Deep Bite Treatment in Patients with Musculoskeletal Disorders

Abstract

Relevance. Improving the effectiveness of the diagnosis and comprehensive treatment of patients with dentoalveolar anomalies associated with disturbances in the oral vestibule architectonics remains a significant issue in modern dentistry. This is because anatomical structures, such as labial frenula, buccal bands, and ankyloglossia, serve as important etiological factors in the development of dentoalveolar anomalies, may contribute to relapse after orthodontic treatment, and can lead to gingival recession. This issue also has legal significance, as the effectiveness of treatment depends on appropriate regulatory support and the actual availability of specialized dental care within the healthcare system. The limited incorporation of modern evidence-based approaches into clinical standards, along with unequal patient access to comprehensive treatment, necessitates the improvement of legal and organizational mechanisms to ensure the quality of medical care.
The objective is to evaluate the effectiveness of the comprehensive treatment of patients with dentoalveolar anomalies associated with altered oral vestibule architectonics using surgical correction and different postoperative therapeutic approaches. Furthermore, it aims to substantiate the need to improve the regulatory and legal framework and to integrate contemporary evidence-based approaches into the system of public health policy in Ukraine.
Materials and Methods. The study involved 30 patients aged 12–15 years with dentoalveolar anomalies and disturbances in oral vestibule architectonics. All patients underwent surgical correction of the oral vestibule using the conventional method, with wound healing by secondary intention. The patients were divided into two groups: Group I received Chlorhexidine-Denta during the postoperative period; Group II received a combination of Chlorhexidine-Denta and a hyaluronic acid–based gel (Gengigel). Clinical, cytomorphometric, and rheographic examinations were performed to assess the condition of the oral vestibule tissues.
Results. Patients demonstrated pronounced alterations in oral vestibule architectonics: the height of labial frenulum attachment was less than 5 mm, and connective tissue bands in the canine and premolar regions were present in 96.7% (²⁹⁄₃₀) of cases. Clinical and laboratory findings indicated reduced blood supply to the vestibular tissues. After treatment, statistically significant differences were observed between the two groups (p < 0.05).
Patients in Group II showed superior outcomes, including the formation of normotrophic scars, the absence of relapse and gingival recession in the canine and premolar regions, as well as the normalization of clinical and laboratory parameters.
Conclusions. A comprehensive approach to the treatment of oral vestibule architectonic disturbances, including surgical correction and the use of hyaluronic acid–based agents in the postoperative period, ensures improved clinical outcomes, promotes optimal tissue healing, and significantly reduces the risk of complications and relapse.