CRITERIA FOR CHOOSING ORTHODONTIC APPLIANCES IN CHILDREN 8–11 YEARS OLD WITH MALOCCLUSION AND TYPE 1 DIABETES MELLITUS

Abstract

Introduction. Type 1 diabetes mellitus (DM1) in children requires a special approach in orthodontic treatment, as the disease affects the condition of the tissues of the oral cavity and makes it difficult to correct malocclusion. The article discusses the criteria for choosing orthodontic equipment and methods of treatment for children with DM1, taking into account their metabolic characteristics. Metabolic disorders that lead to dry mouth (xerostomia), an increased risk of caries and periodontal diseases, as well as delayed tissue healing complicate the choice of orthodontic devices and require special attention to oral hygiene. The aim of the study was to determine the criteria for choosing orthodontic devices for patients aged 8–11 years with occlusion anomalies and DM1. Materials and methods. The study involved children aged 8–11 years: 17 patients with DM1 and 38 children without this disease. Clinical examination methods were used, such as questioning, examination, examination of the oral cavity and teeth, as well as the parotid soft tissues. Results. Patients with DM1, compared with children who do not have this disease, were more likely to experience discomfort caused by the pressure of orthodontic devices on the mucous membrane, which required an increase in the number of unscheduled visits and adaptation of therapeutic measures to the existing condition. To reduce the load on the tissues, the elements of the devices were alternately activated, which helped reduce the risk of complications. Special attention was paid to careful monitoring of glucose levels before starting treatment, which reduced the likelihood of complications, secondary infections and delayed tissue healing at the contact points of the device parts. Conclusion. Patients with DM1 often had changes in the color of the mucous membrane, bleeding gums and long-term non-healing wounds, therefore, it was recommended to use devices made of soft and elastic materials that minimally affected the soft tissues during support and provided comfortable wearing. It is necessary to avoid structures made of plastic with sharp edges that can injure the mucous membrane and regularly to check the condition of the gums and mucous membrane to prevent the development of periodontal diseases and caries. Orthodontic treatment of children with DM1 requires a carefully individualized approach, including interdisciplinary collaboration and the use of minimally invasive techniques. It is necessary to take into account the psychoemotional state of children with DM1, provide them with regular orthodontist supervision, and support from dental specialists. This approach will help minimize the risks of complications and ensure the successful outcome of orthodontic correction of malocclusion, improving the quality of life of patients and their families.