Method for orthopaedic treatment of patients with removable laminar denture

FIELD: medicine.

SUBSTANCE: invention refers to medicine, namely to dentistry and may be used in the orthopaedic treatment of the patients with partial and/or complete denture defects using removable laminar dentures. A method involves making the removable laminar dentures, taking the oral hygienic measures, cleaning the removable laminar dentures. Ozonised olive oil is applied on an internal surface of the prosthetic basis that is followed by applying the prosthesis on the denture defect for 10-30 minutes. The prosthesis with ozonised olive oil applied on the internal surface of the basis is attached once a day for 8-16 days.

EFFECT: method provides more effective patient's adaptation to the removable laminar dentures due to the polycomponent mechanism of ozonised olive oil in the same environment with no negative side effects.

2 ex, 2 dwg

 

The invention relates to medicine, namely to the dentist, and can be used in orthopedic treatment of patients with partial and/or full dentition defects removable laminar dentures.

It is known that the removable laminar dentures have a negative effect on the organs and tissue prosthetic bed. Is a violation of natural self-purification processes, resulting in deteriorating hygienic condition of the mouth. Mechanical impact dentures leads to the development and progression of inflammatory and degenerative processes in the mucosa of the prosthetic bed and periodontal remaining teeth. Created favorable conditions for the activity of the microflora, which in some cases leads to a change in its quantitative and qualitative composition. Violations of local immune protective factors conducive to the development of the above processes. There is a change in the functional parameters of the salivary flow, which is accompanied by change of the quantitative and qualitative composition of saliva. As a result, these processes have an adverse effect on the process of adaptation of patients to removable laminar dentures.

There is a method of clinical application in patients with chronic inflammatory diseases of the oral cavity ozonized is rastvorov (Cm. Fish O., a Comparative assessment of the effectiveness of non-pharmacological methods of anti-inflammatory therapy of chronic periodontitis. Graduate Bulletin of the Volga region. - 2008. - №3-4. - P. 166-169).

This method allows you to have complex effects on tissues and organs of the oral cavity, however, together with numerous advantages it has some disadvantages: the instability of the resulting ozonated solution requires its application immediately upon receipt for 30-40 minutes, which not only allows you to use this medicine at home, but requires the presence in the clinic of the ozonizer and specially trained personnel to obtain and use. Method does not have a local action of ozone directly on the desired area of the dentition or oral. In addition, in connection with short-term effect method has expressed no effect on regeneration and trophic processes in the mucous membrane of the mouth.

Closest to the claimed invention is the use in patients using removable laminar dentures, biopolymer films with immunocorrector "Imudon" for the period of adaptation, which consists in placing the elastic film with this drug on the basis removable laminar denture after conducting individual Gigi the technical events. (See Calibration AS and other evaluation of the effectiveness of drug films with immunocorrector in removable prosthetics. Institute of dentistry. - 2010. No. 1. - P.40-41).

Despite the advantages of the method immunocorrective you can affect a small number of violations that occur through the use of removable dentures: does not have direct anti-inflammatory and antibacterial action, does not affect trophic disturbances. The disadvantages of this method include the relatively rapid elimination of the drug from the mucous membranes of the oral cavity, which leads to more frequent use 2-3 times a day for 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.

The task of the invention is to provide a method of local, more effective impact on tissue prosthetic bed ozonized solution that delivers improved clinical and laboratory parameters tissues of the oral cavity in patients using removable laminar dentures and reduction of terms of adaptation to removable laminar dentures.

This object is achieved by a combination of features, including the manufacture of removable laminar denture is in, the implementation of hygienic measures in the oral cavity, cleaning removable laminar dentures and applied to the internal surface of the prosthesis therapeutic agent, followed by the imposition of the prosthesis and new signs, namely, that as a therapeutic agent use ozonated olive oil, after applying it correctly extract tissue prosthetic bed under the influence of ozonated olive oil for 10-30 minutes, and the imposition of a prosthesis coated on the inner surface of the base ozonated olive oil is conducted once a day for 8-16 days.

The novelty of the proposed method is the use as a therapeutic agent ozonated olive oil, after applying it correctly extract tissue prosthetic bed under the influence of ozonated olive oil for 10-30 minutes, and the imposition of a prosthesis coated on the inner surface of the base ozonated olive oil is conducted once a day for 8-16 days.

