UNIFIED ALGORITHM OF REHABILITATION OF PATIENTS WITH OCCLUSIONAL DISORDERS OF IATROGENIC GENESIS COMBINED WITH VERTICAL MALOCCLUSION

Malocclusion is common dental dis-eases. According to epidemiological studies, occlusal pa-thology in the vertical plane is 5-7% among all anomalies.Occlusial problemscontributeto the violation of basic body functions such as breathing, speech, chewing, which significantly impairs the quality of life of patients.Orthodontic treatment of adult patients has its own characteristics associated with the presence of concomi-tant pathology, as well as the inability to correct some pa-thologies only by orthodontic treatment. In the case of se-vere occlusion, complicated by tooth loss, a combination of surgical, orthodontic and prosthetic methods can achieve the best results. The key to successful treatment of such patients is a detailed diagnosis and a well-developed rehabilitation plan.Occlusive disorders, especially those that have arisen or been provoked as a result of dental treat-ment, usually lead to changes in all parts of the dental sys-tem and a number of complications. These structural 312 (22) квітень-червень, 2022ISSN2521-1455 (Print)ISSN2523-4250 (Online) «Art of Medicine»changes usually make it difficult or sometimes impossible to conduct orthodontic treatment without the use of a set of special preparatory measures.The aim of our study: to propose a unified algo-rithm for complex dental rehabilitation of patients with oc-clusive disorders of iatrogenic origin in combination with vertical malocclusionand to prove its effectiveness.During 2019-2020, 55 patients with occlusive disorders of iatrogenic genesis in combination with pathol-ogy of occlusion in the vertical plane aged 23 to 47 years (mean age 36.1 ± 5.2 years) were examined, including 32 women and 23 men. Depending on the complaints and clinical manifestations, patients were divided into three groups. The first included 16 people with muscular mani-festations, the second -18 with disorders of the temporo-mandibular joint (TMJ) manifestations, the third -21 peo-ple who, in addition to manifestations of TMJ and muscles, had primary neuritic disorders. All patients before and 6 months after treatment underwent clinical and laboratory examinations, radiography, electromyography and digital occlusion analysis of T-scan.There was a complete disappearance or signifi-cant reduction of complaints and symptoms after 6 months of rehabilitation in all 3 groups of patients.The implemen-tation of our complex rehabilitation algorithm has led to the normalization of the bioelectrical activity of the masticatory muscles according to electromyography re-search, which is one of the most important criteria for the transition to the next stage of treatment and replacement of temporary restorations with permanent ones.Positive dy-namics in the position of the TMJ condyles (tested with Computed Tomography) after the use of occlusal splints was observed in all patients and served as a marker for de-ciding to move to the next stage of dental treatment, in-cluding orthodontic correction.Also, occlusal balancing and normalization of the balance of occlusal contacts un-der the control of digital occlusal analysis T-Scan III was achieved in all patients in the preparatory stage and then monitored and maintained at all subsequent stages of com-prehensive rehabilitation.Our study showed that the proposed algorithm for comprehensive rehabilitation of patients with iatrogenic occlusive disorders in combination with vertical malocclu-sion increases the effectiveness of orthodontic treatment of suchpatients and significantly reduces the duration of treatment in all 3 groups. This sequence of diagnostic and therapeutic measures provides the best opportunities for the patient to achieve maximum functional and aesthetic results.