Dynamic analysis of the body's balance with the aid of PODATA platform in patients with vestibular disorders and malocclusions

Introduction: Human posture is linked to a certain stable anatomic position between head, body, and upper and lower limbs. Posturology is the science for the human posture. The connections between the vestibular, ocular, stomatognathic, postural, and proprioceptive systems are studied due to their muscular chains interconnections.Aim: The present research aims to study the characteristics of the body’s balance in patients with vestibular disorders and orthodontic malocclusions, utilizing the PODATA platform.Materials and Methods: A total of 83 patients in the time period November–July 2022 were included. All patients filled out written informed consent forms in order to participate. The study received approval by the Medical University of Varna’s Ethics Committee. Patients were also provided with questionnaires in order to assess their symptoms. An ENT specialist and a dentist examined all patients. Patients were divided into several diagnostic groups.Results: When examined on the platform, patients shifted the center of gravity (CoG) of the body more often backwards and to the right side. Most patients with a shift of CoG backwards and to the right had a temporomandibular disorder (TMD) on the left side. Female patients were more affected than male ones. In patients who also had a vestibular disorder, CoG of the body was more often shifted backwards and to the right. Thirty-one had a malocclusion. Patients with a change of the middle line and deep bite were the most prevalent and they shifted CoG backward and to the right or only backwards.Conclusion: The presented study confirmed that there is a connection between the postural, stomatognathic and vestibular systems. Disorders in either of the systems results in consecutive changes in the others

Epidemiological study of premature extraction of 5-6-year-old children from Northeastern Bulgaria

Primary teeth lost one or more years before the time of their physiological exfoliation are prematurely lost. The aim of this study is to show the percentage of prematurely extracted teeth of urban and rural children, the types of the prematurely lost teeth and the reasons for their early lost. Subject of monitoring of the epidemiological research were 1200 children (half of them are from urban regions and the other half are from rural areas) examined by strictly calibrated teams of dental specialists. The DMF (T+t) index is used to measure the dental health. We calculate the missing teeth associated with the age of the children. The teeth we considered as a prematurely lost, were extracted one and more years before the time of their physiological exfoliation. The percentage of the prematurely extracted teeth is 4,6. There was a statistically significant difference in the relative shares of the prematurely extracted teeth of the urban (3,67 %) and the rural children (5%). The second molars are the most often extracted primary teeth both of the rural children (61,67%) and the urban children (57,7%), followed by the first molars - 35,29% for the rural and 34,41% for the urban children. The canines are the most rarely prematurely extracted teeth - 2,49% (rural children), 7,7% (urban children).The main reason for the early teeth loss is the carious lesions - in 94,12% and only 5,89% - other reasons. This results demonstrates the connection between premature extraction of the primary teeth, carious activity and the need of prophylaxis

Premature tooth loss. Literature review

Преждевременна загуба на временни зъби е налице, когато зъбът е екстрахиран една и повече години преди периода на физиологична смяна. Целта на настоящия обзор е да разгледа разпространението на преждевременната зъбна загуба. Проблемът с преждевременната зъбна загуба налага вземане на профилактика както на зъбния кариес, така и на малоклузиите, чрез поставяне на местопазители.Premature loss of deciduous teeth occurs when the tooth is extracted one or more years before the period of physiological exfoliation. The aim of the review was to examine the prevalence of premature tooth loss. The problem of the premature tooth loss requires prevention as tooth decay and orthodontic deformations by using space maintainers

Dental fear and premature tooth extraction

Dental avoidance is a high risk factor for development of odontophobia and poor oral health including premature tooth extraction in children.The aim of this study is to evaluate the connection between the dental fear and premature tooth loss. Subject of monitoring of the clinical research were 140 school children with mixed dentition. The clinical group consists of 90 children with prematurely extracted teeth. The patients from the clinical group were divided into three groups of 30 patients. The control group consists of 50 children with intact denture. А special questionnaire was filled from the parents of the examined children about the dental fear of their children, whether there is such a fear or not. The results show that while in the control group the majority of children are not afraid of dental treatment - 79,2%, then in groups surveyed more than half of the children said they are afraid of dental treatment, especially the third group - 57,7%. Conclusion: The children with prematurely extracted teeth have a higher level of dental anxiety due to which they are with poor dental health and early tooth loss. The use of behavioural techniques are recommended in order to improve their oral health

Dental malocclusions in children with nasopharyngeal obstruction of allergic origin

