Method of preventing and treating oral inflammation following dental surgery

FIELD: medicine, pharmaceutics.

SUBSTANCE: invention refers to pharmaceutics and represents a method of preventing and treating oral inflammation following a dental surgery, comprising in applying a drug preparation on an incisional wound daily in a patient underwent the implantation procedure and characterised by the fact that the drug preparation used represents a preparation of the strain lactobacillus plantarum 8P-AZ and/or B.bifidum in a dose of at least 10 million live lactic acid bacilli and/or bifidus bacteria.

EFFECT: invention provides simplifying the method of preventing and treating the oral inflammation by making it unnecessary to prepare the drug used if antibiotics are avoided.

2 cl, 9 ex, 9 dwg

 

The invention relates to medicine, namely to the dentist, and for the prevention and treatment of inflammation in the oral cavity of patients after dental surgery, including implant, bone grafting, extractions, simple and complex, periodontal surgery (ICD 10).

Known methods of prevention and treatment of inflammation in the oral cavity after implantation, including antibiotics (flameclaw, Amoxiclav, Augmentin) for 5-7 days, take antihistamines (Arius, claritin), probiotic (Linex), vitamins, rinsing with an antiseptic (chlorhexidine), the bath solution Tantum Verde, the imposition of ointment (Metrogyl, Solcoseryl), taking painkillers and anti-inflammatory drugs (Ketanov, ibuprofen)) and the like (see, for example, www.implant.ru/uhod-za-polostiyu-rta.html, www.tiensmed.ru/news/implantation-ti4z.html).

A disadvantage of known methods is that the use of antibiotics in the number of clinical cases is undesirable. For example, in 30% of cases the patients are confirmed by objective data signs of allergic reactions to antibiotics one group or another, most often this is the case for drugs penicillin.

Also in some patients, the share of which in Russia is 13-35% in different regions, there is a Doc who antolino confirmed resistance to antibiotics of different groups, including, most commonly used in dentistry.

In the presence of dysbiosis and other diseases of the gastrointestinal tract, which can be complicated when taking antibiotics, the purpose of which may itself be detrimental to the organism as a whole, especially in patients of elderly and senile age.

The closest to the invention is a method for the prevention and treatment of perioimplantitis in dental implantation by injection before and after surgery and then daily in the area of the wound by the method of application using a sterile cotton swab supernatant of the culture of autologous mononuclear cells stimulated photomagnetism, in the amount of 3-5 ml per procedure with the protein concentration 250-350 μg/ml for 7 days (EN 2189805 C1, published. 27.09.2002).

The disadvantage of this method lies in the necessity of first obtaining the supernatant of the culture of autologous mononuclear cells of the patient by taking him venous blood for 3-4 days before surgery, discharge from her mononuclear cells and culture supernatant, which greatly complicates and increases the cost of the process of prevention and treatment of perioimplantitis and therefore the whole operation.

In addition, when using a cotton swab for application difficult retention of the drug on the surface of polomer the operating wound, while patients is not recommended for 20-30 minutes to completely eliminate the intake of food and speech load.

The objective of the proposed method is its simplification while maintaining the possibility to completely abandon the use of antibiotics in the perioperative period, while avoiding the development of infectious-inflammatory complications in early and late postoperative period to achieve the most optimal results.

The technical result of the invention is to simplify the method for the prevention and treatment of inflammation in the oral cavity by eliminating the need for pre-production of the preparation used.

The technical result is achieved in that in the method for the prevention and treatment of inflammation in the oral cavity after dental surgery, namely, that the patient after implantation daily on the area of the postoperative wounds caused drug method of application, according to the invention as drug use drug on the basis of Lactobacillus plantarum 8P-A3 and/or B.bifidum dose of less than 10 million live lactobacilli and/or bifidobacteria.

Preferably use appliques in the form of a collagen sponge containing the specified drug.

At the present time and is known drugs Azilect and M-bacterin, widely used for correction of the intestinal microflora, as well as for the treatment of inflammatory diseases of the oral cavity, but they have a much smaller period of antibacterial activity in comparison with the proposed method based on the use of lactobacilli and bifidobacteria sown on media, such as a collagen sponge.

The use of collagen sponges for applications is very convenient because it is easily held in the mouth and does not restrict speech load.

Sponge for the application of lactobacilli and bifidobacteria predstavljaet a porous plate, so when in contact with living cells of Lactobacillus plantarum 8P-A3 and/or B.bifidum, this structure adsorbs them on their surface. The known properties of the collagen sponge, consisting in slow resorption of collagen. Adsorbed on the sponge lacto - and bifidobacteria affect the microflora of the oral cavity and produce a complex of biologically active substances that suppress pathogens and stimulating tissue regeneration processes.

