Medication to reduce irritation of the pulp and/or strengthen the structure of teeth
(57) Abstract:The invention relates to medicine, namely dentistry, concerns the application of bioactive glass as a drug to strengthen the structure of teeth. Bioactive glass containing silicon dioxide, is used for drug that reduces irritation of the pulp of the tooth, as well as pharmaceutical preparation, including the vitreous phase containing silicon dioxide in the form of pastes, suspensions or solution, mixed with a physiologically acceptable liquid or a physiologically acceptable carrier. The preparation can also include sources of calcium and phosphate. Medication when filling tooth canal prevents the flow of liquid and reduces or eliminates nerve stimulation that is perceived as pain. 2 S. and 9 C.p. f-crystals, 16 ill., table 1. The aim of the invention is to develop a new application of bioactive glass and new drugs, containing bioactive glass-based silicon dioxide. These drugs can be used to strengthen the tooth and filling Denisovich channels in the dentin to reduce the pain that is transmitted to the slurry resulting from the presence of open channels.Dentin is composed of extracellular matrix, which is formed by odontoblasts lining the cavity of the tooth filled with pulp. As the formation of dentin and thickening each odontoblast leaves the cell length, i.e. odontoplasty process. Such processes remain within a developing tissue and form detinova channels that pass from the boundary between the system enamel-dentin/cement-dentin in the pulp. Unsecured open detinova channels form a link between the surface of the dentin and pulp.The structure of dentin are shown in detail in Fig. 1.After the cessation of growth of the tooth odontoplasty continue to perform its functions and form secondary dentin from the pulp side of the tooth. They also form hard tissue, for example, nutritionaly dentin, which is the settlement of the AI intracanal dentin significantly higher degree of mineralization mastrubator dentin. Mineralization Denisovich channels is very slow, but a natural process associated with aging of the tooth. Low speed and unpredictability of this process creates certain problems in different clinical cases.Hydrodynamic mechanism of pain transmission in affected dentin can be described as follows:
Detinova channels have a diameter of 1-2 μm. When an incision perpendicular to the surface of the dentin, is found in about 30000-40000 Denisovich channels / mm2. Antinomy channel filled odontoblast process, surrounded by the liquid medium of the slurry. Very large capillary force prevails in the open and exposed to Denisovich channels. Therefore the liquid is mechanically removed from the opening of the channel, quickly replaced by fluid flowing from the pulp. Similarly, substances with a large osmotic pressure (for example, sweet solutions) cause external fluid flow in the channel, which, in turn, leads to transformations of odontoblasts lining the pulp chamber, and the tissues surrounding odontoplasty, resulting activated nerve endings. On the other hand, the irritation, the e hydrodynamic mechanism refers to the flow of fluid in Denisovich channels, caused by the stimulus, and the resulting vibration in the pulp. According to the modern point of view on this issue and the experimental data, the filling channel and implemented in the full or partial prevention of fluid flow can lead to reduction or even elimination of excitation of the nerve that is perceived as pain, regardless of the nature of the primary stimulus (1). The mechanism of pain transmission illustrated in Fig. 3.Clinical problem:
Exposure of the dentin or tintinabula channel leading to the pulp, may be a result of tooth decay. Hard tissue (enamel/cement) that protects the dentin, is destroyed during the process of decay. This situation leads to the famous painful symptoms associated with the formation of the cavity. The pain caused by irritation, which is transmitted to the nerve endings in the pulp by dentinum channels. During the process of decay is usually observed partial mineralization of the content channel. This is a consequence of the occurrence of high concentrations of calcium ions and phosphate due to the process of demineralization of enamel and dentin in the immediate vicinity of intact detinova tissue. Preferably the strengthening of this I shall live with periodontitis diseases of the teeth, and with the normal aging process and characteristics of dental hygiene. In some cases, even in his youth, is the detachment of the gums or the teeth are cut so that the teeth are bared. This phenomenon in itself can lead to painful symptoms in patients who are not primarily provided coverage of the protective dentin and insensitive cement. However, more often the exposure of dentin due to incorrect habits of cleaning teeth that occurs when excessive cleaning intensity, using a coarse brush or incorrect equipment cleaning. All this leads to premature wear and hypersensitivity of the teeth, which affects tolerance to hot/cold/bitter/sweet drinks and food, makes breathing difficult in the case of hot and cold air and interferes with proper oral hygiene.Infection of periodontal tissues and, especially, the treatment of periodontal infections usually leads to peeling and exposure of dentin, usually in fairly large areas. Because successful therapy is to remove the root of cement covering the dentin, and polishing, which additionally wears the teeth, ochevidnaia in more Mature age and dental channels have a significant layer of highly mineralized intracanal dentin, pain symptoms after treatment is less pronounced. On the other hand, the pain resulting from treatment, and in some cases may be severe and can last for weeks, which necessitates the use of analgesics. In the most extreme cases, this irritation can lead to infection and then to the death of the tooth and the root canal, in relation to the care of teeth, teeth with increased sensitivity often create problems related to pain stimuli, and such problems should be solved using a simple and cheap methods of treatment (2). In Fig. 4 shows the tooth and the area with the naked detinova surface.Known methods of treatment:
