RESULTS OF COMPREHENSIVE TREATMENT OF PATIENTS WITH ORTHODONTIC PATHOLOGY AND PATHOLOGICAL TOOTH WEAR.

Abstract

Introduction: To analyze the treatment outcomes in patients with orthodontic pathology and pathological tooth wear under different approaches to correcting the position of the occlusal plane.

Materials and methods: 65 individuals with orthodontic pathology, impaired incisal guidance in the form of absence of the C. Christensen phenomenon, counterclockwise inclination of the occlusal plane, and pathological tooth wear were examined. Patients in Group I received treatment using bracket systems and micro-implants to correct the position of the occlusal plane, while patients in Group II were treated with bracket systems only, without any intervention regarding the occlusal plane. The jaw relationship was assessed according to E. Angle's classification, the level of incisal overlap, the presence of the C. Christensen phenomenon, and lateral cephalometric data were compared to evaluate the position of the occlusal plane relative to the Frankfurt horizontal (angle FH-OP) and the anterior cranial base (angle SN-OP). All patients underwent indirect tooth restorations using reinforced nano-hybrid composite material - 446 restorations in Group I and 489 restorations in Group II, the condition of which was evaluated using a number of criteria.

Results: Before treatment, the FH-OP occlusal plane angle in Group I patients was 1.48±0.61, and the SN-OP angle was 8.92±0.78. In Group II patients, these values were 2.15±0.66 and 7.87±0.70, respectively - all values being below the normal range. After treatment, the FH-OP and SN-OP values in Group I approached the normal range, amounting to 8.55±0.61 and 13.82±0.54, respectively. Sagittal incisal guidance and the C. Christensen phenomenon were fully restored. Eight restorations (1.8%) exhibited marginal adaptation defects, 11 restorations (2.5%) had marginal discoloration, and 3 restorations (0.7%) had cracks; no chipping was observed. In Group II, FH-OP and SN-OP values improved to 2.41±0.67 and 8.12±0.48, respectively, but did not reach the normal range. Sagittal incisal guidance and the C. Christensen phenomenon were restored in only 6 patients (17.6%). Among the restorations, 43 (8.8%) exhibited marginal adaptation defects, 47 (9.6%) showed marginal discoloration, 57 (11.7%) had cracks, and 67 restorations (13.7%) had chipping.

Conclusions: The results demonstrate the effectiveness of the applied treatment approaches for patients with orthodontic pathology and pathological tooth wear, which should be attributed to the normalization of the occlusal plane position, restoration of the C. Christensen phenomenon, the advantages of using orthodontic micro-implants, and the application of indirect tooth restorations.