Method for treating generalized light-degree parodontitis

FIELD: medicine, therapeutic stomatology.

SUBSTANCE: one should apply special medicinal preparations immobilized upon gelatin-glycerin splin, the foundation of which is presented as 28.57% gelatin, 17.86% glycerin and 53.57% water. Moreover, during the first 3 d one should apply malavit thrice daily after breakfast, dinner and before nocturnal period. Then, during 3 d patients should apply medicinal splints with trental in the morning, and before nocturnal sleeping - those with thymogenum, at final stage of therapy for 3 d it is necessary to use splints with collargol in the morning and before nocturnal sleeping. The innovation enables to interrupt inflammatory process efficiently and short period of time due to high-degree releasing of medicinal substances at strong fixation of the splints applied.

EFFECT: higher efficiency of therapy.

2 cl, 1 ex

 

The invention relates to medicine, in particular used in dentistry for the treatment and prevention of inflammatory and destructive processes in periodontal tissues.

One of the most significant stages of complex therapy of inflammatory periodontal disease is a local drug treatment. Research for a long time, has convincingly demonstrated that inhibition of the inflammatory and destructive processes in the periodontium local conservative no less, if not more, effective than the use of reducirujuwih surgical approaches (1, 2).

One of the founding moments of successful local therapy is the choice of the method of drug delivery to the site of the problem. For the treatment of any periodontal disease has traditionally used the following shipping methods: spray irrigation, inhalation, rinse under pressure from a syringe, mouth trays, applications and installations as part of gingival dressing, introduction to periodontal pockets using Turunc, electrophoresis, magnetophoresis, injections. The choice of method of medical treatment and usage of drugs is dictated by the characteristics of the disease, the pharmacodynamics and pharmacokinetics of drugs, the patient's condition. From the route of administration and the procedure of use of a medicinal product depends largely on the possibility of getting it in the inflammation of the periodontium and the effectiveness of treatment (1, 3).

Traditionally used drugs and methods of their introduction have significant shortcomings (4, 5). Antibacterial rinsing and irrigation ineffective due to rapid washout of the treatment solution from the periodontal pocket, due to the high rate of release of borodkova fluid (6). Appliciruemah gels are in the periodontal pocket of the order of 12.5 minutes. After this time in the periodontal pocket is only half of the injected medication. In most cases, this concentration is not sufficient for complete and effective therapy (6, 7, 8). In addition, rapid washout of drugs from the periodontal pocket contribute to the articulatory movements of the lips and cheeks of the patient while talking, swallowing, etc.

Taking into account these factors, many authors consider to be the most promising for the local conservative therapy of inflammatory periodontal diseases the use of immobilized drug prolonged action(5, 8, 9, 10, 11, 12, 13, 14).

The present invention is to provide a method of pathogenetic therapy of inflammatory periodontal diseases (HICP), in particular generalized periodontitis mild severity.

The proposed method is based on step-by-step pathogenetic therapy in palielinamo process in periodontal tissues. Based on the pathogenesis of generalized periodontitis developed a treatment regimen consisting of the following stages:

- base complex treatment;

- antibiotic therapy;

- normalization of microcirculatory disorders in periodontal tissues;

- stimulation of local immunity, local protective factors;

- stimulation of regenerative processes.

As drugs at all stages of drug used tires. Known medicinal gelatin film (LIP), used in dentistry, is a solid plate having as basis of 28.57% gelatin, 66,43% water and 5,00% glycerol (15). The hardness of the films and the small size does not allow to use them for effective treatment of generalized periodontitis. In view of these circumstances, the basis of tyres elected a composition consisting of a 28.57 percent gelatin, 53,57% water and 17,86% glycerol. The glycerin in this concentration gives the tire softness needed to ensure that the tire could be bent according to the shape of the jaw and not injured mucosa. This framework also provides the duration of action of drugs (3-5 hours when applied during the day and throughout the night, when applied before bedtime), strong fixation of the tires on the mucous membrane due to the adhesive properties of gelatin, a high degree of vswobozdaemoe medicinal ve the EU ETS, the affordability associated with cheapness and availability of gelatin and glycerin. The second difference we offer tires from medicinal gelatin films (14, 15) is in a different form and sizes. LIP have average sizes of the order of 10×8×3 mm Given the extent of the pathological process in a generalized periodontitis, medicinal tires must have a length of 50 or 100 mm, a width of 5 mm and a thickness of 2 mm, the dimensions of the tires provide the possibility of medical treatment of one quadrant or the entire upper or lower jaw by the imposition of one bus.

As a medicinal substances immobilized on gelatin-glycerol media, selected medicines, effectively affecting the basic pathogenesis HICP and having a polyvalent action.

No side effects or allergic reactions were observed, which is caused by small doses of medicinal substances in the tires (about 1/10 of the dose in the standard medications).

The introduction of tyres is not traumatic and easy to learn patients.

The ease of use and the duration of the tires allows for a continuous course of drug therapy in home and office environments.

Tires can be used as a means of monotherapy, as well as in combination with other methods of treatment (surgical, orthopedic, visite appenticeship and others).

The example illustrating the invention

In the treatment of generalized periodontitis mild severity in 72 patients was used medicinal tires on the proposed scheme.

First was conducted basic complex treatment, including professional oral hygiene, training and motivation of patients to individual oral hygiene, eliminating local etiological factors leading to chronic injury and functional overload of periodontal tissues (low-quality fillings, dentures etc).

Then patients were instructed in the use of medicinal gelatin tires and was prescribed a course of therapy according to the following scheme.