Toothache resulting from the formation of cavities, regardless of what similar to pain syndromes associated with hypersensitive dentine, refers to the problem from a different region. The sensitivity associated with tooth decay, and pain caused by irritation, usually treated with fillings. At the bottom of the prepared cavity opposite the pulp is placed manufactured the drug, and a biologically active component of this drug is usually a calcium hydroxide (CaOH2). mirani tissue. However, over time this substance promotiom process feleciana. The result of this treatment is the formation of recovery of secondary dentin. The formed layer of tissue separates the pulp from the damaged area or fillings, but he has minimal effect on mineralization Denisovich channels.During filling detinova channels can also be closed glass ionomer cement or various preparations of polymer chemistry (binder plastics, resins, dentinum adhesives). Such substances mechanically clog detinova channels and improve the safety of the set of seals. Theoretically, the fluoride released from glass ionomer cement can have a positive influence on the process of mineralization Denisovich channels. However, there are results of studies on the possible clinical role of such phenomena. Preparations based plastics do not have biological activity, which promotes the healing process and/or the formation of a dense tissue between the pulp and damaged and restored sites.There are a limited number of epidemiological data describing the state of the problem, the light is ü dentin is a common and as a rule, vyisokopribyilnoy problem. Because the symptoms are closely related to patient behavior and the long-term tests, they disappear, and also due to the fact that the industry produces toothpastes, which can lower the sensitivity, the actual state of the problem is difficult to assess solely by how often patients seek professional help from dentists to solve this particular problem. In the treatment of inflammation of the gums and tissues that support the teeth, a very acute problem associated with the need to offer ways relieve symptoms associated with hypersensitivity of the teeth.Currently, there are two different concepts in the treatment of hypersensitive teeth. Such treatment methods are based either on increasing the pain threshold of the patient's tooth, or on the formation of protective mineralization precipitate on the surface of the tooth, or, preferably, in Denisovich channels. In addition, this treatment includes soft (probably chemical) controlling plaque, diet and confirmation that the excitation threshold of the pulp is not reduced in the chewing overload or bad planirovanie paste, which contain substances designed to ease pain associated with sensitive teeth(3, 4, 5, 6). The purpose of the application of such substances is of denaturing (formaldehyde) content tintinabula channel or the formation of mineral precipitation (as strontium chloride, fluoride, abrasives).Perforat sodium may have some therapeutic effects. Potassium nitrate and potassium citrate lower razdrazhimost nerves of the pulp, without affecting the actual content Denisovich channels (7). Problem with substance use, which simply increase the level of activation of the nerve endings (including corticosteroids), is that they do not strengthen the tooth, and the pulp remains open for hydrodynamic irritation even after treatment. Therefore, therapeutic effect of this treatment lasts only a short time. The results of the study of therapeutic effects of toothpastes extremely controversial. On the one hand, there are reports about the effects of placebo, whereas other studies have reported effects reduce pain by up to 80%. Typically the problem associated with the use of such toothpastes, is m follows, toothpaste can be useful for home treatment subacute (subacute) States. However, it is necessary to find a more powerful and fast-acting treatment in cases of acute pain.Currently, in clinical cases, the most common method of treating hypersensitive teeth is the use of fluoride - sodium fluoride or fluoride tin in mixtures containing 2-10% of these substances (8, 9, 10). Fluoride can also be applied topically on the surface of the tooth in combination with compounds based glaze (Duraphat (11)). Glaze prolong the action of fluoride and at the same time, in and of itself may exert a blocking action on the channel. It was shown that, at least within a short period of time the drugs based on fluorides have a positive therapeutic effect. Recently some attention has been drawn to the acidity of such drugs and irritation associated with such acidity. However, it is assumed that the problems associated with the acidity of the pulp, can be facilitated by alternate application of calcium hydroxide and fluoride. This treatment is empirical. In principle, the results were not available. The presence of an alkaline calcium hydroxide may, however, complicate the formation of a practically insoluble and, therefore, desirable perphosphate tin; and instead created more favorable conditions for the formation of calcium fluoride, which is soluble in a neutral ambient conditions. In this situation, treatment can be effective, but temporary.Solutions that promote remineralization of the tooth surface, can also reduce the sensitivity at a sufficiently long-term use. Due to the fact that such solutions are aqueous and act slowly, such method or methods based on the use of toothpastes are not the best for the treatment of acute pain. So for example, used two of the mineralizing solution B. Solution A contained 6 mm PO4and B mm Ca. In addition, both solution contained 0.15 mm NaCl and 5 h/million F. 10 ml of solution A and 10 ml of solution B were mixed in a glass container immediately before use. A mixture of the mineralizing solutions, diluted with water, rinsed his mouth for 1-2 minutes and then spit out. It is recommended to repeat this procedure twice a day, preferably after brushing your teeth with a brush.Oxalate potassium (K2Products based on polymer plastics (resins, destinova adhesives and cyanoacrylate effectively block detinova channels (15). At least in the short time they relieve pain and protect the pulp from the immediate irritation. However, such substances may not be considered as biological, as they do not provide natural healing process and mineralization Denisovich channels. It was also found that detinova adhesives possess the CSO office. In addition, it was shown that the acrylate, meta-acrylate and cyanoacrylate compounds are irritating agents and also possess genotoxic and carcinogenic properties in animal experiments and in studies of cell cultures. "Floor" based plastics also forms a microbial retentive surface at the area of connection gum-tooth, which easily gives the recurrence of recently cured of the disease. Thus, the use of Denisovich adhesives, especially in patients with periodontitis, cannot be considered as promising. When considering the materials it should be noted that the glass ionomer cement have also been suggested for the treatment of hypersensitive teeth (11). The advantages of glass ionomer cement are its properties to bind to dentin and to release fluoride. In practice, the use of glass ionomer cement is difficult especially for the treatment of heavily exposed dentin. However, this substance suitable for the treatment of distinct and relatively deep abrasive damage that can be detected above the gingival margin.In the earlier literature serves to seal detinova channels using silver nitrate. The results of the IP is Ino coloring agent. It was also proposed methods of treatment, including initial treatment