Popova N V, Arsenina O I, Makhortova P I, Gayrbekova L A, Popova A V
Central Research Institute of Dentistry and Maxillofacial Surgery, Moscow, Russia.
People's Friendship Unversity of Russia, Moscow, Russia.
Stomatologiia (Mosk). 2020;99(3):60-70. doi: 10.17116/stomat20209903160.
The aim of this research is to increase the accuracy of determining the position of the tongue, the amount of space occupied by the tongue and space, free from tongue, increase of efficiency of diagnostics of dentofacial anomalies in patients based on CBCT analysis-the study of the skull conducted in transversal, sagittal and coronal planes. Clinical and x-ray examination and orthodontic treatment were carried out in 120 patients with anomalies of the dentition complex. Patients were divided into three groups. Group 1 - 30 patients aged 5 to 11 years. Group 2 - 50 patients aged 12 to 17 years. Group 3 - 40 patients aged 18 to 40 years. All patients underwent CT examination of the skull before treatment, and during the retention period of treatment. After a diagnostic examination of the proposed method for diagnosing the anatomical and functional state of the dentition complex and drawing up a treatment plan, all patients underwent orthodontic treatment, which consisted in the expansion of the upper jaw using various orthodontic appliances for expansion. This method allows to identify anomalies in the position of the tongue before and after orthodontic treatment, to assess the quality of orthodontic treatment, based on the analysis of not only the tongue filling the space of the dome of the palate, but also the position of the bone structures of the skull in three planes. The high quality of the study allows us to give a reliable assessment of the state of maxillofacial structures: the position of the upper and lower jaws, inclination of teeth, the stage of formation of the patient's growth, airway lumen and the influence of tongue on these structures at different stages of development of the maxillofacial skull. When comparing the results of the study, not all patients carried out recovered the anatomical and functional balance of the maxillofacial complex after orthodontic treatment, suggesting the need for more myogymnastics of the tongue before, during, and after treatment.
本研究的目的是提高确定舌头位置、舌头所占空间以及无舌空间的准确性，提高基于CBCT分析（在横断面、矢状面和冠状面进行颅骨研究）对患者牙颌面异常的诊断效率。对120例牙列复合体异常患者进行了临床和X线检查以及正畸治疗。患者分为三组。第一组——30例年龄在5至11岁的患者。第二组——50例年龄在12至17岁的患者。第三组——40例年龄在18至40岁的患者。所有患者在治疗前以及治疗保持期均接受了颅骨CT检查。在对所提出的用于诊断牙列复合体解剖和功能状态的方法进行诊断性检查并制定治疗计划后，所有患者均接受了正畸治疗，该治疗包括使用各种正畸扩弓器对上颌进行扩弓。该方法不仅可以通过分析占据腭穹窿空间的舌头，还可以通过分析颅骨在三个平面上的骨结构位置，来识别正畸治疗前后舌头位置的异常，评估正畸治疗的质量。该研究的高质量使我们能够可靠地评估颌面结构的状态：上下颌的位置、牙齿的倾斜度、患者生长发育阶段、气道管腔以及在颌面颅骨不同发育阶段舌头对这些结构的影响。在比较研究结果时，并非所有接受治疗的患者在正畸治疗后都恢复了颌面复合体的解剖和功能平衡，这表明在治疗前、治疗期间和治疗后需要更多的舌肌训练。
