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

Knowledge of the anatomy of the masticatory muscles is extremely important for understanding para functional muscle disorders. This article describes the anatomy of the masticatory and temporal muscles proper in their hypertonicity from the position of ultrasound examination. With the help of qualitative and quantitative indicators, the structure of the masticatory and temporal muscles proper was studied at rest and under stress. Ultrasound examination revealed point and linear hyperechoic inclusions, trigger points, which made it possible to verify muscle hypertonus.

Relevance. The modern development of practical dentistry and the emergence of new techniques and methods of diagnosis and treatment determine the necessity and expediency of studying the anatomical features of the head, skull, structure of dental arches, and dental segments in general. Knowledge of the patterns and characteristics of the skull structure and their relationship with morphometric, clinical and functional parameters will allow the diagnosis of various forms of maxillofacial disorders based on comorbidity. Materials and methods. The study examined 30 children aged 6 to 12 y.o. to determine the relationship between the type of face and the state of the chewing muscles in children with cerebral palsy. Maxillofacial anthropometric measurements were made, e.g., the bitragional length (t-t) and the distance between the tragion and subnasale landmarks (t-sn); the gnathic index of the face was calculated, and the mouth opening range was measured. The surface electromyography determined the mean biopotential amplitude of the right and left proper masticatory and temporal muscles using the "bruxism" test. Results. The anthropometric measurement data indicate the prevalence of a brachygnathic facial type in children with cerebral palsy. The electromyographic study data evidence spasticity of the masticatory muscles. Conclusion. The obtained data indicate functional overload of the chewing muscles. Masticatory muscles' hypertonicity determined the brachygnathic facial type in children with cerebral palsy.

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 .

Relevance. Spastic cerebral palsy is one of the most common forms of cerebral palsy, in which muscular hypertonia, including jaw muscles, is present. To date, there is no universal algorithm for muscle hypertonia. The diagnosis is made based on complaints and data from an electromyographic study. This paper describes and proves the rationale for including ultrasound and laser Doppler flowmetry (LDF) in additional diagnostic methods. Material and methods. We examined 84 children with cerebral palsy using ultrasound and LDF to study the state of the mastication muscles. The ultrasound examination determined the structure and thickness of the masseter and temporal muscles and detected trigger points and the infiltration site. LDF was performed both at rest and after an occlusal test, which allows assessing the reserve capacities of the mastication muscles. We compared the received data with a group of healthy subjects of the same age. Results. Ultrasound parameters and LDF data differed from the control group. The ultrasound examination revealed trigger points for the first time without patients’ complaints. Congestion caused by damage to muscle cells is characteristic of the local blood flow in children with cerebral palsy. The results of the occlusal test evidenced the mastication muscle compensation abilities, which clinicians should consider during treatment planning. Conclusion. The received data will help dentists diagnose and treat muscle hypertonia, which will prevent pathology deterioration.

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.

Knowledge of the clinical anatomy of the masticatory muscles contributes to the understanding of the etiopathogenetic and physiological aspects of the development of hypertonicity of the masticatory muscles. Hypertonicity of the masticatory muscles is a disease that leads to a number of other dental problems, such as abnormal abrasion, gum recession, trauma to the oral mucosa, wedge-shaped defects. We have developed and patented a pneumatic expander. It is feasible to treat hypertonicity of the masticatory muscles in a complex — myogymnastic exercises on the background of the use of the patented gnatic device. This paper presents clinical and anatomical requirements for the gnathic device as an uncoupling device in the treatment of both teeth and muscle relaxant.