Dissertation for the Degree of Doctor of Philosophy in the Field of Knowledge
"Healthcare", in the Specialty of "Dentistry".
Shupyk National Healthcare University NHU of Ukraine of the Ministry of
Healthcare of Ukraine, Kyiv, 2023.
The dissertation solved a relevant problem in modern dentistry: improving the
effectiveness of the treatment of distal occlusion in children aged 7 to 13 years with
impaired respiratory function. The main task of the work was to justify, develop, and
implement a modified functional orthodontic appliance into the treatment algorithm to
improve the results of treatment in this group of patients.
The scientific novelty of the work lies in the study of the features of clinical,
anthropometric and functional indicators of the dentoalveolar system (DSA) and
functional indicators of breathing with an analysis of the treatment results, which will
make it possible to comprehensively approach the choice of the method of orthodontic
treatment.
To solve the research problems, a comprehensive examination of 231 patients
with distal occlusion was conducted.
The patients were divided into two study groups: 53 children with Class II,
Division 1 malocclusion (51%) were included in Group I, and 51 children with Class
II, Division 2 malocclusion (49%) were included in Group II. Depending on the
appliance used for treatment, each group was further divided into two subgroups. The
first subgroup of Group I included 31 children whose orthodontic treatment was
performed with the proposed modified functional appliance (MFA) (29.8%), and the
second subgroup included 22 children who were treated with a twin-block (21.15%).
Similarly, the first subgroup of Group II included 28 children who were treated with
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MFA (26.92%), and the second subgroup included 23 children who were treated with
a twin-block (22.11%). A control group of 30 children without malocclusion (Class I)
and respiratory pathology was formed.
To improve the effectiveness of patient treatment, a scientifically grounded
methodology for the use of the proposed modified myofunctional appliance (MFA)
(patent for a utility model No. 153998, dated September 28, 2023) was proposed.
Based on the analysis of the results obtained, a number of extremely important facts
were established, and a number of significant factors were identified that affect the
formation of distal occlusion in a defined patient population.
Before orthodontic treatment, chronic catarrhal gingivitis (CCG) of mild and
moderate severity was diagnosed in 29.5% and 6.6% of children in group 1,
respectively; mild and moderate hypertrophy gingivitis was detected in 6.6% and
1.6%, respectively. In group 2, CCG of mild and moderate severity was detected in
38.4% and 8.1% of children, respectively, and mild and moderate hypertrophy
gingivitis in 15.2% and 5.1%, respectively, which significantly exceeded the
indicators of children in group 1 with malocclusion with class II, division I according
to Angle and correlated with the severity of distal occlusion.
In the II group, worse OHI-S hygiene index values (Oral Hyhiene IndexSimlified) were determined: 1.52 ± 0.09 and 1.4 ± 1.01, respectively, for I-1 and I-2
groups, compared to the I group values of 1.6 ± 0.54 and 1.55 ± 0.07, with control values
of 0.6 ± 0.22 (p ≤ 0.05).
