Method of treating periodontitis

FIELD: medicine.

SUBSTANCE: at the first stage, after removing supra- and sub-gingival dental calculus and granulations, cleaning the teeth professionally, rinsing gingival pockets by stream infusions of 1.5% hydrogen peroxide in a cannula delivered through the gingival pockets around the teeth, brought under root furcation if observing the exposed furcation of premolars and molars; the preparation "Calsept" is administered within the frontal teeth for 5-7 days daily into the gingival pockets bringing the cannula similarly around the teeth, whereas the preparation "Calsept-Iodo" is administered within the distal teeth; the dentist recommends that the patient does not eat for 2 hours thereafter. The second stage involves administering a preparation containing bifidus bacteria, e.g. Normoflorin-B or Bifidumbacterin by instillations in a cannula delivered through the gingival pockets around the teeth, brought under the furcation if observing the exposed furcation of premolars and molars; gingival mucous membranes are laid with cotton drains with the preparation for 2 hours daily for 5-10 days.

EFFECT: using the method provides increasing the therapeutic effect ensured by the antibacterial effect, odontotropic and anaesthetic action, bone tissue recovery, action of the therapeutic preparation in difficult-to-access anatomic formations.

2 cl, 1 ex

 

The invention relates to medicine, in particular to dentistry, and can be used for the treatment of periodontitis.

A method of treating chronic periodontitis, characterized by the fact that after the removal of supra - and subgingival dental plaque, antiseptic treatment of the oral cavity and periodontal pockets periodontal pockets administered sterile sponge containing 8% chitosan ascorbate, 2% bovine acetate collagen, metronidazole dose 0,016 mg/cm2once a day with interval of 2 days, the number of sessions 3-5 [patent RU 2301064, 2007].

A method of treating periodontal disease, which consists in that after the removal of dental plaque to dry out the affected area and further treated surface of the cement in the area of inflammation with a solution of citric acid concentration of 0.1 mol/l for 5 minutes and then 0,06% chlorhexidine solution and the mixture Nikiforova. After as a periodontal adhesive bandage is applied Sulfacrylate periodontal pocket with subsequent effects on inflammation ultrasound frequency of 26.5 kHz for 3 seconds [patent RU 2309734, 2007].

The known method of treatment of periodontitis, including local medical therapy in three stages. Thus the first phase is administered into periodontal pockets and cause the gums drug mixture containing, wt.%: perforated sheet by us�oxazin 0,5÷1,0, trihopol 0,5÷1,0, chlorhexidine digluconate 0,001÷0,01, glycerate silicon - rest up to 100. The number of treatments is 5÷6. In the second stage, carry out the application in periodontal canals and gum drug mixture containing, wt.%: vitamin preparation "Aekol" 50÷52, chlorhexidine digluconate 0,001÷0,01, glycerate silicon - rest up to 100. The number of treatments is 3-4 treatments. The third phase is injected into periodontal pockets and cause the gums drug mixture containing, wt.%: hydroxyapatite 7,0÷20,0, chlorhexidine digluconate 0,001÷0,01, glycerate silicon - rest up to 100. The number of procedures is 2-3 treatments [patent RU 2330645, 2008].

The known method of treatment of periodontitis, characterized by the fact that after surgical treatment of periodontal pockets applied to the aqueous solution of the drug tumeric with a concentration of 0.03-0.06 g/ml wound on the surface of the periodontal pocket [patent RU 2332998, 2008].

Known method of treatment of destructive forms of chronic generalized periodontitis, namely, that receive the autoplasma from venous blood of the patient immediately before surgery by centrifugation to obtain three fractions of autoplasma: upper, middle and lower. Allocate a middle fraction, add two to three drops of a ten per cent solution of chloride of cal�tion, mixed to obtain a gel-like mass with allogeneic transplant "Alloplant" and further added to the mixture osteoplastic material xenograft "Osteoplast", when the ratio of the masses between the "Alloplant" and "Osteoblasts" 1:1. Fill the cavity of the defect with the mixture. Model average of the remaining fraction of autoplasma in the form of a membrane protective film across the width of the interdental gap and put her in the interdental gap. Sutured Muco-periosteal flaps over the membrane in the interdental spaces [patent RU 2344772, 2009].

