Today, patients with periodontal diseases have a significant number of abnormalities in the position of teeth and bite. According to the literature, orthodontic treatment of such pronounced anomalies requires a long time and a long retention period. Considering this, it was more important to detect early manifestations of orthodontic pathology for earlier and effective orthodontic treatment in the complex treatment of generalized periodontitis in such patients.
Thus, increasing the effectiveness of orthodontic treatment of patients with generalized periodontitis at a young age depends on the predominance of the autonomic nervous system type and by using a medicinal preparation to stimulate the formation of alveolar bone.
To determine the prevalence of early manifestations of maxillofacial anomalies and related periodontal lesions in young people, 225 young people who sought dental care for the treatment of various dental diseases were examined. A thorough examination of the periodontal condition revealed periodontal lesions (gingivitis and periodontitis) in 219 (97.33%) patients. In most of them, 208 (94.98%) of 219 patients had generalized periodontitis of the first degree, and only 11 (5.02%) of the youngest patients had gingivitis. All 219 (97.33%) patients with periodontal diseases showed signs of traumatic occlusion - the presence of premature tooth contact.
The examination of 150 young people with generalized periodontitis revealed that 67 (44.67%) of them had carious lesions of varying depth and activity (acute or chronic). In all 150 patients with generalized periodontitis, premature contacts (supracontacts) of teeth were detected. The presence of periodontal disease and supracontacts led to displacement of teeth. Most often, in 48 (32.00%) of 150 patients, displacement of the upper front teeth in the vestibular direction with the formation of a pathological diastema and tremor was detected. In 13 (8.67%) patients, in addition to the vestibular displacement of the frontal teeth, their deep overlap was also noted. In 28 (18.67%) patients, displacement of the lower frontal teeth in the lingual direction with the formation of a deep overlap and crowding of the lower frontal teeth was detected.
The removal of all periodontal irritants and cleaning of the root surface together with the individual hygiene measures carried out by the patients led to an improvement in the hygienic condition of the oral cavity and periodontal indices. The first weeks after the start of orthodontic treatment were accompanied by a deterioration of the oral hygiene condition and an increase in inflammatory processes in the periodontal tissues. After the completion of tooth movement in the retention period, the hygienic condition of the oral cavity and the values of periodontal indices improved.
During the retention period, the condition of the periodontal tissues improves and, accordingly, their mineralization increases. In patients of the main subgroup, the amount of calcium increases to 1.95±0.03 μmol/l, phosphorus - 5.87±0.03 μmol/l, and the Ca/P ratio - 1:3.01. In the patients of the comparison subgroup, respectively, 1.86±0.04 μmol/l, phosphorus - 5.01±0.04 μmol/l, and the Ca/P ratio - 1:2.69.
The long-term results of treatment after 6 months showed that in patients who underwent dispensary supervision with the use of retainers, therefore, the achieved result of orthodontic treatment was maintained. During dispensary supervision, assessment and correction of traumatic occlusion must be carried out. A certain level of mineral components of the oral fluid was also maintained during the 6-month examination period.
In the distant follow-up period of 12 months, the correct position of the frontal teeth was achieved in the patients of the main subgroup. In 3 (16.67%) patients of the comparison subgroup, re-displacement of displaced teeth was detected. The proper level of oral hygiene and periodontal indices was maintained. In patients of the comparison group, the value of the root exposure index increased by 1.6±0.07 mm in the main group and by 1.8±0.07 mm in the comparison subgroup.
Medicinal correction of the functions of the autonomic nervous system (in particular, parasympathetic) in combination with the drug "Calcinova", which increases the mineralization of the bone of the alveolar process, increases the effectiveness of medical and orthodontic treatment of patients with generalized periodontitis. More effective orthodontic treatment and a more stable result were achieved by additionally using the drug "Calcinova" in medical therapy, which improves the process of mineralization of the alveolar tissue. The effectiveness of the performed orthodontic treatment is confirmed by clinical and biochemical indicators.
