The prevalence of deep bite indicates that this pathology is one of the most common forms of dental and jaw anomalies both in Ukraine and in the world as a whole. Thus, the average prevalence rate is about 25% and varies depending on the region, age of patients and stage. In particular, in Europe this pathology is diagnosed on average in 37% of the population and is considered the most common among the rest of the world regions. In addition, there is a dependence on age, so a severe stage of deep bite (incisor overlap ≥ 5 mm) is observed in about 20% of children and 13% of adults. Also, among vertical occlusion pathologies, deep bite accounts for approximately 95.2%.
In addition, an important feature of the manifestations of deep bite is the displacement of the joint condyles of the lower jaw distally, as well as hypertonicity of the masticatory muscles, which together create the basis for the development of temporomandibular joint (TMJ) diseases and the appearance of symptoms characteristic of TMJ dysfunctional disorders. Recent scientific studies have proven the connection between the decrease in the distance from the posterior edge of the joint head to the posterior edge of the joint fossa and the occurrence of pain symptoms, which, in turn, is responsible for the increase in the ratio of bioelectrical activity to bioelectrical rest of the muscles and the increase in the severity of muscle changes.
It is also important that, according to studies conducted in recent years, TMJ pathology ranks third in prevalence among dental diseases, in addition, it is necessary to state the undeniable fact of the increase in the prevalence of TMJ dysfunction every year. Thus, as of now, temporomandibular joint pathology is diagnosed in approximately 20% of children and adolescents, as well as in almost 80% of the adult population. In addition, a dangerous feature of the development of TMJ diseases is a long asymptomatic period, which can cause permanent and irreversible changes that negatively affect the quality of life of patients. Therefore, there is a need to develop algorithms for timely diagnosis of initial morphological changes and search for methods for their early leveling.
Based on the above facts, it should be noted that patients with deep bite most often have non-localized pathology, which extends not only to the teeth and dentition, but also to the entire dentofacial apparatus, to which the TMJ, masticatory and facial muscles directly belong. Thus, it is necessary to take into account all components of the diagnosis and pathology, which will allow for a comprehensive approach to both the diagnosis of these patients and the development of a treatment plan in order to choose the optimal method, which will allow achieving not only aesthetic, but also functional results.
Despite the variety of scientific works and studies that highlight different approaches to studying the problems of both deep bite and TMJ pathologies, in domestic and foreign scientific literature we did not find data on the degree of disorders in the musculo-articular complex in deep bite, methods for eliminating these pathologies through orthodontic treatment, and the impact of orthodontic structures not only directly on dental pathology, but also on articular and neuromuscular. Our study is aimed at assessing morphological changes in the TMJ in patients with deep bite after orthodontic treatment using magnetic resonance imaging (MRI), as well as tracking functional changes using muscle-occlusal balance analysis using the Teethan synchromyograph, in order to provide justification for orthodontic treatment of deep bite in TMJ pathology.
The above dictates the need for a deep and comprehensive study of deep bite with manifestations of disorders of the musculo-articular complex, the search and development of new optimal methods of treating this pathology.
Therefore, the goal of our study was to increase the effectiveness of diagnostics and treatment of deep bite with functional correction of the musculo-articular complex by improving its methods, a comprehensive and multidisciplinary approach to the indicated issues.