Introduction: Allergic rhinitis is one of the most common allergic diseases in humans. According to the literature its frequency reaches 30% in children and 40% in adults. In the last two decades, allergies in children have drastically increased.Aim: The purpose of our study is to establish the effect of nasopharyngeal obstruction of allergic origin in the development of the dental arches and occlusion in children with primary and mixed dentition.Materials and Methods: A total of 1667 children from Varna aged between 3 and 12 years were examined. All children were examined by the same orthodontist, while children presenting with mouth breathing were diagnosed and examined by an otolaryngologist. The results of the orthodontic examination of each child were assessed according to 19 indicators, outlined in specially developed tables.Results: In primary dentition 63% are with Class I relationship, while in mixed dentition the precentage of the children with Class II relationship is increased—55% and with mesial occlusion—7%. In vertical dimension in mixed dentition, there are cases of open bite of more than 3 mm and cases of deep bite that are not present in primary dentition.Conclusion: Allergic rhinitis in children with primary and mixed dentition leads to reduction in the size of the jaws, in the sagittal and transverse planes, crossbite in the posterior segment, distal occlusion and overjet. Nasal obstruction of allergic origin creates a greater risk of development of open bite and to a lesser extent, development of deep bite.

Tools for quality of life assessment in patients with obstructive sleep apnea

Obstructive sleep apnea (OSA) is found in 24% of men and 9% of older women. Given the high prevalence of the OSA syndrome and its effects on physical and mental function, the quality of life (QoL) in OSA has aroused great interest in the modern scientific literature. The interest in QoL in patients with OSA is so great that various studies are being conducted. The purpose of this article is to present the various tools for assessing QoL in patients with OSA. For the period January 2020 - June 2020, in the available database (PubMed, BioMedCentral, ScienceDirect, Scopus, Web of Science), a systematic analysis of scientific publications examining the assessment of QoL in patients with OSA was performed. This review illustrates the variety of tools used to study the assessment of health-related QoL and OSA. The published data in the research are mostly limited to the assessment of CPAP, and the effects on QoL after the performed surgical, dental and behavioral treatments for OSA remain largely unexplored

The importance of upper first permanent molars position for the orthognatic occlusion

Development of the dental arches and occlusion in permanent dentition can be divided into several stages and has to be observed regularly. The first permanent molar eruption is related to the onset of significant changes in the developing occlusion. Although this tooth is seen as the `key to occlusion` its value as an anchorage is debatable.The aim of the article is to study the correct position of the upper first molars in the two planes of space - the sagittal and transverse planes.In this article the position of the first upper molar is examined with the aid of diagnostic records, such as study cast, orthopantomogram (OPG), and lateral cephalometrics. A literature review includes Bulgarian and foreigner authors.Angle, who in 1899 referred to the maxillary first permanent molars as the `key to occlusion`, was the first to mention their importance within the dentition. According to Angle, the line passing through the middle of the mesiobuccal cusp of the upper first molar coincides with the line passing through the buccal groove of the lower first molar. After Angle, other authors have discussed the position of upper molars from different point of view, such as their relation or position in the maxilla, anteroposterior axial inclination and rotation. As indicated by Lamons and Holmes molar rotations commonly exist in Class II malocclusions. The molars are usually rotated around an axis lingual to their central fossae. In an ideal occlusion the buccal surfaces of the upper first molars are usually parallel to each other.On the OPG Kurol and Bjerklin measured the axial mesial inclination of upper first molar. The tipping of the molars is measured by the angle formed between the tangent line to the mesial surfaces of the root and crown and the line through the lower margins of the left and right orbits.According to Sassouni, the mesial contour of upper first molar should to lie on the 4th arc - the temporal arc. If the molar is anterior to this arc, a treatment with distalization could be initiated. The temporal arcnasion distance measured on the radius is equal to the distance from point ANS to the upper first molar. The position of the upper first molar varies with the position of the upper central incisors. The basic hypothesis is that if the upper first molar has a fixed position in the face, any increase in the total upper dental arch length will be transferred to the incisor area. Any change in the anteroposterior position of the upper first molar could influence the position of the mandibular- leading to Class II malocclusion.Ricketts pointed out that the average distance from the pterygoid vertical (PTV) to the distal surface of upper first molar is the sum of the age of the patient + 3mm, in a growing patient. This diagnostic method can help the orthodontist to decide whether to extract teeth or to distalize the molars.Any loss of space in the arch is a justification for early orthodontic treatment. Mediopalatal rotation of the upper molar is an additional problem in the final phase as well. The rotation of upper first molars is measured by the angles formed by the intersection of lines going over the tips of the mesiopalatal and distobuccal cusps of each molar (Ricketts line) with a straight line marked over the palatine raphe.The problem of reduced arch length has an impact on the final treatment stage when the major orthodontic goal is establishing a tight teeth intercuspation. The molars influence the transfer of occlusal forces to the facial skeleton. The upper first molar tolerates more changes in the position than the lower one. The correct position of the upper molar ensures a stable occlusion with significantly low grade of relapse