The closest analogue of the invention is a method for the treatment of periodontitis, namely that carried out the removal of supra - and subgingival hard and soft dental deposits, removal of granulation tissue, oral hygiene, professional dental cleaning, and then in periodontal pockets impose a 1.5% solution of hydrogen peroxide jet cannula, through the cannula for periodontal pockets around the teeth, when the exposure of Forcarei premolars and molars into the cannula under the furcation. 20 minutes after washing in periodontal pockets around the teeth for 2 hours, insert a cotton wick with the medication of bifidobacteria. The course of treatment is 5 to 20 procedures. It helps to remove inflammation when deep cleaning of periodontal pockets without unwanted gingival retraction.�tons of natural stimulation of the immune system, substitution of pathological obligately-anaerobic microflora on obligately-anaerobic normal, rapid regeneration of the mucosa while decreasing drug loading [patent RU 2470647, 2012]. The disadvantages of this method are its complexity in cooking and pasted turund, the lack of anti-inflammatory, strengthens bone tissue, medicinal action on mucous, in addition, patients are not able to remove all the pockets with hard-to-reach places that will be an additional hotbed of pathological microflora.

The technical result when using the invention - improving therapeutic effect due to the antibacterial effect without the use of antibacterial drugs, odontotermes, antitoxic, analgesic potency, bone regeneration, the lysis of necrotic tissue, exposure to hard-to-reach anatomical formations of the drug, reducing the duration of treatment.

Said technical result is achieved in that in the method of treating periodontal disease, including oral hygiene, removal of supra - and subgingival dental plaque, removal of granulation, a professional dental cleaning, irrigation of periodontal pockets 1.5% solution of hydrogen peroxide jet cannula, through the cannula for periodontal pockets around the teeth, and p�and the exposure of Forcarei premolars and molars - into the cannula under the furcation, and the introduction of a preparation containing bifidobacteria, in periodontal pockets, according to the invention the treatment is carried out in two phases, with the first stage additionally in periodontal pockets in a similar manner through the cannula around the teeth, in the area of the front teeth enter drug "CellCept", and in distal teeth drug "CellCept - Iodine daily for 5-7 days, after 2 hours of not eating food, in the second stage, the preparation containing bifidobacteria, is administered by instillation of the cannula, through the cannula for periodontal pockets around the teeth, when exposure of Forcarei premolars and molars - into the cannula under the furcation, at the same time impose the mucous membrane of the gums with a cotton turundas with this drug exposure 2 hours daily for 5-10 days. At the same time as the preparation containing bifidobacteria, use Normalien-B or Br.

The proposed method of treatment of periodontitis is as follows. After rehabilitation of the oral cavity, removal of above - and subgingival dental plaque, removal of granulation tissue, of teeth cleaning treatment is carried out in two stages. Thus at the first stage of periodontal pockets (PC) after purification kuratomi, washing with 1.5% hydrogen peroxide solution inkjet cannula, through the cannula by PA�totalnum pockets around the teeth, moreover, exposure of Forcarei premolars and molars - into the cannula under the furcation, for exposure to pathogens within 5-7 days daily administered in the area of the front teeth drug "CellCept", and in distal teeth drug "CellCept - Iodo". The drug "CellCept contains calcium hydroxide, barium sulphate and sterile isotonic solution of the drug "CellCept - Iodine" additionally contains iodoform. For the introduction of drugs cannula administered almost entirely in the PC, getting toothpaste and spend the cannula around the teeth, and when exposure of Forcarei premolars and molars - into the cannula under the furcation, and then 2 hours to eat. The choice of drug "CellCept" based on its composition, it does not contain the base oil, which facilitates mechanical cleaning and washing out of the drug during repeated visits. In the area of the front teeth used "CellCept" without the content of iodoform to avoid changing the color of the teeth, and in distal teeth "CellCept - Iodine" with the content of iodoform. CA(Oh)2over time completely resolves itself.

