MINISTRY of HEALTH UKRAINE VINNYTSYA NATIONAL MEDICAL UNIVERSITY to the name of М. And.Pie " It is ratified" on a methodical conference departments of stomatology of child's age Manager of department doc. Filimonov Y.V.__ _______ " _____ "________ _20 METHODICAL POINTING FOR INDEPENDENT WORK OF STUDENTS AT PREPARATION TO PRACTICAL (SEMINAR) EMPLOYMENT - 11 Educational discipline Ортодонтія Module №11 11 Rich in content module №11 11 Theme of employment Classification of зубощелепно - facial anomalies and deformations. Course 3 Faculty Stomatological Autor VASILCHUK OLEKSANDR SEMENOVICH
Transcript
MINISTRY of HEALTH UKRAINEVINNYTSYA NATIONAL MEDICAL UNIVERSITY
to the name of М. And.Pie
" It is ratified"on a methodical conference
departments of stomatology of child's ageManager of department
doc. Filimonov Y.V._________ _______
" _____ "________ _20
METHODICAL POINTINGFOR INDEPENDENT WORK OF STUDENTS AT
PREPARATION TO PRACTICAL (SEMINAR)
EMPLOYMENT - 11
Educational discipline ОртодонтіяModule №11 11Rich in content module №11 11Theme of employment Classification of зубощелепно - facial anomalies and
deformations.
Course 3Faculty Stomatological
Autor VASILCHUK OLEKSANDR SEMENOVICH
Vinnytsya 2011
1. Actuality of theme : there Is plenty of anomalies and дефор-мацій with alike clinical presentation. Many various classifications which allowed to systematize the різ-ні types of зубощелепних anomalies were offered in this connection. Systematization of anomalies enables to choose the correct going near their understanding, to learn the етіопатогенетичні factors of origin, set a diagnosis and запла-нувати treatment.All classifications of зубощелепних anomalies of по-будовані are mainly on the account of morphological rejections, functional violations, етіологіч-них factors or their combination.
2. Educational aims:
To teach students - stomatologies to classifications of зубощелепних anomalies for
correct establishment of diagnosis and пла-нування treatment.
To know:: types of anomalies of separate teeth : -1) oral position;2) vestibular position;3) супраоклюзія;4) infraocclusion;5) мезіальне position;6) distal position;7) a turn of tooth is about axis;8) diastemas;9) congestion of teeth..Able:- To distinguish the types of occlusions :1) лабіальна, or букальна occlusion;2) лінгвальна, or palatal occlusion;3) медіальна occlusion;4) distal occlusion;5) тортооклюзія;6) infraocclusion;7) супраоклюзія.8) Physiology and pathological types of bites.
ІІІ. Base knowledge, abilities, skills, necessary for a study themes ( міждисциплінарна integration).
Names of previous disciplines Got skillsOrthopaedic stomatology. To know:: types of anomalies of
separate teeth :
Ортодонтія.
Therapeutic stomatology.
-1) oral position;2) vestibular position;3) супраоклюзія;4) infraocclusion;5) мезіальне position;6) distal position;7) a turn of tooth is about axis;8) diastemas;9) congestion of teeth.
Orthopaedic stomatology.
Ортодонтія
Able:- To distinguish the types of occlusions :1) лабіальна, or букальна occlusion;2) лінгвальна, or palatal occlusion;3) медіальна occlusion;4) distal occlusion;5) тортооклюзія;6) infraocclusion;7) супраоклюзія.8) Physiology and pathological types of bites.
4. A task is for independent preparation to employment.
1. Classification of Е. Angle. Advantages and defects.2. Classification And. I. Катца. Advantages and defects.3. Classification And. And. Бетельмана. Advantages and defects.4. Classification of Л. In. Ільїної-Маркосян. Перева-ги and defects.5. Classification In. Ю. Курляндського. Advantages and defects.6. Classification of Д. And. Калвеліса. Advantages and defects.7. Classification of X. And. Каламкарова. Advantages and defects.8. Classification of ВООЗ. Advantages and defects.9. General lines and divergences of classificationsЕ. Angle, And. I. Катца and Л. In. Ільїної-Маркосян.10. General lines and divergences of classifications And. And. Бетельмана and In. Ю. Курляндського.11. Component parts of final diagnosis.
4.1. List of basic terms, parameters, descriptions which a student must master at preparation to employment :
Term Determination
Facial signs Description of skin canopies ( color, new formation, edemata and other)
|Jaw signs. Correct harmonious development of branch, body of bottom and overhead jaws. Corner of bottom jaw in new-born - 164, adults have 117 - 124 degrees.
Inwardly mouth signs. Large and small keys of occlusions, functional norm of dental rows.
4.2. Theoretical questions to employment:
1. Physiology types of bites are description.2. The keys of occlusion are after Енгелем.3. The keys of occlusion are after Ендрюсом ( optimal occlusion).4. Pathological types of bites.