of root surfaces zinc chloride followed by treatment with potassium ferrocyanide. This treatment results in the formation of a protective precipitate on the surface of the tooth. It is reported that the results of such treatment were satisfactory. However, when erroneous swallowed, it should be borne in mind that the agent is toxic.The use of NdYAG laser was proposed as a new approach to filling Denisovich channels. Preliminary results of this treatment are promising. The mechanism of such treatment, the persistence of the results and possible side effects on the pulp still need confirmation.The diversity of possible methods of treatment mentioned above, gives a good picture of the existing dental practice and realistic approaches to the selection of effective treatment of hypersensitive teeth. Even after conducting experiments in a few years none of the suggested alternatives were not clearly better than the other, and thus, cannot be considered as the dominant method of treatment. Common to all proposed is10-(PO4)6X2where X is hydroxide or fluoride), selected by nature for sealing Denisovich channels. Typically, the goal of all these methods was to obtain sediment of any kind, intended for faster lock Denisovich channels (3, 16, 17). None of the tested treatments, the aim was not the creation of conditions conducive to the flow of the process of crystallization as such in the simultaneous addition of calcium and/or phosphate, which essentially involved in the education system sediment/crystal. Therefore, based partly contradictory results reported above may be such a significant ions during the short period of treatment. On the other hand, some of these treatments reflect the results of the cumulative effects of short-term use (e.g., toothpastes and remineralizing solutions). With the exception of concepts such treatment is the use of fluoride-containing preparations, although their action is not based on the increase in the content of calcium or phosphate at the site to be treated.The purpose of the present invention is to eliminate the above is ecostiletto tooth. This drug also provides a new method of effective hardening of the tooth.Distinctive features of the present invention are presented in the independent claims.The present invention relates to new biologically active glass that contains silicon dioxide, with the aim of obtaining a drug that lowers the irritation of the pulp and/or restorative tooth structure. The invention also relates to pharmaceutical drug that reduces irritation of the pulp and/or strengthens the tooth structure. This product contains a glass phase, which represents the biologically active glass containing silicon dioxide in the form of a paste, slurry or solution in a physiologically suitable liquid or associated with such physiologically suitable carrier as fibrinogen or chitin.Hereinafter, the term "bioactive glass containing silicon dioxide" refers to a material containing Si-oxide or Si-hydroxide, and this material provides education and movement Si-Oh-groups. Bioactive glass containing silicon dioxide, can represent, for example, 1) a biologically active glass, related to the mixture of the nd, calcium, magnesium, boron, titanium, aluminum, nitrogen, phosphorus, and fluoride; 2) the glass-water type of sodium silicate; (3) silica gel, for example, Si-hydroxide; 4) a solution containing Si-OH groups; 5) silica gel containing Ca, P, or 6) hydroxyapatite containing Si-oxide or Si-hydroxide. It is essential that bioactive glass containing silicon dioxide, provided education, and the motion of Si-OH groups. It is also recommended that bioactive glass containing silicon dioxide, also provided education and movement of calcium ions and phosphate.In Fig. 5 illustrates the ternary phase diagram of the biologically active site of some of the oxide mixtures. In addition to the SiO2, CaO and Na2O this mixture is, of course, includes the oxides together with the elements mentioned in the previous paragraph. Some of the typical bioactive glass compositions shown in Table 1.Bioactive glass containing silicon dioxide, is used in the drug in powder form suspended in a physiologically suitable liquid, or it is associated with a physiologically applicable media. This drug should be damp enough to keep the interaction between glass or Si-hydroxide, for example, from silica gel.On the other hand, in addition to the Si-oxide or Si-hydroxide, such glassy phase may include one or more of the following elements: Ca, P, Na, K, Al, B, N, Mg, Ti, or F.A suitable composition of the vitreous phase may be as follows, %:
SiO2or Si-gel - 1-100
CaO - 0-40
Na2O - 0-45
K2O - 0-45
MgO - 0-40
Although silikagelevye or liquid vitreous silicate type glass containing alkali can cause mineralization of dentin with calcium and phosphate present in the liquid environment of the body, it is recommended to apply such bioactive vitreous compositions which contain calcium and phosphate. On the other hand, the drug may be added such calcium and phosphate-containing sources, such as ceramic powder.Suitable binding agents can be, for example, fibrinogen or chitin.The preparation can also contain such substances promoting crystallization, as TiO2. Agents that promote crystallization, apply to agents that favor the formation of crystal or increase their size.The drug lead in the second surface, or otherwise Nude detinova surface by the area coverage locally or over the entire surface of the specified drug. Then this drug may be covered with a protective layer of cement or use any other method that prevents moving of the drug. In Fig. 6 illustrates the use of the drug on the surface of the dentin.The following describes some of the technical solutions of the present invention.When setting temporary fillings can be mineralizuet (sclerotherapist) detinova channels by filling the bottom of the cavity, free of caries, bioactive glass containing silicon dioxide (Fig. 7), in accordance with the method described in this invention. The remaining layer of hard tissue as a result of this operation is strengthened and decreases the probability of possible irritation of the pulp in the formulation of a permanent filling or her preparation. In other words, tissue layer, reinforced in accordance with the method described in this invention also functions as an insulating layer. In cases of absence or very thin tintinabula layer glass performs the functions of a biologically active surface, which promotes Abu caries, the less mineralizovannyh dentin.Erosion of tooth refers to the phenomenon in which the tooth surface is dissolved by the action of acids that are not produced by bacteria, as in the case of caries. These acids fall in the oral cavity with frequent rises gastric juice to the level specified in the cavity (for example, at high pH and bulimia). This same situation can occur, for example, in the case of heartburn (ulcer) when eating large quantities of citrus