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THE STRUCTURE OF THE DIAGNOSTIC COMPUTER PROGRAM DEVELOPED FOR THE DIAGNOSIS OF DENTAL ANOMALIES Murtazaev S.S. (Republic of Uzbekistan) Email: [email protected]
Murtazaev Saidazim Saidagzamovich - PhD in Medicine, Docent; ORTHODONTIC AND CHILD PROSTHETICS DEPARTMENT, TASHKENT STATE DENTAL INSTITUTE, TASHKENT, REPUBLIC OF UZBEKISTAN
Abstract: a computer analysis of cephalometric images and plaster models of the jaws in 86 patients (growing 56, not growing 30). The data obtained during the examination of patients with various forms of dental anomalies are given. A detailed description of the structure of the computer program "Cephalopro" developed at the Department of Orthodontics and Dental Prosthetics of the Tashkent State Dental Institute is given. and a comparative description of the program "Cephalopro" with other foreign analogues.
Keywords: cephalometric analysis, computer programs, orthodontic treatment.
СТРУКТУРА ДИАГНОСТИЧЕСКОЙ КОМПЬЮТЕРНОЙ ПРОГРАММЫ, РАЗРАБАТЫВАЕМОЙ ДЛЯ ДИАГНОСТИКИ ЗУБОЧЕЛЮСТНЫХ АНОМАЛИЙ Муртазаев С.С. (Республика Узбекистан)
Муртазаев Саидазим Саидагзамович - кандидат медицинских наук, доцент, кафедрв ортодонтии и зубного протезирования, Ташкентский государственный стоматолологический институт, г. Ташкент, Республика Узбекистан
Анотация: проведён компьютерный анализ цефалометрических снимков и гипсовых моделей челюстей у 86 пациентов (растущих - 56, не растущих - 30). Приводятся данные, полученные во время обследования пациентов с различными формами зубочелюстных аномалий. Даётся подробное описание структуры компьютерной программы "Cephalopro ", разработанной на кафедре ортодонтии и зубного протезирования Ташкентского государственного стоматологического института, и сравнительная характеристика программы "Cephalopro " с другими зарубежными аналогами.
Ключевые слова: цефалометрический анализ, компьютерные программы, ортодонтическое лечение.
Complete and accurate diagnosis of anomalies of the dental system is one of the most important tasks of the orthodontist, as it serves as the basis for drawing up a rational treatment plan and determining its scope [1, 3, 7]. There are various methods of examining the patient's face, making plaster models of jaws. Diagnostic methods are constantly being developed and improved -anthropometry of jaw models, cephalometric X-ray of the head in lateral and anterior side
projections, orthopantomography. These methods complement each other and provide an opportunity to assess the morphological state of the dental system [2, 4, 6, 8, 12].
X-ray is recognized as one of the most informative diagnostic methods. It allows you to accurately and in detail to study the morphological state of the dental system in patients, in particular with distal occlusion of dentition, to determine the severity of the anomaly and identify the causes of its development [5, 6, 9, 11].
In recent years, when analyzing the cephalometric analyzing, there has been a tendency to use various computer programs, which can significantly reduce the time that the doctor spends to perform the examination and archiving the data obtained [3, 8]. Computer programs introduced into the practice of orthodontists reflect progress in society, and in medicine in particular. Scientists from all over the world are engaged in creating computer programs for the cephalometric analysis. They are very popular, as the calculation of cephalometrics manually takes a lot of time and effort from a doctor. Using computer programs saves the doctor's time tenfold. Computer assessment allows you to avoid some of the errors associated with the low quality of the cephalometrics, which can be improved with the help of computer technology [6, 10, 12]. The Department of Orthodontics and Dental Prosthetics of the Tashkent State Dental Institute is developing a program for computer processing of lateral cephalometrics "Cephalopro". The program consists of several sections (Fig. 1). The program module takes in the form of a picture the following photos and X-rays:
- cephalometric film "lateral";
- cephalometric film "anterior";
- photographs of the face taken from the front of the patient.
Section of temporary storage of the process and processing of photos and x-rays. This section provides users with the ability to support changes made to a software module and continue them if necessary.
Fig. 1. General overview of the program module
Library section - dental area algorithms. This section is the basis of the program module, which can provide the doctor with a variety of information about the status of photographs and x-rays. These algorithms can be subdivided into logical groups depending on the image types (the above 3 types), which receive the software. These algorithms serve as input values, which are given in photographs and X-rays, they are selected by users based on specific guidelines.
Section - storage of analysis results. In this section, based on the selected algorithm, the results obtained from the patient are stored in accordance with his name and type of algorithm.
