Method of treating chronic generalised periodontitis
SUBSTANCE: method of treating chronic generalised periodontitis includes the influence on an affected area by the therapeutic diode laser "HELBO" 2075 F/Theralite" with photosensitase "HELBO Blue Photosensitizer", with the application after the laser influence on the periodontium affected area of an adhesive gingival bandage, to prepare which the antioxidant "Melaxen", kalanchoe sap, glycosamine hydrochloride, dimethylsulphoxide, water dentine and solcoseryl dental adhesive paste are applied in specified quantities.
EFFECT: achievement of an anti-inflammatory, antiseptic and reparative effect, which makes it possible to stop inflammation in the tissues of periodontium and obtain stable long-lasting remission.
1 tbl, 2 ex
The invention relates to medicine, namely to dentistry, Periodontology, and is intended for use in the treatment of chronic inflammatory periodontal disease.
From an existing prior art it is known that the treatment of periodontal diseases should be comprehensive and include: (a) the elimination of a microbial factor; b) enhancement of antioxidant activity of the organism; C) the restoration of microcirculation.
Complex treatment objectives: elimination of traumatic occlusion, the elimination of inflammation of periodontal tissues, the suspension of the destructive process, restoration of impaired function of periodontal tissues, stimulation of regeneration, the preservation of the dentition as a single dentition, excluding the most probable pathological factors .
Development of new methods of therapy and the search for new therapeutic methods, combining the above properties, is the urgent issue of improving the treatment of diseases of fabrics of parodont.
The closest in technical essence to the claimed solution and selected as a prototype is a method of treatment of inflammatory periodontal diseases, including chronic generalized periodontitis with the use of antibacterial photodynamic system. It includes in with�BOJ therapeutic diode laser "HELBO" 2075 F/Theralite" with a wavelength of 670-690 mm and a power density of 75 mW/cm 2special liquid (token) photosensitize - "HELBO BLUE Photosensitaiser" .
The method of treatment is as follows.
Gingival grooves or periodontal pockets are handled by photosensitizes for 2-3 minutes, depending on their depth.
Photosensitize after the expiration of the exposure time and thoroughly rinse with water, and then produce the effect of laser light on the affected area for 1-2 minutes.
The advantage of this method of treatment: after applying on periodontal tissues photosensitize occurs staining of cell membranes parodontopathogenic and other microorganisms, dystrophic modified epithelial cells, with subsequent sensitization of cells to monochromatic light therapeutic diode laser. Monochromatic laser light causes a chemical reaction resulting in release of free atomic oxygen and peroxide radicals, which is accompanied by destruction of microorganisms and dystrophic altered cells.
The disadvantage of this method: as a result of impact of the laser system emerged oxidative stress is not adjustable and is accompanied by a short period of remission, i.e. it requires frequent re-treatments. The method does not provide isolation of periodontal tissues with saliva, microorganisms, and n�shevich residues, which leads to relapse.
The task is to develop a new effective method of treatment of chronic generalized periodontitis, combining the effects of photodynamic system and isolation of periodontal tissues under the adhesive gingival dressing with antioxidant.
The task is solved by the use of adhesive gingival dressings containing antioxidant "Melaxen", Kalanchoe juice, glucosamine hydrochloride, dimethyl sulfoxide, as a basis - solcoseryl dental adhesive paste, in the following ratio of components, wt.%:
|The juice of Kalanchoe||10-20|
|Solcoseryl dental adhesive paste||else|
The use of components outside of these intervals does not make sense, because it does not give the desired effect.
The above differences of the proposed technical solution� from the prototype gives us grounds to believe it meets the criterion of "scientific novelty".
The authors do not know of such a technical solution with the same set of essential features and provide similar positive effect, on this basis, it is possible to consider the proposed solution meets the criterion of "inventive step".
The composition and properties of adhesive gingival dressing.
Drug Melaxen" is selected as an antioxidant.
The juice of Kalanchoe was chosen as a reparative agent, glucosamine hydrochloride as an anti-inflammatory and mild analgesic agent, dimethyl sulfoxide used as a conductor and a weak antiseptic. Components dressings have pharmacological synergism.
The technology of preparation of the adhesive of the gingival dressings simple and affordable. It is this: the Kalanchoe juice is mixed with dimethylsulfoxide and water dentin. In this mixture was dissolved glucosamine hydrochloride and "Melaxen", then the parts in the solution was injected solcoseryl dental adhesive paste with constant stirring. Mixing time: 3 minutes. Adhesive gum bandage is applied on the affected area with a spatula or trowel. Curing time in the mouth for 3-4 minutes.
