MUSCULAR AND FUNCTIONAL ACTIVITY OF THE TONGUE IN PEDIATRIC PATIENTS IN CONDITIONS OF FUNCTIONAL OCCLUSION AND OPEN BITE

Abstract

Introduction. For the purpose of rational diagnosis, prevention and orthodontic treatment of dentognathic deformations, including open bite, it is advisable to establish and take into account correlations between tongue pressure values in different measurement zones Aim of the Study. To analyze the muscle-functional activity of the tongue in pediatric patients without components of the symptom complex of dentognathic deformations in the sagittal, vertical, transverse and open bite directions, to establish relationships between the values of tongue pressure on the surrounding areas of the oral cavity in different measurement zones. Research Materials and Methods. The force of tongue pressure (F, H) on the surrounding areas of the oral cavity of the upper and lower jaws was determined at different levels of the palatal and lingual surfaces of the teeth using a FlexiForce film force sensor (Tekscan, USA) with a surface area (S, mm²) of 78,5 mm² without stable attachment. Results. The results of tongue pressure measurements (P, kPa) on the surrounding areas of the oral cavity showed significant differences between different measurement zones at the time, when it was recommended to press the tongue on the sensor, and during swallowing, in both patients without components of the symptom complex of dentognathic deformations in the sagittal, vertical and transverse directions (n = 34) and with an open bite (n = 26). Assessment of pressure distribution showed that in children without dentognathic deformations, the pressure of the anterior part of the tongue to the palate dominates during swallowing (ZK1 > ZK3), while at the moment when patients were advised to press on the sensor, the load shifts to the lower frontal and lateral areas (Z3, Z4, Z7). The obtained results represent patterns of functional activity of the tongue in different measurement zones, which is of great importance for clinical practice, as it can be used for a comprehensive assessment of the orthodontic status of patients and the development of an optimal treatment strategy for dentognathic deformations, namely when choosing orthodontic constructions. Conclusions. The different indicators of maximum tongue pressure values revealed during the study at the moment when it was recommended to press on the sensor in pediatric patients in conditions of functional occlusion (Z4 – 103,5 ± 45,4 kPa; 95% CI: 87,7–119,4 and Z7 – 92,5 ± 40,8 kPa; 95% CI: 78,3–106,8) and with open bite (Z3 – 101,6 ± 22,4 kPa; 95% CI 92,5–110,6 and Z1 – 96,7 ± 24,2 kPa; 95% CI 86,9–106,5) indicate differences in the muscular and functional activity of the organ and reflect the features of its functional interaction with the dentition. During swallowing, among patients without components of the symptom complex of UAC deformities, the average pressure values in the area of the middle third of the palatal surface of the upper incisors (6,9 ± 2,0 kPa; 95% CI: 6,2–7,6) exceeded the average values in the area of the lingual surface of the lower incisors (5,6 ± 1,4 kPa; 95% CI: 5,1–6,1), while with open bite, the diametric opposite was established (5,2 ± 2,2 kPa; 95% CI: 4,4–6,1 versus 7,4 ± 2,3 kPa; 95% CI: 6,5–8,3). The identified clusters of consistent loads and the general fragmentation of the correlation structure indicate individualized mechanisms of functional adaptation of the tongue to occlusal conditions.