In this section it is possible to save the results belonging to the same patient and algorithm. First, the patient must be registered to use this section. Each recorded information is sorted by the time it was entered.
Section - patient registration. In this section, patient information is included in the database of the program module before starting the procedure. Then the doctor will be able to analyze the images in this software module and save the results. Information about the patient (name, date of birth, address, telephone, mail, information about parents, information about the patient's diseases before this day and orthodontic treatment) is recorded during the registration process.
Section - print analysis results. Using this section, you can print out the results and examination information for each patient. This section also allows you to view parts without printing.
Section-enlarge picture(magnifier) The software module has additional tools to help the user work to simplify the image processing process. One of these tools is the ability to zoom in on photos and x-rays in the whole picture. There are also objective tools that allow you to simply enlarge the image and precisely set the point in the image.
At the moment, the development of the program "Cephalopro" is ready to section "analysis of lateral cephalometric X-ray images" in the Uzbek language. The monitor has the following support structures (Fayl, Yordam, lupa, rasmni ochish, algaritm turi - contains analysis methods for several authors, and also there are buttons - natija, tozalash algoritmini tanglang saqlang, Fig. 2).
Using this program, 86 lateral cephalometrics of the skull of patients aged 7 to 42 years with sagittal bite anomalies (distal and mesial occlusion) were analyzed.
All patients were divided into "growing" and "non-growing." There were 56 teenagers in the growing group (19 boys and 37 girls). The non-growing group consisted of 30 people (14 men and 16 women).
As a result of the study, structural features, growth changes in the facial skeleton of patients were identified, an accurate pathogenetic diagnosis of the anomaly was made, and a treatment plan was drawn up.
There are many options for the structure of the facial skeleton, and they are very diverse (table). The most common is an abnormality such as lower retrognathia, manifested as a distal bite, followed by lower retrognathia in combination with an underdevelopment of the lower jaw, which also manifests as a distal bite.
The pathogenesis of the development of mesial bite is also different. The first place in frequency is occupied by the slopes of the jaws and the increase in angles, the second by the lower prognathia, then the upper micrognathia, in addition there are combined pathologies (upper retrognathia combined with micrognatia, upper micrognathia, lower macrognathia combined with predicate).
Fig. 2. Development of the programs "Cephalopro", section «analysis of lateral cephalometric film» in Uzbek
language
Table 1. The results of the study on the distribution ofpatients depending on the pathogenetic diagnosis
Type of anomaly Occlusion Type
mesial distal
Clinical diagnosis Mesial bite Distal bite
X-ray cephalometric diagnosis
The slopes of the jaws, changing the angles of the jaw 2 9
Upper micrognathia 5 4
Lower retrognathia 12
Lower prognathia 3
Upper retrognathia in combination with micrognathia 6
Lower retrognathia in combination with micrognathia 17
Upper micrognathia, lower macrognathia in combination with prognatia 3
A comprehensive examination of the patient and computer-based analysis of the cephalometrics will answer many questions. It will be possible to avoid mistakes when planning orthodontic treatment, in particular, it will help to decide whether to remove the patient's teeth or to go the way of increasing the length of the dentition and expanding the jaw. To show in which direction the profile of the patient will change, whether there will be an excessive flattening after removal, whether the extension of the jaw will not worsen the patient's appearance.
Thus, it can be concluded that, based on the clinical examination, a preliminary diagnosis can be made and the pathogenesis of the anomaly can be taken into account, as the table shows that not all anomalies are characterized by typical cephalometric signs (referring to distal occlusion with lower retrognality, mesial occlusion with lower prognosis). Patients are characterized by a variety and unexpected combinations of the structure of the facial skeleton.
In appearance with an accuracy of up to 100%, it is impossible to determine the mechanism of development of the anomaly, since in the oral cavity it manifests itself only as a symptom - an abnormal bite, which can be combined with the wrong position of the teeth. In such cases, it is even more difficult to navigate: what to put in the foreground: the curvature of the dentition or the pathology of occlusion. Orthodontic treatment of such patients will not be adequate without a complete comprehensive examination and X -ray data.
It should also be noted that the widespread introduction of computer programs into the practice of an orthodontist helps to make a more accurate diagnosis and significantly speeds up this process. Together with the creation of programs for the cephalometric analysis, work is underway to automate other survey methods, including the analysis of facial photos and diagnostic models. Along with the desire of programmers to save the doctor from the difficulties associated with the diagnosis of anomalies and planning orthodontic treatment, we should not forget that the decision is made by the person and he is responsible for the patient too. It is impossible to make the diagnostic process completely impersonal and automated.
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