The method of treatment of periodontitis

 

(57) Abstract:

The invention relates to medicine and can be used in dentistry. Spend osteochondroplasty with the introduction periodontal pocket resorbable membranes. As resorbable membranes use film "deplin". The film hydrophilic side is placed in the bone defect. When this film is used with the size of the overlying bone defect with vestibular and approximal sides of at least 3 mm, the Proposed method allows to isolate the cavity of the bone defect from germination him in the soft tissues, which leads to targeted tissue regeneration.

The invention relates to medicine, namely to the dentist.

Known surgical method for the treatment of periodontal disease using directed regeneration of periodontal tissues nerezorbiruemoy membrane of silicone [Chupakhin P. C. Use not resorbable membranes for directed regeneration of periodontal tissues.//Diss. Kida. the honey. Sciences. - M-2001.- 170].

The effectiveness of this treatment method due to the fact that silicone membrane securely insulate the cavity of the bone defect from sprouting in his soft tissues and prepa">

However, the drawback of this method is repeated surgery to remove the membrane, as it is not absorbed in the wound. Also require additional fixation with medical glue or titanium screws, which can lead to an allergic reaction to the glue and additional bone injury.

The closest to the invention is a method of treatment of periodontitis by osteochondroplasty with subsequent introduction into the periodontal pocket resorbable film "Resolut XT" [film based polyglycolide and trimethylantimony] . [A. S. Grigoryan, A. I. Volozhin, etc. //Dentistry. M. 2001. 1. S. 74].

However, when using this method there is a local allergic reaction. In addition, due to low adhesional this film requires additional fixation using suture material, which leads to trauma of the surrounding bone, the soft tissue defect.

The purpose of this invention is to reduce side effects and decrease the morbidity method for increasing the adhesion of the film.

This objective is achieved in that in the method of treatment of periodontitis by osteochondroplasty with subsequent introduction into the periodontal pocket resorb is at the hydrophilic-hydrophobic layer, placing the hydrophilic side of the bone defect.

It is desirable to use the film size, the overlying bone defect with vestibular and approximal sides.

As the hydrophilic-hydrophobic film can be used in the film "deplin". The composition of the hydrophilic layer is a poly(beta-oxyethyl) methacrylate and hydrophobic - plasticized polyvinyl butyral with a ratio of hydrophilic to hydrophobic layer (35-40:5). The sorption capacity of the water and the blood is 3-5 g/, the Degree of adhesion to intact skin 23 N/m Film micropolarizer, takes the form of a wound surface, is fixed by the surface tension forces without adhesive coating, ensures the normal metabolic processes in the wound, prevents the plasma loss.

The method is as follows. Under local anesthesia spend a horizontal incision, departing 1-2 mm from the gingival margin to the vestibular side, without additional vertical cuts. Using a steel trowel prepare the chin mucoperiosteal flap. The curettes to remove the granulation tissue debris. Using ultrasonic instrument and diamond burs, remove dental deposits, process alveolar bone neg the comfort flap.

Then directly under the defect prepare the membrane from the film "deplin". Dimensions are transferred using a graduated probe. You must comply with the following conditions: vestibular and approximal sides of the membrane should overlap the bone defect by at least 3 mm To reposition and suturing of the flap membrane installed over the treated bone defect. The flap is fixed in each mizuna between the seams of the polyamide yarn. Stitches are removed on day 7.

The effectiveness of this method is evaluated on the basis of clinical and radiographic methods.

Example. Patient N., 1959 R., addressed to the center of Periodontology crid complaining of bleeding gums when brushing teeth, periodically emerging gnetaceae of the gums, tooth mobility.

Diagnosis: generalized periodontitis medium-heavy degree;

Indexes hygiene green-Vermilion-2,5; Silness-Loe is 1.75. When probing the sharply painful gums that bleed easily. Index Of Mulleman-2.0. In region 36, 37, 35, 34 of the periodontal pockets of pus. Tooth mobility of 1-2 degrees; 36-3 degree. Periodontal pockets 4-8 mm.

When x-ray examination revealed a.

After completion of the preliminary treatment in the field 37, 36, 35, 34 were osteochondroplasty using the film "deplin". After the anesthesia and the risk of detachment of the flap in the area of 36 found extensive lesion of bone destruction 12-13 mm. Produced mechanical and medical treatment of the defect. From the film "deplin" was formed membrane, the edge of which overlaps the bone defect 3-4 mm from all sides. The flap is stitched in nylon thread.

Postoperative period was quiet. Painkillers taken only in the first day after surgery. Collateral edema was mild, had persisted for two days. Mucosal flap is already on the third day after surgery was a pale pink color. The healing took place by first intention. Hygienic indexes decreased (green-Vermilion-0,75), (Silness-Loe to 0.5). Index of Mulleman decreased to 1.0 within a month after surgery. The application of the film "deplin" has led to an increase in the intensity of regional blood flow in the tissues of the periodontium, as evidenced by the data of laser Doppler flametree (LDF).

Before surgery LDF - 13,60,3 srvc.ed. After surgery to 6 months - 15,70,5 srvc.ed.

Depth Koss 7.5 mm This is due to scarring of the mucosal flap and bone tissue regeneration. These changes were confirmed on radiographs.

Thus, the film "deplin" securely seals the cavity of the bone defect from sprouting in his soft tissues and prevents impact on transforming blood clot adverse environmental factors, and the effect of targeted tissue regeneration. In addition, the use of film "deplin" with good adhesion, does not require additional fixation of the soft tissues, eliminating traumatic stress on them. One of the positive properties diplan" is the length of its biodegradation is about one month. Moreover, in the process of biodegradation, the film does not emit toxic products, there is a bioinert material. The film has a mild hemostatic action, atraumatic, creates conditions for the normal regenerative processes, available and cost effective.

The method of treatment of periodontitis by osteochondroplasty with the introduction periodontal pocket resorbable membranes, characterized in that as a resorbable membranes use film "Dkryvim bone defect with vestibular and approximal sides of at least 3 mm

 

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