Method of orthopedic treatment of women after post-menopausal period by means of removable plate dentures

FIELD: medicine.

SUBSTANCE: invention relates to medicine, namely to dentistry, and can be used in orthopedic treatment of women in post-menopausal period in case of complete or partial defects of dentitions by means of removable plate dentures. For this purpose cream "Ovestin" is applied on surface of denture basis in thin uniform 0.5-1.0 mm thick layer. Treatment is carried out daily once during 10 days from the moment of application.

EFFECT: method also ensures reduction of bleeding, keratinisation, improvement of microcirculation in mucosa of denture bed and as a result acceleration of socially-psychological adaptation of said contingent of patients.

2 dwg, 1 ex

 

The invention relates to medicine, namely to the dentist, and can be used in orthopedic treatment of women in postmenopausal period with complete and partial defects of dentition removable laminar dentures.

The result is a genetically determined deficiency of synthesis and secretion of hormones in women in the postmenopausal period processes characterized by disorders of metabolism, functions of tissues and organs, including dental system. Disorders caused by deficiency of estrogen in women in this period of life, and are characterized by changes in the mucous membrane, which appear thinning, atrophy of the epithelium and the development of inflammation. These circumstances may have an adverse impact on the adaptation of women to removable laminar dentures.

There is a method of orthopedic treatment of women with postmenopausal period removable laminar dentures with the use of biopolymer films with immunocorrector "Imudon" for the period of adaptation, which consists in placing elastic film on the basis removable laminar denture after carrying out personal hygiene activities (Calibration AS assessment of the effectiveness of drug films with immunocorrector in removable prosthetics / Calibration AS, prima is eve, NV, Leshcheva E.A. and others // the Institute of dentistry. - 2010. No. 1. - P.40-41).

The disadvantage of this method is quite rapid elimination of the drug from the mucous membranes of the oral cavity, resulting in a need frequent use 2-3 times a day, lasting 7-10 days, then 2-3 times a week for 14 days, and shallow penetration "Imudon" in the mucosa of the prosthetic bed because of hemodynamic disorders in it.

Closest to the claimed invention, the achieved result is a method of orthopedic treatment of women with postmenopausal period by use of adhesive means "Tizol with propolis" (LLC "Olympus", Russia, RF patent №2177304). To improve the fixation of removable laminar dentures composition is applied with a brush to clean the locking surface of the removable laminar denture, thereby increasing the fixation and stabilization of the latter, which contributes to the reduction of terms adaptation (Zheludev S.E. Adhesive means in prosthetic dentistry. - M: Medical book. "Dentistry", 2007. - s).

Along with the positive effects from the use of the specified adhesive means having a bacteriostatic, local anesthetic, dermatophytosis and antiviral effect due to included in his SOS is AB propolis, there are several disadvantages, among which is an allergic reaction to the components of the material and the lack of prevalence of this drug on the market. In addition, the disadvantage of this method is the lack of influence on the pathogenetic links of postmenopausal dental disorders in women related to estrogen deficit.

The authors proposed a method of orthopedic treatment of women with postmenopausal period removable laminar dentures, by local application of cream "Avastin" under the prosthesis basis.

The technical result of the proposed method is to increase the efficiency of the orthopedic treatment of women with postmenopausal period removable laminar dentures due to local use of estrogens.

The technical result is achieved in that on the inner surface of the prosthesis basis is applied in a thin uniform layer of 0.5-1.0 mm cream "Ovestin daily and once daily for 10 days after overlay dentures.

The way the orthopedic treatment of women with postmenopausal period removable laminar dentures demonstrated by figures 1 and 2. The figure 1 presents the dental formula of the patient H. The figure 2 presents the form completed by the patient N.

The method is as follows.

Women who m the early postmenopausal period of life (age from 49 to 55 years), previously not using removable laminar dentures prescribe the drug "Avastin".

The drug "Avastin" (JSC Organon OSS, the Netherlands) apply after carrying out hygienic measures in the oral cavity and cleaning of dentures, spot applied on the inner surface of the prosthesis basis and evenly distribute a thin layer of 0.5-1.0 mm on it. Treatment once daily for the first 10 days after imposition of removable laminar dentures. "Avastin" - oestriol drug short duration. Causes increased proliferation of the epithelium, stimulates blood flow, promotes restoration of the epithelium when it is atrophic changes and increases the resistance of the epithelium to infectious and inflammatory processes.