fruits and drinking a large amount of sour wine or spirits. In such situations, the tooth surface is quickly being eroded (Fig. 8), and the tooth becomes hypersensitive. In the treatment of primary disorders and surfaces in accordance with the method of the present invention are achieved two advantages: eliminates the high sensitivity and dentin becomes more resistant to new acid effects due to its higher degree of mineralization. Because the seal dentin strengthens teeth against mechanical wear, the drug of the present invention can be used to treat other types of abrasive damage, for example, those that occur when the wrong habit chetsya infected, that results in destruction of the bone surrounding the tip of a tooth root. With proper treatment can preserve the functionality of the teeth of this type. However, this tooth is more brittle than healthy tooth, and it is easy to crack and even breaks. In the temporary filling empty root canal vitreous paste/slurry of the present invention prior to final sealing can mineralizuet detinova channels and strengthen the tooth (Fig. 9). At the same time, this method creates favorable conditions for the healing process of the bone in the tip of the root.In prosthetics crowns tooth opilivayut in the form of tapered pillars on top of which establish an artificial crown. In the process of filing exposes a very large number Denisovich channels, resulting teeth are highly sensitive position until the completion of the work. During this process cut the teeth cover temporary crowns. Temporary crowns can be fastened in place using biologically active paste containing silica glass as a bonding agent (Fig. 10). The advantages of this method is similar to achievable with restaurat is on the edges of the crowns of the prosthesis becomes less susceptible to caries.Achieved clinical effect is based, firstly, on the fact that the drug induces the crystallization of Apatite in Denisovich the canals of the tooth; and, secondly, the drug promotes the formation of dentin in the induction of odontoblast activity.If we consider the desirability of steps, preferred is a situation where a high concentration of calcium ions and phosphate remains in the immediate vicinity Denisovich channels long enough to be sure that these ions are most deeply was diffundiruet in the channels. The actual process of precipitation/crystallization is caused by factors, called nucleator (initiator education germ), which lowers the energy barrier to the formation of crystals, and triggers the natural process of filling Denisovich channels. According to the present invention, a nucleator, and ions that contribute to the composition of the sediment and the size of the crystal, are delivered from outside the touch active glass that contains silicon dioxide, with the tooth.Education core:
Mineralization is a complex and difficult controlled biological is intensive and continuous research. One of the main distinguishing characteristics of the mineralization is the fact that although the serum and tissue fluids are supersaturated solutions in relation to the content of calcium and phosphate in the tissues was not observed spontaneous crystallization. For example, tissue fluid, or other fluids with equivalent concentrations of calcium and phosphate can be stored in vitro for an unlimited time without the formation of crystals. If then in a test tube add a very small crystal of hydroxyapatite, begins the growth of crystals at the expense of calcium and phosphate present in the solution. The crystallization is initiated without such assistance, as the condensation of ionic clusters, which is a prerequisite for the formation of nuclei of crystals, requires energy costs similar chemical reactions. The overcoming of the threshold requires special conditions and/or exposure to external factors (nucleator).In principle, the initiation of crystallization, i.e., the formation of nuclei of crystals can occur in three ways:
1) Number of inorganic ions can be increased so that a critical number of ion clusters formed locally and od the compensation of any ion clusters. The resulting embryo crystals provides for the development of crystallization by increasing its own size or acting as a nucleator in relation to other surrounding labile ionic clusters (secondary formation of nuclei of crystallization). If the formation of the crystal is initiated as described above, such a path is called homogeneous formation of nuclei (homogeneous nucleation).2) In the presence of factor (nucleator), which lowers the energy threshold, preventing the formation of nuclei of crystals, there is no need to increase the concentration of ions. If the formation of the crystal is initiated by an external nucleator, such a path is called heterogeneous formation of embryos (heterogeneous nucleation).3) There are agents that increase energy threshold and, thus, prevent the formation of germ crystals. One of the most well known agents of this type is pyrophosphate. Therefore, the removal or decontamination of such locally acting inhibitor can promote mineralization.Immediately after the formation of the germ crystals he continues to grow this way, but that is th environment mineralization of the connective tissue also includes cellular activity. Cells build mineralization frame formed extracellular matrix. At least in the beginning of the process of mineralization of small patterns covering membrane (matrix embryos) can be observed on the surfaces of cells, forming a solid fabric. These embryos contain calcium-binding lipids and alkaline phosphatase. It is suggested that such specific conditions are especially favorable for the formation of the primary crystalline core. Immediately after the formation of crystal nuclei bubbles-embryos burst and crystal leaves the inside of the cell and becomes a building block of solid tissue. Since such bubbles appear only at the beginning of the formation of hard tissue, it is clear that there must be another mechanism leading to mineralization of the tissue. In fact, the extracellular matrix contains only a few organic molecules that are able to function as nucleators, at least in vitro. Such molecules include, for example, osteonectin, phosphoprotein, collagen, anionic phospholipids and such sulfur-containing compounds as chondroitin sulfate and keratinolytic.Alkaline phosphatase is always found where formattable an enzyme, which in alkaline medium is involved in the hydrolysis of various organic compounds, and in the allocation of phosphate ions.Intracanal dentin contains no real mineralisation frame (organic matrix). It has been shown in the preparation of demineralized tooth samples when detinova channels turned out to be hollow in those areas that were filled intracanal dentin. However, the observed phenomenon does not exclude the participation of nucleators in the mineralization of intracanal dentin. Apparently, there is a completely opposite situation, since we know that odontoblast and/or their processes react to some stimuli and, at least to some extent able to accelerate the formation of a protective intracanal dentin. However, it is possible that the primary stimulus does not stimulate cellular activity, but its effect is enough to initiate the degeneration of cells. Therefore, part of degenerating cells can function as nucleators. The last case, at least in part, an indication of a pathological phenomenon. A third alternative is that some components of tissue fluid, becauseyou case, when the cement layer of the root surface is removed during the treatment of periodontitis and detinova channels are exposed in the form reminiscent of the wound surface with open connections to the pulp of the tooth.Silicon dioxide, as the initiator of the formation of embryos (nucleator):
