Bite pathology in patients with signs of undifferentiated connective tissue dysplasia (UCTD). Possibilities of aesthetic correction of changes in the lower third of the face in patients with UCTD after orthodontic treatment

Background: The possibilities of modern medicine allow to improve the appearance of a person’s face without resorting to radical surgical interventions. One of the frequent requests in the practice of a cosmetologist is the elimination of aesthetic problems that patients experience after completing orthodontic correction of the dentoalveolar system. As a rule, this changes the volume of soft tissues of the lower third of the face, hypertonicity of the masticatory muscles occurs, nasolabial folds increase, patients note skeletonization of the face, a change in the oval – a feeling of an “aging” face appears. And, of course, these changes cause psychological discomfort to the patient.

Objective: Determination of the incidence of bite pathology in patients with signs of undifferentiated connective tissue dysplasia (UCTD) and the presence of polymorphisms of the genes responsible for the synthesis of collagen and elastin.

Materials and methods: The pilot study involved 71 patients. All patients underwent genetic testing, questionnaires on the presence of phenotypic features of UCTD, assessment of the risk of UCTD and bite pathology.

Results:

1. The results of the study show that the study groups have significant differences in the presence of bite pathology, which is confirmed by low p values for most of the analyzed markers. Particularly pronounced differences were observed for the genetic markers rs7787362_ELN and risk, which may indicate their importance in predicting bite pathology. Significant differences were also found for the marker rs1800012_COL1A1, which may indicate its role in this pathology.
2. Patients without bite pathology have significantly higher chances of having the rs1800012_COL1A1_CC and rs7787362_ELN_TT genotypes. Patients with bite pathology more often have rs7787362_ELN_CC genotypes, a high risk according to the questionnaire. These data highlight the importance of genetic testing for assessing the risk of developing bite pathology and may help in developing individualized approaches to treatment and prevention.
3. Patients with bite pathology malocclusion (group 1) have significantly higher scores on the questionnaire (15.0 [13.0; 16.0]) compared to patients without pathology (group 0, 10.0 [8.0; 10.0]). This indicates that the presence of bite pathology was associated with higher values in the questionnaire, which may reflect more pronounced clinical or demographic features in this group.
4. The conducted correlation analysis showed that there was a significant correlation between bite pathology and undifferentiated connective tissue dysplasia (R=0.619; p<0.001*).
5. Also, the presence of polymorphism in the rs7787362_ELN gene significantly increases the risk of bite pathology, while the rs1800012_COL1A1 and rs7787362_ELN genes with no polymorphisms have a protective value in predicting the absence of bite pathology.

Conclusion: Modern achievements in aesthetic medicine make it possible to effectively correct changes that occur during or as a result of orthodontic correction, which can cause psychological discomfort in the patient. Interdisciplinary interaction between orthodontists and cosmetologists will play a special role in the future. The authors believe that it is especially important to introduce aesthetic and functional prognosis into orthodontic practice in order to minimize aesthetic and psychological problems in patients.