Abstract
<jats:p>Since the anatomical and functional features of the tongue are of great importance in the formation of dentognathic deformations, the study of the variations of its pressure in children depending on orthodontic status, especially during swallowing, is of great clinical importance. The aim of the study was to compare the features of the muscular and functional activity of the tongue in the areas of the middle third of the palatal and lingual surfaces of the central incisors of children with distal, mesial and open bites, as well as without components of the symptom complex of dentognathic deformations in the sagittal, vertical and transverse directions during swallowing. In the course of the study, we analyzed the results of diagnostic screening of children aged 5-12 years (n=103): with distal (n=31), mesial (n=12) and open (n=26) bites, as well as without components of the symptom complex of dentofacial deformities in the sagittal, vertical and transverse directions (n=34). The study revealed intergroup differences in tongue pressure during swallowing for both individual zones (ZK1, ZK2) and the integral index ⟨ZK1, ZK2⟩. An important qualitative feature of the swallowing profile is the ratio of the ZK1 and ZK2 zones, namely, in the group of patients without components of the symptom complex of dentognathic apparatus in the sagittal, vertical and transverse directions, a maxillary dominant pattern was observed (ZK1>ZK2: 6.9±2.0 kPa versus 5.6±1.4 kPa), while in all other groups the ratio was the opposite (ZK1<ZK2). Taken together, the results of the analysis indicate that the most significant changes in the groups of pediatric patients during swallowing, depending on the orthodontic status, are an increase in pressure in ZK2 and/or the integral index ⟨ZK1, ZK2⟩ in distal occlusion, as well as a combination of a decrease in ZK1 and an increase in ZK2 in open bite. In contrast, in mesial occlusion, the differences from the normotypical values are generally less pronounced. The distribution of ⟨ZK1, ZK2⟩ values generally has moderate intergroup differences. In the distal occlusion group, there is a tendency for the median and interquartile range to shift towards larger values compared to the group without components of the symptom complex of deformities of the dentognathic apparatus in the sagittal, vertical and transverse directions, which is consistent with a statistically significant increase in the integral index in this group. For mesial occlusion and open bite, the distribution of ⟨ZK1, ZK2⟩ largely overlaps with the normotypic range, but the variability is greater than without deformities. At the same time, it should be taken into account that similar integral values of ⟨ZK1, ZK2⟩ can be formed with different ratios of components ZK1>ZK2 or ZK1<ZK2. It was found that during swallowing, distal occlusion is associated with an increase in the integral index of tongue pressure in the frontal zones ⟨ZK1, ZK2⟩, while for open bite, a redistribution between the specified zones with a decrease in the palatal (ZK1) and an increase in the mandibular (ZK2) frontal component of pressure without a significant change in the integral level is more characteristic. Such a pressure profile may reflect specific features of the functional pattern of tongue position and movements in the frontal area during swallowing in patients with different types of occlusion. </jats:p>