A. A. Vorobyev’s research while affiliated with Volgograd State Medical University and other places

Relevance . Relevance. Cerebral palsy is a persistent lesion of the nervous system. Though it is stable, the consequences of the lesion are progressing. Muscle hypertonicity is one of the principal complications which may progress. The spasticity of chewing muscles limits mouth opening, which prevents the children from practising good oral hygiene and results in multiple dental diseases. Such patients need dental care with a specific approach. The relief of masticatory muscle hypertonicity should be a priority. Nowadays, there is a large variety of methods for treating spasticity.The study aimed to comparatively analyse the effectiveness of methods for relieving masticatory muscle hypertonicity in children with cerebral palsy. Materials and methods . The patients formed two groups: the first group used kinesio taping to reduce spasticity, and the second group was prescribed adaptive chewing muscles exercises combined with the gnathic device. The study evaluated the clinical results using the developed screening diagnosis and functional results by electromyographic examination after 14 days and three months. Results . Both groups showed positive treatment routcomes. Children demonstrated significant improvement clinically and electromyographically. However, the short-term observation discovered a faster effect of kinesio taping, though the differences were not statistically significant. Adaptive chewing muscles exercises combined with the gnathic device are more effective in the long run, which statistical analysis of data reliably ref lects. Conclusion . The study reliably proved the need to include both kinesio taping and adaptive myofunctional exercises in the treatment to relieve muscle hypertonicity. There were no side effects or complications. Treatment planning requires an individual approach based on the clinical situation .

Spasticity of the masticatory muscles in patients with cerebral palsy (cerebral palsy) is noted in 60 % of cases. Due to the limited opening of the mouth, it is often very difficult for a dentist to perform manipulations in the oral cavity. First of all, it is necessary to correct the muscle tone of the chewing muscles, which is the key to the success of a full-fledged dental treatment. This article proves the effectiveness of the combined effect on the spasticity of the masticatory muscles in a patient with cerebral palsy on the example of a clinical case. The dental status, the state of the chewing muscles before the treatment and after 3 months are described. Correction of muscle hypertonicity was carried out by performing a complex of adaptive myohymnastics in combination with a pneumatic trainer after injections of abobotulotoxin type A. The first experience of combined effects on the spasticity of the masticatory muscles in a patient with cerebral palsy indicates the prospects for further development and implementation of this technique.

The hypertone of chewing muscles is the leading reason of development of pain of non-odontogenic character in maxillofacial area. This pathology is rather widespread, at the same time has permanent character and is characterized average or heavy degree of expressiveness of clinical symptoms. Muscular pains considerably reduce working capacity and worsen quality of life of patients. Treatment of a hypertone of chewing muscles is relevant in stomatology. For clear understanding of genesis of development of muscular frustration in work the anatomy of a temporal and mandibular joint and chewing muscles is in detail presented systems. Modern methods of treatment of a hyper tone of chewing muscles include correction of occlusion that doesn’t eliminate a painful symptom; orthopedic and orthodontic treatment with application a cap. However, application of above-mentioned methods is rather effective, there is no exact understanding of the mechanism of their action. At some patients the temporary improvement of a state is noted, – gets the chronic sluggish long course of development of a disease which doesn’t give in by any known methods subsequently from others. Dentists perfectly understand this fact, at the same time the disappointment from the treatment comes in spite of the fact that all efforts were bent on improvement of knowledge in the field of factors predictors of development of pathology, modern methods of diagnostics and treatment of muscular frustration. In this work the use of the pneumoexercise machine mouth gag as the device relaxing muscles and separating device on the one hand, and possibilities of his use as a stimulator of process of the return development of the available already structural and functional changes of muscle tissue with another is proved. Accurate indications and contraindications to use of this device are submitted. It is recommended to use the device as the low-invasive method which isn’t leading to irreversible consequences. Further need of development of practical recommendations on uses of the pneumoexercise machine mouth gag as is obvious to patients and their parents, and to dentists in the medical and preventive purposes.