Thus, the influence of ozonized olive oil on a tissue of the oral cavity within 10-30 minutes can specifically and more long-term impact on tissue prosthetic bed, preventing inflammatory and dysbiotic processes, exerting a positive influence on traffic the ski violations. This ozonated olive oil is in direct contact with the tissue prosthetic bed longer and more slowly dissolves in the oral fluid, thereby reducing the number, frequency, and time of the procedure, as well as to achieve better therapeutic results: improve the hygienic condition of the mouth, reducing the severity of inflammatory processes in the periodontium and the mucosa of the prosthetic bed, improvement of microcirculation and optimization of regenerative processes in the mucosa of the prosthetic bed, save the quantitative and qualitative composition of the microflora of the oral cavity, and consequently, reduction of terms of adaptation to removable laminar dentures.

In the prior art according to patent information research not identified a technical solution with a specified set of essential features that can be attributed to the proposed signs on the patentability criteria of the object to having novelty.

Proposed distinguishing features of the proposed facility for the specialist does not obviously follow from the prior art, which confirms the conformity of the invention, the criterion of patentability - inventive step. The proposed combination of known and new features in conjunction with the description of work supply the aqueous solution allows to recognize the object clinically applicable.

Figure 1 shows the photo removable laminar denture coated on the inner surface of its base ozonated olive oil.

Figure 2 shows a cross-section removable laminar denture placed in the mouth is coated on the inner surface of its base ozonated olive oil.

Removable laminar denture consists of artificial teeth 1 and the base 2, on the inner surface of which in contact with the tissues of the dentition and oral cavity of the patient, caused by a layer of ozonated olive oil 3. When applying removable laminar denture fits snugly to the outer surface of the top 4, or the lower jaw in the area of the missing teeth.

The proposed method of orthopedic treatment of patients removable laminar dentures as follows:

Initially, carry out the manufacture of removable laminar dentures, then spend hygienic measures in the mouth and do the cleaning removable laminar dentures and receiving ozonated olive oil. Then on the inner surface of the base 2 laminar prosthesis taken of the patient's dentition, put the pre-prepared ozonated olive oil 3. Laminar prosthesis coated on its inner surface with ozonated olive the new oil 3 place in the field of dentition defect 4. This ozonated olive oil 3, located on the base surface 2, is in direct contact with the tissue prosthetic bed 4 and acts on them. The duration of exposure to ozonated olive oil on a tissue prosthetic bed is from 10 to 30 minutes. Then the prosthesis is removed, propulsives running water and then use them carried out in the usual manner, i.e., the prosthesis is installed in the oral cavity of a patient until the next application of ozonated olive oil. This procedure of treatment once a day for 8-16 days.

A specific example of implementation of the proposed method.

Patient D., 64 years old, asked on 21 September 2011 with the aim of rational prosthesis. Thus complained of partial absence of teeth, difficulty chewing food, the diction, the aesthetic dissatisfaction. Moved and comorbidities according to the patient: history of chronic bronchitis, hypertension. The teeth were removed gradually as a result of their mobility. Removable dentures have not used. External examination: the severity of noso-lip and chin creases, slight decrease in the height of the lower part of the face.

Diagnosis: partial absence of teeth in the upper jaw of the 3rd class on Kennedy: partial no the of the teeth in the lower jaw of the 2nd class on Kennedy: the generalized periodontitis, moderate severity, chronicity: 1.7 - chronic fibrotic periodontitis.

Treatment: the manufacture of die-cast cult stud tabs on 1.7 with the subsequent production of artificial composite metal crowns. Orthopedic treatment of partial absence of teeth of the mandible was carried out in the traditional way - partial removable laminar dentures. After applying removable laminar denture was appointed the rate of application of ozonated olive oil for fourteen days. Ozonated olive oil was applied once daily in the evening after the hygienic cleaning of the teeth and the denture on the inner surface of its basis and is distributed evenly on it, then the prosthesis was placed in the defect area of the dentition for 20 minutes. Then the prosthesis was removed, rinsed under running water and then use them was carried out in the usual manner. Surveys were conducted before the prosthesis, two weeks, one month and three months. It was found that topical application of ozonated olive oil with the use of removable laminar dentures had a favorable impact on the hygienic condition of the mouth, which is determined by the hygiene index Fedorov-Volodkina: hygiene index was decreased from 2.0 to 1.5 for the second week. Register what was significant improvement in the condition of periodontal tissues, that was manifested by the decrease in the prevalence of gingivitis: the index of the prevalence of gingival inflammation (PMA) was decreased from 64 source percent to 32 percent to 3 months of observation. Decreased gingival bleeding index Mulleman-Saxena in the outcome of 1.6, three months to 0.6. The results of cytological examination testified normalization of regenerative processes in the mucosa of the prosthetic bed: was the increase of the index of differentiation of epithelial cells with 328 units 380 units to month observations with subsequent stabilization and gradual increase of the index values of keratinization with 30% in Exodus to 57% for the month of observations. Increased resistance of the mucous membrane of prosthetic bed, increased perfusion of the tissue by the second week of observation, continued quantitative and qualitative composition of the normal microflora. Thus, local application of ozonized olive oil on the surface laminar prostheses resulted in improvement of clinical and laboratory indices of tissue prosthetic bed and shortening of adaptation.

