.. et al. Rol’ obshchikh faktorov v patogeneze razvitiya deformatsiy zubochelyustnoy sistemy [The role of common factors in the pathogenesis of the development of deformations of the dental system]. Stomatologiya. 2002;4: 57–60. (RU)

19. Holovanova I. A., Lyakhova N. A., Sheshukova O. V. [et al.] Studing the skills attitudes on factors affecting dental health of children. Wiad Lek. 2018; 3(II):640–647.

20. Bida O.V. Stomatolohichne zdorov’ya ditey molodshoho ta seredn’oho shkil’noho viku i kryteriyi yoho otsinky [Dental health of children of junior and middle school age and criteria for its evaluation]. Ukrayins’kyy stomatolohichnyy al’manakh.2007;1:51-54. (UA)

21. Savychuk N.O., Klityns’ka O.V. Stomatolohichne zdorov’ya ditey, metodolohichni pidkhody ta kryteriyi yoho otsinky [Dental health of children, methodological approaches and criteria for its assessment]. Sovremennaya stomatolohyya. 2008;1:94-98. (UA)

22. Voronkova A. V., Smaglyuk L. V. Changes in biochemical parameters of oral fluid in patients during the orthodontic treatment with a bracket system under the action of a developed mucosal gel with probiotic Wiad Lek. 2018;3(I):496–500.

23. Voronkova H. V., Smahlyuk L. V. Zminy biokhimichnykh pokaznykiv rotovoyi ridyny u patsiyentiv, yaki znakhodyat’sya na ortodontychnomu likuvanni breket-systemoyu [Changes in biochemical parameters of oral fluid in patients who are on orthodontic treatment with fixed system]. Aktual’ni problemy suchasnoyi medytsyny. 2017;3 (59):199–202. (UA)

24. Trofymenko K. L., A. YE. Karasiunok Kompleksnyy pidkhid do ortodontychnoho likuvannya patsiyentiv v rann’omu zminnomu prykusi [Comprehensive approach to orthodontic treatment of patients in the early mixed dentition]. Aktual’ni problemy suchasnoyi medytsyny Visnyk Ukrayins’koyi medychnoyi stomatolohichnoyi akademiyi. 2016;3 (55):23–26. (UA)

25. Ham A., Cormack D. Histology. Toronto.1983:1-48.

26. Avetikov D.S. Izucheniye biomekhanicheskikh svoystv kozhi sostsevidnoy oblasti pri vypolnenii kosmeticheskoy otoplastiki [Study of the biomechanical properties of the skin of the mastoid area when performing cosmetic otoplasty]. Klíníchna khírurgíya. 2015;8(876): 41-44. (RU)

27. Bugrovetskaya O.G., Maksimovskaya L.N., Bugrovetskaya Ye.A. Vzaimosvyaz’ funktsional’nogo sostoyaniya zubochelyustnoy i vegetativnoy nervnoy systemy [Interrelation of the functional state of the dentition and autonomic nervous systems]. Manual’naya terapiya.2010; №2(38):18-23. (RU)

28. Tsimbalistov A.V., Lopushanskaya T.A., Chervatok A.Ye. Stomatologicheskiy status bol’nykh s zabolevaniyami opornodvigatel’nogo apparata [Dental status of patients with diseases of the musculoskeletal system]. Institut stomatologii. 2005;29: 68-69. (RU)

29. Perova Ye.G. Kharakter zubochelyustnykh anomaliy i deformatsiy u detey s razlichnym sostoyaniyem oporno-dvigatel’nogo apparata [The nature of dental anomalies and deformities in children with different state of the musculoskeletal system]. Institut stomatologii. 2010;46:74-75. (RU)

30. Levenets A.A.,.Perova Ye.G O vzaimosvyazi skolioticheskoy bolezni i zubochelyustnykh anomaliy i deformatsiy [On the relationship of scoliotic disease and dental-maxillary anomalies and deformations]. Stomatologiya. Rezhim dostupa: http://www.mediasphera. ru./Journals/stomo/dentali/253/3821/(RU)

31. Zozulya I.S., Bredikhin A.V., Bredikhin K.A., at al. Myshechno-fastsial’naya disfunktsiya, puti yeye korrektsii [Musculo-fascial dysfunction, ways of its correction]. Mezhdunarodnyy nevrologicheskiy zhurnal. 2014;4 (66):41-50. (RU)

32. Semashko L.V. Stabilometricheskiye issledovaniya vliyaniya original’noy sistemy PFA na funktsiyu ravnovesiya [Stabilometric studies of the influence of the original PFA system on the equilibrium function]. Vestnik vosstanovitel’noy meditsiny. 2009;5:97-100. (RU)

33. Smahlyuk L. V., Kulish N. V., Voronkova H. V. at al. Analiz morfometrychnykh pokaznykiv rozvytku nyzhn’oyi shchelepy u patsiyentiv z perekhresnym prykusom za danymy ortopantomohramy [Analysis of morphometric indices of development of the mandible in patients with cross-occlusion according to orthopantomograms]. Visnyk problem biolohiyi ta medytsyny. 2018;1(146):307–310. (UA)

34. Delaire, J. L’analyse architecturale et structurale cranio-faciale (de profil): principes theoriques. Quelques examples d’emploi en chirurgie maxillo-faciale/ Rev Stomatol Chir Maxillofac.79 (1978):1-33.