In the second stage, the preparation containing bifidobacteria, is administered by instillation of the cannula, through the cannula for periodontal pockets around the teeth, when the exposure of Forcarei premolars and molars - into the cannula under the furcation, while draped tears�simple membrane of the gums with a cotton turundas with this drug exposure 2 hours daily for 5-10 days. At the same time as the preparation containing bifidobacteria, use Normalien-B or Br.

After a deep wash PC hydrogen peroxide, ensuring their full mechanical antiseptic cleaning, disinfecting, antiseptic, deodorizing and hemostatic and stimulating blood flow to the effects, tissue oxygenation having oxidation-reduction capability, and guarantees the minimal trauma of the procedure, apply therapeutic effect of calcium hydroxide inside the PC around the tooth: bactericidal activity, anti-inflammatory properties, tissue solubility, hemostatic effect, inhibition of resorption of tooth tissues, the stimulation of bone regeneration processes.

Every visit from PC purify entered "CellCept" and "CellCept - Iodine", granulation tissue, as contained calcium hydroxide is neutralized by the buffer systems of the surrounding tissues and enter a new portion of the drug. Calcium hydroxide is biocompatible to the tissues, as, thanks to its low water solubility and diffusion there is a slow increase of pH required to kill bacteria localized in PCs and other hard-to-reach anatomical formations of periodontal. Because of these characteristics of calcium hydroxide relates to EF�objective, but slow-acting antiseptic is sterile and immunodefiency material. Antibacterial activity of CA(Oh)2possesses due to its high alkalinity and release into the aquatic environment of hydroxide ions is highly active free radicals. Bactericidal activity is due to several mechanisms: damage to the cytoplasmic membrane, denaturation of proteins due to the destruction of ionic bonds, DNA damage microbial cells. Neutralizes acidic environment of inflamed tissues. Calcium hydroxide neutralizes endotoxin, gidrolizu portion of lipopolysaccharide (LPS, bacterial toxins) membrane of G-bacteria, released when the death of microorganisms and maintenance of inflammatory reaction after the death (microflora PC strictly anaerobic and gram-negative). Calcium hydroxide due to the inhibitory effects on osteoclasts stops bone resorption, stimulates osteo-, dentin - and cementogenesis, reduces inflammation of tissues surrounding the tooth due to the reduction of substrates adhesion of macrophages, causes superficial caustic (burning) effect on living tissues due to the high pH, reduces the porosity of the capillaries, promotes antiexudative effect, absorbs carbon dioxide, which is necessary for life anaerobe�'s bacteria seals the cell membrane, reducing the sensitivity of nerve receptors, tissue and activates enzymes (alkaline phosphatase), providing a remineralising effect and inhibiting a bacterial enzyme that allows for the successful conservative treatment of periodontitis. In the closed curettage impossible complete removal of granulation tissue from a periodontal pocket.

Calcium ions have a mineralizing effect on sensitive, after scaling and polishing, tooth tissue, reduce discomfort, are the building material for the formation of bones and teeth, neutralize corrosive acidic environment, due to the inflammation, regulate the growth and activity of cells of all kinds of fabrics, reduce vascular permeability, are a factor in blood clotting, anti-inflammatory action, coagulate and dissolve necrotic tissue, have good biological compatibility, toxic, teratogenic, carcinogenic effects are absent.

Inflamed periodontal tissues are cyanotic, that is experiencing hypoxia, therefore, the use of hydrogen peroxide and hydroxyl groups, which are split into atomic oxygen and water, saturate the tissues with oxygen, neutralize free radicals (products of inflammation) and detrimental effect� on obligately-anaerobic pathogenic flora PC. Introduction calcium hydroxide after washing with hydrogen peroxide contributes relatively more prolonged exposure than after treatment with other antiseptics.

