Method for preventing galvanosis in the oral cavity

FIELD: medicine.

SUBSTANCE: method involves introducing semi-finished products manufactured from various metal alloys having passed all technical treatment stages of dental prosthesis production and kept in artificial saliva not less than during 1 h. Their electrochemical potentials are measured. Metal alloy is selected for future artificial denture so that its potential differs from dental structures already available in patient's oral cavity not more than by 80 mV.

EFFECT: accelerated material selection.

3 dwg, 1 tbl

 

The invention relates to medicine, namely to prosthodontics.

The known method of prevention of galvanize, according to which treatment is directed at eliminating the heterogeneity of metals in the mouth. The reason for removing metal prostheses are high voltage (150 mV). When combined prostheses stainless steel, gold, amalgamated dental fillings first eliminate amalgamated dental fillings, and then stainless steel [Goa L.D. diseases of the mucous membranes of the oral cavity caused by materials dentures (etiology, pathogenesis, clinic, diagnostics, treatment, prevention): author, dis... Prof. the honey. Sciences. - M., 2001, - 53 S.].

The disadvantage of this method of prevention galvanize is that the sequence of elimination from the mouth of the materials, causing galvanize, can only lead to elimination through a considerable period of time galvanise, but is not the basis of selecting a new material for the prosthesis.

The known method of prevention of galvanize, which requires:

- To determine the size of potential metal dentures or fillings separately;

A large value of the EMF allows to identify the worst quality material prosthesis and time to resolve.

- The same method can determine is whether the quality of the final fixed prosthesis, putting them on for some time in artificial saliva (Todorova - 100.0 g of 1% solution of lactic acid and 900,0 g 0.9% saline at pH saliva of the patient) and measurements of the potential of each prosthesis is individually (Onishchenko B.C. metal Alloys used in dentistry and their main characteristics /lecture/.- M, colius, 1982, - 20 C.).

The disadvantage of this method of prevention galvanize is the fact that it is not known quantitative value of the EMF that would not lead again to the emergence of galvanize in a given patient, and that measuring the potential ready fixed prosthesis and received a negative result, the physician may not use the prosthesis, which is not economically justified.

The essence of the invention lies in the fact that patients determine the electrochemical potential of each metal constructions present in the mouth, then into the oral cavity of the patient alternately enter blanks of various metal alloys, past all the technical stages of the fabrication of dentures and stored for at least 1 hour in artificial saliva, and measure their electrochemical potentials, while choosing the metal alloy for the future of the prosthesis, a potential different from the potentials of metal dental structures that already exist in the oral cavity of this PAC is enta, not more than 80 mV.

The choice of such a maximum value permissible potential difference (80 mV) is related to the fact that patients with symptoms of galvanize this potential difference is at the confidence level p≤ 0,05 101,6±18,7 MB and significantly different from that in patients with metal structures in the mouth, but without the effects of galvanize (36,2±12,1 MB) on the same level of confidence.

Biophysical basis of this method is that the natural passivation of the metal alloy in the saliva of the patient flows within 50-60 minutes and stops only when the occurrence of a sufficiently thick oxide layer on the metal surface. Pre-exposure of the metal alloy in artificial saliva creates a protective oxide layer, as well as the pH of the saliva of patients only tenths of pH units different from that of artificial saliva, the passivation process flows for 2-3 minutes. This provides stable readings bipotentiality that reflect the values of the electrochemical potentials of metal structures made from this alloy, which will be installed on them in the mouth of the patient within 1 hour after orthopedic treatment. Besides the selection of the alloy when it takes a few minutes.

How is the trail is accordingly:

1. Pre-made set of metal blanks in the form of crowns made of various alloys of metals: alloy gold 900 samples, Gelezinkeliai alloy Dentan-D, silver-palladium alloy (PD-250), chromium-Nickel steel (HT), DENTAL NSA vac, past all the technical stages of the fabrication of dentures. Next to each blank with the inner side soldered postreply conductor in PVC insulation and place solder to avoid contact with the saliva resealable plastic acrylated (Fig 1.).

