The prevalence of children’s dental anomalies is up to 75%, most of them are in the sagittal area, which appear under the influence of different exo – and endogenous factors. This encourages orthodontist to cooperate with otolaryngologist for complex approach in diagnostics and treatment of dental anomalies because from their decision concerning the elimination of the root cause of nasal breathing disorder the further choice of methods of treatments and elimination of functional disorders, which leads to improving the quality of treatment or reduce the likelihood of relapse depends.
The widespread introduction of secondary and direct cephalometry into orthodontists’ practice with the aim of defining features of the building of a facial skull among the patients with different dental anomalies gave the opportunity to diagnose differentiated diagnostics of nasal shapes of dental anomalies and allowed not only to make a diagnosis objectively and to choose the most rational method of orthodontist’s treatment.
The emergence of cone-beam computed tomography as a diagnostic radiological method of research led to great distribution in clinic practice, however, nowadays there is no consensus concerning application of CBCT among children with orthodontist’s indication and there are no clear protocols, which define the scope of study in each specific case, which became the subject of our further research.
In dissertation there is theoretical generalization of results of current studies and a new solution of actual scientific and practical task of modern dentistry,
which is to raise the quality of diagnostic algorithms for patients with sagittal bite anomalies with nasal breathing disorder and their influence on method’s choice by developing a diagnostics algorithm and by improving the hardware treatment.
The object of study: sagittal bite anomalies between the age of children from 7–12 years old with nasal breathing disorder, transverse and linear dimension of upper and lower jaw, 3D cephalometric analysis of cone-beam computer tomography, modified orthodontic appliance for widening the upper jaw.
Methods of study: epidemiological – for defining the spreading of sagittal bite anomalies among children; clinical – to investigate patients’ complaints and their anamnestic data and also the evaluation of extraoral signs and intraoral signs of dental anomaly; functional – clinic and functional breath test; radiological (cone beam computed tomography) – for determining the anatomy of the facial skull: jaw size and their position in space, occlusal ratio and tilt of the teeth; anthropometric – the measurement of transversal and sagittal sizes of upper jaw on the basis of the method by Moers on CBCT; mechanical and mathematical – physical feature analysis of orthodontic appliance; static – for determining normal values of cephalometric parameters and study validity.
According to the results of epidemiological study it was determined that sagittal bite anomalies among all of 702 examined children from 7 to 12 years old were the most common and constitute more than a half of all examined – 376 (53,5%) individuals. At that time sagittal bite anomalies on the background of respiratory disorders were found in 182 children (30%) among that distal occlusion prevailed - 130 (71,4%) individuals from all examinations, mesial occlusion – 39 (21,4%) individuals, but absent bite pathology was revealed only in 13 (7,2%) individuals.
According to inclusion criteria from 702 examined children we selected 182 people for further additional examination and collected aggregate survey data and examination, which are aimed at people identification, who will enter the main treatment group (with sagittal bite anomalies and nasal breathing disorders).
From 182 patients were found 100 (55%) with sagittal bite anomalies without nasal breathing disorders (NBD), 13 (7%) – had NBD without bite pathology, thus for further research we include 69 patients, who, according to the results of objective examination and survey had distal and mesial bite on the background of nasal breathing disorder.