35. Admakin O.I., Geppe N.A., Mamedov A.A. Rezul’taty provedeniya programmy profilaktiki stomatologicheskikh zabolevaniy v gruppakh detey s allergicheskoy patologiyey [The results of the program for the prevention of dental diseases in groups of children with allergic diseases].Voprosy sovremennoy pediatrii. 2006;5:12. (RU)

36. Accurso B., Mercado A., Allen CM. Multiple endocrine neoplasia-2Bpresenting with orthodontic relapse. Angle Orthod. 2010;80(3):585-590. (RU)

37. Carlos Fabue L., Soriano YJ., Perez MGS Dental management of patients with endocrine disorders. J Clin Exp Dent. 2010;2(4):196-203.

38. Patney A Kocher, Pai K.M., Sholapurkar A.A. Debre Semelaigne syndrome and associated orofacial aspects: report of a case. J. Oral Sci.2011;53:29-32.

39. Reichert C,. Deschner J., Jager A. Influence of diabetes mellitus on the development and treatment of malocclusions – a case report with literature review. J Orofac Orthop. 2009;2:60-175.

40. Povoroznyuk V., Vovk I., Orlik T. at al. Kostnaya tkan’ u devochek i podrostkov. Svyaz’ s polovym i fizicheskim razvitiyem (chast’ 1) [Bone tissue in girls and adolescents. Relationship with sexual and physical development]. Pedíatríya, akusherstvo ta gínekologíya. 2000;2 (7):-95. (RU)

41. Smahlyuk L. V., Fetisova A. L., Lyakhovs’ka A. V. Anomaliyi shchelepno-lytsevoyi systemy u divchat iz porushennyam reproduktyvnoyi funktsiyi [Anomalies of the maxillofacial system in girls with a violation of reproductive function].Ukrayins’kyy stomatolohichnyy al’manakh.2012;2:56-59. (UA)

42. Soliman A., De Sanctis V, Elalaily R, Advances in pubertal growth and factors influencing it: Can we increase pubertal growth? Indian J. Endocrinol. Metab. 2014;18:53-62.

43. Fujita T., Ohtani J., Shigekawa M. Influence of sex hormone disturbances on the internal structure of the mandible in newborn mice. Eur J. Orthod. 2006;28(2):190-194.

44. Piras V., Tuveri F., Dessi C. Relation between hypogonadism and malocclusion in beta-thalassemia major patients: analysis of 122 subjects Minerva Stomatol. 2003;52(5):241-246.

45. Mamedov A.A., Admakin O.I., Zholobova Ye.S. Narusheniye rosta i razvitiya zubochelyustnoy sistemy u detey s yuvenil’nym revmatoidnym artritom [Impaired growth and development of the dentition in children with juvenile rheumatoid arthritis].Stomatologiya detskogo vozrasta i profilaktika.2009;4:31-35. (RU)

46. Мicky A., Mandall, R., Gray, D. Juvenile idiopathic arthritis (JIA): a screening study to measure class II skeletal pattern, TMJ PDS and use of systemic corticosteroids, J. Orthod.- 2010; 37: 6-15.

47. Persson E.C,. Engstrom C., Thilander B. The effect of thyroxine on craniofacial morphology in the growing rat. Part I: A longitudinal cephalometric analysis. Eur J Orthod. 1989;11;59-66.

48. Supiyeva E.T. Osobennosti profilaktiki stomatologicheskikh zabolevaniy u detey, prozhivayushchikh v ochage yodnogo defitsita [Features of the prevention of dental diseases in children living in the center of iodine deficiency]. Stomatologiya detskogo vozrasta i profilaktika.2002;3-4:88-92. (RU)

49. Scaramucci T., Guglielmi C.A., Fonoff R.D. Oral manifestation associated with multiple pituitary hormone deficiency and ectopic neurohypophysis. Clin. Pediatr. Dent. 2011;35:409-413.

