For the treatment of periodontal disease by bacteriophages

 

(57) Abstract:

The invention relates to medicine, namely dentistry. For the treatment of periodontal disease is used to treat gingivitis and periodontal disease, is used for this concentrate bacteriophages, for example, in a gel base, the applicators of various modifications (threads, plates, gels, sprays). The tool does not cause allergic reactions, not irritating the mucous membrane of the oral cavity.

The invention relates to medicine, namely to the dentist, and can be used in the treatment of gingivitis, of periodontitis.

Due to the fact that one of the factors for the emergence and development of periodontal disease (RFP) is the mass multiplication of pathogenic microorganisms, for their treatment used antimicrobial drugs. Currently, a large selection of antibacterial agents such as chlorhexidine, listerin, sangviritrin, trichopol and antibiotics, which are used both topically and systemically. However, the use of these drugs is associated with various side effects. Chlorhexidine with long-term use vybyvaet the emergence of resistant flora, change in taste, color suspiciou dysbacteriosis (Pastushenkov " L. C., Lesiovskaja E. E. ) (Pharmacotherapy with the basics of herbal medicine, part II, St. Petersburg, 1995, S. 61) and a number of antibiotic-resistant strains (N. Beloborodov.In., Bogdanov, M. B., Black T. C.) (Algorithms for antibiotic therapy, a guide for physicians, 1999, , Moscow).

In addition, antibiotic therapy is often accompanied by allergic reactions and other side effects.

Treatment of periodontal disease is complicated by the fact that the agents of this infectious process are both aerobic and anaerobic forms of bacteria, so the assignment of one or two drugs is sometimes insufficient or requires many additional preliminary studies.

The urgency of this problem involves the search for and development of new drugs and dosage forms for the treatment of periodontal disease, easy to use, with good organoleptic characteristics, which do not cause side effects, highly effective against certain bacteria.

The closest to the technical essence of the present invention is for the treatment of periodontal disease - drug Metrogylum.

Known drug M is indeed a microorganism. The drug has antibacterial and antibacterial activity against obligate anaerobes, particularly bacteroids and fuzobakteri, but metronidazole is not sensitive aerobic microorganisms that are involved in the inflammatory process. In addition, if the drug is noted side effects (irritation in the coating, metallic taste in mouth, nausea, and so on) (Reference Vidal, 1998 E-148).

A disadvantage of the known tools is the necessity of using high doses of a sufficiently long duration of courses and the need for additional funds for the rehabilitation and correction of microbiocenosis.

The task of the invention is the expansion of the means for anti-inflammatory therapy in periodontal diseases.

The technical result of the invention consists in expanding Arsenal of drugs for the integrated treatment of periodontal disease, do not cause allergic reactions and not irritating the mucous membrane of the oral cavity and is compatible with the means and methods of traditional therapy, rapid relief of inflammatory processes for surgical Leche is howling basis, applicators of various modifications (threads, plates, gels, sprays). For the first time as antimicrobial, anti-inflammatory, a prophylactic agent in the treatment of periodontal disease apply gel with bacteriophages.

Concentrate bacteriophage, cleaned and put in a gel base, is a mixture of feralization stafilokokkovogo, steptococcus, wolinella, actinobacillus bacteriophages, purified by differential centrifugation. As the gel used Carbomer (VR) and derivatives of cellulose. The final concentration of each phage was 108PFU/ml To improve the organoleptic and anti-inflammatory properties of the drug in the composition was administered essential oils and alcoholic extracts of medicinal plants. For the treatment of periodontal diseases meets all the requirements of medical immunobiological preparations containing bacteriophages on indicators specific activity, microbiological purity, toxicity, etc.

The product has the appearance of a translucent gel with light yellow or greenish tint. The gel is intended for the treatment of purulent-septic diseases of the periodontium, the statements of the application are gingivitis, periodontitis and other infections of the periodontium.

The gel can be recommended for the disease, but also as a preventive measure before and after surgical interventions to prevent secondary infection (R. F. Zaripova, C. Y. Khitrov, etc. /Journal of Microbiology / 1998, No. 5, S. 47-50). The drug can be used to combat clinical infections (staph).

The gel contains bacteriophages active against clinical strains of bacteria, including strains of Staphylococcus 95%; Streptococcus - 90-98%; vainly - 90-97%; actinobacillus - 90-96%. The drug is active against antibiotic resistant microflora, more effective than drugs with metronidazole.

The drug is safe in therapeutic doses and doses exceeding therapeutic 10 times, does not cause allergic and other adverse reactions, has no contraindications for use. Unlike antibiotics pills when the application does not violate the biocenosis of the intestine.