The proposed ratio of therapeutic substances is optimal and provides therapeutic effect of the drug. Doses of drugs installed� experimentally.
Characterization of components of the adhesive gingival dressing.
Drug Melaxen" - a synthetic analogue of indole hormone of the pineal gland - melatonin. It is more effectively neutralizes formed in the free radical oxidation of highly toxic hydroxyl and peroxyl radicals than the widespread natural antioxidants.
In the juice of Kalanchoe contains flavonoids, organic acids (malic, acetic, citric), tannins, polysaccharides, enzymes, vitamin C, micro and macro elements - aluminum, iron, magnesium, calcium, copper, silicon and manganese. In dentistry it is used for gingivitis, periodontal disease II and III degrees and aphthous stomatitis, causing the mucous membranes of the oral cavity in the form of applications or aerosol inhalation.
Glucosamine (2-deoxy-2-amino-D-(+)-glucose) is active chondroprotective agent, its low molecular weight and high pharmacological activity, to ensure high efficiency in the treatment of inflammatory processes in the periodontium. Glucosamine hydrochloride has a stimulating effect on reparative processes in the structures of connective tissue origin, and also contributes to the inhibition of them in post-traumatic degenerative processes. Probable mechanism of reparative action glitch�Zamin is to stimulate the synthesis of glycosaminoglycans and collagen.
Dimethyl sulfoxide - DMSO (Dimexidum) is an antiseptic agent that has anti-inflammatory and antimicrobial activity, and also exhibits local anesthetic properties for pain syndromes of various etiology, it has a wide range of effects on the sources of inflammatory processes, as he, along with dissolved substances it penetrates through the mucosa of the oral cavity without damage, acting as a factor that increases the penetration of drugs through the epithelial barriers.
Water dentin added to ensure isolation from saliva, gingival dressings due to the acceleration of its hardening in the mouth.
Solcoseryl dental adhesive paste (Reg. No. 015194/01-2003) provides accelerated healing, pain relief and protection of the wound surface. In addition, the paste provides high adhesion (adhesion) of the medicinal components, introduced in the composition to wet the mucous membrane, and, consequently, ensures long-term depositing of all medical components of the ointment in the mucosa needed to stimulate the process of regeneration, pain relief, sorption and healing.
The method of treatment is as follows.
All patients undergo a thorough dental hygiene with removal of soft plaque, over - and p�despojo Tartar followed by polishing of the teeth and existing fillings.
Then the gingival grooves or periodontal pockets are handled by photosensitizes within 1-3 minutes. The result is a staining of the cell membranes parodontopathogenic and other microorganisms, dystrophic modified epithelial cells by photosensitizes, with subsequent sensitization of cells to monochromatic light therapeutic diode laser.
Photosensitize after the time of exposure, wash off thoroughly with water, then area of the periodontal tissues exposed to laser light from laser photodynamic system "HELBO" 2075 F/Theralite" with a wavelength of 670-690 mm and a power density of 75 mW/cm2within 1-2 minutes.
Then on the affected area of periodontal applied with a spatula pre-prepared gingival adhesive bandage. The curing time in the mouth is 3-4 minutes. Thanks to the dense coverage of the teeth and alveolar process provides maximum protection contained in the bandage of drugs from diffuse erosion of the oral content and, thus, conditions are created for formation of a drug depot and a deep penetration into tissues.
Thus, the claimed method of treatment of generalized periodontitis allows for optimization of therapy of inflammatory diseases of periodontal tissues, as �concludes laser photodynamic system, isolation of periodontal tissues under the adhesive gingival dressing with antioxidant due to the unique combination entered into its components.
The effectiveness of the proposed method is confirmed by examples of specific performance.
Conducted a comprehensive survey of 142 patients of the main group of patients with chronic generalized periodontitis (Class XI. Diseases of the digestive system (K - K)), gingivitis and periodontal disease (K05), chronic periodontitis (05.3) of varying severity and 20 patients with intact healthy periodontium in age from 18 to 60 years. Table 1 presents the distribution of patients depending on sex, age, severity and duration of the disease.
Depending on the principles of treatment of patients of the main group were divided into two subgroups. In the first subgroup of patients (A) in addition to the traditional drug therapy (TMT) were treated according to the method prototype. In the second subgroup (B) in addition to TMT and antibacterial photodynamic therapy (APDT) has used the claimed method of treatment.
Depending on the severity of periodontitis was isolated patients with periodontitis mild severity (PLIST, I), periodontitis of moderate severity (PSST, II) and severe periodontitis severity (PTST, III).