The dissolution of silica glass of the type used in the examples is minimal at pH below the surface 9. Above pH such dissolution is greatly enhanced and is dominant at pH values in excess of 9.5. The hallmark of active glass is that it increases the pH in the surrounding environment, and Si(OH)4molecules begin to dissolve. It is quite clear that when using granules of small size in a confined reaction space pH is high enough that, in turn, leads to a rich selection of silicon dioxide. In the biological environment of silicon dioxide is also distributed in the tissues.Ca, P layer, deposited on the surface of the glass enriched with silicon dioxide over the entire area of deposition. This fact confirms the active role of silica in the sediment. Because silicon dioxide is distributed in the tissues, he mo is ical systems, where glass is one of the components, an important factor is the ability of collagen to act as a nucleator in respect of Apatite crystals.When contacting the glass, for example, with a liquid system of the body surface reactions of glass called fast ion exchange, since hydrogen ions and H3O+ions in biological fluids diffuse to the surface of the glass, and alkali ions Na+and+in turn, stand out from the glass. The grid formed Si-O-Si bonds of the glass is destroyed, but at pH values below 9.5 can immediately repolymerization enriched in silica, gel-like layer on the surface of the glass. However, in this situation, the silicon dioxide also always dissolves. At pH values above 9.5 this dissolution is complete. the pH of the surrounding liquid has a strong effect on ion exchange. Low content of silicon dioxide in the glass and an open structure formed by the net atomic structure of silicon dioxide, promotirovat rapid exchange of ions. Ions of calcium and phosphate in the glass diffuse through the layer is enriched with silicon dioxide; and they were the first to form an amorphous calcium phosphate layer on layer, enriched dioxide is blowing days layer, enriched with silicon dioxide, and calcium phosphate layer gradually get thick. At the same time, amorphous calcium phosphate begins to crystallize in Apatite. Formed Apatity layer is enriched with silicon dioxide. This fact is indirect evidence that in the inorganic system formed of glass and liquids, there is a silicon dioxide acting as a nucleator crystal formation. The above-mentioned reaction on the surface of bioactive glass illustrated in Fig. 11.The present invention is illustrated in more detail by the following examples.Example 1.SiO2(Belgian sand), Na2CO3, CaCO3and CaHPO4H2O were mixed in the required proportions and transferred into a platinum crucible. The crucible was placed in an oven at a temperature of 1360oC. After three hours, the crucible was removed from the furnace and the molten composition was poured into pure water. The composition of the resulting crushed glass was equivalent to the composition N 4 (S53P4) in Table 1. The glass was immediately removed from the water and washed with alcohol. Such glass is grinded into fine powder in a ball mill and sieved. Particles smaller than 45 μm in the present invention as follows: the glass powder (1.2 g) suspended in water (0.4 g) before it is applied on the surface of the tooth root.Example 2.Preparing a powder of glass (S45P7), which is equivalent to 5 shown in Table 1. When cooking used the same original materials and methods as outlined in Example 1, with one exception: the melting time was 2.5 hours at 1340oC. the Prepared glass powder suspended in physiological saline before use.Example 3.Powder glass (S46P0) having the same composition, that composition No. 7 in Table 1, were prepared in accordance with the procedure described in Example 2. This composition did not contain phosphate. The resulting glass powder before applying suspended in physiological saline.Example 4.The composition described in Example 3 was modified in such a way that Al2O3replaced by an equivalent amount of SiO2. In other respects, the glass powder was prepared in accordance with the method described in Example 3. The resulting composition was isolated silicon dioxide faster than the composition of Example 3. The prepared glass powder suspended in physiological saline before use.Example 5.Powder nutricionales CTE is SiO2and Na2CO3and the glass was melted for 3 hours at 1350oC. the Prepared glass powder before using suspended in water.Example 6.Industrial liquid glass, i.e. nutritionally solution, used in their natural form in the preparation of the present invention.Example 7.Industrial liquid glass was neutralized with hydrochloric acid. The resulting Si-gel washed with water, subjected to ion exchange, Si-gel was dried, and the powder suspended in water prior to use in accordance with the procedure outlined in Example 1.Example 8.Pre-clinical experiment:
The experiment involved six people (5 women and one man) with an average age of 51 years. Four studies have recently been subjected to surgery periodontal valve. All six objects of study have experienced the suffering associated with sensitive and hypersensitive dentine. Just was subjected to treatment 19 teeth. Biologically active powder glass (S53P4; table 1, the maximum particle size of 45 μm) was mixed with physiological saline solution with formation of a suspension/paste directly before ispolzal. The paste was divided into a treated area with the foam blades with the formation of a fairly thick layer. The treated area was covered surgical sealant (Coe-Pak) for a week. Subjective pain patients, measured using the visual analogue scale (VAS) immediately after the treatment period, was used to assess pain. The pain was easily aroused by blowing air and scraping, using a probe. The degree of pain was measured in a scale from cutting pain to no pain.The results:
In Fig. 12 demonstrated a subjective assessment of pain after the initial treatment period. In all patients the pain was almost gone after only one treatment. The treatment was repeated on two objects, then none of the patients did not experience pain when probing the teeth or their blowing. One of the patients after 3 months conducted a post-control inspection. The patient no longer had a hypersensitivity.Example 9.Small samples cut from the gums during operations outcrops tooth performed on young patients, were cultured on bioactive glass substr the Finance tissue was suitable for studying the reaction between the bioactive glass and various types of soft tissue. The advantages of tissue cultures are that you receive a simultaneous study of the reactions of the epithelium and connective tissue. In the study of such samples by electron microscopy, it was found that the epithelial cells form an organic bond, i.e. hemidesmosome, and structure, resembling basal lamina on the surface of the glass.In this experiment, the results of which were published previously (18) showed that epithelial cell engraftment to the biologically active glass and have adhesion to the glass.Example 10.Ca-P precipitation found in cultivated connective tissue in vitro.The tissue cultivation was carried out as described in Example 9. Staining for von Kossa calcium salts revealed Ca-P precipitation with distance from the surface of the glass deep into the connective tissue under examination with an optical microscope. The analysis of the sample by scanning electron microscopy confirmed the following histological conclusion: the collagen fibrils of the connective tissue trapped inside apatitovo layer growing on the surface of the glass (Fig. 13 and 14).Elementry CLASS="ptx2">In vitro experiments on decalcification dentin.Removed tooth cut into sections with a thickness of 200 μm and was treated with hydrochloric acid to dissolve the inorganic components. Detinova channels were opened up as a result of the removal of dissolved highly mineralized intracanal dentin. The remaining matrix was soft and contained almost pure collagen Type 1, for example, is the same as the connective tissue of the mucous membranes of the oral cavity. Using the method of tissue culturing as described in Example 9 dentin were incubated for 5 days in culture. It was found that the glass (S53P4) and collagen do not stick to each other, but because of the collagen sample was flexed manually, it became hard as antinomy segment before the acid treatment.In the study under an optical microscope, it was found that the segment was remineralizers to a depth of 100-150 μm. Detinova tube near the surface of the glass were completely mineralized (Fig. 15 and 16).This experiment shows that bioactive glass containing silicon dioxide, acts as a medium that can be used for mineralization of the collagen structure is the possibility to strengthen tooth tissue using the drug of the present invention in the case when its use is associated with root canal therapy and tooth filling. In addition, this experiment also shows that use of the drug of the present invention can strengthen the collagen and make the agent is suitable for use as a bone substitute or another type of drug that can be implanted in living tissue.Example 12.In vivo experiments on rats.Experimental periodontal bone defects were created palatal near the molars in the upper jaw rats. Bioactive glass (composition = S53P4 in Table 1) powder (granule size 250-315 μm), mixed with a saline solution was applied on one side of the jaw, keeping the other side as a control. To initiate the healing process of the bone defect action of biologically active glass was carried out for 3 weeks. A soft cloth was the same as for the experimental and control sides. The epithelium was readerservice on the tooth surface, and connective tissue does not show infiltration of inflamed cells. It has been found that such material was biocompatible with this plot.Held the ehniki should be clear, the technical solution of the present invention can take various forms within the scope of the following claims.References
1. Narhi, M. V. O., Dent. Clin. North. Am. 1990, 34:439-448.2. Kontturi-Narhi V. Dentine hypersensitivity - factors related to the occurence of pain symptoms. Thesis 1993.3. Greenhild J. D. & Pashley, D. H., J. Dent. Res. 1981, 60:686-698.4. McFall W. T. & Morgan W. C., J. Calls. 1985, 56:288-292.5. McFall W. T. & Hamrick, S. V., J. Calls. 1987, 58:701-705.6. Addy M. et al., Br. Dent. J. 1987, 163:45-51.7. Chesters R. et al., J. Clin. Calls. 1992, 19:256-261.8. Krauser J. T., J. Prosthet. Dent. 1986, 56:307-311.9. Kern D. A. et al., J. Calls. 1989, 60:386-389.10. Squillaro R. et al., J. Dent. Res. 1981, 60:461.11. Hansen, E. K., Scand. J. Dent. Res. 1992, 100:305-309.12. Pashley, D. H. & Galloway, S. E., Arch. Oral. Biol. 1985, 30:731-737.13. Kerns et al., J. Calls. 1991, 62:421-428.14. A. Salvato et al., J. Dent. Res. 1990, 69:169.15. Swift, E. J. et al., Jada Vol. 125. 1994, 571-576.16. Brian Harvey W. H. & E. Johansen, J. Calls. 1972, 43:373-380.17. Imai y & Akimoto T., Dental Material Journal, 1990, 9:167-172.18. Tuominen U. I. et al. Bioceramics Vol. 6, 1993, pp. 151-156. 1. The use of bioactive glass containing silicon dioxide as a drug to reduce irritation of the pulp and/or strengthen the structure of teeth.2. The use of the Cabinet, paste, suspension or solution with a physiologically acceptable liquid or associated with a physiologically acceptable carrier.3. Application under item 1 or 2, characterized in that the bioactive glass containing silicon dioxide, includes calcium ions and phosphate, or the fact that the sources of calcium and phosphate is introduced into the drug.4. Pharmaceutical drug that reduces the irritation of the pulp of the tooth and/or strengthens the tooth structure in the form of a vitreous phase comprising bioactive glass containing silicon dioxide, physiologically acceptable liquid to a paste, suspension or solution, or physiologically suitable binder, such as fibrinogen or chitin, the drug is damp enough to save the chemical interactions between the glass phase and the dentin to transfer silicon dioxide in detinova cloth.5. The drug under item 4, characterized in that it contains sources of calcium and phosphate.6. The drug under item 4 or 5, characterized in that the preparation contains a tool that facilitates the growth of crystals in the target tissue.7. The drug under item 4, 5 or 6, characterized in that the glass phase is SDA one or more of the following elements: Na, K, Ca, Mg, B, Ti, Al, P, N, or F, or a solution containing Si - OH groups.8. The drug under item 7, characterized in that the phase of the glass has the following composition, %:
SiO2or Si-gel - 1 - 100
CaO - 0 - 40
P2O5- 0 - 60
Na2O - 0 - 45
K2O - 0 - 45
MgO is 0 to 40
9. The drug under item 7, characterized in that the phase has the following composition, %: SiO2- 53, CaO - 20, P2O54 and Na2O - 23.10. The drug under item 7, characterized in that the phase has the following composition, %: SiO2- 45, CaO - 22, P2O5- 7, Na2O - 24, B2O3- 2.11. The drug according to any one of the preceding paragraphs, characterized in that it comprises a ceramic powder.