5. types of anomalies of separate teeth are dates description
1) oral position; 2) vestibular position; 3) супраоклюзія; 4) infraocclusion; 5) мезіальне position; 6) distal position; 7) a turn of tooth is about axis; 8) diastemas; 9) congestion of teeth.. Types of occlusions are description 1) лабіальна, or букальна occlusion;2) лінгвальна, or palatal occlusion;3) медіальна occlusion;4) distal occlusion;5) тортооклюзія;6) infraocclusion;7) супраоклюзія.8) Physiology and pathological types of bites.
4.3. Practical works (task) which are executed on employment :
1. To prepare the gipseous models of jaws, phantoms of overhead and bottom jaws.
2. To prepare оклюдатори with the gipseous models of jaws in an occlusion.3. To learn to determine small and large keys of occlusions.
5. A plan and organizational structure of lesson are after discipline.
3.2. General estimation of educational activity of student.
3.3 Informing of students is of theme of next employment.
IV. Basic questions of theme :1. Classification of Е. Angle.2. Classification And. I. Катца. 3. Classification And. And. Бетельмана.4. Classification of Л. In. Ільїної-Маркосян.5. Classification In. Ю. Курляндського. 6. Classification of Д. And. Калвеліса. 7. Classification of X. And. Каламкарова.8. Classification of ВООЗ.9. General lines and divergences of classificationsЕ. Angle, And. I. Катца and Л. In. Ільїної-Маркосян.10. General lines and divergences of classifications And. And. Бетельмана and In. Ю. Курляндського.11. Component parts of final diagnosis.
VI. Literature:
basic: - П. С. Фліс Ортодонтія.
additional: - Хорошилкина Ф. I. Руководство for ортодонтии.
Laid down the methodical pointing: ace. Васильчук О. С.
The methodical pointing is discussed and ratified on meeting of department from _________ 200_ Protocol №__.
Зав.кафеди
pedodontia
кан.мед.н., associate professor Філімонов Ю.В.
Table of contents of theme : Classification of зубощелепних anomalies and deformations
There is plenty of anomalies and дефор-мацій with alike clinical presentation. Many various classifications which allowed to systematize the різ-ні types of зубощелепних anomalies were offered in this connection. Systematization of anomalies enables to choose the correct going near their understanding, to learn the етіопатогенетичні factors of origin, set a diagnosis and запла-нувати treatment.All classifications of зубощелепних anomalies of по-будовані are mainly on the account of morphological rejections, functional violations, етіологіч-них factors or their combination.The most wide confession was got by класи-фікації, built on the basis of morphological changes. They are based on immobile connection of лицево-го skeleton, except a bottom jaw, with other bones of skull. To Tom, in opinion of scientists, a facial skeleton is not under harmful influence of внутріш-ніх external factors and such змі-нам is not subject, as a зубощелепна system.First morphological classification in осно-ву which principle of correlation of зуб-них rows is fixed on the whole, Е was offered. Angle in 1889.This classification is based on мезіодистальному correlation of first permanent молярів of both jaws, which an author defined a term "key of occlusion".On the view of Е. Н. Angle, the place of location of верх-нього of sixth tooth always answers localization of crista zygomatica, due to прорізуванню of him тіль-ки in this place. Overhead sixth tooth of Е. Angle named "punctum fixum"
(fixed point). Постій-не of location of sixth tooth, in opinion of scientist, it is determined, at first, by the immobile report of supramaxilla with basis of skull, secondly, that he always cuts through behind second тим-часового моляра. Therefore all атипові correlations of permanent молярів arise up only due to wrong position of bottom jaw.Anomalies of bite of Е. Angle divides into three classes.A-one - the "key of occlusion" is not broken: мезіальний the cheek tubercle of first overhead по-стійного моляра is located in intertubercular бо-розні of bottom first permanent моляра. Пато-логія, thus, localized only ahead from first молярів and touches the or location of teeth, or development of alveolar sprout and body of jaws (rice. 5.1).A tourist class is characterized distal роз-ташуванням of bottom first permanent моляра.At such correlation of мезіальний a щіч-ний tubercle of first overhead permanent моляра is ahead from the intertubercular furrow of first bottom permanent моляра. Визнача-ється or contact onenominal humps, or the мезіально-щічний tubercle of first overhead по-стійного моляра is situated between the tubercle of дру-гого премоляра and мезіальним by the cheek tubercle of first permanent bottom моляра, that зале-жить from complication of deformation. The changes of співвідно-шення teeth touch all dental row. At a tourist class two підкласи of anomaly is possible: дру-гий class, first підклас - distal розташуван-ня of bottom jaw, at which overhead frontal teeth are inclined forward and located fan-shaped, with diastemas and тремами (rice. 5.2). In a tourist class, second підкласі - overhead frontal teeth are located rakish in an oral side, deeply recovering lower (rice. 5.3).In both підкласах distal correlation in lateral areas can be one and bilateral.The third class is characterized мезіальним роз-ташуванням of bottom first permanent моляра in relation to onenominal overhead. At such співвід-ношення of мезіальний a cheek tubercle of first верх-нього of permanent моляра is behind from the intertubercular furrow of first permanent моляра of bottom jaw. The bottom frontal teeth of перекрива-ють are overhead. Also can be the anomaly of the third class bilateral and one-sided (rice. 5.4).