Control examination of patients wire�in terms 7 days 1 month, 3-6 months and 1 year on the stages of complex treatment.
The traditional scheme of examination of patients with dental pathology included a survey, inspection, palpation, auscultation and occlusal diagnosis. The survey was carried out in a certain pattern and in a certain sequence.
In a survey of patients complained of: pain, bleeding and swelling of the gums, bad breath, aesthetic dissatisfaction due to exposing the necks of the teeth, as well as their mobility.
When collecting history of the disease drew attention to the likely causes and manifestations of the disease, the nature and characteristics of the course, what treatment was conducted, what was his efficiency. When collecting history of life was noted that somatic pathology, which will affect the course of periodontitis, as well as to cases of intolerance or Allergy to drugs.
On the eve of the oral cavity was assessed the state of the mucous membrane, the location of the frenulum and folds, the depth of the vestibule, the height of the alveolar processes. In the oral cavity was inspected: the language, the location of the frenulum of the tongue, palate, Palatine arch, tonsils, posterior wall of the pharynx.
During the examination of teeth drew attention to the situation of the tooth, its shape, colour, with�the ground state of the hard tissue, sustainability. The results of the inspection recorded in the dental formula.
All patients were given traditional comprehensive treatment plan. It included training the individual oral hygiene, selection tools, occupational hygiene, appointment of a local anti-inflammatory drugs. When periodontitis mild and moderate severity were conducted vector therapy, surgical curettage, patchwork operation, if necessary, splinting, rational prosthesis splinting.
Clinical observation of the patients of subgroup B showed that the application of the proposed method on the background of integrated traditional therapies have helped reduce the indicators of hygienic index to 1,14-1,18 in patients with chronic generalized periodontitis. Within a week the patients reported no bleeding when brushing your teeth, indices PMA, PI was significantly decreased (p<0,05), indicators of bleeding index (PBI) were significantly lower compared with initial evaluations, the vacuum resistance of the capillaries gums increased, which shows a pronounced anti-inflammatory action of the claimed method of treatment.
In a comparative evaluation index in subgroups A and B, it was observed a more rapid improvement of the hygienic condition of the oral cavity in group A. the Decrease in the index PMA, PI, PBI also noted�examples in both of the studied subgroups. On the background of treatment, the formation of the hematoma, and hence the resistance of the capillaries in the gums to vacuum, increased in both groups (p>0,05).
However, the indicators in the subgroup And were slightly worse than in the subgroup B, which used the claimed method (the differences are in most cases significant (p<0,05).
The most important indicator - the number of relapses in group B after therapy decreased to 0.56±1,04% per year, in the subgroup And the figure was 3,44±0,95% per year.
Thus, the claimed method of treatment of chronic generalized periodontitis allows to solve the main problem of treatment of chronic generalized periodontitis is to reduce the number of relapses and increase the period of remission of the disease.
Clinical example 1.
Patient S., 39 years old, appealed with complaints of bleeding that occurs when brushing your teeth, sore gums, increased tooth sensitivity, tooth mobility, halitosis. These symptoms can be tense in the offseason, arising, from words of the patient, at least 5-6 times a year.
From the anamnesis installed: discomfort in the oral cavity appeared about 4 years ago. Earlier treatment was carried out according to the traditional scheme: professional teeth cleaning with the use of the drugs Metrogyl-de�TA. Recent treatment from a periodontist was conducted 4 months ago. The presence of concomitant chronic somatic diseases denies.
During the inspection revealed the following: the depth of the vestibule of the oral cavity, the length of the frenulum of the lips within normal limits. The physiological occlusion, crowding of the teeth of the lower jaw in the anterior region. During the inspection found dental plaque supragingival and subgingival, hard and soft consistency. Hyperemia with cyanosis interdental and marginal gingiva and alveolar, change its configuration. Gingival papillae moderately swollen, adhere tightly to the surface of the teeth, when touched can bleed easily. Is determined by the mobility of the teeth 2 degrees on Fleszar mainly front segment. When probing periodontal pockets are defined by a depth of 4.5 mm, the nature of the exudate serous-purulent in moderation. Neck teeth bared, hyperesthesia of teeth.
These additional studies: hygienic indexes:
PMA - 43,17±1,36%, PI - 3,62±0,008, Muhlemann - Son was 2.11±0,04; Loe - Silness - 1,85±0,13; Green - Vermillion - 2,13±0.05; the depth of periodontal pockets was 4.6±0.14 mm.
