COMPLEX TREATMENT OF DENTAL AND JAW ANOMALIES ON THE BACKGROUND OF ARCHITECTURAL DISORDERS OF THE VESTIBULE OF THE MOUTH

Abstract

The aim of the study. The aim is to improve the effectiveness of comprehensive treatment of patients with pathological occlusion on the background of violations of the architecture of soft tissues of the vestibule of the mouth. Research methods. 30 patients with pathological occlusion and violation of the architecture of the vestibule of the mouth were examined and treated (anomalies of frenulums, the presence of connective tissue strands in the area of the vestibule of the mouth). Patients of group I (15 people) therapeutic treatment, orthodontic treatment with removable and non-removable orthodontic appliances, surgical correction of anomalies in the architecture of soft tissues of the vestibule of the mouth by plastic surgery, where the surgical wound is healed by secondary tension. Patients of group II (15 people) treatment is supplemented by our proposed surgical correction of tendons by frenuloplasty and vestibuloplasty, where the surgical wound heals with primary tension. In the postoperative period, chlorhexidine denta and gеngigel were prescribed according to the instructions. A clinical study was conducted, where the main point was to determine the height of attachment of connective tissue strands and bridle of the lip and the presence of changes in periodontal tissues, including recessions of the gums. The condition of the surgical wound and the processes of postoperative scar formation were studied, cytological examination of the mucous membrane was performed according to G.V. Banchenko. Scientific novelty. All patients before treatment were diagnosed with a violation of the architecture of the vestibule of the mouth, which was manifested by highly attached strands in the area of the canines, premolars and frenulum of the lip on the lower jaw (less than 5 mm); low-attached strands in the area of the canines, premolars and frenulum of the lip on the upper jaw (less than 5 mm). In patients where the surgical wound healed with primary tension, there was a significant difference in cytological characteristics (p≤0.05) and the formation of normotrophic scar, which did not cause traumatic effects on periodontal tissues, the position of a particular group of teeth. In the second group of patients there was a significant difference in the phenomenon of "creeping attachment" in comparison with the first group (p≤0.05). Conclusions. Surgical correction of disorders of the architecture of the vestibule of the mouth is an important stage of comprehensive treatment of patients with dental and jaw anomalies on the background of disorders of the architecture of the soft tissue of the vestibule of the mouth. Cytological characteristics of the oral mucosa and clinical characteristics of the postoperative scar indicate the predominance of surgery, where the wound heals with primary tension.