Rice. 5.1. A-one is after Енглем. Rice. 5.3. Tourist class, second підклас after
Енглем
Rice. 5.2. Tourist class, first підклас of Lines 5.4. The third class is after Енглем.
Except the sagital anomalies of bite, Е. Angle distinguishes seven types of anomalies of separate teeth :1) лабіальна, or букальна occlusion;2) лінгвальна, or palatal occlusion;3) медіальна occlusion;4) distal occlusion;5) тортооклюзія;6) infraocclusion;7) супраоклюзія.Classification of Енгля had great success in the end XIX of century, because brought in some line-up in діа-гностику of зубощелепних anomalies and deformations. This was first accessible after simplicity, only за-гальноприйнята classification of anomalies of bite in the world, which is gladly used specialists and in our time.But, without regard to it, classification of Енгля has a row of defects.At first, the location of first моляра of supramaxilla not always occupies a permanent place: at moving away of премолярів or their edentia he can be displaced мезіально. In addition, a supramaxilla can occupy an antelocation in a skull, the location of first моляра changes and then.Secondly, to use classification of Енгля it is possible only in a variable and permanent bite.Thirdly, classification represents the anomalies of bite only in a sagital plane, not враховую-чи anomalies for vertical lines and трансверзалі.Fourthly, does not take into account functional and aesthetic violations.Functional diagnostics of anomalies of запро-понував And. I. Катц (1940). In the classification he took into account functional pathology of жуваль-них muscles.
For basis of morphological changes an author takes correlation of молярів after Енглем, розгляда-ючи three possible groups of rejections in development of зубощелепного vehicle, complementing every group of anomalies the functional state of muscles of maxillufacial area.
The first group includes all anomalies from порушен-ням of functional norm only in the area of фрон-тальних teeth, at normal correlation of first permanent молярів. Functional pathology arises up due to predominance of vertical motions of bottom jaw above lateral and shows up functional insufficiency of all masticatory musculature.The second group is after the morphological structure of відпо-відає // class after Е. Angle, and from the point of view of function characterized by the excalation of muscles, that ви-сувають bottom jaw. Thus considerably змен-шується area of functioning masticatory повер-хонь of both dental arcs, there is divergence of горби-ків and furrows of articulating teeth.The third group answers morphological будо-ві of III of class after Енглем, that related to the excessive function of muscles which pull out a bottom jaw.Thus, classification of anomalies of bite of Катца had an attempt to connect the morphological displays of violations with functional pathology of жуваль-них muscles and reason of development of anomalies.The main lack of this classification is that she takes into account only the anomalies of bite in a sagital plane and from the morphological point of view has the same не-доліки, that and classification of Енгля. Theoretical поло-ження were built on empiric conclusions, as in that time there were not methodologies of study of functions of separate muscles.Classification of Л. In. Ільїної-Маркосян (1967) is built taking into account influence of function of muscles of mouth and біляротової areas on forming and development of the зубощелепної system, and also особли-вості structures of скронево-нижньощелепних joints, which by means of masseters carry out motions of bottom jaw in different directions.Л. In. Ільїна-Маркосян offered класи-фікацію anomalies of bite, built on the signs of displacement of bottom jaw during closing of teeth. Such distribution has a large practical value. All anomalies were up-diffused on sagital, вер-тикальні and трансверзальні. Instead of terms "distal" and "мезіальний" bite запропоно-вано terms "постеріальний" and "антеріальний". Classification of Л. In. Ільїної-Маркосян has a large practical value (table. 5.1).Classification And. And. Бетельмана (1956) all зубощелепні anomalies are divided on an anomaly by position of separate teeth and anomaly of articulation.The anomalies of articulation are examined after three directions: sagital, vertical and трансверзальним, taking into account here функціональ-ну pathology after Катцем.Characterizing patho-occlusions, an author went out the morphological features of ортогнатичного bite. A rejection is in interrelation of dental rows in sagital, vertical and трансверзальній planes at an orthognathia result in appearance of
pathological forms of bite in the same three directions. From here, on an idea And. And. Бетельмана, there is не-обхідність to distinguish three groups of pathological forms of dental occlusion : sagital, vertical and трансвєральні anomalies of bite.
