RU2441591C1 - Method for quantitative determination of dentoalveolar and facial anomalies - Google Patents

Abstract

FIELD: medicine.

SUBSTANCE: invention is referred to the area of medicine, namely to orthodontia, and can be used for determination of expression degree of dentoalveolar anomaly features in sagittal, vertical and transversal directions. It allows to receive the models of jaws, lateral and anterioposterior teleradiograph (TRG), orthopantomogram (OPTG), anterioposterior and profile photos of the patient face, to determine the disruption of chewing and vocal apparatus. The analysis of lateral TRG is performed using the method by R.A. Fadeev and A.V.Kuzakova. To every sign in accordance with the data of table 1 - “Quantitative determination of dentoalveolar and facial anomalies” the first, second or third degree of expression is assigned.

EFFECT: method provides for determination of expression of dentoalveolar anomaly features: morphologic, occlusion, aesthetic, functional, teeth crowding, its retention and adentiion in sagittal, vertical and transversal directions due to quantitative determination of dentoalveolar and facial anomalies.

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Description

The invention relates to the field of dentistry, in particular to orthodontics. The method allows to characterize the RFA quantitatively by assigning it to the signs of one of three degrees of severity. The method can be used to improve the quality of diagnosis of RFA.

PCA are characterized by the following features: morphological, occlusal, aesthetic, as well as functional disorders, the close position of the teeth, their retention and adentia. Most of these signs should be considered in the sagittal, vertical and transverse directions. Existing known methods for diagnosing AFA: evaluation of gypsum models of the jaws, analysis of X-ray photographs, photographs of the patient’s face and teeth, functional research methods [2] make it possible to localize the anomaly, make a pathogenetic or qualitative diagnosis, but do not quantify the symptoms of AFA, and therefore do not give a complete picture of the complexity of the upcoming treatment.

There is a method for evaluating RFA [1], which is closest to the method for quantitative evaluation of RFA, adopted as a prototype, which makes it possible to distinguish three degrees of severity of mesial occlusion, but it has several disadvantages:

- only morphological and occlusal signs of AFA are evaluated;

- signs are evaluated only in the sagittal direction;

- the method is applicable only to patients with a mesial ratio of the dentition.

The objective of the proposed method is to evaluate all the signs of AFA in the sagittal, vertical and transversal directions by assigning to each sign the degree of severity.

To solve the problem, a method for quantitative assessment of RFA has been proposed, which allows you to determine the severity of signs of RFA: morphological, occlusal, aesthetic signs in the sagittal, vertical and transverse directions, as well as functional disorders, the close position of the teeth, their retention and adentia, to assign the first to these signs second or third degree of severity.

The proposed method allows to characterize the signs of AFA quantitatively in the sagittal, vertical and transverse directions.

To explain the method of quantitative assessment of RFA, table 1 is proposed (see Fig. 1), which presents the parameters, guided by which, the signs of RFA are assigned the first, second or third degree of severity. The vertical columns of the table show the directions:

sagittal, vertical and transverse, and in horizontal - signs of AFA: morphological, occlusal, aesthetic and functional. In the second part of the table in vertical columns presents such characteristics as the close position of the teeth, their retention and adentia, in horizontal - their possible degrees of severity.

The method of quantitative assessment of RFA works as follows:

models of the jaws, lateral and contour teleentgenograms (TRG), orthopantomogram (OPTG), contour and profile photographs of the patient are analyzed, malfunctions of the masticatory system, the close position of the teeth, their retention and adentia are evaluated. Analysis of lateral TRG is carried out according to the methodology of Fadeev R.A., Kuzakova A.V., 2009 [3]. Each feature, in accordance with the data in Table 1, is assigned a first, second or third degree of severity, thus RFA is quantified.

To illustrate the work with this method, we give several

extracts from medical records.

Patient B., 26 years old (Fig. 2 a-c). He went to the clinic with complaints about the close position of the teeth of the upper and lower jaws.

Figure 2. Photographs of the face of patient B., 26 years old, before treatment: a) a face photograph of the face; b) a face photo with a smile; c) profile photo of the face.

When examining the oral cavity revealed a close position of the front teeth of the upper and lower jaws, the mesial ratio of the dentition, cross occlusion in the lateral sections, the displacement of the interdental line, an open bite in the anterior section, the narrowing of the dentition of the upper jaw (Figs. 3, 4 a-d) . OPTG patient B., 26 years old, before treatment.

Figure 4. Photos of the dentitions of patient B., 26 years old, before treatment: a) dentitions in the right projection; b) dentitions in a direct projection; c) dentitions in the left projection; g) the upper dentition in a direct projection; g) the lower dentition in a direct projection.

Analysis of lateral TRH confirmed that the anomaly is concentrated mainly at the level of the dentition.

Figure 5. Copy of lateral TRH of patient B., 26 years old, before treatment.

Using the data of Table 1, we obtained the following quantitative assessment of the signs of RFA of patient B., 26 years old (Table 2.3).

Results of the quantitative assessment of RFA

patient B., 26 years old, before treatment: morphology, occlusion, aesthetics, function.

table 2 Direction Morphology Occlusion Aesthetics Function Sagittal one one one Vertical 2 one one Transversal 2 one

The results of a quantitative assessment of RFA of patient B., 26 years old, before treatment: close tooth position, retention, adentia.

