Method for treating surface of prepared teeth with antiseptic preparations

FIELD: medicine, stomatology.

SUBSTANCE: for treating one should apply successively 3%-hydrogen peroxide solution followed by 1%-silver nitrate solution. This provides high antiseptic effect in combination with minimal dental dyeing with solver nitrate solution.

EFFECT: higher efficiency.

6 ex, 1 tbl

 

The invention relates to medicine, namely to dentistry and Microbiology.

The action of microorganisms and their toxins are the major cause of pathological changes in tissues of the teeth that may cause complications after fillings and dentures. Therefore, the choice of effective antiseptic is very important to the successful operation of a dentist. However, research on the effectiveness of antiseptics in comparative perspective, used in dental practice, it is not enough.

There is a method proposed Hummerlimousine and Gdiscover ("Medical and instrumental processing channel" // New in dentistry, 2001, №6. pp.96), where 3% hydrogen peroxide solution is used as the wash liquid. Contact with living tissue or organic substances, hydrogen peroxide immediately dissociates molecular oxygen and water.

Quick selection of gas bubbles contributes to the mechanical cleaning of the root canal from necrotic tissue, dentinal shavings.

The disadvantage of this method is that 3% hydrogen peroxide solution has a lack of bactericidal activity.

According to microbiological studies determining the sensitivity of microflora of oral antiseptics in vitro, the most effective range is raspredeleniya and spectrum is derived biguanide - chlorhexidine (Dmitrieva L.A., A.E. Romanov, Tsar V.N., Ushakov W., Karnaukhov A.T., White O.N. Comparative antibacterial activity of new antiseptics and prospects of their use in dental practice, Dentistry. - 1997. No. 2. - p.26-27). Clinical trials have shown a fairly high efficiency of this drug and its new dosage forms of corsodyl and eludril in vivo (HE Ivanov, E.A. Kuznetsov, V. Tsarev., Bizyaev A.F., Romanenko, NV, Chuvilin VA Clinical and microbiological evaluation of a new dosage form of chlorhexidine - corsodyl and eludril for the prevention of infectious complications of intraosseous implantation// Dentistry. - 2000. No. 1, pp.31-35). A strong bactericidal action of these drugs is associated with gaseous chlorine, penetrating deep into the dentinal tubules and disinfecting their contents.

The disadvantage of this method is the lack of achievement of absolute sterility after treating the tooth surface.

In the work Annraoi, Songaria, Ehabitykah, Yaw, Nesterevoy (studying the effects of various antiseptics on the microflora of the oral cavity// Actual problems of epidemiological safety. - Stavropol, 2002, p.36) the most detailed data on the effect of the discrepancies between the different antiseptics on the microflora of the tooth surface in vitro and in vivo.

To determine the antiseptic effect in vitro of the oral cavity of patients were allocated to 3 strains of gram-positive streptococci and 1 strain of gram-negative rods. As antiseptics tested 0.5% potassium permanganate solution, 3% solution of hydrogen peroxide, silver nitrate (0.003 to 30%), officinal solution of chlorhexidine and Miramistin.

Strains of microorganisms sectors were sown on Petri dishes with agar of Hottinger (pH 7,2) and on the surface of the Central sector apply a drop of antiseptic. Cup crops were placed in the incubator for 24 h at a temperature (T) 37°C. the Action of an antiseptic were registered by the formation of sterile spots on the location application on the agar. A positive result was considered complete absence of growth of microbial cells in the zone of application of the antiseptic with the growth of culture is a continuous lawn around the specified area.

It is established that effective antibacterial properties in vitro have a 3% solution of hydrogen peroxide, silver nitrate 0.3%concentration and above, officinal solution of chlorhexidine.

Studied the bactericidal action of various antiseptics on the microflora of the oral cavity in vivo.

Material from the surface of the tooth was taken with a sterile swab and placed in a test tube with 2 ml of buffered saline solution (SFR) pH of 7.2. From each tube was made of the seed of 0.1 ml of n is 3 cups of agar Hottinger (pH of 7.2). Then the tube with the remaining material was added 3 ml of broth of Hottinger (pH of 7.2) and the sample is incubated at a temperature of 37°C. After 3 h the rearing of each sample were sown in 0.1 ml of 3 Petri dishes with agar of Hottinger (pH of 7.2), and test tubes with research material was left in a thermostat at T 37°With 18 h for visual account of the growth of microorganisms.

From the colonies from the agar of Hottinger and suspensions of microbial cells with liquid nutrient medium was prepared smears that were stained by gram stain. In smears from the oral cavity was observed various coccus, rod-shaped and filamentous microorganisms.

It is established that the surface treatment of the tooth with 0.5%potassium permanganate solution does not give a significant antiseptic effect, which is consistent with the results obtained in vitro. He has been a noticeable antiseptic effect after treating the tooth surface officinal solution of Miramistin. Significant antiseptic effect was observed after treating the tooth surface officinal solution of hydrogen peroxide (3%) and chlorhexidine (0,05%), and 1% solution of silver nitrate. Each of these antiseptics are recommended for treatment as the most effective drugs.

This method is used for the prototype.

The disadvantage of the prototype is the lack of achievement of absolute sterility.

Celtiberia is to maximize the sterility of the surface of the prepared teeth.

This is due to the fact that as antiseptics for treatment of the teeth, the proposed method using 3% solution of hydrogen peroxide and 1% solution of silver nitrate.