To the sagital anomalies of bite deviations behave from a norm in the мезіодистальному співвід-ношенні of dental rows : distal and мезіальний bites. A distal bite is characterized by distal position of bottom jaw, and also functional
insufficiency of muscles, what висува-ють bottom jaw, and колового muscle of cavity of mouth. In addition, depending on the degree of development of jaws And. And. Бетельман distinguishes four forms to the дис-тального bite:first form - bottom мікрогнатія;second form - overhead макрогнатія;third form - overhead макрогнатія and bottom мі-крогнатія;fourth form - supramaxillary прогнатія with narrowing in lateral areas.At a мезіальному bite is a bottom jaw of роз-ташована мезіально, м'язи-висувачі superfluously роз-винуті, and ретрактори is developed not enough. Мезі-альний a bite has three forms:first form - overhead мікрогнатія;second form - bottom макрогнатія;third form - overhead мікрогнатія and bottom ма-крогнатія.To the vertical anomalies after And. And. Бетельма-ном the cases of deviations belong from an orthognathia, from the point of view of degree of ceiling by the overhead фрон-тальними teeth of lower. This pathology has two forms: deep and open bites.A supraocclusion arises up at the excalation of muscles which pull out a bottom jaw. Open - at the excalation of muscles which lift a bottom jaw, and also circular muscle of mouth.Two forms of slanting bite behave to the трансверзальних anomalies. First form - on one side teeth articulate as at a ортогнатично-му bite, and on the second - a supramaxilla is narrowed and bottom teeth recover overhead.Second form - all bottom jaw is displaced in one side, and due to it on one side the palatal surfaces of overhead lateral teeth recover the щіч-ні surfaces of lower, and on the second - the tongue surfaces of bottom lateral teeth recover cheek поверх-ні overhead, id est teeth close up not masticatory by tubercles, but lateral smooth surfaces.This state arises up as a result of functional insufficiency of one of м'язів-висувачів, left or right, depending on that, a bottom jaw is displaced in what side.The first form has the name of one-sided slanting bite, second - bilateral.Classification of anomalies of position of separate teeth on And. And. Бетельманом foresees 9 types of their position :1) oral position;2) vestibular position;3) супраоклюзія;4) infraocclusion;5) мезіальне position;6) distal position;7) a turn of tooth is about axis;8) diastemas;9) congestion of teeth.Advantage of classification And. And. Бетельмана of поля-гає in the facilitation of realization of differential діа-гностики in ортодонтії. General concepts "дисталь-ний" and "мезіальний" bites, divided into forms, allow to specify a
differential diagnosis. Classification gives not only morphological but also functional description of deformations.The lacks of this classification consist in the недо-статньому reflection of etiology of зубощелепних anomalies.In basis of classification In. Ю. Курляндського (1957) is morphological changes of bite. Author of відмі-тив, that at presence of interdependence between a form and function it is enough to describe the type of anomaly on the basis of one of these two factors. After classification In. Ю. Курляндського, зубощелепні anomalies are up-diffused on:1) anomalies of form and location of teeth;2) anomalies of dental row;3) anomalies of correlation of dental rows.To the first and second form of зубощелепних ано-малій зубоальвеолярні forms belong to, to the third - гнатичні. The basic forms of anomalies can по-єднуватися with the anomalies of form and position of окре-мих teeth or with violations in correlation of separate areas of dental arcs.Classification of зубощелепних anomalies In. Ю. Курляндського :1. Anomalies of form and position of teeth.1.1. Anomalies of form and sizes of teeth : макродентія, мікродентія, teeth are acanthoid, teeth of кубоподібні et al.1.2. Anomalies of position of separate teeth : пово-рот about axis, displacement in a вестибуляр-ному or to oral direction, displacement in distal or to мезіальному direction, violation of height of location in the зубно-му row of crown of the tooth.2. Anomalies of dental row.2.1. Violation of forming and прорізування of зу-бів : absence of teeth and their rudiments (аден-тія), formation of supernumerary teeth.2.2. Ретенція of teeth.2.3. Violation of distance is between teeth (diastemas, треми).2.4. Uneven development of alveolar sprout, excalation or his excessive height.2.5. Narrowing or expansion of dental row.2.6. Anomalous position of a few teeth.3. Anomalies of correlation of dental rows.The anomaly of one development or both dental ря-дів creates the certain wattle-fence of betweenness by the зуб-ними rows of overhead and bottom jaw :1) excessive development of both jaws;2) excessive development of supramaxilla;3) excessive development of bottom jaw;4) excalation of both jaws;5) excalation of supramaxilla;6) excalation of bottom jaw;7) open bite;8) deep chisel ceiling.Next to the positive going near the study of ве-личини and location of separate areas of зубоще-лепного vehicle, this classification has defects. In her did not find
the reflection of anomaly, обумов-лені by мезіодистальним displacement of teeth and dental arcs, displacement of bottom jaw, also etiologic factors of development of зубощелепних anomalies.Д. And. Калвеліс (1957) considers that кла-сифікації morphological changes, which touch teeth, dental rows and all bite on the whole, must underlie, taking into account etiology and value of these від-хилень for a function and aesthetics.Зубощелепні of anomaly and deformation of прику-су is distributed from the point of view of comfort of work of practical ортодонта and have 3 groups:1) anomalies of separate teeth;2) anomalies of dental rows;3) anomalies of bite. Classification of Д. And. Калвеліса:1. Anomalies of separate teeth.1. Anomalies of amount of teeth :• edentia - partial гіподонтія and complete;• supernumerary teeth (гіпердонтія).2. Anomalies of size and form of teeth :• giant teeth;• subulate teeth;• distorted forms of teeth;• teeth of Гетчинсона, Фурньє.3. Anomalies of structure of hard fabrics of teeth :• hypoplasia of dental crowns.4. Violation of process of прорізування of teeth :• premature прорізування of teeth;• detained прорізування of teeth. //. Anomalies of dental rows.1. Dyspoiesis of dental rows : And Anomalous position of separate teeth :• labelial-cheek прорізування of teeth;• піднебінно-язикове прорізування of teeth;• мезіальне прорізування of teeth;• distal прорізування of teeth;• subzero position (infraocclusion);• pride (супраоклюзія) of place;• turn of tooth (torsiversion);• transposition of teeth;• дистопія of overhead dog-teeth.2) Скупчене position of teeth.3) Треми is between teeth (diastema). 2. Anomalies of form of dental rows :• narrowed dental row;• a dental row is saddle-shaped constrained;• V -подібна form of dental row;• quadrangular form of dental row;• asymmetric dental row. ///. Anomalies of bite.
