Американский Научный Журнал FEATURES OF ORTHODONTIC TREATMENT OF CHILDREN WITH NON-CARIOUS LESIONS OF HARD TISSUES OF TEETH

Abstract. According to the epidemiological survey in the Republic of Bashkortostan, a high prevalence of dentoalveolar anomalies and non-carious lesions of hard dental tissues in children was revealed. Non-carious lesions of the teeth limit the use of metal elements in orthodontic appliances. Orthodontic treatment was performed for 26 children aged 7-11 years with dentoalveolar anomalies in combination with non-carious lesions of the hard tissues of the teeth. The authors evaluated the effectiveness of the use of LM activator in orthodontic treatment of children of the observed group. The scheme of complex dental treatment of this category of patients is presented. Скачать в формате PDF
American Scientific Journal № ( 31) / 2019 19

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С.В. 1 -е изд. Уфа: ООО "Печатный домъ", 2016.

FEATURES OF ORTHODON TIC TREATMENT OF CHI LDREN WITH NON -CARIO US LESIONS
OF H ARD TISSUES OF TEETH

Chuikin Oleg Sergeevich
Snetkova Tatyana Vladimirovna
Fardutdinova Alia Omarovna
Sharafutdinova Guzel Khakimovna
Muradyan Shushanik Artakovna
Mansurova Sofia Marsovna
Department of Pediatric Dentistry and Orthodontics,
Bashkir State Medical University , Ufa

Abstract . According to the epidemiological survey in the Republic of Bashkortostan, a high prevalence of
dentoalveolar anomalies and non -carious lesions of hard den tal tissues in children was revealed. Non -carious
lesions of the teeth limit the use of metal elements in orthod ontic appliances. Orthodontic treatment was performed
for 26 children aged 7 -11 years with dentoalveolar anomalies in combination with non -cario us lesions of the hard
tissues of the teeth. The authors evaluated the effectiveness of the use of LM activator in orthodontic treatment of
children of the observed group. The scheme of complex dental treatment of this category of patients is presented.
Key words : dentoalveolar anomalies, non -carious lesions of hard tooth tissues, LM activator, remineralizing
thera py, complex dental treatment regimen.

According to an epidemiological survey
conducted by the Department of Pediatric Dentistry and
Orthodonti cs, the prevalence of dentoalveolar
anomalies in Ufa, which is the center of the
petrochemical industry of the R epublic of Belarus,
during the period of a milk bite is 35.2%, in the early
shift bite - 72.5%, in the late interchangeable bite -
78.4%. Anomal ies in the structure of the hard tissue of
teeth were detected in 18.4% of the examined children,
enamel hypopla sia of temporary teeth in 17.8% of
preschool children, and permanent teeth in 10.9% of
schoolchildren. In the structure of tooth enamel
hypoplas ia, a large part falls on systemic enamel
hypoplasia, which is 64.7%. This indicator is six times
higher than th e data on the prevalence of enamel
hypoplasia in children living in areas with more
favorable environmental conditions [1 -6]. The
formation of e namel of permanent teeth begins at the
end of fetal development, but the main part of the
histogenesis of hard t issues of permanent teeth
proceeds after birth. Hypoplasia of permanent teeth
mainly reflects the condition of the child in the first

