Hristina Arnautska

THE ROLE OF MOUTH BREATHING ON DENTITION DEVELOPMENT AND FORMATION

https://www.journal-imab-bg.org J of IMAB. 2018 Jan-Mar;24(1) ABSTRACT Introduction: The influence of mouth breathing on the development of the dentition and dento-facial deformities is a problem causes concerns among the medical specialists. Mouth breathing has a major impact on the development of the maxillo-facial region, occlusion and muscle tonus. Aim: The aim of this study is to assess the relationship between etiological factors, pathogenesis and disturbances in mastication in mouth breathing patients. Material and methods: For this article, data is obtained from 43 medical, literary sources. Results: Literature review demonstrated that mouth breathing habit affects mostly children aged 7 12 years. In the vast majority of studies, the authors established a relation between mouth breathing and the development of maxillo-facial region and occlusion. The malocclusions described include a distal occlusion, anterior open bite, increase overjet, posterior crossbite, crowding and average incisors inclination disturbances. These clinical conditions become more complicated in the late-mixed and permanent dentition if mouth breathing continues to persist. Conclusion: The habitual mouth breathing is a great medical problem nowadays. An increasing numbers of patients with this condition although the development of technology for early diagnostic is embarrassing. This condition is strongly related with different malocclusions such as anterior open bite, overjet, distal occlusion, underdeveloped and narrow upper jaw, increased anterior facial height.

CARIES PREVALENCE AMONG 5-7 - YEAR-OLD CHILDREN IN NORTHEAST BULGARIA

The aim of the current epidemiological research is to present the caries prevalence in children and on tooth surfaces in 5-7 – year-olds from Varna. The object of the current epidemiological research is a representative part of 100 5-7 – year-old children, randomly chosen. The unit of observation is temporary and early mixed dentition, primary molars and their occlusal and approximal surfaces. The survey was carried out according to WHO’s criteria. For caries risk assessment it is used the ICDAS system, where for a diagnostic limit was chosen d3mft. As a result from the conducted epidemiological research it is concluded that in this age group 93% of the children have experience with caries and barely 7% are caries free (dmft/ DMF(T+t)=0). The intensity d1-3mft and D1-3MF(T+t) of the caries have an average value of 5,76 ± 2,9. The relative share of the approximal caries of the primary molars on maxilla and mandible is 81,5% for both. The relative share of the occlusal caries is 19,6%. In the current research, it is not established statistically significant difference (P>0,05) concerning approximal lesions on first and second primary molar. There is the statistically significant difference (P<0,05) in the relative share of occlusal caries, which mainly affects the occlusal surface on the second primary molar. The relative share of the children without occlusal caries on primary molar is 60%, while those without approximal caries is barely 18%.

Orthodontic extrusion with followed surgical extraction of high-risk lower third molar

lower third molar with sings that indicates high risk of postoperative complications. Materials and methods: We represent an orthodontic extrusion followed by surgical extraction of lower third molar. For precise diagnostics and approach to suitable method of treatment we used standard panoramic radiograph and CBCT. As a method of surgical treatment we chose assisted orthodontic extraction with individually manufactured ring with soldered bar, fixed to tooth 47. Results: In our clinical case we achieved traction of the impacted lower third molar to safe distance from the mandibular canal. On the second stage of the treatment we performed a classic odontectomy without affect or damaging the IAN. Conclusion: The classic odontectomy is surgical method with high risk of damaging the IAN when the impacted tooth is very close to the mandibular canal. The orthodontic extraction like an alternative surgical method of high-risk lower third molars is preventive method, by which there is minimal risk of damaging the nerve during the surgery. The orthodontic extrusion makes the following surgical extraction a safe and secure method for the patient.

Necessity of CBCT – examination in assessment of the surgical approach for the extraction of impacted lower third molars

Aim: The aim of this research is to demonstrate the necessity of CBCT – examination for evaluation of the surgical approach of high risk impacted lower third molars. As “high risk” we defined lower third molars which have signs of proximity to the mandibular canal seen on standard panoramic radiography. Material and methods: All patients who had undergone a CT examination between september 2015 and october 2016 were reviewed. We included images from conical-beam computed tomograph made in the Department of radiologic diagnose, University medical and dental centre of the Medical university of Varna. The device used is Planmeca ProMax 3D Max with software for images Planmeca Romexis. We chose 100 images randomly. From these images we selected 39 images with high-risk lower third molars. We examined different signs with which we defined the exact position to the mandibular canal of 60 wisdom teeth and we managed to asses the risk of damaging the IAN during a classical odontectomy of these teeth. In the research we included the panoramic radiographs of 20 patients from these 39 cases. Results: From the examination of the CBCT images we found: 28 lower third molars where the mandibular canal runs apical and have contact; 11 where the mandibular canal runs apical in contact with the tooth and it’s seen penetration of the apices of the tooth; 10 where the mandibular canal runs buccal with contact; 8 where the mandibular canal runs lingual with contact; 3 where the mandibular canal runs between the roots touching one/both of them. In three of the cases we found severe deviation of the root apices. From the examination of the panoramic radiographs we found: 5 cases with darkening of roots in the apical area; 8 with interruption of white line (lamina dura) of the mandibular canal; 1 with diversion of the mandibular canal with/without narrowing of the mandibular canal; 6 without any of these three signs. Conclusion: The development and rapid commercialization of new technologies like CBCT allows us to have precise images and exact diagnosis of the diseases in the oral and maxillofacial area. Our study confirmed the high diagnostic value of CBCT regarding to precise the position of the lower third molars to the mandibular canal and IAN. This gives the clinician the opportunity to determine which lower third molars are “high risk” teeth and to choose the best method for surgical treatment.