Features of deep bite diagnosis in patients with disorders of the musculo-articular complex

Abstract

Deep bite occupies one of the leading places among all dental-jaw anomalies and, depending on the region of the world, is diagnosed in 21–45% of patients who have sought orthodontic care. In turn, in different clinical cases, the etiology of this pathology, its nature, and the influence of external and internal factors on it differ. The changes caused by the occurrence of a deep bite in the patient also spread to the muscle-articular complex, causing disturbances not only in its functionality, but also in the morphology of the tissues of the temporomandibular joints. Complaints about functional disorders are increasingly common among orthodontic patients with a deep bite, and the need for not only aesthetic rehabilitation, but also, above all, the restoration of normal function comes to the fore. Therefore, the aim of this work is an in-depth comprehensive analysis of patients with a deep bite by studying disorders of the musculo-articular complex and features of the development of craniofacial bone structures. In turn, the first, but fundamental stage on the way to the distribution of the patients examined by us for further research is the clinical stage of the study. In particular, we collected subjective data, anamnesis, patient complaints, which, in turn, were divided into aesthetic, functional and dysfunctional, and were analyzed; clinical evaluation of the severity of temporomandibular joint dysfunction according to Helkimo; clinical examination of the patient and identification of two types of deep bite. In addition, we analyzed the X-ray examination of the examinees, namely, the lateral teleroentgenography, which gave us reason to assume the interdependence of the features of the morphology of the craniofacial bones, the position of the incisors, and the condition of the patients’ musculo-articular complex. After a detailed analysis of the data we received, we came to the conclusion that it is most appropriate to divide the examined patients into two groups: with a mild degree of severity of temporomandibular joint dysfunction and with an average degree of severity. In turn, these groups should be divided into two subgroups, depending on the features of the location of the incisors: with medium or more pronounced (protrusion) incisor inclination and with insufficient (retrusion) incisor inclination. The obtained results dictate the need for further and more in-depth research into the peculiarities of diagnosis and treatment of patients of the obtained groups.