MALOCCLUSION-RELATED TONGUE MOVEMENT DISORDERS IN PATIENTS WITH NEUROLOGICAL IMPAIRMENTS

Abstract

The paper considers tongue movement disorders as one of the first hallmarks of the multiple neurological impairments. The main clinical presentations of tongue motion disorders and their manifestation in patients of the clinical group have been defined. The emphasis on the need for the interdisciplinary approach in the diagnosis and treatment of tongue dysfunctions has been made. The issue of the prevalence of occlusal abnormalities among patients with tongue movement disorders and their need in prosthetic treatment has been covered. The aim of the study was the improvement of the diagnosis of malocclusion-related tongue movement disorders in patients with neurological pathology in the form of defects in dentition. Purpose The paper is aimed at the improvement of the diagnosis of malocclusion-related tongue movement disorders in patients with neurological pathology in the form of defects in dentitions Object and Methods Tongue movement disorders in patients with malocclusion in the form of defects in dentitions have been studied. Correlation between tongue movement disorders and malocclusion in the form of defects in dentitions has been analyzed. 50 patients with tongue movement disorders, who received treatment at Neurological Department of Sklifosofskiy Poltava Regional Clinical Hospital and Poltava Municipal Hospital No.1 have been involved into study and assigned to clinical group. The average age of patients is 51 yrs. Experimental control groups (50 people) had defects in dentitions, uncomplicated with secondary deformations and pathological teeth wear, not related to somatic pathology. The average age of such patients is 21 yrs. Results and Discussion Clinical observations of group of patients with neurological pathology showed that 43 patients (86%) had defects in dentitions and required prosthetic treatment; 7 patients (14%) had no malocclusions in the form of defects in dentitions. Among the examined patients with tongue movement pathology, caused by neurological impairments, an extensive occurrence of speech disturbances, namely, aphasia (up to 68%), dysarthria and dysphonia (up to 44%) have been detected. Cases of dysphagia and bradylalia were rare and accounted for 36 % and 20 %, respectively. Prominent manifestation of abovementioned symptoms was noted in individual cases on the average of 6%. Poor manifestations of symptoms of tongue movement disorders, caused by neurological pathology were noted more often. Pathological reflexes occured only in 20% of patients. Neurological patients with tongue movement disorders have been examined with regard to malocclusions. It has been ascertained that absolute majority of patients had defects in dentitions (86%) and required prosthetic treatment. 32 patients with defects in dentition of the upper jaw and 33 patients with defects in dentition of the lower jaw have been revealed. The majority of the revealed defects are assigned to Kennedy Class III. Conclusion The results of the study have shown that the majority of neurological patients, who received treatment at neurological hospital with regard to neurological diseases, causing the tongue movement disorders, have occlusive pathology (86%). Among them the majority of patients have aphasia (up to 68%), dysarthria and dysphonia (up to 44%) as a symptoms of tongue movement disorders and no pathological reflexes. Therefore, the improvement of diagnosis of tongue movement disorders symptoms by a prosthodontist is crucial for successful diagnostics and treatment of neurological diseases.

Keywords

• tongue, neurodentistry, malocclusion.