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Murtazaev Saidmurodkhon Saidaloevich, Ph. D., Tashkent State dental institute Head of Pediatric dentistry department E-mail: [email protected] Dusmukhamedov Makhmud Zakirovich, DMD, Professor, Tashkent State dental institute Professor of pediatric maxillofacial surgery department E-mail: [email protected] Murtazaev Saidazim Saidagzamovich, Ph. D., Tashkent State dental institute Senior lecturer of Prosthodontics and Orthodontics department
E-mail: [email protected]
Ethnic aspects of orthognathic bite
Abstract: In the early 20th century the sphere of use of craniology data in medicine significantly spread. Improvement of methods of diagnostics, operative technique and increase of surgical interference in organs of head
characterized new approach to the questions which seemed well studied. Contemporary level of orthodontics and jaw facial surgery requires high level of metric accuracy in determination of forms, spatial position and dimensional characteristics of cerebral and facial skull. Numerous researches of international authors are devoted studying of separate parameters of the skull taking into account different facial and cranial indicators.
Keywords: Ethnic norm, orthognathic bite, cephalometric analysis.
Introduction. Contemporary level of orthodontic ic because parameters of tooth rows are not indicated in differ-
help includes rather complex forms of pathogenic diagnostics without which neither early prevention of tooth jaw anomalies
and deformations nor their consequent apparatus and reconstructive treatment could be performed. Very significant methods of such diagnostics of tooth jaw facial anomalies are anthropometrical and cephalometrical researches [1; 2; 3; 4].
Thus orthodontic literature contains more different cephalometric analysis, however none of them is universal for attaining all goals and all of them have their disadvantages. Therefore we consider correctly using several methods of cephalometric analysis at once for the same patient. Besides cephalometric analysis are mainly based on comparison of data received as the result of the specified patient's examination (group of patients) with average statistical meanings in this population (for example, Caucasians). Therefore for the las decades a raw of works devoted to studying of morphometric and cephalometric indicators of nor for separate ethnic groups and nationalities which have their particularities appeared in foreign literature [5-17]. Nevertheless, norm indicators developed by foreign authors need to be checked in their acceptability for people in our geographical area. Use of these average meanings in diagnostics of tooth jaw anomalies for our population will be hardly correct. Therefore it is appropriate to examine group of people for our geographical area with developed orthognathic bite.
Ethnic norm and signs of orthognathic bite
According to E. Angle (1889), first molars influence on the correct relation of tooth rows which are erupting first and differ by permanent localization and take stable position in the base of the skull. He suggested classification which is based on mesio distal relations of tooth rows. At that E. Angle indicated three basic classes.
Class I — relation of first permanent molars is correct, at this mesial buccal cusp of first molar of the upper jaw is in the intercuspal groove of first molar of the lower jaw.
Class II — mesial buccal cusp of the first molar of the upper jaw is before intercuspal groove of the first molar of the lower jaw. To characterize relation of frontal teeth E. Angle indicated two subclasses: with protrusion of the upper incisors as Il/class 1, and with retrusion of the incisors as Il/class 2.
Class III — mesial buccal cusp of the first molar of the upper jaw is located behind intercuspal groove of the first molar of the upper jaw [18].
In the literature data about frequency of bite types are also seen as well as in different ethnic groups [19; 20; 21].
Orthognathic bite is considered as anatomic functional norm in contemporary literature which is seen in 50-80% of cases [22]. When loosing teeth recreation ofbite is problemat-
ent combinations and proportions with dimensions of head, face and jaws in representatives of different ethnic groups. That is why currently bite estimation by only character of tooth rows closure does not correspond to modern demands and possibilities of science and [23]. Estimation of tooth rows of orthognathic bite dimensions in proportionally hierarchy connection with lineal and angular parameters, indicators of jaws, face and head which are taken from naturally volu-metrical situation of all structures in alive person is actual not only for ethnic anthropology and clinical anatomy but also for cosmetology, jaw facial surgery, orthodontics, prosthodontics, especially at reconstruction of teeth, tooth rows and lost bite and face and also medico-legal practice for person identification. [24; 25; 26; 27; 28].
Many authors tried to give notion to the word "bite". We consider Persin L. S. gave the most precise determination to word bite. «Bite is multiple closure of tooth rows at habitual position of the lower jaw". According to the author, the first and the main sign of bite is multiple closings of tooth rows. No closure- no bite. Persin L. S. identified notions "physiologic bite" and "physiologic occlusion". "Bite of tooth rows is determined at central and habitual position of the lower jaw. At physiologic closing of tooth rows central position of the lower jaw and its habitual position are the same" [29].
