ANALYSIS OF THE DYNAMICS OF CHANGING THE INDICATORS OF THE FUNCTIONAL OCCLUSION ASSESSMENT METHOD T-SCAN IN PATIENTS WITH OCCLUSION DISORDERS WHICH HAVE BEEN ARISEN OR WERE ACTIVATED AS A RESULT OF INCORRECT DENTAL SURGERY

DOI 10.26886/2523-6938.1(2)2018.9 UDC: 617.3 ANALYSIS OF THE DYNAMICS OF CHANGING THE INDICATORS OF THE FUNCTIONAL OCCLUSION ASSESSMENT METHOD T-SCAN IN PATIENTS WITH OCCLUSION DISORDERS WHICH HAVE BEEN ARISEN OR WERE ACTIVATED AS A RESULT OF INCORRECT DENTAL SURGERY I. A. Shynchukovskyi, PhD, Associate Professor, V. P. Nespryadko, MD, PhD, Professor, O. G. Tereshchuk, PhD, Assistant, N. S. Khrol, PhD, Associate Professor, A. V. Oleinyk А. А. Bogomolets National Medical University, Ukraine, Kiev

Many people have dentitions with some elements of occlusal disharmony, which leads to the development of "muscle stress". In this case, the masticatory system loses its ability to adapt adequately, the functional state of the TMJ elements is disrupted, with the result that inflammatory and dystrophic changes may occur.
In most cases, these factors are unstable and under a loss of adaptive capacity, they can lead to dysfunction of the elements of dentomaxillofacial apparatus, in particular, elements of TMJ, and acquire temporary or chronic forms [3,4].
The mere list of typical primary symptoms in dysfunction shows that it is due to the state of the muscles and occlusion, which in turn ensure the condition and function of the joint. Therefore, the diagnosis of "arthritis" or "arthrosis", which is often established in these cases, should have a clear pathogenetic basis, which requires the use of a comprehensive study of the organs and structures of the maxillo-facial area [2,3,4].
If the loss of a significant amount of teeth occurred, the antagonizing teeth are displaced, the contact points on some teeth disappear, the teeth are placed fanwise, which leads to a decrease in the occlusal vertical dimension. Alveolar processes atrophy, and the patient has to push the lower jaw forward when chewing a food. A decrease in the occlusal vertical dimension leads to a functional displacement of the Bioenergetics in mMedicine and Biology № 1(2), 2018 ISSN 2523-6938 masticatory apparatus together with changes in the TMJ and masticatory muscles. Recovering the vertical dimension and the position of the lower jaw as they werebefore any changes in the dentitions means that the masticatory apparatus must be secondly replaced, which is undesirable, and sometimes impossible, due to profound anatomic changes in the TMJ. If the period after tooth loss is long enough, the compensatory-adaptive position of the lower jaw becomes stable, which can lead to misdiagnosing in determining the central ratio of the jaws.
Difficulties also arise because the markings, which make it possible to restore the occlusal vertical dimension, are lost as a result of the loss of teeth and atrophy of the alveolar processes.
It should be noted that the nature of the occlusion of teeth is affected by "factors of occlusion", such as: morphological structure of the posterior tooth occlusal surface, incisor path, terminal hinge axis, compensatory curves, articular sagittal and transversal pathways and angles. That is why any indirect restorative dental manipulation requires careful analysis of the ratio between the upper and lower jaws at the time of the re-prosthetics.
Materials and methods: the work is considering the application of various approaches to the analysis of occlusal adjustment of dentitions in the preparatory re-prosthetics stage. Therefore, our patients were allocated to treatment groups.
In total, we examined and treated 134 (100%) patients    giving an opinion on the planning of further treatment.
The results of first group of 60 patients (44.8%) are shown in Fig. 1, 2.
Occlusion time indicators are increased to 0.52 ms, the disocclusion time is increasedto 0.70 ms, the balance of the right and left side is 20% -80%, that is 60% -80% of the allowable limit, which is due to the unpronounced occlusal surface architectonics of the teeth and dentitions and the possibility of occlusion in different positions.
The results of second group of 40 patients (29.9%) are shown in Fig. 3, In the first subgroup of the second group of 23 patients (17.2%, 57.5%), the balance of the right and left side is 45%-55%, which corresponds to the norm.
This is due to the pronounced occlusal surface architectonics of the teeth and dentitions and the possibility of occlusion in one position, which can be explained by the pronouncement of the steepness and height of the slopes of the dental tubercles.
In the second subgroup of the second group of 17 patients (12.7%, 42.5%), the balance of the right and left side is 70% -30%, that is 60% -80% of the allowable limit. This is due to impaired fixation and improperly restored distal support on removable previous orthopedic structures.   Occlusion time indicators are increased to 0.5-0.7 ms, the disocclusion time is decreased to 0.3 ms, the balance of the right and left side is 40% -60%, that is 60% -80% of the allowable limit, which is due to the neurogenic pathology history.

Conclusions.
Our treatment demonstrated that the greatest success rate was achieved in patients of the second treatment group.
From the prognostic point of view, the diagnosis and planning of further treatment based on the analysis of occlusive adjustment with T-scan is the most expedient method that allows us to achieve a functional optimum in the future.