Influence of age of patients with distal occlusion on complex orthodontic-surgical treatment

Purpose: to present clinical observation data and analyze the effectiveness of the orthodontic-surgical approach in the treatment of distal occlusion, taking into account the age factor. Materials and methods. The study examined 60 patients aged 18 to 45 years with distal occlusion of the dentition with narrowing of the upper jaw. The patients were stratified into control and study groups of 30 patients each, as well as into two age subgroups: the younger age group (18—25 years; n=15) and the older age group (30—45 years; n=15). In the control group, correction of distal occlusion was previously performed using a bracket system without the use of a MARPE device, whereas in the study group, treatment was performed using a bracket system in combination with a MARPE device. The control group was considered as a retrospective group. The treatment results were compared with the baseline data in the study group based on the Penn index. The main indicator of effectiveness is correction of distal occlusion, stability of achieved occlusal contacts. Results. Comparative analysis revealed that the transversal expansion of the upper jaw in patients aged 18—25 years was significantly more pronounced than in patients aged 30-45 years, both with orthodontic braces treatment and in combination with MARPE. When using only the bracket system, the increase in width was 1.2 mm in the young and 0.7 mm in the older group (p<0.001), and when using MARPE — 2.8 mm and 1.5 mm, respectively (p<0.001). The expansion was accompanied by an improvement in occlusal ratios: normalization of the position of molars and canines, reduction of the incisor gap and the formation of more uniform contacts. The achieved correction of distal occlusion remained stable during the observation period. Conclusions. The conducted research allows us to conclude that an integrated approach using the MARPE device and a bracket system provides a more pronounced transversal expansion of the upper jaw and contributes to the effective correction of distal occlusion compared with the use of a bracket system. At the same time, the patient’s age remains a significant factor influencing the outcome. The results obtained emphasize the importance of individual treatment planning, taking into account the patient’s age and morphofunctional features of his maxillofacial region in order to achieve a stable occlusal result.