Comprehensive approach to treatment of malocclusion in children with different degree of caries resistance

Relevance. Skeletal malocclusion stands at the head of all oral diseases and is encountered in 32-35% of children and adolescents in Russia [7;12;15]. The number of malocclusions has increase due to various reasons, one of which is early extraction of deciduous carious teeth resulting in impaired vertical dimension and occlusion of teeth [1;14]. Diagnosis with due regard to caries resistance degree and planning of respective operative and orthodontic treatment are indispensable in children with skeletal malocclusion. 

Purpose – to increase effectiveness of functional treatment of malocclusion in children with various degree of caries resistance.

Materials and methods. There were examined 108 patients aged between 6 and 16 with Class I malocclusion according to Angle, abnormal arch-to-arch relationship and tooth position and various degree of caries resistance. 4 groups were formed: high, sufficient mean, decreased mean and low caries resistance of dental enamel. Intensity of carious process was detected in all patients before and after orthodontic treatment. The effectiveness of reminerlization administered by removable orthodontic appliances was evaluated by electrometrical testing of hard dental tissue. Surface EMG was used to assess normalization of tone of maxillofacial muscles in children by average amplitude of biopotentials of superficial masseter and temporalis muscles.

Results. Сhanges in caries intensity in children after treatment with removable orthodontic aligners indicate the necessity for remineralization of hard dental tissues during orthodontic treatment and it is confirmed by decrease of electroconductivity of enamel in children with sufficient mean, decreased mean and low degree of dental enamel caries resistance. Increase of biopotential mean amplitude during «total mastication» for masseter and temporal muscles confirms effectiveness of preformed elastic positioner along with myodynamic exercises.

Conclusions. The conducted study proves the necessity of comprehensive approach with procedures  increasing the degree of caries resistance of hard dental tissues during orthodontic treatment of skeletal malocclusion in children. 

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