The correlation between the rotation of upper first permanent molars and malocclusions in the individual dental arch and in the occlusion

IntroductionMalocclusions disturb the integrity of the dental arch and the interdental/occlusal relationship. All this leads to a change in the position of the upper molars in the sagittal, transversal and vertical plane. The rotation of the upper first molar leads to a shift of position of molar cups in a mesio-distal direction demonstrated by the great impact on the distribution of occlusal forces.AimThe rotation of upper first molars should not be underestimated in the biometrical analysis of diagnostic dental casts as this can lead to incomplete and improper treatment plan.Ðœaterials and MethodsOur study investigated 681 children aged 7-10 years who attended the Department of Orthodontics at the Faculty of Dental Medicine in Varna. All children were clinically evaluated and biometrical assessment of diagnostic dental casts was performed. Diagnostic records included also photo-analysis and measurements of diagnostic dental casts. The relationship between the rotation of upper first permanent molars and the transversal and sagittal dimension, and also the overjet were assessed. The degrees of rotation were classified using the Friel and Vigano methods.ResultsA regressional statistical analysis was conducted to determine the frequency of malocclusion and to establish the relationship between the rotation of upper first permanent molar and the length of the arch, the intercanine distance, and the overjet. The comparative analysis demonstrated inverse relationship not only between the rotational position of the molars and the length of the arch, but also between the canine distance and the rotation of the upper molars (p<0.01). It is reported that when an overjet up to 4 mm is present,  the mediopalatal rotation of the molars is negatively affected.ConclusionLosing the length of the arch leads to compression of the dental arch, medialization of permanent molars and crowding of the frontal teeth. The problem of mesiopalatal rotation of upper first permanent molars is manifested through increased overjet and increased overbite

Significance of the DMF(T+t) index for the children with prematurely extracted teeth

Premature extraction of temporary teeth is a consequence of different factors such as socio-economic status of the population, level of caries activity, oral hygiene, presence of fluoride in water, philosophy of the dentist. The aim of this article is to compare the DMF (T+t) between children with premature extraction and those without premature extraction. Subject of monitoring of the clinical research were 140 children between 6 and 9 years old.  The clinical group consisted of 90 children with prematurely extracted teeth, divided into three groups. The control group consisted of 50 children with intact denture. The dental status was examined and registered according to the WHO by the DMF (T+t). There was a statistically significant difference in the distribution of caries DMF(T+t) between the control groups (2.34±019) and clinical groups (between 5.17±0.33 and 6.40±0.41). The children with premature extraction of temporary teeth had higher caries activity compared to the control group (children without early loss of teeth). The children with prematurely extracted temporary teeth and severe orthodontic deformation had the highest prevalence of DMF(T+t). These results demonstrate the connection between DMF(T+t), malocclusions and the need for prophylaxis

Diagnostic approach to the incorrect position of lower second premolars

Abstract: The lower second premolar is regarded as the third most common impacted tooth after lower wisdom teeth and upper canines. The aim of the present study is to apply objective diagnostic methods to help determine the impaction likelihood of lower second premolars and their distal inclination. For the purpose of this study 137 panoramic radiographs (OPGs) have been examined of children aged 8 - 16 years. The methodology used in this study helped measure the inclination and angle between the lower second premolar and the crown and axis of the first permanent molar and the mandibular plane. Prevalence of the distal inclination of lower second premolars was observed. Indicators for the impacted lower second premolar proved to be the germ inclination of the lower fifth tooth in relation to the first molar of more than 30° and the intersection of the crown of the sixth tooth by the axis of premolar as well as the inclination towards the mandibular plane of less than 68°. Early extraction of deciduous molars, reserving or creating space when there is a lack of space, allow for favourable conditions for altering the eruption path of the premolar