20 American Scientific Journal № ( 31) / 20 19
years of l ife. This defect develops in various diseases
that occurs in children during the formation and
mineralization of teeth. Systemic enamel hypoplasia
(SGE) accounts for 90.6% of all types of hypoplasia.
Ozhgikhina N.V. (2002) revealed a high prevalence of
dec ay of permanent teeth in children with systemic
enamel hypoplasia - 87.09% [7 -13]. The carious
process that deve lops against the background of
hypoplastic enamel is proceeding actively, several
carious cavities are possible on one tooth. Hypoplastic
teeth are highly sensitive, as evidenced by the
established fact of the early occurrence of the carious
process in rec ently erupted teeth. Children with SHE
need medical supervision by a dentist in order to carry
out preventive measures aimed at preventing the
development of caries and adequate treatment of
already encountered complications of enamel
hypoplasia. Non -cario us lesions of the teeth limit the
use of metal elements in removable orthodontic
appliances, and can also cause deterioration in the
fixation of fixed orthodontic systems. Considering
possible complications, we used an LM activator in this
category of pati ents in orthodontic treatment.
Objective: to evaluate the effectiveness of the use
of LM activator for the treatment of gastroenteritis in
child ren with non -carious lesions of the teeth. Under
our supervision, there were 26 children aged 7 -11 years
with de ntoalveolar anomalies in combination with non -
carious lesions of the teeth, in the orthodontic treatment
of which the LM activator was used - a standard
apparatus of industrial production having the form of
ideal occlusion. The device is made of biocompati ble
and elastic silicone. Available in different sizes and
four modifications - low model (for correcting deep
incisal occlusion / disocclusion) , high (for treating
vertical incisal disocclusion), long (used for eruption of
second permanent molars) and sho rt (before eruption of
second permanent molars), 37 different combinations
of models and sizes allow you to choose the specific for
each patient without making individual changes. Early
orthodontic treatment with the help of an LM activator
allows normaliz ing occlusion of the dentition, the
function of the masticatory apparatus, and optimizing
the formation of the dentofacial system during the
gro wth and development of the child. Indications for
the use of LM activator are: bad habits of the child in a
temp orary and early shift bite; anomalies of occlusion
in the horizontal, vertical and transverse planes;
crowding of teeth in the frontal section a nd their
rotation; it is possible to use an LM activator as a
retention appart. Contraindications to the use of LM
activator: class III anomalies according to Engl
classification, significant narrowing of the upper jaw,
conflict between children and parent s, serious
pathology of the respiratory tract. Individual selection
of the LM activator is carried out using the LM -
OrthoSizer measuring line. When determining the size
of the activator, it is necessary to take into account the
presence of crowding of the teeth or, conversely,
diastema, three. Depending on the pathology, an
activator of a larger or smaller size is u sed than
obtained according to the measurement results [1, 4, 7 -
11, 14 -19]. The clinic explains to patients and their
parents the need to use an LM activator, provides
training in proper hygiene when using an activator,
determines the application regimen ( two to three hours
during the day and during night sleep). In order to
increase the effectiveness of treatment with an LM
activator, the patient is offered a special motivational
material: a visual instruction made in the form of a
diary card with colorful applications. In the diary every
day is marked with a multi -colored sticker as a sign of
the successful use of the device, there are also gift cards
that can be installed in the lid of the container for the
activator. During the initial examination of the
observed patients during the period of a shift bite, the
following results were obtained: 23 examined (88.5%)
had decay of temporary teeth, dec ay of permanent teeth
was revealed in 16 people (61.5%). Intensity of caries
by KPU index + kp = 4.8. The level of hygiene in the
Green Vermillion index is 2.5 points (bad). All
observed patients were diagnosed with anomalies of
individual teeth (mainly in the frontal section),
anomalies of occlusion were detected in 13 children.
Six patients were diagnosed with loc al hypoplasia, 19 -
systemic hypoplasia, including 21 - spotted form, four
- grooved form, Stanton -Capdepon dysplasia - in one
patient. All obse rved patients underwent the following
dental treatment methods: training in individual oral
hygiene; controlled and professional oral hygiene;
reorganization; orthodontic treatment with an LM
activator; exogenous caries prophylaxis with the use of
reminera lizing drugs. Toothpaste R.O.C.S. was
prescribed as remineralizing agents. for adults, since
due to the action o f the enzyme bromelain, it effectively
and safely eliminates plaque and for a long time delays
its formation, has an anti -inflammatory effect, a nd
provides fast remineralization of teeth with calcium and
phosphorus, which is necessary for the prevention of
caries [14 -19]. Patients were advised to alternate
R.O.C.S. toothpaste. for adults with R.O.C.S.
toothpastes for children and schoolchildren wh o
contain the unique AMIFLUOR complex, which is a
combination of aminofluoride and xylitol. For each
remineraliz ation, R.O.C.S. Medical Minerals in the
form of applications lasting 12 -15 minutes once a day.
Applications were combined with the use of an LM
activator, which contributed to the isolation of the gel
from saliva and its long -term preservation on the teeth .
The children were under dispensary observation for
two years. During the second examination (after one
year), the index of CPU + CP amounted t o 4.8; Green
Vermilion Hygiene Index is 1.6 points (good). The
control of oral hygiene testified to the observan ce of the
standard method of toothbrushing, the correct timing of
the use of toothbrushes and the use of anti -carious
toothpastes. In the group we observed, an increase in
the intensity of caries was not noted. All patients
showed positive dynamics in orod ontic treatment: the
formation of the correct shape of the dentition,
elimination of crowding of the front teeth, bad habits
and myofunctional d isorders of the maxillofacial
region, normalization of the tongue. The LM activator
has several advantages: indi vidual selection of size and
model, cost -effectiveness (low -cost device), ease of
use, short visit to the doctor, longer intervals between

American Scientific Journal № ( 31) / 2019 21

visit s to the doctor (two months), the laboratory
manufacturing step is not required, and does not injure
hard tooth tissues, allows correction of dentoalveolar
anomalies, myofunctional disorders and functions of
the dentofacial system, as well as remineralizin g
therapy at home.
Clinical case. Patient G., 8 years old. Diagnosis:
vestibular position 2.1, 2.2 teeth, oral p osition 3.2, 4.2
teeth, diastema on the lower jaw, systemic hypoplasia
of enamel of permanent teeth. Orthodontic treatment is
carried out by an LM activator (low, short model, size
60), remineralizing therapy.
Findings. Given the high prevalence of
dentoal veolar anomalies and non -carious lesions of
hard tooth tissues in children in the Republic of
Bashkortostan, it is advisable to include an LM
activator in early orthodontic treatment, which avoids
the use of fixed orthodontic structures at later stages of
the formation of the dentofacial system. The presented
scheme of complex dental treatment of children with
AF in the presence of non -carious les ions of hard
tissues of teeth provides not only the effectiveness of
orthodontic treatment, but also a high leve l of
protection of teeth at all its stages.

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