ORAL HYGIENE STATE IN CHILDREN WITH CONGENITAL DEFECTS OF THE ALVEOLAR PROCESS ON THE MAXILLA

Bone plasty of congenital and residual defects of the alveolar process of the upper jaw is a technically difficult surgical intervention which is necessary for full rehabilitation of a patient with congenital lip and palate clefts. This operation creates conditions for stabilization of maxilla fragments and normalization of the upper jaw development and also for successful teeth eruption. The aim of the study: To assess the state of oral hygiene before surgery in children with congenital residual defect of the alveolar process we used Fedorov-Volodkina Hygiene Index and index of the intensity of gingivitis (РМА) according to Masser-Parma. Materials and methods: The study was performed on three clinical subgroups of patients (n=54) aged 8 to 18 years who had congenital residual defects of the alveolar process of the maxilla. Subgroup 1 (n=13) – boneless bone plasty, subgroup 2 (n=11) – bone plasty using autologous mandibular graft, and subgroup 3 (n=30) – bone plasty with tibial bone graft. The state of oral hygiene of the subgroups was assessed using the Fedorov-Volodkina Hygiene Index (1971) and the level of inflammation of the marginal periodontium was assessed according to the PMA index (Masser-Parma, 1960). Results: The level of oral hygiene in patients of all subgroups before treatment ranged from 2,6 to 3,0 («poor level» of oral hygiene). The using of standard prophylactic dental therapy allowed to achieve a «satisfactory» level of hygiene in all three clinical subgroups of patients. The condition of the marginal periodontium according to the PMA index in all subgroups corresponded to 35,0% (gingivitis of moderate severity). Preventive treatment reduced the level of inflammation to 15,0-20,0% in all subgroups. The subgroup 3 was the most compliant to treatment. Conclusions: The unsatisfactory oral hygiene level and the condition of periodontal tissues among patients with congenital and residual defects of the maxilla alveolar process increases the risk of postoperative complications. Preventive dental treatment improves oral hygiene and reduces the intensity of the inflammatory process in the marginal periodontium. That is an important and necessary component of the successful comprehensive rehabilitation of the patient with congenital maxillofacial area malformations.