Antibacterial effects of the drug, due to the specific lysis of pathogenic bacteria in inflammation under the action of bacteriophages. Regardless of the method of introduction of preparations of bacteriophages penetrate into the blood and lymph/P> The use of drugs with known bacteriophages for the treatment of septic wounds, post burn, traumatic and intestinal infections (Levin, Bruce and J. J. Bull./The American Natural ist, 1986, V 147, pp. 881-898, RF patent N 2113476, MKI6C 12 N 7/00, BI N 17, 1998), for the treatment of traumatic infections of the anterior eye (RF patent N2142288, MKI6A 61 K 35/76, BI N 34, 1999, Aecermann H. W., M. S. Dubow//C. R. C. Press, Boca Raton, Florida, 1987, 231 p.). Drugs have proven to be the best hand, are quite high therapeutic effect. However, phage therapy is not received widespread use for a number of reasons, one of which is the limited range of political action or imperfect form of the drug. Therefore, for optimal activity of the drug is necessary to eliminate those causes. To solve the first task was carried out search for new bacteriophages, which would have specific activity against periodontopathogenic. Phages were isolated directly from the purulent discharge of periodontal pockets, purulent wounds, wastewater. Special attention was paid to phages possessing activity against Actinobacillus actinomicetemcomitans, since this microorganism is one of the most aggressive not only as the agent that causes lysis of l is ery to the periodontal tissues (Flves - Taylor., Meyer D., K. Mintz, Adv Dent Res 1995; 9: 1: 55-62, MUD Michael Stracka, Csc, New in dentistry N 4, 2000 (84) page 4 (review)).

Work on the selection of bacteria-promontogno, their identification and selection in pure culture was made on the basis of the Medical unit N 165 on volunteers - patients with different periodontal diseases.

Conducted tests on volunteers. Gel with phages were used in the treatment of chronic generalized periodontitis and gingivitis varying severity and localization. The tool used topically in the form of applications on the gum for 5-10 min as anti-inflammatory therapy, in parallel with the traditional treatment (sanitation of the oral cavity). In the control group of patients treated "Metrogel jelly".

When using gel phages rapid relief of inflammation, reduction of edema, hyperemia, krovotochivst gums. In some cases, it was noted abstsedirovanie already after 1-2 treatments. Compared with the control group the rate of anti-inflammatory therapy was reduced from 7-10 procedures to 1-6 depending on the severity and distribution process. Indexes papillary-marginal-alveolar (PSE) decreased after applying the gel with phages with 51,78 to 15,30, in the clinical picture, identified by dental and clinical examination, and laboratory data of the study in the dynamics.

Bacteriological examination of smears and culture of samples taken from mucous and purulent discharge parodontax pockets, almost all patients were selected culture: Staphylococcus aureus - 55, Streptococcus pyogenes - 62, Actinobacillus actinomiceterncomitans - in 48 patients, Wolinella sp. - in 51 patients.

Cultures had hemolytic, coagulase and catalase activity.

After anti-inflammatory therapy had a control seeding, electron microscopy and watched the changing composition of the microflora.

Below are examples of treatment in identical conditions in two different drugs:

Metrogylum (Metrogyl) jelly and gel with bacteriophages.

Example No. 1.

A diagnosis of periodontitis of moderate severity. The treatment was carried out as follows: on both jaws applied the gel with bacteriophages with exposure time of 5-10 min until complete absorption. After the third procedure, inflammation were stopped; disappeared redness, swelling, bleeding gums, mucous membrane of the gums compacted, adjacent to the teeth. Time for anti-inflammatory t 20,00 after treatment.

Example N 2

Diagnosed with chronic periodontitis of moderate severity. The treatment was performed as described in example No. 1 scheme. Three days later, after three treatments disappeared redness, swelling, bleeding gums. Mucous obraczka gums tightly to the teeth. Reduction papillary-marginal-alveolar index (ACA) has occurred with 48,33 to 7.14.

Example No. 3.

Diagnosed with chronic severe gingivitis severity. Used metrogylum jelly as described in example No. 1 scheme. To relieve inflammation, swelling took six treatments. Reduction papillary-marginal-alveolar index (ACA) has occurred with 60,49 to 16.00.

Example N 4

The diagnosis of chronic generalized severe periodontitis severity. Treatment consisted of 10 treatments metrogylum jelly. Inflammation, swelling, and bleeding were not fully cropped. Reduction papillary-marginal-alveolar index (ACA) has occurred with 37,33 to 20,51. He was appointed additional antibioticotherapy.

Thus, it was found that gel with the phage does not cause a negative effect in the form of irritation, allergic or sensitizing effect. The gel helps to reduce the severity of inflammatory is ofhow not inferior efficiency Metrogylum jelly, in some cases exceeds it, also very well tolerated. In none of the cases from 62 patients not marked toxic or allergic effect, while metrogylum jelly in some cases a toxic effect and poorly tolerated by patients from the point of view of organoleptics.

Apply the remedy for the treatment of periodontal disease provides fast relief of the inflammatory process, reduces the index of the ACA, does not cause allergic reactions, absorbs quickly.

For the treatment of periodontal disease: gingivitis, periodontitis bacteriophage does not contradict and can be combined with any generally accepted methods and means of treatment of periodontal disease (antibiotics, antiseptics and others).

The use of phage preparation as an anti-inflammatory and stimulants for the treatment of periodontal disease.

 

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