The results of microbiological studies: Bacteroides spp 3,7±0,13; Porphyromonas gingivalis 4,8±0,12; Prevotellaintermedia 4,9±0,21; A. actinomycetem Commitans 5,41±0,12; Fusobacteriumspp 3,5±0,08; Actinomycetesspp 4,92±0,13; S. salivarius 2,8±0,2; Peptostreptococcusspp 5,9±0,11; Streptococcusspp. 2,9±0,21; S. milleri was 4.1±0,9; Corinebacterium 0,7±0,02.
Result�you biochemical studies: MDA - Of 0.95±0.01 nmol/ml; AOA - 2,32±0,03 Mmol/l; ODS was 29.2±0,9%; catalase activity was 29.2±0,1(mcab/L.); GENDER/JSC oral fluid - 0,41±0,06.
Diagnosis: Chronic generalized periodontitis of moderate severity.
First visit: Produced by professional teeth cleaning with the removal of soft and hard dental deposits, carried out the procedure APDT therapy with overlay adhesive gingival dressings claimed by the scheme, antiseptic treatment of the oral cavity, the recommendations for oral hygiene. The patient an appointment within 7 days.
Second visit: Antiseptic treatment of the oral cavity, the procedure performed APDT therapy with adhesive gingival dressing of the claimed scheme.
The results of the survey after treatment (7-10 days):
PMA - 14.52±1.86%, PI - 1.14±0.06, Muhlemann - Son - 1.32±0.24, Loe - Silness - 1.17±0.12, Green - Vermillion - 1.41±0.18, depth of periodontal pockets - 3.6±0.18 mm.
The results of microbiological studies (7-10 days): Prevotellaintermedia 1,9±0,11; A. actinomycetemcommitans 2,4±0,16; Actinomycetesspp 0,95±0,15; S. salivarius 1,6±0,08; Peptostreptococcusspp 0,60±0,04; Corinebacterium 3,4±0,01; Bacteroides spp, Porphyromonas gingivalis, Fusobacteriumspp., Streptococcusspp., S. milleri is not found.
The results of biochemical studies (1 month): MDA - 0,62±0.04 nmol/ml; AOA - 1,11±0,02 Mmol/l; ODS - 31,1±0,18%; catalase activity is 32.2±0,12 (mcab/L.); GENDER/JSC oral fluid - 0,56±0,02.
The results of the survey on �dalannah time points after treatment:
Patient survey C. after 6 months. No complaints. On examination revealed moderate hyperemia and swelling of the interdental papillae in the area of the front teeth.
These additional studies: hygienic indexes: PMA - 13,17±1,36%, PI - 1,92±0,08, Muhlemann - Son - 1,71±0,04; Loe - Silness - 1,85±0,13; Green - Vermillion - 1,03±0.05; the depth of periodontal pockets and 2.9±0,34 mm.
The results of the microbiological examination:
A. actinomycetemcommitans 2,65±0,26; Streptococcusspp. 1,20±0,06; Corinebacterium 4,4±0,2; Bacteroides spp. Porphyromonas gingivalis, Fusobacteriumspp., S. milleri, Actinomycetesspp., Prevotellaintermedia, S. salivarius, Peptostreptococcusspp. - not found.
The results of biochemical studies: MDA - 0,58±0.01 nmol/ml; AOA - 4,4±0,03 Mmol/l; ODS - 39,2±0,9%; catalase activity - 35,2±0,1 (mcab/L.); GENDER/JSC oral fluid - 0,13±0,06.
The results of examination of the patient P through 1 year: no complaints, no recurrence of the disease, loose teeth front the band, the condition of periodontal tissues is good, IG (oral hygiene index) is satisfactory.
Clinical example 2.
Patient P., 53 G., appealed with complaints of persistent bleeding that occurs when brushing your teeth and taking solid food, sore gums, increased tooth sensitivity, tooth mobility, halitosis.
From the anamnesis installed: considers himself ill since 2005, after suffering flu. Dental care rarely drawn, based in�nom, when there is a need for a denture. Notes the seasonality of acute illness (spring and autumn). Treatment from a periodontist took place about 5 months ago before the prosthesis. The presence of concomitant chronic somatic diseases denies.
The examination of the oral cavity: the Depth of the vestibule of the oral cavity, the length of the frenulum of the lips within the normal range, severe traumatic occlusion in the anterior region due to declining bite. During the inspection found a large amount of soft plaque, supragingival and subgingival dental plaque. Hyperemia with cyanosis interdental and marginal gingiva and alveolar, change its configuration. Gingival papillae moderately swollen, adhere tightly to the surface of the teeth, and bleed easily. Tooth mobility grade 3 by Fleszar (front panel). When probing periodontal pockets are defined by a depth of 6.0 mm, the nature of the exudate serous-purulent in moderation. Neck teeth bared 2/3, hyperesthesia of teeth.