1. Sagital anomalies of bite :1) прогнатія;2) прогенія: erroneous and true.2. Трансверзальні of anomaly of bite :1) narrowed dental rows;2) disparity of width overhead and ниж-нього of dental rows :• violation of correlation of lateral зу-бів is on one side (slanting or односто-ронній crossbite).3. Vertical anomalies of bite :1) supraocclusion:• recovering bite;• the combined bite is from прогнатією (да-хоподібний);2) open bite:• veritable bite (rachitic);• traumatic bite (as a result of шкід-ливих habits).The lack of this classification consists in недостат-ній attention to functional violations of зубоще-лепного vehicle.Classification of X. And. Каламкарова (1972) is клініко-морфологічна description of прику-су, which the used suggestions of Е were in. Angle (1889), Н. And. Агапова(1929), G. Korkhaus (1939)A. М. Schwarz (1951), Д. And. Калвеліса (1957)B. Ю. Курляндського (1957), Л. In. Ільїної-Марко-сян (1967), Ф. I. Хорошилкіної (1969). Класифіка-ція takes into account not only clinical displays deformations but also morphological changes, conditioned by the anomalies of odontogeny and bones of face (table. 5.2).
Ф. I. Хорошилкіна (1976) from data of телерент-генологічного inspection distinguishes зубоальвеолярні of тагнатичні feature, macro, нормо- or мікро-гнатію, front, AV or back location of jaws and their inclination in relation to a skull. For the да-ними study of lateral telesciagrams of chairman, on characteristic signs she divides the anomalies of bite into three basic forms: зубоальвеолярну, гнатичну and mixed. This classification of anomalies of до-зволяє to pin-point on localization of pathology and ви-брати rational method of treatment.
Classification of anomalies of ВООЗ (1968)Worldwide organization of health protection in сво-їй systematization of diseases offers such кла-сифікацію of зубощелепних anomalies :1. Anomalies of size of jaws :1.1. Макрогнатія of supramaxilla1.2. Макрогнатія of bottom jaw1.3. Макрогнатія of both jaws1.4. Мікрогнатія of supramaxilla1.5. Мікрогнатія of bottom jaw1.6. Мікрогнатія of both jaws
2. Anomalies of position of jaws in relation to basis of skull :2.1. Asymmetry2.2. Нижньощелепна of прогнатія2.3. Supramaxillary прогнатія2.4. Нижньощелепна ретрогнатія2.5. Supramaxillary ретрогнатія3. Anomalies of correlation of dental arcs :3.1. Distal occlusion3.2. Медіальна occlusion3.3. Excessive ceiling3.4. Excessive recovering bite3.5. Open bite3.6. Crossbite of lateral teeth3.7. Лінгвооклюзія of lateral teeth of bottom jaw4. Anomalies of position of teeth :4.1. Congestion4.2. Moving4.3. Turn4.4. Intervals are between teeth4.5. Transposition
Classification of Л. С. Персіна (1989) морфоло-гічна after the character. She is based on кла-сифікаціях of Д. And. Калвеліса and ВООЗ.Classification of anomalies of occlusion of dental rows on ./7. С. Персіним :1. Anomalies of occlusion of dental rows.1.1. Lateral area1.1.1. For сагіталі:• distal (дисто-) occlusion;• мезіальна (мезіо-) occlusion.1.1.2. For vertical lines:• дизоклюзія.1.1.3. For трансверзалі:• cross occlusion;• вестибулооклюзія;• палатинооклюзія;• лінгвооклюзія.1.2. Frontal area1.2.1. For сагіталі:• sagital chisel дизоклюзія;• reverse chisel occlusion;• reverse chisel дизоклюзія.1.2.2. For vertical lines:• vertical chisel дизоклюзія;• direct chisel occlusion;• deep chisel occlusion;• deep chisel дизоклюзія.1.2.3. For трансверзалі:• трансверзальна chisel occlusion;• трансверзальна chisel дизоклюзія.2. Anomalies of occlusion of pair of teeth-antagonists :2.1. For сагіталі2.2. For vertical lines2.3. For трансверзалі.From data of the British standards of grant of сто-матологічної help (Oxford, 1998) classification of співвідношен-ня dog-teeth is used in the clinic of ши-роко, because position of dog-teeth also serves as the markpoint of ортодонтичного treatment :/ class - an overhead permanent dog-tooth is in an interdental interval between a permanent stomach-tooth and first премоляром;// class - an overhead permanent dog-tooth is in an interdental interval between a stomach-tooth and lateral chisel;/// class - an overhead permanent dog-tooth is in an interdental interval between first and second пре-молярами of bottom jaw.