Besides closing Trezubov V. N. indicated other signs of bite:
1) tooth row of the upper jaw covers tooth row of the lower jaw in the area of lateral teeth with buccal cusps and in the frontal area anterior overbite is 1/3 of the length of the crown;
2) each tooth has two antagonists with exception for central lower incisors and upper third molars;
3) midline between central incisors of the upper and lower jaws coincides;
4) length of the crown decreases from central incisors to molars;
5) multiple fissure cuspal contact of teeth from the right and left is present and closing;
6) occlusion from the right and left side is class 1 by Angle
All these signs (exception first) are specific for physiologic
types of bite. It should be noted that Trezubov V. N., by characterizing ortognathic bite as normal indicated its transitional forms [30].
Ethnic particularities of bite are studied in Anikiyen-ko A. A., Rogov M. E. (2002), Haldyeva N. I., Zubov A. A. (2005), Sanzhitsyrenova (2000), Chaban A. V., Proskoko-va S. V. (2000) works when studying teeth dimensions, tooth rows, apical bases in teleuts, northern hakas' and chulim ty-
urkr. It was noted that mongoloids are inclined to macrodon-tism (large teeth) [31; 32; 20; 21; 33].
At this fact, some authors (Mirgazizov M. Z., Smerdi-na L. N., 1998; Chaban A. V., Proskokova S. V., 2000) [34; 33]consider macrodontia as pathogenic factor on anomalies of tooth rows, and other Haldyeva N. I., Zubov A. A. (2005); Sanzhitsyrenova T. I., Anikienko A. A. (1999); Budaev A. A., Belozertsev A.Iu. (2004); Galera V, Cunha E. (1993); Brenchley Z., Oliver R. G., (1997) [32; 21; 35; 36; 37] — as ethnic variant of norm.
Thus, Baydik O.D (2005) supposed that every ethnic group should have its norm of teeth dimensions, shape and sizes of tooth rows, jaws and skull in common [22].
Thu KM, Winn T, Abdullah N, Jayasinghe JA, Chandima GL. (2005), indicated that indices of tooth rows developed by Pont and Linder Hearth for caucasians in the boundary ofXIX, XX century can lead to faults in diagnostics of anomalies of tooth rows in mongoloids, particularly in buryats. In some representatives of mongoloid race (hants, buryats, Eskimos, Mongols, Kazakhs, yakuts, etc.) wide dimensions of tooth rows and alveolar arch are prevalent [38; 39; 40].
Ethnic norm and shape of tooth rows.
Bite is made from morphological strucrures: tooth rows and teeth. The latter have not only aging, sex particularities but also racial ethnical and individual [41; 42; 43]. Composed tables of teeth, tooth rows and indices parameters are meant for Caucasians and do not consider ethnic territorial and other distinctions [44]. Many researches indicated variabilities of dimensional and relief signs of teeth and tooth rows [2; 45; 21; 46; 40].
Since Myulreyter's times (1889) normal shape of tooth row is used to consider ellipsoid for upper jaw and paraboloid for lower jaw. Alveolar rows of jaws in different ethnic groups were studied by Zanina-Pokrovskaya V. S. (1973). The author indicated the following forms: ellipsoid, paraboloid, U-shaped, trapezoid, hyperboloid and square. Each of these forms, as Zanina-Pokrovskaya noted, is seen with different frequency. Upper alveolar row is very variable in all ethnic groups, as in men as in women. More often ellipsoid, paraboloid and U-shaped form is seen, trapezoid and hyperboloid is less often [47]. Thus, for example, according to the data of different researchers, ellipsoid arch is seen in men's skull from 0% (Chukchi, Tungus, Kirghiz) to 76,92% (italians); paraboloid — from 0% (Italians, Papuan, Indian) to 46,66% (Ingush); U-shaped — to 0% (Italians, Moldavian) to 47,62% (Ainu). Trapezoid shape is seen in all groups less often and only in Yakut frequency of occurrence has reached 29,17%. Hyperboloid shape is seen less often, — maximum in Negros (15,39%). Square form occurs very seldom — maximum (9,52%) — in Ainu. In mongoloid groups ellipsoid arch is seen less often than in Caucasians. In Caucasians groups U-shaped and paraboloid shapes are seen less often than in mongoloids. Lower jaw is different by more stable form. Paraboloid form is prevalent in it, its other forms are seen less often. According to A. A. Zubov's
observations (1973) more characteristic form of the upper tooth row for men is angular forms (trapezoid and square) which is apparently connected with formation and eruption of large canine. During examination ofyoung men and women G. G. Manashev (2000) noted that the most frequent form of the upper and lower jaws is paraboloid, U-shaped form occurs in young women more often [48]. When analyzing of casts with computer program Reflex Plotter Jones M. L., Richmond S. (1984) made conclusion that the ideal form of the tooth row is parabola. However authors carried out investigation on small material — only on 28 pairs of casts [49]. G. V. Kuznecova et al. (1998) prepared patterns for making normal tooth row of nine sizes with intervals 1 mm. In the basis is graphic method of Hawley- Herber- Herbs based on the sum of mesio distal diameters of incisors and canines. Received curve has form of ellipse [50]. However, according to Hmelevskiy S. I. (1984), for modern person ellipsoid shape of the upper tooth row and paraboloid shape of the lower jaw is less possible and thus, as the author noted, they are not typical. During morphofunctional studying of tooth rows S. I. Hmelevskiy established that tooth jaw facial system is build on the base of circles and spheres which allow it to organically fit in spherical organization of the whole skull [51].
