Method of treating inflammatory periodontal diseases

FIELD: medicine.

SUBSTANCE: invention refers to medicine, namely dentistry, and may be used for local therapy of inflammatory periodontal diseases. That is ensured by the daily applications of powdered cellulose surgical cotton on a dentogingival edge after curettage to normalise the microcirculation and hemodynamic values.

EFFECT: method provides higher clinical effectiveness in periodontal diseases, reduced complications and disability periods due to normalising the free radical levels in the damaged tissue while reducing inflammation and accelerating the process of epithelialisation of periodontal tissues.

2 ex

 

The invention relates to medicine, in particular to the dentist, and can be used for the local treatment of inflammatory periodontal diseases.

Treatment of inflammatory periodontal diseases, especially local, is a major problem in dentistry due to the fact that their treatment does not provide a durable long lasting effect, and the disease leads to tooth loss in 5 times more frequent than the complications of caries. For local treatment uses a variety of antiseptic, antibacterial ointments, gels and sorbents (gelvin, digipan and others)

In periodontal practice for local applications use the application sorbents such as Eleven", "Digimon", activated carbon fiber material "Dnepr-MN", etc. In the local application of sorbents selectively extracted from tissues and bringing! the body of microbes, tissue decomposition products, toxins, thereby anti-inflammatory, and detoxification effect. In addition, the sorbents prevent the penetration into the internal environment of the body of microbes and their toxins, products of the decay of tissues, contributing to the elimination of these components inflammation, increasing the functional activity of T - and b - lymphocytes, supporting the perifocal tissue fixed level peroxidation l is pidof, contribute to the preservation of tissue protective antioxidant properties. Sorbents are well tolerated, does not cause allergic reactions. Side effects in the application of sorbents was not detected.

However, the used sorbents have several disadvantages. For example, when using activated operatorassisted material "Dnepr-MN" and "Digipan" necessary protective bandage of paraffin or special Kappa [see RF patent for the invention №2231377, IPC A61 No. 5/067, A61L 15/22, A61 No. 2/06], while using the "Glavina" is mandatory isolation of saliva, as in the interaction with the saliva of this sorbent is dissolved [see RF patent for the invention №2031646, IPC AC 6/12].

The closest in technical essence to the claimed method of treatment is a method of treatment of parodontosis by application of medicines at the gingival margin (periodontal pocket), in which the gingival pocket impose biopolymer film hydrophilic layer, which includes reverse and voltaren, for 10-12 hours and the procedure is repeated daily until normalization of microcirculation and hemodynamics periodontal tissues [see RF patent for the invention №2153319, IPC AC 6/02, AK 1/02].

The disadvantage of this method of treatment is a long and complex process, and incomplete relief of inflammation couples is the cost-don't.

Technical result achievement, which aims this invention is to improve the results of local treatment of inflammatory periodontal diseases while simultaneously simplifying the treatment process.

The technical result is achieved by a method for the treatment of inflammatory periodontal diseases by application of medicines, for example, sorbents, repeat the procedure daily until normalization of microcirculation and hemodynamics of periodontal tissues, which as drug use powdered surgical cotton wool, which after curettage put on the gingival edge.

Medicine that is used in the implementation of the method of treatment is powdered surgical cotton wool, which is manufactured by RU patent for the invention №2390591 through the implementation of physical-mechanical effects on the treated cotton cellulose fiber.

The proposed method of treatment was tested on a group of animals.

Research (measuring the level of nitric oxide and copper) was performed using the method of electron paramagnetic resonance (EPR). The experiment involved the following groups of animals: group 1 (5 animals) with experimental periodontitis without treatment (observation within 21 days after surgery); 2 group 5 animals) also with experimental periodontitis, but treated powdered cellulose surgical cotton wool through the introduction of it in the pathological portantly pocket (since the 14th day from the beginning of the experiment and during the next 7 day); group 3 - control (10 animals) with intact periodontium.

For sample preparation for measuring the EPR study animals were deceptional was rapidly removed and homogenized fragment the area of the inflamed gum section in the animals of the 1st and 2nd groups, as well as a fragment of the area of the inflamed gum section in animals 3 (control) group, was added 1 ml of the buffer on the basis of N-2 - hydroxyethylpiperazine - N'-2 econsultancy acid - HEPES (50 mm, pH 7,4) with the addition of 10 mg/ml bovine serum albumin - DSA, 1 mg/ml Na DECK (5.8 mm) and 0.4 mg/ml FeSO4(2.6 mm).

