Method for evaluating pulp viability after odontopreparation

FIELD: medicine.

SUBSTANCE: method involves recording dental pulp blood vessels rheodendogram and determining vascular tone index value. Patient electrocardiogram is recorded during the whole dental treatment course before and after tooth odontopreparation concurrently with dental pulp blood vessels rheodentogram recording. Parasympathetic division of nervous system activity index is measured. Vascular tone index ratio with respect to parasympathetic division of nervous system activity index value is determined. The value is compared to a reference value corresponding to its value measured before carrying out odontopreparation. The received value deviating from norm and being not greater than 30%, inflammation process progress in dental pulp is considered to be the case and removal of tooth pulp is advised.

EFFECT: high accuracy and information capacity of evaluation results.

1 tbl

 

The invention relates to medicine, therapeutic and orthopedic dentistry, and in particular to methods of assessment of the inflammatory process in the pulp of the tooth after odontophoridae.

The known method definition inflammation of the tooth pulp method electroodontodiagnostics (Chertkova NR. The pulp of the tooth. Modern methods of diagnostics. - M., 1999, p.21-23).

The disadvantage of this method is the fact that when electroodontodiagnostics must take into account the fact that the digital performance of its results depend on the patient's age, his mental state and excitability of the nervous system, as well as the anatomical dimensions of the tooth, the correct position of the active electrode, denticles in the pulp chamber.

The closest in technical essence and the achieved result is a method of determining the inflammation of the pulp of the tooth redintegratio based on measuring the electrical complex impedance, the so-called impedance. Impedance measurement of a tooth carried out by passing through it an electric current of high frequency.

Impedance measurement of the tooth occurs at the time of increasing the speed and volume of blood in the vascular system of the pulp during the systole of the heart. The magnitude of the impedance of the tooth see if redintegratio on the computer monitor in graphical form. The coincidence R is dentagra on their configuration diagnose the presence or the absence of pathological changes in the pulp of the tooth. In addition to the visual evaluation of the vascular tone of the pulp and their functional state is determined by the amplitude and time slots retinogram (RDH) is a numeric indicators such as the index of peripheral resistance - IPA index elasticity - IE, a measure of vascular tone - TCP and eographically index - RI. (Chertkova NR. The pulp of the tooth. Modern methods of diagnostics. - M., 1999, p.21-23).

With all the advantages of this method include the following disadvantages: lack of clear indications for removal of tooth pulp of the tooth, the likelihood of reversibility of the inflammatory process.

The technical result, which directed the establishment of this invention is to improve the accuracy and informative assessment of the inflammatory process in the pulp of the tooth after odontophoridae by using the index of parasympathetic tonus of the vegetative nervous system of the patient during diagnosis of an inflammatory process in the pulp of the tooth.

The technical result is achieved in that in the method of assessment of the inflammatory process in the pulp of the tooth after odontophoridae, based on registration retinogram vessels of the pulp of the tooth, the determination of the value of the indicator of vascular tone during dental treatment, before and after odontophoridae tooth is produced in the lead registration of the electrocardiogram of the patient at the time of registering retinogram vessels of the pulp of the tooth, measure the activity index of parasympathetic division of the autonomic nervous system of the patient, then determine the ratio of the magnitude of the rate of vascular tone to the value of the activity index of parasympathetic division of the autonomic nervous system and the deviation values obtained relations from the norm is judged on the nature of the inflammatory process in the pulp of the tooth of the patient.

The method is as follows.

Prior to the preparation of the investigated tooth produce registration retinogram vessels of the pulp instrument "DIATOM" computer analysis of diagnostic performance (Device "DIATOM" in 1996, approved by the Committee on new medical technology health Ministry and is manufactured by the company "MEDS" , Moscow), determine the value of vascular tone (TCP).

Simultaneously with the removal retinogram produce the registration of the electrocardiogram in a patient device "ELON-M"off-the-shelf enterprise "New devices" (certificate №ROSS Kiimu), determine the value of the index of parasympathetic division (PAIRS) of the autonomic nervous system of the patient (Kalakutskii LI, Manelis AS Apparatus and methods of clinical monitoring. Tutorial, Samgau them. Academician Sergei Korolev, Samara, 1999, pp.31-33).