Othmana S, Xinwei E, Lim Sh, Jamaludin M, Mohamed N, Zamros Yuzaidi M, et al. (2012) made investigations on 120 casts of Malays and 129 casts of Malaysian aborigines for determination of morphological differences of tooth rows. Results of researches showed that ethnic Malays and Malaysian aborigines have similar tooth rows in shape and size. In both ethnic groups more popular form to tooth rows is oval and less popular is square [52].
Nabil M. Al-Zubair (2013) on 398 casts made investigations to assess shape of tooth row in adult Yemenites. In the result five forms of tooth rows were discovered and narrow form is the most widespread (30,9%), the wide form (23,9%), and less widespread form is average (9.3%) whereas wide and angled shapes made 18,3% and 17,6% accordingly [53].
Lee K, Trang V, Bayome M, Parke J, Kim Y, Kook Y. (2013) compared Korean and Vietnamese patients, as a result, they discovered that Vietnamese patients had significantly larger tooth rows relatively to Koreans. Among Koreans all three forms of tooth rows were evenly distributed but Vietnamese often have square shape of tooth rows [54].
Olmez S, Dogan S. (2011) compared shapes and sizes of tooth rows in ethnic Turks and established that at anomalous bites, according to Angle's classification, conical, oval and square shapes of tooth rows are mostly seen. With help of this research at treatment of orthodontic patients authors suggest to consider ethnic variants of norm to attain esthetic functional and stable shape of the row [55].
Thus, according to the data of the above mentioned researches tooth rows have different form, naturally connected with the shape and construction of the whole skull. At this
authors indicated many-sided variability of jaw shapes, tooth rows and the whole skull gave little information on variability of tooth sizes, shape of tooth rows and arches in representatives of different ethnic groups of modern population. To a smaller extent, variability of a separate organ (tooth) organization in its relation to the jaws and skull were considered.
The history of metisation (crossbreeding)
Siberia has always attracted the attention of researchers, including anthropologists, geneticists, historians, linguists, dentists [56; 34; 57; 32; 58; 59]. Immigrants to America crossed this territory in the Upper Paleolithic period. There is the ancient "open" contact border of Mongoloids and Caucasians in Western Siberia, which led to a confusion of the two major races and led to the need for active learning of metisation. "The mixing of peoples and races metisation — a powerful process that should be considered as one of the most fundamental factors of division of the human population on the big and small race. The appearance of the "intermediate", most often of mixed origin, but sometimes undifferentiated racial types occurred in ancient times. That was population of western and southern Siberia, the Ural and Central Asia, border between Caucasians and Mongoloids [22].
According to McComb J. et al. (1996), the population of Altai is genetically different from other indigenous groups in Siberia. This causes an even greater interest in the study of
the indigenous population of the Altai, and especially in comparison with Caucasians. There were little cephalometric and odontometric indicators cited in these studies. The authors did not indicate the condition and size of the teeth, dentition and occlusion, or cite the data resulted in a small clinical material. Facial and cranial size and topography of a modern human being century vary not only in connection with the territory of residence. They change with racial-ethnic lines, which is partly associated primarily with some specific adaptation to climatic factors [60; 61; 62; 63].
Analyzing the sources listed in the research, it is noted that most of the researchers discuss various departments of the head, face, skull isolated from each other. Describing the structure of the skull or head, they do not pay attention to the shape and structure of the teeth, dental arches, occlusion, or vice versa, they indicate the structure of the latter and do not give information about the shape of the face and head, taking the racial-ethnic and regional characteristics in account.
Thus, we consider conduction of a comprehensive research of the shape and size of the head, face, jaws, teeth and dentition with orthognathic bite. This allows to identify the most reliable signs of extraoral indicators of bite, create new analog models of jaws with the racial and ethnic features for the people of our geographic area.
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