With a combination of calcium hydroxide with iodoform are enhanced therapeutic properties. The iodoform is obtained through contact with the tissues undergoes gradual decomposition, releasing free iodine. Iodine has a deodorizing, antimicrobial, resolving, anti-inflammatory, contributing to the purification of the granulation effect. On the surface of the granulation tissue formed albuminates of iodine, providing anesthetic and astringent effect, reducing the irritation of receptors.

The instillation of an aqueous solution containing bifidus bacteria, prevents the growth of another pathological and saprophytic microflora. In addition, lacto - and bifidobacteria can affect various parts of the immune system, regulating nonspecific and specific cellular and humoral immunity that ensures the effectiveness of treatment in inflammation. Through the allocation of lacto - and bifidobacteria lactic acid suppressed the growth of microbial pathogens, including opportunistic. Provide quick replacement of pathological microflora normal, create a protective biofilm on the mucosa, protecting it from viruses, bacteria, fungi, protozoa, cover�represent the presence of the colonizing potential, stimulate phagocytic activity of neutrophils, macrophages, immunoglobulin synthesis And participate in the formation of interferons, is able to suppress the production of Ig E, then there is a natural immunomodulator and reduce the sensitization of the mucous and body.

Bifidobacteria help to increase your own lactoflora to normal. The use of lactobacilli in the oral cavity in the form of applications may result in multiple tooth decay, formation of biofilms on tooth surfaces.

Bacteria Normoflorins L and B are biologically active, start working from the first minute of contact with the mucosa, the product of domestic production, antagonistically active against pathogenic pathogenic flora of our region.

The proposed method allows to remove the inflammation and to avoid unwanted gingival retraction, to avoid the use of antibacterial drugs. The blunt end of the cannula allows for maximum deep introduction of the cannula into the PC with minimal trauma. The method can also be used with marginal periodontitis, is the prevention of diseases of the oral mucosa, atrophy of bone, partial or fully edentulous, diseases of the gastrointestinal tract, respiratory system, urogenital system, etc.

This method treated 27 pain�'s. In all cases was achieved the specified technical result.

The present invention is illustrated by the following example. Patient K. R., 1967, when receiving complaints of bleeding gums, pain while chewing and discomfort in the gums, bad breath, suppuration in the field of 17, 16, 15 teeth, front lower incisors. Objectively: mucous gums are hyperemic, swollen, bleeding when probing, the allocation of purulent discharge in the area 17, 16, 15 teeth, front lower incisors are determined periodontal pockets with a depth of 5-6 mm. teeth supragingival and subgingival hard and soft plaque. Specific breath. Diagnosis: chronic generalized severe periodontitis severity.

Was treated: after eliminating iatrogenic causes of periodontitis, sanation of the oral cavity, removal of above - and subgingival dental plaque, removal of granulation tissue, of teeth cleaning treatment was performed in two stages. Thus at the first stage of periodontal pockets (PC) after purification kuratomi, washing with 1.5% hydrogen peroxide solution inkjet cannula, through the cannula for periodontal pockets around the teeth, and when exposure of Forcarei premolars and molars - into the cannula under the furcation, for exposure to pathogens were injected daily in the area of the frontal�'s teeth "CellCept", and in distal teeth - "CellCept - Iodine", extruding the paste and holding the cannula around the teeth, and when exposure of Forcarei premolars and molars - into the cannula under the furcation in 5 days in the area of the teeth, then advanced within 2 days continued in the field of 17, 16, 15 teeth, front lower incisors, and then 2 hours it was impossible to eat. In the second stage, the preparation containing bifidobacteria, was administered by instillation of the cannula, through the cannula for periodontal pockets around the teeth, when the exposure of Forcarei premolars and molars - into the cannula under the furcation, simultaneously overlaid mucous membrane of the gums with a cotton turundas with this drug exposure 2 hours daily for 10 days. At the same time as the preparation containing bifidobacteria, used Normalien-B. After treatment objectively: the mucous membrane of the gums are pale pink in color, firmly attached to the tooth surface, PC decreased with depth up to 1.5-2 mm, dental plaque no, there is no specific breath. Hygienic index by Fedorov-volodkina good. When viewed through 6 months, 1 year recurrence of periodontitis was observed.