Next, determine the ratio of the magnitude of the rate of vascular tone (TCP) to the value of the Indus the sa parasympathetic division of the autonomic nervous system (PAIRS), expressed as a percentage. The resulting value of the relationship is taken for the norm (initial value), which exceeds 30%, which indicates the viability of the pulp of the tooth.

After odontophoridae investigated tooth produce registration retinogram vessels of the pulp of the tooth and determining the value of the indicator of vascular tone (TCP).

Next, make the registration of the electrocardiogram in a patient device "ELON-M" and the determination of the index value of the parasympathetic division (PAIRS) of the autonomic nervous system.

Then determine the ratio of the magnitude of the rate of vascular tone (TCP) to the value of the index of parasympathetic division (PAIRS) of the autonomic nervous system of the patient, expressed in percent. The resulting value is compared with the norm (initial value). If the resulting value is the deviation from the norm and does not exceed 30%, it is judged on the development in the pulp of the tooth of the inflammatory process, and the tooth must be removed from the tooth.

CLINICAL EXAMPLE. Patient S. 28 years turned to the dental office CMSC No. 3 for the purpose of rehabilitation of the oral cavity. Complained of defects of dentition.

Objectively:

P
The dental formula
AboutPPPP
1716151413121121222324252627
4746454443424131323334353637
PAbout

With the caries;

P - seal;

On - the absence of a tooth.

The condition of the abutment teeth: 16 and 14 deep caries, 35 and 37 is intact.

Diagnosis: Partial secondary edentulous in the maxilla and in the mandible, 3 class at Kennedy.

Researched eographically indicator title in the abutment teeth before and after deep odontophoridae under metal-ceramic prostheses (table no.1).

It was further recorded the electrocardiogram at all clinical stages of the prosthesis. The floor is or the value of the parasympathetic division of the autonomic nervous system: PAIRS (see table 1).

Determined the ratio of the magnitude of the rate of vascular tone (TCP) to the magnitude of the parasympathetic division (PAIRS) of the autonomic nervous system, expressed as a percentage. It was:

1. 35 and 37 of intact teeth to preparation 35,7%, after preparation 44.4 per cent through the day - to 43.3%, after 3 days - 34,3%, after 5 days of 29.4%. Developed inflammation of the pulp 35 and 37 of the tooth. Performed root canal therapy teeth data.

2. 14 and 16 of the teeth prior to the preparation of 40%, after preparation 43.2 per cent through the day - 46,2%, after 3 days - 40,2%after 5 days - 36,7%. Data supporting teeth preserved the vitality of the pulp after odontophoridae.

It is possible to conduct an unlimited number of measurements of the index of the inflammatory process in the pulp of the tooth at all stages of treatment or prosthetics. The method is absolutely harmless for the patient and for the researcher, non-invasive.

Using the proposed method allows to determine the inflammation of the pulp in the intact tooth, tooth by caries, pulpitis, periodontitis, as well as the reaction to the preparation of dental hard tissues in therapeutic and orthopedic dentistry.

Studies 82% of patients surveyed showed the effectiveness of this method of assessment of the inflammatory process in the pulp of the tooth, as well as accurate and informative as it contains clear PRA is critical recommendation for a dentist about tactics of treatment.

A method of evaluating the viability of the pulp of the tooth after odontophoridae, including registration retinogram vessels of the pulp of the tooth, the determination of the value of the indicator of vascular tone, characterized in that throughout the dental treatment of a patient before and after odontophoridae tooth produce the registration of the electrocardiogram of the patient at the time of registering retinogram vessels of the pulp of the tooth, measure the activity index of parasympathetic division of the autonomic nervous system of the patient, then determine the ratio of the magnitude of the rate of vascular tone to the value of the activity index of parasympathetic division of the autonomic nervous system, compare the ratio with the norm, which corresponds to the value used ratios to odontophoridae, and if the resulting value is the deviation from the norm and not exceeds 30%, it is judged on the development in the pulp of the tooth of the inflammatory process, which indicates the need be removed from the tooth the tooth.



 

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