2. In order to accelerate future passivation process workpieces in the mouth of a patient is placed for 1 hour or more in artificial saliva of the following composition:

Table 1
ComponentFormulaConcentration, g/l
Thiocyanat potassiumKSCN0,517
Sodium bicarbonateNano31,253
Potassium chlorideKCl1,471
Sodium dihydrophosphateNaH2PO4·2H2O0,1878
Lactic acidCH3MONSOON0,90

3. Using biopotentials with input from what roleplayer not below 10 10Om, using active (metal) electrode sequentially measure the electrochemical potential of each metal structures (dentures, crowns, inlays and the like) with respect to chloride reference electrode (electrode type EVL-MS with electrolytic key at the end)that is placed on the portion of the mucous membrane of the anterior floor of the mouth in the midline through the pad, moistened with saline. At the same time before each measurement with a cotton swab moistened with ethyl alcohol, processed denture and dry it by air blast.

4. In the oral cavity of a patient, in the place of the proposed location of the prosthesis, in turn impose crowns from the set. After 3 minutes after introduction into the oral cavity (this is enough time for passivation of the workpiece in the saliva of the patient, because after that you don't change the electrochemical potential) measure their electrochemical potential by the same method as the potential of other metal structures in the oral cavity (figure 2.), but electrical contact with a metal workpiece is carried out using electrical conductor soldered to the workpiece. At the other end of the conductor, derived from the oral cavity, in contact with the active measuring electrode bipotentiality (Fig 3.).

5. Dimension e is chrominissca potentials blanks spend as long while the greatest difference between the electrochemical potential of the workpiece and the available mouth other metal structures will be less than 80 mV.

Example: patient M., 1951 R., 29.10.02, was referred to the clinic of orthopedic dentistry with complaints aesthetic defect due to absence of teeth in the upper jaw on the left.

From the migrated and comorbidities the patient notes peptic ulcer disease duodenal ulcer, chronic cholecystitis.

From the case history revealed that the non-removable metal prosthesis with a titanium nitride coating were made in the period from three to five years. In the last year were removed 24 and 25 teeth about complications of caries.

Physical examination installed: height of the lower section of the face is not reduced, nose and chin creases expressed according to age. The oral mucous membrane is pale pink in color, moderately moist, without visible pathological changes. The defect in the upper jaw on the left.

The dental formula is:

Bite orthognathic. Solder bridge CNS based on 13 and 15 teeth, single metal crown, stainless steel with titanium nitride coating based on 16, 22, 36, 37, 44 and 46 teeth meet clinical requirements. Seals 23, 26, 27 teeth have Ho is Osee marginal fit, no change in color.

Diagnosis: the defect of dentition of the upper jaw, the third class at Kennedy.

Treatment plan: to make a bridge with busprione compound and the titanium nitride coating based on 23 and 26 teeth, make selection of the material for the prosthesis of the defect.

Measurement of electrochemical potentials of the non-removable metal prostheses in the field:

Put the billet of chrome-Nickel steel are included in the scope of the defect on the upper jaw on the left. After 3 minutes, its electrical potential was equal to 180 mV. With the introduction in the same place for the procurement of Gelezinkeliai alloy “Dentan-D” its electrochemical potential after 3 minutes was equal to -280 mV.

As a structural material for bridges selected chromium-Nickel steel, as the maximum potential difference between the metal structures available to the patient in the oral cavity and preparation of chromium-Nickel steel, amounted to 51 mV.

25.10.03. A follow-up examination one year after prosthesis:

The patient has no complaints. Fixed metal structures meet clinical requirements. Hygienic index “satisfactory”. Sample Schiller-Pisarev - negative. Electrochemically the potentials in the field:

The maximum difference of potential was -60 mV.

The proposed method was carried out selection of the material for the prosthesis in 10 patients. A follow-up examination one year later showed that complaints patients do not have. In functional and aesthetic terms prostheses patients meet. The electrochemical potential difference in this group of patients does not exceed 80 mV.

The application of the proposed method provides the following advantages:

1. The objectivity of the method of prevention of galvanize provided by use of the measuring equipment.

2. The economic justification of the choice of material for the prosthesis.

3. Quick and easy selection.

A method for preventing galvanize in the oral cavity by determining the potential difference between the metal structures, characterized in that the mouth of the patient alternately enter blanks of various metal alloys, past all the technical stages of the fabrication of dentures and stored for at least 1 h in artificial saliva, and measure their electrochemical potentials, while choosing the metal alloy for the future of the prosthesis, a potential different from the potentials of dental structures that already exist in the oral cavity of the patient, not more kemna 80 mV.



 

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