On this time there is not only classification which would satisfy in a complete measure all лікарів-ортодонтів. In Ukraine most widely застосову-ваними is to classification of Е. Angle, And. And. Бетельмана, Д. And. Калвелгса, Л. П. Григор'євої. Last ча-сом, in connection with realization of positions of Болонської of declaration in the system of higher medical education, запро-поновано transition on МКХ-10 (international класи-фікацію illnesses). In "Protocols of grant of стома-тологічної help", given out МОЗ of Ukraine and ЦМК from higher medical education in 2005, нозо-логічні units and their forms are presented according to a few classifications - Е. Angle, A. I. Betel-delusion, Д. And. Калвеліса, ВООЗ and МКХ-10.In everyday practice of ортодонти зустріча-ються with the row of зубощелепних anomalies, when not-possible determination of diagnosis is according to existent classifications.With the aim of standardization of studies of ортодонтії in ви-щих educational establishments and offer the grant of ортодонтич-ної help formulation of diagnosis as follows:• morphological part (anomalies of bite are in three planes, anomaly of dental rows, anomaly of окре-мих teeth) is determination according to adapted МКХ-10 and determination of class after Е. Angle;• etiologic part;• functional part;• aesthetic part.
5.1. Question for self-control and tests1. Classification of Е. Angle. Advantages and defects.2. Classification And. I. Катца. Advantages and defects.3. Classification And. And. Бетельмана. Advantages and defects.4. Classification of Л. In. Ільїної-Маркосян. Перева-ги and defects.5. Classification In. Ю. Курляндського. Advantages and defects.6. Classification of Д. And. Калвеліса. Advantages and defects.7. Classification of X. And. Каламкарова. Advantages and defects.8. Classification of ВООЗ. Advantages and defects.9. General lines and divergences of classificationsЕ. Angle, And. I. Катца and Л. In. Ільїної-Маркосян.10. General lines and divergences of classifications And. And. Бетельмана and In. Ю. Курляндського.11. Component parts of final diagnosis.
Variant №1. Theme № 11.
1. Transfer in the chronologic order 4 periods in development of basic classifications of зубощелеп-но-лицевих anomalies, what булі is offered abroad:A. Енгелевський, доенгелевський, симонов-ський, шварцевський.Б. Симоновський, доенгелевський, енгелев-ський, шварцевський.B. Доенгелевський, енгелевський, симонов-ський, шварцевський.Доенгелевський, симоновський, енгелев-ський, шварцевський.Д. Доенгелевський, енгелевський, шварцев-ський, симоновський.
2. How many підкласів in 2 classes of classification анома-лій of bite of Е. Angle?A. 2. Би. 1.B. 3. Е. 5. Д. 4.
3. Who of scientists did offer three взаємоперпен are дикулярні planes for morphological діа -гностики of зубощелепних anomalies?A. Schwarz. Би. Катц.B. Симон. Е. Е. Angle. Д. Калвеліс.
4. How is it possible conditionally to divide all зубощелепні anomalies are offered?A. Morphological, етіопатогенетичні;Б. Functional, morphological, етіопато - genetic.B. Aesthetic, morphological, етіопатогене - тичні.Functional, aesthetic, етіопатогене - тичні, morphological. Д. Етіопатогенетичні, aesthetic.
5. Who of scientists did offer concept "функціо-нальна norm of dental rows" and "Functional pathology"?A. Енгль. Би. Schwarz.B. Катц.Калвеліс. Д. Бетельман.
6. Who of scientists did underline 'язок forms and functions in the classification of взаємозв?A. Катц.Б. Калвеліс.B. Каламкаров.Курляндський. Д. of Schwarzas.
7. Classification of anomalies of bite in three взаємо -перпендикулярних directions, which is based on a presence or absence of displacement of bottom ще-лепи at a "usual" occlusion, it was offered:A. Ільїною of -Маркосян. Би. Катцем.B. Каламкаровим. G. Симоном.Д. Калвелісом.