In the first 3 days patients took bus with malavita (TU 9158.0001.29731500-95) three times a day after meals and at bedtime (antibacterial and anti-inflammatory therapy). Given the extremely wide range of actions malavita, you can refuse a preliminary bacteriological analysis of the microflora of periodontal pockets on sensitivity to antibiotics and systemic antibiotics. The duration of the dissolution tires malavita in the oral cavity (4-5 hours during the day and throughout the night after the reception before going to sleep) at the specified course of treatment ensures the continuity of antibacterial and anti-inflammatory action within three with the current.

During the next 3 days the patients had used in the morning drug of tyre answered, and before bedtime - with timagenes. Local application trental allowed to quickly arrest the microcirculatory disorders, to improve the rheological properties of blood and normalize the supply of oxygen to tissues that eliminated such leading pathogenetic factors as venous congestion, increased vascular permeability, cellular exudation and filtering, hypoxia periodontal tissues. Timogen enhances immunity and stimulation of reparative processes, oppressed with HICP, which allows to break the "vicious circle" of the pathogenesis of HICP.

At the final stage of treatment to consolidate the achieved results patients used tires with colloid for 3 days in the morning and before bedtime. Colloid, with astringent, antiseptic and anti-inflammatory action, well epithelium wound surface on the mucous membranes and restores its density and texture.

As a result of the course of pathogenetic therapy composition immobilized preparations in the main group index bleeding PBI (papilla bleeding index) has become equal to "0", whereas in the control group bleeding preserved in 20% of cases. The hygiene index green-Vermillion (OHI-S) in the study group decreased by 81.6%, in the control 79.4%. Periodontal index Russell (PI) in the study group decreased by 62,0%, 55.9% in the control group. On the ninth day of treatment in the main group 100% of the patients were in a state of clinical well-being and remission, whereas in the control group to 20% of patients needed additional treatment.

Thus, the proposed method pathogenetic therapy of generalized periodontitis mild severity composition immobilized preparations effectively and in a short time to arrest the inflammatory process and to achieve not only the state of remission, but complete cure of this disease.

Literature

1. Greenstein G. Periodontal response to mechanical non-surgical therapy a review // J. Calls. - 1992. - G3. - P.118-130.

2. Bezrukova IV New methods of treatment of inflammatory periodontal diseases // New in dentistry. - 2001. No. 4. - P.55-57.

3. Alushin M.L., Alekseev C.V., Lee NR. Reconstitue acrylic polymers in pharmacy // pharmacy. - 1986. - T.35, No. 1. - C.71-76.

4. Higuchi T. Vision of the future // Acta Pharm. Suec. - 1983. - Vol.20, No. 1. - P.70-71.

5. Higuchi W.I., Ho N.F.H.. Meecle H.P. Desing on oral drug delivery systems - past, present and fiiture // Drug Dev. and Ind. Pharm. - 1983. - Vol.9, N 7. - P.1227-1239.

6. Dahlen g et al. Microbiological observation at periodical sublingual antimicrobal irrigation of periodontal pocets // J. Dent. Res. - 1989. - G8. - P.1714-1715.

7. Goodson J.M. Periodontal response to mechanical non-surgical therapy a review // J. Calls. - 1992. - G3. - P.118-130.

8. Oosterwall P.G.M., Mikh F.H.M., Renglli H.H. learense of a topically applied fluorescein gel from periodontal pocets // J. Clin, Calls - 1990. - 17. - P.613-615.

9. Anan'ev V.N., Novikov OUT, the Furies, VA and other medicinal gelatin films in medicine. - M.: publishing house. KRUK, 2001. - 199 C.

10. Beer G.M., Lamarca TI Modern trends in choice of methods of treatment of patients with pathology of the periodontium // proceedings of the Russian scientific forum "Dentistry on the threshold of the third Millennium". - M., 2001. - S-134.

11. Concanen A.P., V.K. Leontiev periodontal Diseases. - Yerevan, 1998. - 358 S.

12. Ushakov W., grudanov A.I., Curagen G.A., V. Tsarev. The application of adhesive medical tapes "diplan-dent" in dentistry /Periodontology. - 2000. No. 3. - S-14.

13. Oparin SV Prevention of periodontal disease // materials of the first all-Russian Congress of Dentistry of the XXI century: issues of prevention". - Perm, 2001. - P.137-138,

14. Avca 2003118497 from 23.06.2003, Novikov OUT, Anan'ev V.N., Furin VA and other Method of treatment of diseases of the mucous membranes.

15. RF patent №2147874. Purina E.A., Novikov OUT, Asanova T.A. Composition framework for medical films. Declared 03.02.1998. Publ. 27.04.2000. BIPM No. 12.

1. A method for the treatment of generalized periodontitis mild severity, with basic complex treatment, antibiotic therapy, normalization of microcirculatory disorders in periodontal tissues, stimulation of local immunity and regenerative processes, characterized in that, as the ant is bacterial therapy is administered Malawi, for normalization of microcirculatory disorders in periodontal tissues injected trental, to stimulate local immunity enter timogen and regenerative processes - colloid, with the medicinal substances injected immobilizerturning on gelatin-glycerin bus, the basis of which to 28.57% gelatin, 17,86% glycerol and 53,57% water, and in the first 3 days the patients used tires with malavita three times a day after meals and at bedtime, during the next 3 days used by patients in the morning drug of tyre answered, and before bedtime - with timagenes, at the final stage of treatment within 3 days of drug use tires with colloid in the morning and before bedtime.

2. The method of treatment according to claim 1, characterized in that the medicinal size of tyres in the 50×5×2 mm or 100×5×2 mm.

3. The method of treatment according to claim 1, characterized in that the base complex treatment includes professional oral hygiene, training and motivation of patients to individual oral hygiene, eliminating local etiological factors leading to chronic injury and functional overload of periodontal tissues: low-quality fillings, dentures.



 

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