Analysis of neuromuscular and occlusal characteristics of the dento-maxillofacial apparatus of patients by the method of electromyography using the TEETHAN device

Abstract

Summary. The elimination of the symptoms of bite pathology and the causes of their occurrence are reflected not only in the patient's well-being, but also in the durability of restorations and structures performed by a dentist-orthopedic doctor. An objective analysis of changes in the functional state of the masticatory muscles before and after dental interventions allows for a more accurate assessment of the initial state when planning restoration and monitoring the treatment (direct and indirect restorations, implantation, orthodontic treatment).

The aim of the study – to analyze the neuromuscular and occlusal characteristics of the patients' maxillofacial apparatus by electromyography using the TEETHAN device.

Materials and Methods. A clinical and laboratory examination of patients with defects of the crown part of the tooth before prosthetics and 6 months after prosthetics was performed. Of these: 80 (48.5 %) patients were prosthetically implanted with fixed structures manufactured by the laboratory method, and 85 (51.5%) patients – by the digital method. The total number of patients with crown defects on the upper jaw was 84 (50.9 %), while on the lower jaw – 81 (49.1 %). Of them, 85 (48.5 %) were women and 80 (51.5 %) were men. For complete diagnosis, information on the state of the main muscles responsible for closing the teeth was used to plan and control treatment on the TEETHAN device; as well as statistical methods.

Results and Discussion. In 45 (27.3 %) patients of the 1st group, TEETHAN results were normal after prosthetics. After 6 and 12 months after prosthetics, the patients of the first group had the following TEETHAN results: (POC MASSETER – 84.15 %, POC TEMPORALIS – 89.98 %, TORSION – 92.13 %, BАR – 85.84 % А – (N90<(%)<100), IMPACT – 97.87 % (N. 85<(%)<115), in the second group after 12 months: in 7 (17.5 %) patients after prosthetics on the TEETHAN device, we recorded minor changes (POC TEMPORALIS – 89.98%, POC MASSETER – 84.15 %,  TORSION – 92.13 %, BАR – 85.84 % А – (N. 90<(%)< 10), IMPACT – 97.87 % (N. 85<(%)<115), ASIM – 7.62 %).

Conclusions. The relationship between the violation of the occlusal-articulatory balance 6 months after the prosthetics of patients with full controlled occlusal load with the use of veneers and artificial crowns according to a digital protocol (preceramics, zirconium dioxide) was established, the functional capacity of the neuromuscular component of the OA was restored to 79.4 %, and in the case of prosthetics with bridge-like structures made according to a digital protocol, this percentage of restoration of functional capacity was  58.9  and 64.3 %, respectively. Analyzed complications and justified treatment algorithm for patients with this pathology, the results of the study are the adaptation of the masticatory apparatus to the new interalveolar height and occlusal-articulation ratios of the jaws, which allows directing the doctor's actions to the necessary treatment steps.