Variant №2. Theme № 11.001.What form of alveolar sprouts is a norm
for children on the first year of life? а) form of ellipse б) трапецієвидна в) half-round г) of Y of -образная д) none of transferred
002.What correct correlation of jaws is in vertical direction in the formed temporal bite? а) the frontal teeth of supramaxilla recover lower on 1/3 б) regional closing of chisels в) frontal teeth of supramaxilla
the lower recover less than, than on 1/3 г) absence of contacts is between foreteeth д) presence three between foreteeth
003.Main for description of bite for a child is а) amount of teeth б) form of dental rows в) ceiling of frontal teeth г) position of teeth д) form of dental rows and their correlation
in a state of central occlusion
004.What from the transferred signs characterize optimally there is closing of teeth in a central occlusion in a permanent bite? а) every tooth has on one antagonist б) every tooth has for two antagonists в) every tooth has for two antagonists
except for the second chisels and second моляров г) every tooth has for two antagonists
except for central bottom chisels and last overhead моляров
д) every tooth has for two antagonists except for central bottom chisels
005.A change of curvature of alveolar sprouts is for vertical lines for children testifies 1 toа) about preparation to the прорезыванию teeth б) about forming of open bite в) about the variant of height of alveolar sprouts for this child г) about forming of зубочелюстных anomalies in vertical direction д) none of the transferred answers
006.The presence of сагиттальной crack for a child after 6 months testifies а) about forming of трансверзальных anomalies of bite б) about forming of open bite в) about forming of crossbite г) about forming of distal bite
д) a right answer is not adopted
007.Forming of what function of the зубочелюстной system more active in all violated at the shortened bridle of language for children 9-12 months? а) function of swallowing б) function of breathing в) function of suction г) function of closing of lips д) function of language
Variant 3. Theme № 11.
1. A language at swallowing for children in age one year resists а) in an overhead lip б) in a bottom lip в) in різці of overhead and bottom jaw in default of their closing г) in різці of overhead and bottom jaw at serried teeth д) in bottom chisels at serried teeth
2. In the stage of відправного push at the infantile type of swallowing a language is: а) on the bottom of cavity of mouth б) after supramaxillary alveolar sprouts в) between foreteeth г) between teeth д) after bottom foreteeth
3. For the physiology type of swallowing characteristic position of language а) between foreteeth б) after overhead chisels в) abuts against an overhead lip г) abuts against a bottom lip the д) pushing away of language is from the internal surface of lips
4. The function of mastication begins to be formedа) in 6-9 months б) in 12 months в) after 1.0-1.5 г) after прорезывания of central chisels on an overhead and bottom jaw д) after прорезывания of lateral chisels on an overhead and bottom jaw
5. A fressreflex for a child goes out in a normа) 3-6 months б) 9-12 months в) after 1 г) in 6-9 months д) after прорезывания of temporal teeth
6. Bandage which presses, on the alveolar sprout of supramaxilla
shown atа) open bite which is formed б) the broken nasal breathing в) stygmographs of supramaxilla г) of зубоальвеолярной stygmograph of supramaxilla д) supraocclusion which is formed
7. By a basic differentially-diagnostic sign anomalies which are formed, and variants of norm of bite, is а) attracting background for development of pathology б) активнодействующая reason в) functional rejections of the зубочелюстной system г) early morphological signs of anomalies of bite д) the inherited factor
Variant 4. Theme № 11.
1. By the basic symptom of the wrong swallowing, to the anchorwomen to development of open bite, isа) tension of muscles of bottom lip is at swallowing б) tension of muscles of chin is at swallowing в) at swallowing in the moment of відправного push language
sent in interdental space г) symptom of "thimble" д) tension of temporal muscles
2. About development of anomalies of biteconditioned by violation of the nasal breathing, testifies а) forerake of chairman б) violation of closing of lips the в) lengthening of bottom third of person is in a state of calmness г) unclosing of lips д) presence of double chin
3. Активнодействующей by reason, to the anchorwoman to the compression of frontal area of bottom jaw, possiblyа) subzero attachment of bridle of language
to the alveolar sprout of bottom jaw б) attachment of bridle of language
to the alveolar sprout of bottom jaw в) wide bridle of bottom lip г) suction of bottom lip д) all is transferred
4. As a result of harmful habit during sleep to underlay hands under a head and to press on a bottom jaw formedа) сплощення of jaw from one side б) change of tone of muscles of maxillufacial area в) narrowing of supramaxilla
г) displacement of bottom jaw aside д) narrowing of overhead dental row
5. The too high head of a bed during sleep for pectoral children conductsа) to displacement of bottom jaw back and restrains the height of jaw forward б) does not influence on correlation of jaws в) to the antedisplacement of bottom jaw г) to deformation of jaws д) to development of open bite
6. Pelting of chairman conducts during sleep of child а) to the antedisplacement of bottom jaw б) does not influence on correlation of jaws в) to displacement of bottom jaw back, not hindering to her height forward г) to forming of supraocclusion д) to forming of open bite
7. Harmful habit of suction of пустушки and baby's dummy leads а) to distal position of bottom jaw б) to forming of gothic sky в) to the stygmograph of frontal area of supramaxilla г) to ретрузии of frontal area of bottom jaw д) there is not a right answer
Variant 5. Theme № 11.