Table 3 1st degree 2nd degree 3rd degree Close tooth position + Retention Adentia

Patient P., 23 years old. Appealed to the clinic with complaints of poor facial aesthetics (Fig.6 a-b). On examination, tooth loss was detected 46, during the previous orthodontic treatment were also removed 24 and 24 teeth, the distal ratio of dentition, deep incisal overlap (Fig.7 a-d).

6. Photographs of the face of patient P., 23 years old, before treatment: a) a face photograph of the face; b) a face photo with a smile; c) profile photo of the face.

7. Photos of the dentitions of patient P., 23 years old, before treatment: a) dentitions in the right projection; b) dentitions in a direct projection; c) dentitions in the left projection; g) the upper dentition in a direct projection; g) the lower dentition in a direct projection.

Analysis of lateral TRG, OPTG, photographs, models of the patient's jaws showed that there is lower retro- and micrognathia, posterior position of the chin, protrusion of the lower incisors (Fig. 8). Use of the table. 1 allowed to characterize the RFA anomaly of the patient quantitatively, assigning to each sign the severity (see table. 4,5).

Fig. 8. Copy of lateral TRH of patient P., 23 years old, before treatment.

The results of a quantitative assessment of RFA of patient P., 23 years old, before treatment: morphology, occlusion, aesthetics, function.

Table 4. Direction Morphology Occlusion Aesthetics Function Sagittal 3 2 one Vertical 3 one one Transversal one N

Results of the quantitative assessment of RFA

Patient P., 23 years old, before treatment: close tooth position, retention, adentia.

Table 5. 1st degree 2nd degree 3rd degree Close tooth position + Retention Adentia

Patient P., 21 years old. Appealed to the clinic with complaints of chin protrusion, posterior position of the upper lip, facial asymmetry (Fig. 9 a, b).

Fig.9. Photos of patient P., 21 years old, before treatment; a) a face photo; b) profile photo of the face.

When examining the dentition, their mesial cross ratio in the anterior and lateral regions, an open bite was determined. The separation of the dentition in both vertical and sagittal directions was 5 mm. There was also a close position of the front teeth of the upper and lower jaws, the absence of the first upper premolar on the right and left, as well as the right lower lateral incisor and premolar (Fig. 10).

Figure 10. The ratio of the dentition of patient P., 21 years old, before treatment: a) dentition in the right projection; b) dentitions in a direct projection.

Despite the previously conducted therapeutic measures, by adulthood, the anomaly has become more pronounced. A thorough clinical and radiological examination, the study of digital photographs of the dentition, as well as the analysis of the profile TRG allowed us to make the following diagnosis: upper micrognathia, lower macro- and prognathia, anterior position of the chin of the lower jaw, close position of the teeth in the front of the upper and lower jaw, loss 14, 24, 41 and 44 teeth (11). Based on the data in Table 1, the signs of RFA were quantified, each of them was assigned a severity level (Tables 6, 7).

11. Copy of lateral TRH of patient P., 21 years old, before treatment.

Results of the quantitative assessment of RFA

patients P., 21 years old, before treatment: morphology, occlusion, aesthetics, function.

Table 6 Direction Morphology Occlusion Aesthetics Function Sagittal 3 3 3 Vertical 2 2 3 Transversal one 2 one

Results of the quantitative assessment of RFA

Patient P., 21 years old, before treatment: close tooth position, retention, adentia.

Table 7 1st degree 2nd degree 3rd degree Close tooth position + Retention Adentia

Thus, the proposed method for quantitative assessment of RFA allows to characterize RFA quantitatively in the sagittal, vertical and transverse directions by assigning it to the signs: morphological, occlusal, aesthetic, functional, close position of the teeth, their retention and adentia, first, second or third degree of severity.

Information sources

1. Gioeva Yu.A., Persin L.S. Mesial occlusion of the dentition. - Textbooks for students of postgraduate education. - M .: Medicine, 2008 - 192 p., P. 100 (prototype).

2. Persin L.S. Orthodontics. Modern methods for the diagnosis of dentofacial anomalies. - A guide for doctors. - M .: IZPTs Informkniga LLC, 2007. - 248 p.

3. Fadeev R.A., Kuzakova A.V. Clinical cephalometry. - A manual on the diagnosis of orthodontics. - St. Petersburg: LLC "MEDI publishing house", 2009. - 64 p.

Claims (1)

A method for the quantitative assessment of dentofacial anomalies (ZCHA), including obtaining side and face tele-roentgenograms (TRG) of the head, orthopantomogram (OPTG), face and profile photographs of the patient's face, jaw models, the study of the functions of the masticatory-speech apparatus, characterized in that they evaluate the face TRG in the transversal direction, lateral TRG in the sagittal and vertical directions, face photo of the face in the transverse direction, profile photo of the face in the sagittal and vertical directions, models jaws in the sagittal, vertical and transverse directions, OPTG in the transversal direction, assess malfunctions of the masticatory-speech apparatus, close position of the teeth, their retention and adentia, then to each of the signs of ocular occlusion: morphological, occlusal, aesthetic, functional, close tooth position, their retentions and adentia assign the first, second or third degree of severity in the sagittal, vertical and transverse directions in accordance with table 1 - Quantitative assessment of dentition facial anomalies.

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