Optimization of orthodontic treatment for children with Angle class III malocclusion by determining the influence of blink-reflex indices

Abstract

Background: The actual problem is developing the neurophysiological criteria for the diagnosis and monitoring of children with Angle class III malocclusion, because in this pathology there is a wide range of preclinical disorders with adverse influences upon various functions of the body. The interdisciplinary approach is supplemented by neurophysiological diagnosis, which facilitates a correct monitoring of orthodontic treatment during the mixed dentition stage. In recent years, neurophysiological methods gained a wider spread in the diagnosis and monitoring of children with Angle class III malocclusion. Aim of the study: assessing the correlations between the blink reflex indices and the degree of anxiety or anticipated pain. Material and methods: Fifty eight children aged from 9-12 years, who were divided into 2 groups, statistically equivalent by age, gender, facial development degree, presence of a balanced psycho-emotional state. Patients in both groups were examined using traditional clinical exams and complementary exams were completed through neuro-physiological examination of the blink reflex. In our studies, we performed a correlative analysis between the R3 indices (presence/absence), the degree of dental anxiety, assessed on the Dental Anxiety Scale according to N. Corah and pain self-assessment indices based on the Visual Analogue Scale (VAS). Results: In children with Angle class III malocclusion, in the blink reflex complex, in 31% of cases the R3 wave is present, which is associated with psycho-emotional mechanisms of inhibition/activation for anticipated pain. Conclusions: Perspective future research in children with Angle class III malocclusion needs to be focused on uncovering the correlation between the expression degrees of trigeminal reflexes with the functional disorders in the stomatognathic and extra-stomatognathic systems (vestibular functions, pain syndromes, etc.).