The thesis is devoted to improving of orthodontic treatment of adolescent girls with disorders of reproductive system formation through studying and analyzing of clinical and functional state of dentomaxillary area and using of the optimal orthodontic appliance. Clinical examination was conducted in 57 adolescent girls who were divided into two groups: main and control. The main group consisted of 32 girls with disorders of reproductive system formation from 12 to 17 years. The average age of girls was 14,7±0,31 years. The control group consisted of 25 girls at pubertal age with regular menstrual cycle who were somatically healthy and had no history of gynecological diseases. The average age of girls in the control group was 14,5±0,33 years. Based on clinical examination and special methods morphological and functional features of dentomaxillary area in girls with disorders of reproductive system formation were analyzed. 40.6% of these girls had the high and very high class of orthodontic treatment need. Compared with the control group crowding of III-IV severity degree was observed in 6.2 times more often, narrowing of dental arches was greater in 2.3 times, the lack of space of upper and lower dental arches was greater in 2.9-3.8 respectively in girls of the main group (p<0.01). All the girls with disorders of reproductive system formation were detected asymmetry size of components of the temporomandibular joint on the left and right sides, significantly increased and asymmetric EMG-activity of the temporal and masseter muscles (p<0.01); clinical symptoms of temporomandibular joint dysfunction were observed in 93.8% of them. The thesis presents data on correlative relationships between physical pubertal development, bone mineral density and state of tooth-jaw area in adolescent girls with disorders of reproductive system formation. 56.3% of adolescent girls were found a deficiency of body weight with a decrease in body mass index to 17,23 ± 0,45 kg / m?. Asthenic type of body structure was observed in 5.2 times more often in the main group, the lag of menarche and secondary sexual characteristics was 1-1,5 years, compared with the control group (p<0.01). In the stages of skeletal maturity of cervical vertebrae lag of 1 year was determined compared with girls in the control group (p <0.01). Bone mineral density was significantly lower in 90.6% of adolescent girls of the main group. In 56.3% of these girls was defined osteopenia of different degrees of severity. Efficiency of the developed method of functional correction of TMD in adolescent girls with malocclusion was grounded and clinically confirmed. The proposed method, which included using of individual occlusal splint, consisted of occlusal overlays on upper molars and premolars, connected by frontal gum part. The design of the device creates conditions for reducing the bioelectric activity of masticatory muscles, providing decompression in the joints, leading to the achievement of the lower jaw position of physiological rest and functional muscle balance. Results of control examination, electromyography of masticatory muscles, postural tests, made in a month, 3 and 6 months, significantly improves orthodontic treatment of malocclusion with TMD caused by imbalance in the masticatory muscles in adolescent girls with disorders of reproductive system formation.