1. Method of treating periodontal disease, including oral hygiene, removal of supra - and subgingival dental plaque, removal of granulation, a professional dental cleaning, prom�tion of periodontal pockets 1.5% solution of hydrogen peroxide jet cannula, swiping the cannula for periodontal pockets around the teeth, and when exposure of Forcarei premolars and molars - into the cannula under the furcation, and the introduction of a preparation containing bifidobacteria, in periodontal pockets, characterized in that the treatment is carried out in two phases, with the first stage additionally in periodontal pockets in a similar manner through the cannula around the teeth, in the area of the front teeth enter drug "CellCept", and in distal teeth - drug "CellCept - Iodine daily for 5-7 days, after 2 hours of not eating food, drug, containing bifidobacteria administered by instillation of the cannula, through the cannula for periodontal pockets around the teeth, when the exposure of Forcarei premolars and molars - into the cannula under the furcation, at the same time impose the mucous membrane of the gums with a cotton turundas with this drug exposure 2 hours daily for 5-10 days.

2. A method according to claim 1, comprising administering to the quality of the preparation containing bifidobacteria, Normoflorin-B or Bifidumbacterin.



 

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20 cl, 7 ex, 3 tbl

FIELD: medicine, pharmaceutics.

SUBSTANCE: invention refers to biotechnology and immunology. What is presented is a host cell of Bordetella pertussis, Bordetella bronchiseptica or Bordetella parapertussis, which is used as an adjuvant or for preventing or treating whooping cough, having the low activity of endogenous glycosyltransferase at least 98% identical to the amino acid sequence SEQ ID NO: 2 as compared to the activity of glycosyltransferase of a relative parent strain, wherein the low activity is ensured by using an inactivating vector, which causes the inactivation of expression of a sequence of endogenous nucleic acid coding glycosyltransferase, or reduces to a low level of expression of the sequence of endogenous nucleic acid coding glycosyltransferase by the fusion of nucleic acid coding glycosyltransferase with a low-level or inducible promotor. What is disclosed is a preparation consisting of LPS of the above host cell with an increased replacement of hexosamine 1' or 4' phosphate groups of LPS referred to a lipid A, as compared to a LPS preparation from the related parent strain; thereby LPS is characterised by producing at least 8 ions in the ESI-MS spectrum, wherein the preparation is used as an adjuvant or for preventing or treating whooping cough. What is presented is using the above host cells or the LPS preparation for producing the preparation for preventing and/or treating whooping cough, or producing the drug preparation for immunising a mammal, wherein the host cells or LPS is used as an adjuvant. What is described is a pharmaceutical composition used as the adjuvant or for preventing or treating Bordetella infection containing the above host cell or above LPS preparation in an effective amount and a pharmaceutically acceptable carrier.

EFFECT: invention enables producing the pharmaceutical preparation of Bordetella cells or LPS, possessing the high immunogenicity as compared to the preparation of the related parent strain Bordetella.

12 cl, 7 dwg, 3 tbl, 1 ex

FIELD: medicine.

SUBSTANCE: wound surface is treated with 3.0-1.5% hydrogen peroxide; then keeping the wound wet, Ichthyosin dressing prepared by streptocide powder 0.5-2.5g and Ichthyol ointment 5.0-10.0g dissolved in castor oil 94.5-87.5ml is applied. The agent is applied once a day; the therapeutic course makes 16 days. That is combined with performing an integrated treatment.

EFFECT: invention provides both the antibacterial and anti-infectious, and local anti-inflammatory, local anaesthetic, wound-healing effects, improves the blood supply, stimulates the epidermis regeneration, intensifies the keratosis processes that enables accelerating the wound cleansing from the purulonecrosis process, and a length of preparation for aurografting.

1 tbl, 2 ex

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