A distinctive feature of the proposed method is combined sequential use of these antiseptics.

The possibility of practical use of the proposed method is confirmed by the examples of its specific implementation.

Example 1. The surface treatment of the tooth conducted by 1-2 times wiping his official chlorhexidine (0.05 per cent). After drying with a sterile cotton swab rubbed the surface of the tooth and the swab was aseptically placed in a test tube with 2 ml of physiological solution (FR). After 1-2 h did seeding on solid nutrient medium. Then in a test tube was added 2 ml of broth of Hottinger (pH of 7.2), and incubated at temperature 37°C. the Next test sowing on solid nutrient medium was 3-6 h and 18-20 h from the beginning of cultivation in liquid nutrient medium.

After treating the tooth surface officinal solution of chlorhexidine in the material of the FR was not observed bacterial growth in 55.5% of cases, 3-6 h of cultivation - 44.4% of cases, and after 18-20 h of growth was recorded in 100% of cases (table 1).

Example 2. The surface treatment of the tooth conducted by 1-2 times p is tirania its officinal solution of hydrogen peroxide (3%). The study material from the surface of the teeth for sterility after processing was carried out similarly to example 1.

After treating the tooth surface officinal solution of hydrogen peroxide (3%) in the material of the FR was not observed bacterial growth in 83.3% of cases, 3-6 h rearing in 66.6% of cases, and after 18-20 h - on the contrary, growth was recorded in 100% of cases (table).

Example 3. The surface treatment of the tooth conducted by 1-2 times wiping his 1% solution of silver nitrate, which provides minimal staining of the teeth. The study material from the surface of the teeth for sterility after processing was carried out similarly to example 1.

After this treatment the material of the FR was not observed bacterial growth in 72.7% of cases, 3-6 h rearing is 54.5% of cases, and after 18-20 h, in contrast, was notable growth in 100% of cases (table).

Example 4. Processing the tooth surface was performed by combined sequential wiping his first official (3%) hydrogen peroxide solution (1-2 times), and then a 0.3% solution of silver nitrate (1-2 times), which ensured minimal staining of teeth.

After treatment of the teeth in this combined manner in the material of the FR was not observed bacterial growth in 93.3% of cases, 3-6 h of cultivation - 86.4% of cases, and after 18-20 h in 20.0% of cases.

Example 5. On the working surface of the tooth was performed by the combined sequential wiping his first official (3%) hydrogen peroxide solution (1-2 times), followed by a 1% solution of silver nitrate (1-2 times).

After the processing surfaces of the teeth in this combined manner in the material of the FR was not observed bacterial growth in 100% of cases, 3-6 h of cultivation - 94.7% of cases, and after 18-20 h in 36.8% of cases (table).

Example 6. Processing the tooth surface was performed by combined sequential wiping his first official (3%) hydrogen peroxide solution (1-2 times), followed by a 10% solution of silver nitrate (1-2 times), which led to a sharp blackening of the tooth.

After this treatment the material of the FR was not observed bacterial growth in 100% of cases, 3-6 h rearing - in 100% of cases, and after 18-20 h - 43.7% of cases.

Obviously, the oral cavity abundantly inseminated by microflora, and therefore, after exposure to an antiseptic various representatives microflora for many reasons may re-enter treated with antiseptics surface of the tooth. This complicates the process of achieving absolute sterility before production of prosthetic crowns. Apparently, the simultaneous impact of many factors may partially distort the effect of single and combined effects of antiseptics. The latter cannot be established only by simple summation. When using antiseptics without concomitant with the change in any case failed to achieve absolute sterility on the prepared surface of the tooth. This is indicated by the fact that after processing only one antiseptic remaining single living cells gave after 18-20 h rearing the gains on the liquid, and then a dense nutrient medium in 100% of cases.

Only the combined use of antiseptics to ensure the absence of gains after 18-20 h after rearing on liquid and dense nutrient media 20,0-43.7% of cases (table).

From these examples it follows that the bactericidal effect takes place when all the presented methods. At the same time the most significant effect is observed in the case of a combined use of antiseptics.

Thus, it is not enough to apply for an effective antiseptic processing of the prepared teeth only hydrogen peroxide or silver nitrate. You must use them consistently as synergists; initially to treat officinal solution of hydrogen peroxide (3%) to obtain a rapid, but short-term bactericidal effect, and then 1-2 times the processing of a 1% solution of silver nitrate, which achieves the high antiseptic activity with minimal staining of teeth.

19


DEPENDENCE ANTISEPTICALLY ACTIVITY FROM the METHOD of SURFACE TREATMENT PREPAIRE THE DATA of the TEETH
N p/pThe method of processing the surface of the prepared teethPrior to incubationIncubation 3-Incubation 18
General.

Nr.
Col. Ref.% neg.General.

Nr.
Col. Ref.% neg.General. Nr.Col. %% neg.
1.0.05% chlorhexidine9555,59444,49--
2.3% hydrogen peroxide121083,312866,6---
3.1% of silver nitrate11872,711654,411--
4.3% hydrogen peroxide, 0.3% of silver nitrate151493,3151386,615320,0
5.3% hydrogen peroxide, 1% of silver nitrate19100191894,719736,8
6.3% hydrogen peroxide, 10% silver nitrate1616100161610016743,7

The method of processing the surface of the prepared teeth antiseptic means, characterized in that for dental treatment applied consistently 3% hydrogen peroxide solution, and then 1% solution of silver nitrate.



 

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