Method for the prevention and treatment of inflammation in the oral cavity after dental surgery is carried out as follows: a product made on the basis of Lactobacillus plantarum 8P A3 (e.g.: Lactobacterin) or strain-based B.bifidum (e.g.: Bifid bacterin), or combinations thereof, used in the form of applications in the area of the wound (e.g., collagen sponge), a dose of 7-10 million live lactobacilli and/or bifidobacteria. Therapy should be initiated immediately after surgery at least 1 time a day and then up to 3 months after the intervention. The duration of each procedure is 20-30 minutes.

Figure 1-figure 9 presents the results of surveys of patients on clinical examples 1-9, respectively.

Clinical examples

Clinical example No. 1.

Dynamics of appearance of lactobacilli in patients receiving probiotics the patient A. age 71 years, with dysbiosis, suffering for 15 years, gastric ulcer, after conducting a dental implant without the use of antibiotics. Currently, the gastrointestinal disease in remission. However, taking antibiotics due to surgical dental treatment refused. As an alternative anti-inflammatory treatment and prevention of postoperative complications were appointed collagen sponge with fractions of lactobacilli.

The results are shown in figure 1.

The vertical axis is the value of the decimal logarithm of CFU in the sample.

1. Background survey

2. Examination 30 days after

3. Survey after another three and a half months is a

P1 - lactobacilli

P2 - extraneous microflora

Application was carried out using a collagen sponge with a fraction of lactobacilli daily for 3 months. Each session lasted 30 minutes. The number of lactobacilli in each sponge was 107. The peculiarity of the microbiological status of the patient was consistent reduction in the number of third-party microflora, presents coccal forms and yeast-like microorganisms on the background of increase in the number of lactobacilli and their subsequent reduction after the application of the methodology. To stabilize the intestinal microflora, the patient was assigned Lactobacterin by a standard method within 3 weeks.

When viewed over 1 month - mucous membranes of the mouth pink, tissue healed by primary intention. Complications were found. Stomach content analysis on a dysbacteriosis has shown stability indices of the normal flora of the intestine.

Clinical example No. 2.

Dynamics of the content of bifidobacteria patients 69 years after the periodontal surgery without the use of antibiotics. Six months ago the patient underwent a left basal pneumonia, for treatment of which was used antibiotics penicillin for 14 days at a dose of 1800 mg per day. In addition, on the basis of laboratory studies in the patient is detected violations of the immune status (studied as humoral, and cellular immunity), and therefore, it was decided to hold the postoperative period without the use of antibiotic therapy.

Applications factions of bifidobacteria on collagen sponge was conducted daily for 30 days. Each session lasted 30 minutes. The number of bifidobacteria in each sponge was 107.

The results shown in figure 2.

1. Background survey

2. Examination 30 days after

3. Examination after one month

P1 - bifidobacteria

P2 - extraneous microflora

The peculiarity of the microbiological status of the patient was consistent reduction in the number of third-party microflora, presents coccal forms and yeast-like microorganisms against the growth performance of the normal microflora of the oral cavity. However, no complications, as the tissues of the mouth, and the General condition of the patient not identified in any inspection immediately after surgery (early postoperative period: 1, 3, 7 days); not when viewed through 1 month after the surgery.

Clinical example No. 3.

Dynamics of the content of lactobacilli and bifidobacteria in patient C., 87 years of age with allergic reaction in the form of angioedema on antibiotics in the penicillin family after a difficult removal of the UBA. Prior to the manipulation carried out a laboratory study of the sensitivity to antibiotics penicillin. Identified resistance to this group; in the group of drugs cephalosporin - allergic reaction; therefore, it was decided to hold the postoperative period without the use of antibiotic therapy.

The results shown in figure 3.

The vertical axis represents the number in decimal logarithm of CFU per sample; 1 - background survey; 2 - examination after 3 weeks; 3 - examination after another 1 month; P1 is a mixture of lactobacilli and bifidobacteria; P2 - extraneous microflora;

Applications factions of lactobacilli and bifidobacteria on collagen sponge was conducted daily for 30 days. Each session lasted 30 minutes. The number of lactobacilli and bifidobacteria are equal and amounted to 107each sponge. The peculiarity of the microbiological status of the patient has been consistently reducing the number of extraneous microflora, presents coccal forms and yeast-like microorganisms, against the growth of the number of lacto - and bifidobacteria and their subsequent reduction.