A second specific example of implementation of the proposed method.

A patient, 62 years of age, asked on 26 November 2011 with the aim of rational prosthesis. Complained of a complete lack of teeth, inability to chew, aesthetic neodol toronot. Allergic anamnesis is not burdened. Suffer from bronchial asthma, essential hypertension. The development of this disease: the teeth were removed gradually, due to their mobility and/or destruction. Removable dentures have not used. External examination: the severity of noso-lip and chin wrinkles, reducing the height of the lower section of the face, drooping corners of the mouth. In the mouth: mucous membrane is pale pink, moderately moist, moderately pliable, palpation painless, without visible pathological changes. Was determined moderately severe atrophy of the alveolar ridge of the upper jaw and severe atrophy of the alveolar part of the mandible. Diagnosis: complete absence of teeth in the upper jaw, type II by Oksman, 1 class on Supply; the complete absence of teeth in the lower jaw, type III by Oksman, 1 class on Supply. Treatment: orthopedic treatment of complete absence of teeth of the mandible was carried out in the traditional way full removable laminar dentures.

After fabrication of removable laminar dentures were prescribed course of using ozonated olive oil for 16 days. Ozonated olive oil was applied once daily in the evening after hygienic cleaning teeth and dentures on the inner surface of their bases and evenly distributed ALOS on them, further, the prosthesis was placed in the upper and lower jaw for 20 minutes. Then the prosthesis was removed, rinsed under running water and then use them was carried out in the usual manner. The survey was conducted before the prosthesis, two weeks, one and three months after.

Topical application of ozonated olive oil with the use of removable laminar dentures had a favorable impact on the hygienic state of the removable laminar dentures determined by the method Ambjornsen: 1.6 points after 2 weeks of use of the prosthesis. The results of cytological examination testified normalization of regenerative processes in the mucosa of the prosthetic bed: higher index of differentiation of epithelial cells with 334 units to 375 units to month observations followed by stabilization and a gradual increase in the index values of keratinization with 44% in Exodus to 68% for the month of observations. Was also determined for the enhancement of nonspecific resistance of the mucous membrane of prosthetic bed, which was confirmed by the increase in positive reactions adsorption of microflora from 30% in Exodus to 74% after two weeks of observations. The results of laser Doppler flowmetry microvasculature of the mucous membrane of prosthetic bed showed a positive trend is AI enhance perfusion of the tissue by the second week of observation at all control points, equal 23,44 PF. units with respect to the original value, which amounted to 15,14 PF. units Microbiological study showed preservation of the quantitative and qualitative composition of the normal microflora. The total antioxidant activity of oral fluid was increased from 0.5 mm to 1.4 mm in a month after the imposition of the prosthesis. Analysis of the questionnaires filled out by the patient, testified to the onset of full adaptation to the removable laminar denture to a 16-day wear.

Currently, the authors carried out the treatment method proposed more than 60 patients. The inventive method is technically easy to implement, allows you to have a prolonged and local action on a wide range of disorders that occur in tissues and organs of the oral cavity with the use of removable laminar dentures: a positive effect on the oral hygiene, the state of the periodontal and mucosal tissue prosthetic bed, keeps the normal microflora composition and leads to a reduction in terms of adaptation.

The application of the proposed method is possible at home.

The way orthopedic treatment of patients removable laminar dentures, including the manufacture of removable laminar dentures, the implementation of hygienic measures in the oral cavity, cleaning removable laminar dentures and drawing on the principles of the indoor surface of the prosthesis remedies followed by the imposition of the prosthesis, characterized in that as a therapeutic agent use ozonated olive oil, after applying it correctly extract tissue prosthetic bed under the influence of ozonated olive oil for 10-30 min, and the imposition of a prosthesis coated on the inner surface of the base ozonated olive oil is conducted once a day for 8-16 days.



 

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