Evalution of Alterations in Soft Tissue Profile and Masseter Muscle Following Early Treatment of Anterior Crossbites in Children
Project no. 234 · Status: Kapanmış · 2018
Summary
Functional and dental anterior crossbite cases are frequently encountered in children. In functional anterior crossbites, in the rest position, the maxillary and mandibular incisors are in a tete-a-tete bite state, the mandible is behind, and the condylar heads are in their normal position. When closing, usually the mandible shifts forward due to the primary contact points, thus resulting in anterior crossbites. The accurate diagnosis of these cases and their timely treatment can prevent the development of future problems. Especially in children, it is recommended to treat functional problems as early as possible. If functional anomalies are not treated early enough, they may progress into morphological anomalies, in which treatment becomes much more difficult and complex. This can cause the impairment of both chewing function and dentofacial esthetics in later years. Esthetics should be examined as a whole in children. Therefore, in addition to correcting the dental bites and function, changes in soft tissues should also be evaluated. This study aimed to investigate the effectiveness of early intervention in reducing future problems, especially those related to the soft tissue profile and changes in the masseter muscle in children with functional or dental anterior crossbites. It was also aimed to investigate the effects of problems caused by this malocclusion on the patients’ quality of life and psychosocial development. This research included 20 patients aged seven to 10 years that presented to Ege University Faculty of Dentistry Department of Pedodontics for routine controls or due to dental complaints and were found to have anterior crossbites. Soft tissue analysis was performed by taking the initial cephalometric films of the patients, and ultrasonographic images were obtained from the masseter muscles. In addition, a questionnaire was applied before and after treatment in order to determine the effect of the condition on the patients’ quality of life. The patients were treated by applying a mandibular retractor for 12 months. At the end of treatment, cephalometric film and soft tissue analyses were repeated. In addition, ultrasonographic images were obtained again from the masseter muscle. When the cephalometric analysis results of the patients with anterior crossbites were examined, an statistically significant increase in the SNGoMe, Max1-SN, Max1-NA, Max1-Na and Ls-E values was observed. In addition, there was a decrease in the IMPA value. There was no statistically significant difference in the SNA, SNB, ANB, Wits, FMA, Mand1-NB, Mand1-NB, Interincisal, LI-E, nasolabial and convexity angle values before and after treatment. When the soft tissue analysis of the patients before and after treatment was examined, a statistically significant increase was observed in the lower face height, upper lip length, vertical length of the chin, nasomental angle, and mentolabial sulcus depth. There was also a statistically significant decrease in the convexity angle. In the ultrasonographic evaluation of the masseter muscle, there was an increase in the thickness of this muscle was observed during both rest and contraction. Lastly, the questionnaire administered to measure the effect of oral health on quality of life revealed a decrease in the total score. In conclusion, with the regular use of a mandibular retractor, the growth of the mandible is stopped, and the growth of the maxilla is promoted, thus preventing anterior crossbites. It is considered that the treatment of malocclusion at an early age has a positive effect on patients’ quality of life; however, there is a need for long-term studies on this subject with a larger number of patients.