During examination of the oral cavity after 1 month the patient has no complaints, mucous pink, atrophic, signs of inflammation is not observed is highlighted.

Clinical example No. 4.

Dynamics of the number of lactobacilli in the patient D., 77 years after the last 12 months of operation Billroth I in the modification of the Comptroller of Finsterer after implant surgery.

In the study prior to implantation of the normal flora of the gastrointestinal tract found dysbacteriosis. The implantation operation is conducted on the background of the application of probiotics in 1 week. The patient refused the use of antibiotic therapy in the early postoperative period, he was appointed the application of lactobacilli on collagen sponge with prolongation of the course of probiotics for another 2 weeks.

The results shown in figure 4.

The vertical axis represents the number of decimal logarithm of CFU per sample; 1 - background survey; 2 - examination 14 days later; 3 - examination after 1 month; P1 - lactobacilli; P2 - extraneous microflora.

Applications factions of lactobacilli on collagen sponge was conducted daily for 30 days. Each session lasted 30 minutes. The number of lactobacilli sostavlyalo 10*7 per sponge. The peculiarity of the microbiological status of the patient has been consistently reducing the number of extraneous microflora, presents coccal forms and yeast-like microorganisms, against the growth of kolichestve.podrobnee their subsequent reduction.

At the control examination after 1 month revealed: the mucous membranes of the mouth is pink, signs of inflammation are observed. Analysis of normal intestinal microflora, conducted 1 month after implantation showed normalization of the intestinal microflora on therapy with probiotics for 3 weeks (1 week before implantation, 2 weeks after implantation).

Clinical example No. 5.

Dynamics of the number of bifidobacteria in the patient that is, 70 years after taking probiotics for 1.5 weeks. In connection with maloinvazivnogo upcoming planned surgical intervention and the patient's wish not to take antibiotics, we suggested the use of collagen sponges with bifidobacteria within 1 month after the treatment.

The results shown in figure 5.

The vertical axis represents the number of decimal logarithm of CFU per sample; 1 - background survey; 2 - examination 10 days later; 3 - up at 1 month after surgery; P1 - bifidobacteria; P2 - extraneous microflora.

Applications factions of bifidobacteria on collagen sponge was conducted daily for 30 days. Each session lasted 30 minutes. The number of bifidobacteria was 10*7 per sponge.

The composition of the microflora, the patient was p the increase in the number of bifidobacteria and decrease in the content of foreign microflora.

Examination of the oral cavity after 1 month showed no complications, as from the oral cavity organs and changes in medical status of the patient.

Clinical example No. 6.

Dynamics of the number of lactobacilli in the patient I., 64 years old, also refused antibiotic treatment due to the fear of the development of gastrointestinal dysfunction, in patients receiving probiotics for 2.5 months (2 weeks prior to surgery implant and sinus lift and 1.5 months after the operation).

As an alternative to antibiotic therapy in the early postoperative period, we have proposed the use of collagen sponges with lactobacilli within 1 month after the treatment.

The results are shown in Fig.6.

The vertical axis is the number in decimal logarithm of CFU per sample; 1 - background survey; 2 - inspection 30 days later; P1 - lactobacilli; P2 - extraneous microflora.

Applications factions of lactobacilli on collagen sponge was conducted daily for 30 days. Each session lasted 30 minutes. The number of lactobacilli was 107each sponge.

The composition of microflora in patients on background therapy was to increase the number of lactobacilli and a decrease in the content of foreign microflora.

During examination of the oral cavity through 1 month after implantation and anus-lifting marked tissue healing by primary intention, the absence of any signs of inflammation.

Clinical example No. 7.

Dynamics of the number of bifidobacteria and lactobacilli in the patient K., 58 years of age with allergic reaction to antibiotics penicillin, macrolides, cephalosporine in history and the need for multiple tooth extraction in patients receiving probiotics for 2 months (2 weeks before surgery and six months after the operation).

When conducting objective methods of diagnosis before surgery-laboratory screening to identify allergens to antibiotics of these groups, confirmed the sensitivity of the potential complications. In this regard, from antibacterial therapy, it was decided to refuse.

In addition to course of probiotics for relief of possible complications, the patient was carried out appliques collagen sponges with lacto - and Bifidobacterium within 1 month after treatment. The results are shown in Fig.7.

The vertical axis represents the number in decimal logarithm of CFU per sample; 1 - background survey; 2 - inspection 30 days later; P1 - lacto - and bifidobacteria; P2 - extraneous microflora.