Clinical example

The treatment by the present method.

Patient P., 50 years old, came on 14 September 2010 with the aim of rational prosthetics.

Complained of partial absence of teeth, difficulty chewing food, the diction and phonation.

Moved and comorbidities according to the patient: hepatitis, tuberculosis, sexually transmitted diseases was not sick. Allergic anamnesis is not burdened. Conducted surgery for uterine fibroids in 2002 (surgical Meno is Naoussa).

The development of this disease: teeth removed gradually, the last about three weeks ago. Removable laminar dentures have not used.

External examination: the severity of nasolabial and chin creases, slight decrease in the height of the lower part of the face.

The figure 1 presents the dental formula of the patient N.

In the mouth: mucous pale pink color, with no visible pathological changes. 2.3 previously were under the crown. Artificial plastic crown 2.1, 2.2 do not perform anatomical shape of the teeth and do not reach the edge of the gum 1-1,5 mm Artificial stamped crown 4.7 with lots erase decorative spray does not reach the gingival margin by 0.8-1 mm, the mobility of the first degree.

Diagnosis: partial absence of teeth on the upper jaw 1 class on Kennedy; partial absence of teeth on the lower jaw 2 class 3 sub-Kennedy; irrational artificial plastic 2.1, 2.2 and stamped steel with decorative plating 4.7 crowns.

Treatment: cutting and removal of artificial plastic corank 2.1, 2.2 and pressed crown 4.7; made new artificial plastic crown on 2.1, 2.2, 2.3 and 4.7. Prosthetic treatment of partial absence of teeth on the upper and lower jaws were carried out in the traditional way of partial removable laminar zu the different prostheses.

After applying removable laminar dentures were prescribed course of Ovestin" within ten days. The drug was applied once daily to the internal surface of the prosthesis basis and uniformly distributed on it.

The survey was carried out before application of prostheses, two weeks, one and three months.

In addition, the patient throughout the period of observations were made of the data in the questionnaire (figure 2), which allowed to judge the timing of adaptation to removable laminar dentures.

Local application of estrogen when using removable laminar dentures had a beneficial effect on tissue prosthetic bed, leading to lower values papillary-marginal-alveolar (PSE) index to two weeks of use of the prosthesis, which amounted to 8.3% and its stabilization to the first month of observations of 8.3% compared to the original level, equal to 16.6%. Despite the irritating removable laminar dentures on periodontal tissue topical application of 0.1% cream estriol after applying prostheses contributed to the decrease of the values of the index bleeding gums on Meuleman(points) by the second week of 0.25 compared with outcomes equal to 0.75 and stabilization of the examined indicator to the first month of observations, amounting to 0.25. The results of cytological examination testified about what sileni the degree of maturation of epithelial cells with 425 units up to 456 units to the month of observation and reduction index values of keratinization with 78% in Exodus up to 70% - to-month observations. The results of ultrasonic Doppler flowmetry microvasculature of the mucous membrane of prosthetic bed showed a positive trend of increased perfusion of the tissue by the second week of observation at all control points, equal 21,95 PF. units with respect to the original value, which amounted to 17,28 PF. unit, and stabilization of the index-to-month observations 21,02 PF. units

Analysis of the questionnaires filled out by the patient, testified to the onset of full adaptation to removable laminar dentures to the thirteenth day of wearing dentures, which allows to judge about the high efficiency of the proposed method.

The claimed method treated 18 patients with a good clinical result.

Thus, the claimed method has a high efficiency because the local application of estrogen in women with postmenopausal period under the bases removable laminar dentures leads to improved clinical and laboratory indices of tissue prosthetic bed and shortening of adaptation.

The advantage of the proposed method over the known is that the inventive method has a positive effect on the condition of the gums, mucous membrane prosthetic bed and helps reduce the structure of terms adaptation removable laminar dentures in women of postmenopausal age. And this in turn can have a positive effect not only on increasing the comfort when using the prosthesis, but also on the acceleration of socio-psychological adaptation of this contingent of patients.

The way the orthopedic treatment of women with postmenopausal period removable laminar dentures by applying a therapeutic agent, characterized in that on the inner surface of the prosthesis basis is applied in a thin uniform layer of 0.5-1.0 mm cream "Ovestin daily and once daily for 10 days from the date of imposition of prostheses.



 

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