SUBSTANCE: invention relates to polymerised dental material and method of itsmanufacturing. Polymerised dental material contains filler, which includes in organic connecting substance partially aggregated nanosize filler and other inorganic and/or organic filler, selected from group, which consists of milled filler, which has average size of particles from 0.2 mcm to 50 mcm, and spherical filler, which has average size of particles from 0.1 mcm to 50 mcm. Method of obtaining material includes stages of organic modifying of partially aggregated nanosize filler, including of said nanosize filler with modified surface in organic connecting agent, and then including of said other inorganic and/or organic filler in organic connecting agent.
EFFECT: dental material by invention includes economic aggregated fillers, such as silicon dioxide, obtained by pyrolysis, and has advantages of materials, based on nanosize fillers, in particularl mechanical properties.
25 cl, 2 dwg, 4 tbl, 6 ex
SUBSTANCE: invention relates to medicine, namely to therapeutic dentistry and deals with medications for deep fluorination of teeth, intended for prevention and treatment of dental caries. Composition for prevention and treatment of dental caries contains sodium fluoride, acrylate-methacrylate copolymer, ethyl alcohol and water with definite component ratio. Used is acrylate-methacrylate copolymer, selected from copolymer of n-butyl acrylate, 2-hydroxyethyl methacrylate and acrylic acid, copolymer of n-butyl acrylate, n-butyl methacrylate, hydroxypropyl methacrylate and acrylic acid and copolymer of 2-ethylhexyl acrylate, 2-hydroxyethyl metacrylate and methacrylic acid, and possessing, due to the method of its obtaining, properties, which ensure migration of fluoride-ions from film to tooth enamel and their penetration into dental tissues.
EFFECT: small thickness and absence of refraction of the film, obtained in drying fluorine-containing lacquer, makes its presence on teeth surface imperceptible for patients themselves and invisible for other people, which increases patient's life quality considerably.
1 tbl, 3 ex
SUBSTANCE: invention relates to dentistry, namely to root bonding systems for filling canals and carious cavities. Claimed bioactive root bonding system contains dentine conditioner, primer and adhesive. Primer contains amino-acids: histidine - 0.01%-0.2%, lysine - 0.05%-0.4%, arginine - 0.2%-1.6% from total weight quantity of primer. Material has good affinity to dentine, easily penetrates into dentinal canals, suppresses pathogenic microflora.
EFFECT: complex composition of primer preserves collagen fibres in hybrid layer of dentine, forms chemical-mechanical bond of wet dentine with bonging-resins, completely isolates prepared dentine.
21 cl, 1 ex
SUBSTANCE: what is used is an oral composition containing a polyguanidine compound expressed by formula (I) and orally acceptable carrier. There are also presented: a method for the target delivery of the composition into the oral cavity, a method for inhibition of the development and prevention of dental caries, a method for the treatment of caries lesions.
EFFECT: group of invention provides the antimicrobial, anti-caries action.
19 cl, 3 dwg, 1 tbl, 2 ex
SUBSTANCE: invention discloses a composite adhesive for attaching composite filler materials to hard dental tissue, characterised by that the starting adhesive used is a polymer composition containing 10-47.5 wt % urethane di(meth)acrylate, 2.5-40 wt % esters of aromatic tri- or tetracarboxylic acids with methacryloyloxy groups of corresponding anhydrides, 25-75 wt % volatile, water-miscible solvent, 0.01-2.5 wt % photoinitiator, which is mixed with multilayer carbon nanotubes in solid to liquid weight ratio of 1:0.0005; dispersion is carried out under ultrasound action with frequency of 20000 Hz for 30 s.
EFFECT: obtaining an adhesive whose components penetrate dentinal canals and cracks formed when preparing a tooth, and increasing adhesion of the filler material to hard dental tissue.
FIELD: medicine, pharmaceutics.