Applications factions lacto - and bifidobacteria on collagen sponge was conducted daily for 30 days. Each procedure Dellas minutes. The number of lacto - and bifidobacteria was the same and amounted to 107each sponge.

The composition of the microflora of the patient was to increase the number of lacto - and bifidobacteria and decrease in the content of foreign microflora in the absence of inflammatory reactions in the examination after 1 month.

Clinical example No. 8.

Dynamics of the number of lactobacilli in the patient L., 67 years of age with chronic dysbiosis in patients receiving probiotics within 5 weeks prior to periodontal surgery.

As an alternative to antibiotic therapy in the early postoperative period the patient was assigned the application of lactobacilli on collagen sponge.

The results shown in Fig.

The vertical axis represents the number of decimal logarithm of CFU per sample; 1 - background survey; 2 - examination 5 days after 5 days after surgery; 3 - inspection within 30 days after surgery; P1 - lactobacilli; P2 - extraneous microflora;

Applications factions of lactobacilli on collagen sponge was conducted daily for 30 days. Each session lasted 30 minutes. The number of lactobacilli was 10*7 per sponge.

The peculiarity of the microbiological status of the patient has been consistently reducing the number of extraneous microflora, presents coccal fo the Mami and yeast-like microorganisms, against the backdrop of increase in the number of lactobacilli followed by a decline.

When examining a patient after 1 month of complications, both on the part of the whole body, and the organs of the oral cavity is not detected. When you re-analysis of the status of the intestinal microflora in 2 months after surgery in patients receiving probiotics found to stabilize the condition of the intestinal microflora with a tendency to improve.

Clinical example No. 9.

Dynamics of the number of bifidobacteria in the patient M, 73 years with a need for dental implantation. From receiving antibiotic therapy, the patient refused.

Alternatively, in the early postoperative period (within the first month after surgery), the patient was treated using applications with bifidobacteria on collagen sponge.

The results are shown in Fig.9.

The vertical axis is the number in decimal logarithm of CFU per sample; 1 - background survey; 2 - examination 5 days after implantation; 3 - up at 1 month after surgery; P1 - bifidobacteria; P2 - extraneous microflora.

Applications factions bifidobacteria on collagen sponge was conducted daily for 30 days. Each session lasted 30 minutes. The number of bifidobacteria was 10*7 per sponge.

<> The peculiarity of the microbiological status of the patient has been consistently reducing the number of extraneous microflora, presents coccal forms and yeast-like microorganisms, against the growth of the number of bifidobacteria followed by a decline.

At the control examination after 1 month of complications were found, the implant is integrated into the fabric.

Therapeutic antibacterial effect when utilisation is achieved by stabilizing intestinal, as well as indirectly, through the secretion of bacteriocins - products of microorganisms with antimicrobial properties. This property microorganisms allows not only to restore and maintain the normal microflora of the oral cavity, but also to maintain the normal microflora of the gastrointestinal tract, because the use of antibacterial drugs in 100% of cases dysbacteriosis of the intestine. However, when a sufficient level of immunity and defenses of clinical symptoms of dysbiosis will not be identified, while in the presence of predisposing factors (reduced immune status, antibiotics shortly before the planned intervention), to avoid clinics dysbacteriosis will be almost impossible). Also the development of complications in the postoperative period is, including purulent, can be avoided by not using the standard protocols of the pattern of antibiotic prophylaxis.

1. Method for the prevention and treatment of inflammation in the oral cavity after dental surgery, namely, that the patient after implantation daily on the area of the postoperative wounds caused drug method of application, characterized in that the quality of drug use drug on the basis of Lactobacillus plantarum 8P-A3 and/or B.bifidum dose of less than 10 million live lactobacilli and/or bifidobacteria.

2. The method according to claim 1, characterized in that use appliques in the form of a collagen sponge containing the specified drug.



 

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FIELD: medicine, pharmaceutics.

SUBSTANCE: invention refers to medicine, and concerns a method for preparing a drug preparation of an immunomodulator for severe purulent-septic and autoimmune diseases on the basis of a peptide fraction recovered from mammalian spleen tissue or cells (particularly swine or cattle spleen). Substance of the invention: there are mixed biologically active substance - that is a peptide fraction recovered from mammalian spleen tissue or cells with a substance preventing protein molecule coagulation, and an antibiotic. Gelofusine is used as the substance preventing protein molecule coagulation.

EFFECT: invention provides the high therapeutic effect in preventing and treating the purulent-septic and autoimmune diseases.

1 dwg, 1 ex, 3 tbl

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