50. Kawala B., MatthewsBrzozowska T., Bieniasz J. Dental and skeletal age in children with growth hormone deficiency treated with growth hormone – preliminary report Endokrynologia, diabetologia ichoroby przemiany materii wieku rozwojowego: organ Polskiego Towarzystwa Endokrynologow Dzieciecych,2007;4:210-212.

51. Singleton D.A., Buschang P.H., Behrents R.G. Craniofacial growth in growth hormone-deficient rats after growth hormone supplementation. Am J. Orthod. Dentofacial Orthop. 2006;130(1):69-82.

52. Erum R. van, Mulier M., Carels C. Craniofacial growth in short children born small for gestational age: effect of growth hormone treatment. J. Dent. Res. 1997;76(9):1579-1586.

53. Differential responses to parathyroid hormonerelated protein (PTHrP) deficiency in the various craniofacial cartilages. Anat Rec. 1999;255(4):452-457.

54. Silbermann M., Weiss A., Raz E. Retardative effects of a corticosteroid hormone upon chondrocyte growth in the mandibular condyle of neonatal mice. J.Craniofac.Genet.Dev. Biol. 1981;1(1):109-122.

55. Ohrn K., Al-Kahlili, BHuggare. J. Craniofacial morphology in obese adolescents. Acta Odontol Scand.2002; 60(4):193-197.

56. Solow B, Sonnesen L: Head posture and malocclusions. Eur J Orthod. 1998;20:685-693.

57. Lippold C, Danesh G, Hoppe G, at al. Trunk inclination, pelvic tilt and pelvic rotation in relation to the craniofacial morphology in adults. Angle Orthod. 2007;77:29-35.

58. Andrade AS, Gaviao MB, Gameiro GH at al. Characteristics of masticatory muscles in children with unilateral posterior crossbite. Braz Oral Res. 2010;24(2):204-210.

59. Gungora A Y, Turkkahramanb H. Effects of Airway Problems on Maxillary Growth: A Review European Journal of Dentistry. 2009;3:250-254.

60. Pol’ma L.V., Lomakina V.M., Talalayeva Ye.V. Opredeleniye motivatsii patsiyentov pri planirovanii ortodonticheskogo lecheniya [Definition of patient motivation in planning orthodontic treatment]. Ortodontiya. 2009;1(45):77. (RU)

61. Karasiunok A. Ye., Smahliuk L. V. The role of parents in motivation for orthodontic treatment for children. Wiad lek. 2018;3(I):529–533.

62. Karasyunok A. YE. Rezul’taty zastosuvannya psykholohichnykh metodiv pry ortodontychnomu likuvanni ditey u period zminnoho prykusu.[Results of the application of psychological methods in orthodontic treatment of children in the period of mixedocclusion]. Aktual’ni problemy suchasnoyi medytsyny. 2017;3 (59): 211–215. (UA)

63. Dybov A.M., Ospanova G.B. Vliyaniye potrebnosti patsiyentov v ortodonticheskom lechenii na udovletvorennost’ yego rezul’tatami. [The impact of patients’ needs in orthodontic treatment on satisfaction with its results]. Ortodontiya. 2009;1(45):62. (RU)

64. Grzywacz I. Znacheniye esteticheskogo komponenta v indekse potrebnosti v ortodonticheskom lechenii pri otsenke sub”yektivnoy potrebnosti v ortodonticheskom lechenii, [The value of the aesthetic component in the index of the need for orthodontic treatment in assessing the subjective need for orthodontic treatment]. Ortodonticheskiy referativnyy zhurnal. 2004;3:6. (RU)

65. Minayeva I.N. Profilaktika zubo-chelyustnykh anomaliy kak faktor povysheniya urovnya stomatologicheskogo zdorov’ya detey [Prevention of tooth-jaw anomalies as a factor in increasing the level of children’s dental health]. Ortodonticheskiy referativnyy zhurnal. 2004;3: 74-75. (RU)

66. Klages U., Bruckner A., Zentner A. Dental aesthetics, self-awareness, and oral health-related quality of life in young adults. European Journal of Orthodontics. 2004;26(5):507-514.

67. Vieira-Andrade R.G., de Paiva S.M, Marques L.S. Impact of Malocclusions on Quality of Life from Childhood to Adulthood Issues in Contemporary Orthodontics http://dx.doi.org/10.5772/59485 39-55.

Authors’ contributions:

According to the order of the Authorship.

Conflict of interest:

The Authors declare no conflict of interest.

CORRESPONDING AUTHOR

Anna Karasiunok

Ukrainian Medical Stomatological Academy

Shevchenko 23 str., 36011 Poltava, Ukraine

tel: +380677544193

e-mail: orthodontic.umsa@gmail.com

Received: 22.03.2019

Accepted: 10.05.2019