When this ligand DECK, iron ions and NO form stable, detected using EPR complex FeII(NO)(DETC)2. Simultaneous binding of Cu(ll) b L"NR with the formation of the complex Cu11(DETC)2also detected using EPR.

In intact rats, the concentration of copper Cu2+in the fragment of intact gum amounted to 7.93·10-5±0,42·10-5nitric oxide when it was not registered. Experimental acute periodontitis has caused the emergence and the sharp increase in the level of nitric oxide in the tissue is s gums to 7,489×10 -7±0,61×10-7(P<0.05), and almost without changing the concentration of copper of 7.93×10-5±0,42×10-5. When periodontitis, and any other inflammatory process increases production of inducible NOS (NO synthase). While nitric oxide is rapidly oxidized by oxygen to nitrite and/or nitrate, elevated levels of which can cause damage, leading to the destruction of proteins and DNA, and even cell death.

In the local treatment of powdery cellulose surgical cotton wool in the gums significantly decreased level of nitric oxide (to 3.12×10-7±1,85×10-7and a few copper (vs. 5.47×10-5±2,44×10-5)(P<0,05).

The clinical part of the

To improve the results of complex treatment of periodontal diseases sorbent - powdered cellulose surgical cotton wool was used as local funds.

The study included 25 patients aged 19-50 years with a diagnosis of chronic generalized periodontitis of moderate severity without the expressed General somatic pathology. For research patients underwent curettage, after which the gingival edge was filled with sorbent powder for detoxification and degradation products of microorganisms. The procedure was repeated 4-5 times until complete epithelialization and restore the mucous membrane of the gums. For fixation, then, is the Cabinet does not require special trays and bandages.

Found that patients of the main group on the next day after curettage and filling of periodontal region sorbent powdered cellulose surgical cotton noted the absence of pus, pain and redness of the gums.

Example 1. The patient Ivanov A.I., residing in the city of Kazan, 38 years old.

Diagnosis: Chronic generalized periodontitis of moderate severity.

Patient assessment was conducted according to the standard scheme. To assess the condition of periodontal tissues used index of oral hygiene on the Fedorov-volodkina, periodontal and PMA-indices, the sample of Siler-Pisareva (iodine number Sverakova).

According to treatment: Indicators of poor hygiene and amounted to 2.5 points. Periodontal index was -4,0 used Index RMA amounted to 43.5 used Iodine number -4,5 used

A survey conducted immediately after a 10-day course of treatment with sorbent. Indicators of hygiene has improved and amounted to 1.5 points. Periodontal index of 2.0 used Index RMA amounted to 35 used Iodine number - 3 usled

Example 2. the patient Vanova PS, residing in the city of Kazan, 50 years.

Diagnosis: Chronic generalized severe periodontitis severity. Patient assessment was conducted according to the standard scheme. To assess the condition of periodontal tissues using the index and oral hygiene by Fedorov-Volodkina, periodontal and PMA-indices, the sample of Siler-Pisareva (iodine number Sverakova).

According to treatment: Indicators of poor hygiene and amounted to 3.5 points. Periodontal index was -5,0 used Index RMA amounted to 48.5 used Iodine number -5 usled

A survey conducted immediately after a 10-day course of treatment with sorbent powdered cellulose surgical cotton wool. Indicators of hygiene has improved and amounted to 2.5 points. Periodontal index of 2.9 usled Index RMA amounted to 35.5 used Iodine number - 3,5 used

Thus, treatment of inflammatory periodontal diseases using sorbent - powdered cellulose surgical cotton will increase the effectiveness of periodontal treatment will reduce the number of complications and the time of disability, has a positive impact on the normalization of the level of free radicals in the damaged tissue, greatly reducing the inflammatory process in the periodontal and speeding up the process of epithelialization of periodontal tissues.

The method of treatment of inflammatory periodontal diseases by application of medicines at the gingival margin with the same procedure is repeated daily until normalization of microcirculation and hemodynamics of the periodontium, characterized in that as a drug use powder C is rulesnew surgical cotton wool, after curettage put on the gingival edge.



 

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