1. By the most frequent reason of development of мезиального bite with the antedisplacement of bottom jaw isа) harmful habits б) change of position of language в) humps of dog-teeth of temporal teeth which was not worn away г) violation of breathing д) does not know
2. To forming of deformations of dental row for children in the period of variable bite promotes а) wrong book-mark of teeth б) early exodontia в) supernumerary teeth г) anomalies of soft fabrics of cavity of mouth д) chronic diseases
3. Specify a risk factor, contributory infringement to development of зубочелюстных anomalies in the period of temporal biteа) premature exodontia б) anomalies of attachment of soft fabrics are on the eve of cavity of mouth в) early moving away of temporal teeth г) harmful habits for a child д) all is transferred
4. Specify that conducts an unfavorable factor
in forming of зубочелюстных anomalies in the антенальном period of childа) heredity б) disease of mother в) wrong position of fruit a г) trauma is psychical and mechanical mothers д) violation of diet of mother
5. Specify reliable reason which results in an origin distal (постериального) biteа) habit to suck a finger б) habit to get a bite bottom lip в) habit to get a bite overhead lip г) parafunction of breathing д) humps of temporal dog-teeth which was not worn away
6. Specify a leading sign which stipulates the parafunction of languageа) short bridle of language б) powerful bridle of overhead lip в) violation of terms of прорезывания teeth г) mionectic tone of circular muscle of mouth д) mouth breathing
7. Specify the most reliable reason, what results in the origin of crossbiteа) habit to displace a jaw aside б) habit to suck a finger в) lazy mastication г) infantile method of swallowing д) destruction of crowns of teeth
Variant 6. Theme № 11.
1. Anomalies which are formed pass to formed as a result ofа) presence of активнодействующих reasons б) of functional rejections в) of the genetically conditioned factors г) of early loss of teeth д) of all transferred factors
2. An etiologic factor in development of anomaly of bite is a а) child sucks a finger б) for a father symptom of supramaxillary прогнатии в) sleeps with the exposed mouth г) early exodontia д) all is transferred
3. Allow to forecast development of зубочелюстных anomalies а) wrong rearing б) violation of breathing в) for the parents of anomaly of bite г) languid mastication
д) harmful habits
4. With greater authenticity to forecast symptom of close position of frontal teeth it is possible а) in the first year of life б) in early age в) in preschool age г) in school age д) in all periods
5. A diagnosis is pathology" which is "formed, based on an exposure а) of активнодействующих reasons б) symptoms of зубочелюстных anomalies в) risk factors г) of etiologic factor
in combination with the insignificant rejections of norms of bite д) passively operating reasons
6. By the most frequent reason of narrowing of dental row of supramaxilla it isа) habit to suck a finger б) wrong position of language в) habit to bite an overhead lip г) parafunction of breathing д) does not know
7. Specify information from anamnesis, which can matter for the unfavorable prognosis of distal bitea а) child from the day of birth was on the artificial rearing,
it was ill a rachitis, a mother has a distal supraocclusion б) a child on 1th of life had a fever of lungs,
the mixed rearing is from 5 months, the first teeth were cut through in 6 months
a в) child in 3 months lifted a head, noted caries of V(V teeth
г) change of form of jaws, in sleep underlays a hand under a head д) short bridle of overhead lip
Variant № 7. THEME № 11.1. What violations guilty to represent the diagnosis of зубощелепно-лицевих anomalies up-to-date development of ортодонтії?А. Morphological, functional, aesthetic. б. Morphological, functional, aestheticетіопатогенетичні, general violationsto the organism.В. Functional, aesthetic, morphological, етіопатогенетичні.Етіопатогенетичні, morphological, функ-ціональні, general violations of organism.Д. Етіопатогенетичні, morphological.
2. Term "labial (букальна)" occlusion of запро-понував :A. Катц. Би. Schwarz.B. Енгль.Калвеліс. Д. Каламкаров.
3. What scientist in the classification did distinguish the на-ступні groups of зубощелепних anomalies : anomalies of separate teeth, anomaly of dental rows and анома-лії bite?A. Schwarz.Б. Бетельман.B. Калвеліс. G. Катц.Д. Енгль.
4. What position of bottom jaw is in new-born is considered it physiology? а) distal б) neutral в) антериальное г) a right answer is not adopted д) мезиальное
5. What position of bottom jaw children have in 6-9 months does behave to the variant of norm? а) distal б) neutral в) антериальное г) мезиальное д) a right answer is not adopted
6. In development of gothic form of sky by a basic etiologic factor it is а) genetic conditionality б) harmful habit of suction of language в) violation of the nasal breathing г) violation of posture д) suction of baby's dummy
7. A language at swallowing for children in age one year resists а) in an overhead lip б) in a bottom lip в) in різці of overhead and bottom jaw in default of their closing г) in різці of overhead and bottom jaw at serried teeth д) in bottom chisels at serried teeth
