EFFECTIVENESS OF DISTRACTION AND ORTHOGNATHIC INTERVENTION IN THE TREATMENT OF MESIAL OCCLUSION IN PATIENTS WITH MAXILLARY UNDERDEVELOPMENT

Mesial occlusion is a complex orthodontic pathology that adversely affects facial aesthetics, masticatory function, and patient quality of life, making timely treatment critical. One of the modern methods of correction is distraction osteogenesis, which allows gradual expansion of bone structures while minimizing the risk of relapse. The choice of treatment is based on the patient's clinical presentation, with distraction being a priority in cases where traditional surgery is contraindicated. Aim of the study was a detailed analysis of the effectiveness and safety of various treatment methods for mesial occlusion in adult patients with maxillary underdevelopment. Material and methods. The study included 15 adolescent patients between the ages of 19 and 23 with skeletal mesial occlusion. Baseline diagnostic data were obtained for each patient, and the volume of bone tissue in the vestibulo-oral direction at the site of planned implant placement was assessed during preparation for implant placement. Statistically significant differences between alternative quantitative characteristics with normal distributions were evaluated using Student's t-test. A difference was considered statistically significant at p<0.01. The study was carried out in compliance with the main provisions of the Council of Europe Convention on Human Rights and Biomedicine (4 April 1997), the World Medical Association Declaration of Helsinki on the Ethical Principles for Scientific Medical Research Involving Human Subjects (1964-2013), ICH GCP (1996), orders of the Ministry of Health of Ukraine No. 690 of 23.09.2009, No. 944 of 14.12.2009, No. 616 of 03.08.2012. The work is a fragment of the research project “Correction of violations of osteogenesis processes in the treatment and prevention of complications of dental diseases wartime” state registration No. 0123U103247. Results. The results of the study showed that in adult patients, orthognathic surgery ensures favorable skeletal outcomes for maxillary mesialization. However, when the replacement of lateral incisors with canines is feasible, this treatment approach may reduce the number of rehabilitation stages while achieving dentoalveolar relationships that conform to normal standards. The use of distraction osteogenesis in adult patients has yielded good results and may be justified in cases of critical reduction of maxillary body dimensions or contraindications to conventional orthognathic surgery. Conclusion. Distraction osteogenesis and orthognathic procedures effectively correct mesial occlusion, ensuring a stable increase in the sagittal dimension of the maxilla and improving occlusion. Replacement of lateral incisors with canines minimizes the need for additional surgery in cases of agenesis. The choice of treatment method should be based on individual clinical indications and risk assessment for each patient.