SUBSTANCE: invention refers to chemical-pharmaceutical and cosmetic industry and represents an oral film prepared of an aqueous mixture containing: a water-soluble polymer filming agent representing an edible non-ionic cellulose derivative, such as hydroxypropyl cellulose; a bioactive glass; wherein the film is adhesive to at least one tooth in an oral cavity for as much as 60 minutes before the film dissolves or substantially dissolves, and wherein the above film is able to remineralise the teeth. The invention provides the filming process in the aqueous medium by combining the edible non-ionic cellulose derivative with the bioactive glass, which stays relatively intact during the production process and maintains its bioactivity.
EFFECT: film provides the effective dental remineralisation, inhibits the growth of cariogenic and periodontal bacteria on the dental surface and adjacent gingival tissues.
14 cl, 1 ex, 10 dwg
SUBSTANCE: group of inventions deals with processing surface of inorganic oxide particles, compound for processing surface of particles, particles of inorganic oxide with processed surface and their application in curable dental composites. Method of processing surface of inorganic oxide particles contains stages, at which compound for surface processing is obtained by interaction of first functional group, which is functional group of multi(meth)acrylate monomer, containing branched or cyclic group, characterised by molecular weight, at least, 350 g/mol, with second functional group, which is functional group of silane compound, with first and second functional groups reacting with formation of covalent bond, with formation of urethane, urea or amide bonds; and compound for surface processing is combined with particles of inorganic oxide. Inorganic oxide particles with surface are also claimed, processed by said method, and curable dental composite, containing polymerisable resin composition and said inorganic oxide particles with processed surface. One of versions of particles with processed surface can be obtained with application of compound for surface processing, which represents silane compound, representing derivative of multi(meth)acrylate monomer with molecular weight, at least, 600 g/mol and, at least, three (meth)acrylate groups. Compound is also claimed, which contains silane group, covalently bound by means of urethane, urea or amide bond with multi(meth)acrylate monomer, containing branched or cyclic group, characterised by molecular weight, at least, 350 g/mol.
EFFECT: application of inorganic oxide particles with surface, processed by claimed method, in composition of curable dental composite provides reduced shrinkage of such composite.
19 cl, 10 ex
SUBSTANCE: biological primer of a crown bonding system containing histidine, lysine, ethylene glycol methyl ester, diglycidyl dimethacrylate, urethane dimethacrylate, ethanol, hyaluronic acid and water in the following proportions, wt %: hyaluronic acid (0.01-0.05), histidine (0.01-0.2), lysine (0.05-0.4), arginine (0.2-1.6), ethylene glycol methyl ester (30-85), diglycidyl dimethacrylate (1-15), urethane dimethacrylate (1-15), ethanol (2-20), water (the rest).
EFFECT: higher affinity and physiologic substantivity of the biological primer to solid dental tissues.
SUBSTANCE: method for producing aerogel involves the stages of providing a first dispersion solution of zirconium dioxide containing crystalline metal oxide particles having a median size of primary particles of no more than 50 nanometres, adding a radical reactive surface modifier to the dispersion solution of zirconium dioxide to produce a radical polymerised surface-modified dispersion solution of zirconium dioxide, adding a radical polymerisation initiator, heating to form gel, extracting alcohol if any from the gel by supercritical extraction to produce aerogel. Solid aerogel containing an organic material and crystalline metal oxide particles is produced. A crystalline metal oxide particle count varies within 3 to 20 volume percent according to a total volume of solid aerogel with at least 70 mole percent of a crystalline metal oxide represents ZrO2. The zirconium dioxide particles are produced in a hydrodynamic reactor 100 containing a feeding tank 110, a pump 120, a tube reactor 130, a cooling device 160.
EFFECT: produced aerogel can be sintered as a fully-dense material that makes it possible to use the same, in particular for making dental restoration and orthodontic appliances.
17 cl, 4 dwg, 9 tbl, 34 ex
SUBSTANCE: invention relates to medicine and can be used in orthopaedic and orthodontic dentistry. Composition of light-curing composite material contains an organic matrix, organo-inorganic filler, initiating system which consists of a polymerization initiator of thermal type of benzoyl peroxide and photo initiators of camphorquinone and dimethyl ketal benzyl, and is presented in the form of one paste with the following ratio of ingredients, %wt: urethane dimethacrylate-15.0÷29.0; elastomer Exothane 26 of firm Esschem - 8.0÷16.0; TGM-3 (triethylene glycol dimethacrylate) - 2.0÷3.8; camphorquinone - 0.005÷0.4; dimethyl ketal benzyl - 0.005÷0.4; benzoyl peroxide - 0.005÷0.4; polymerization activator ethyl-4- dimethyl aminobenzoate - 0.2÷1.8; auxiliary additives - 0.01-÷0.9; organic filler polyurethane CS-400-5.0÷8.0; non-organic filler silicon oxide fine - 10.0÷20.0; organic filler polymethyl methacrylate - the rest. Auxiliary additive can include pigments, and/or UV light absorber and/or antioxidants. Organic matrix consists of urethane dimethacrylate, elastomer and triethylene glycol dimethacrylate. Organo-inorganic filler contains modified by oligomeric mixture polymethyl methacrylate and cluster, consisting of modified oligomeric mixture of polyurethane CS-400 and preliminarily silanized finely divided silicon oxide. At that the oligomer mixture contains urethane dimethacrylate, triethylene glycol dimethacrylate, elastomer, camphorquinone, ethyl-4-dimethyl aminobenzoate.
EFFECT: technical result consists in providing of the required level of polymerization during 4 minutes with preservation of good quality of operational characteristics of light-curing composite with reduction of minimum quantity of introduced photo initiator and initiator of thermal type.
1 cl, 1 dwg, 5 ex