These additional studies:
Hygienic indexes: PMA - form for 61.42±1,5%, PI - for 6.24±0,46, Muhlemann - Son - 3,36±0,10, Loe - Silness - 2,73±0,19, Green - Vermillion - 3,18±0,15. The presence of periodontal pockets with a depth of 6.5±0.4 mm.
The results of microbiological studies: Streptococcusspp 3,15±0,11; A. actinomycetemcommitans 4,4±0,16; Actinomycetesspp 5,6±0,10; S. salivarius 3,65±0,12; Peptostreptocccusspp 6,3±0,10; Corinebacterium 0,8±0,01; Bacteroidesspp 4,50±0,22; Porphyromonasgingivalis 5,50±0,20; Fusobacteriumspp 4,10±0,10; S. milleri 4,55±0,18; Prevotellaintermedia 6,50±0,15.
The results of biochemical studies:
MDA is 1.85±0.02 nmol/ml; AOA - 1,7±0,8 Mmol/l; ODS - 19,8±0,8%; catalase activity was 18.8±0,2 (mcab/l).
Diagnosis: Chronic generalized periodontitis severe degrees of severity in the acute stage
First visit. Removes soft and hard dental deposits, carried out the procedure APDT therapy with overlay adhesive gingival dressings claimed by the scheme, antiseptic treatment of the oral cavity, the recommendations for oral hygiene. The patient an appointment within 7 days.
The second visit. Antiseptic treatment of the oral cavity, the procedure performed APDT therapy with overlay adhesive gingival dressings claimed by the scheme, antiseptic treatment of the oral cavity, the recommendations for oral hygiene. The patient an appointment within 7 days.
The third visit. Antiseptic treatment of the oral cavity, the procedure performed APDT therapy with overlay adhesive gingival dressings claimed by the scheme, antiseptic treatment of the oral cavity.
These additional studies after treatment:
Hygienic indices (7-10 days): PMA - 17,13±0.21%, the PI - 4,37±0,19, Muhlemann - Son - 1.81±0.09, Loe - Silness - 1.56±0.12, Green - Vermillion - 1.31±0.04, depth of periodontal pockets�new - 4,5±0.15 mm.
The results of microbiological studies (7-10 days): Streptococcusspp 1,20±0,06; A. actinomycetemcommitans 1,4±0,16; Porphyromonasgingivalis 1,3±0,03; Actinomycetesspp S. salivarius, Peptostreptococcusspp, Corinebacterium, Bacteroidesspp, Fusobacteriumspp., S. milleri, Prevotellaintermedia - not found.
The results of biochemical studies (1 month): MDA - 1,25±0,04 nmol/ml; AOA - 1,22±0.52 Μmol/l; ODS and 33.4±0,82%; catalase activity is 28.5±0,32 (mcab/L.); GENDER/JSC oral fluid - 1,05±0,01.
The results of the survey in the remote terms after treatment:
No complaints. The examination of the patient P. in 6 months. after the treatment showed that there is moderate redness and swelling of the interdental papillae in the area of the front teeth.
These additional studies:
Hygienic indexes: PMA - 18,4±0,34%; PI - 4,12±1,2;, Muhlemann - Son - of 1.91±0,04; Loe - Silness - 1,95±0,13; Green - Vermillion - 1,83±0.05; the depth of periodontal pockets and 3.2±0,34 mm.
The results of the microbiological examination: A. actinomycetemcommitans 2,85±0,29; Streptococcusspp 1,80±0,02; Corinebacterium 3,4±0,2; Bacteroides spp. Porphyromonas gingivalis, Fusobacteriumspp., S. milleri, Actinomycetesspp., Prevotellaintermedia, S. salivarius, Peptostreptococcusspp. - not found.
The results of biochemical studies: MDA - 0,78±0.02 nmol/ml; JSC - 1,37±0.22 µmol/l, SOD - 31,8±0.72% and the activity of catalase - 29,9±0,1 mcab/L.
The results of examination of the patient P. in 1 year: no complaints, no recurrence of the disease, loose teeth front 1 degree, condition TC�her periodontal good, IG (oral hygiene index) is satisfactory, the depth of periodontal pockets is, on average, to 1.3±0.22 mm.
Thus, the obtained data allow the clinic to characterize the developed method of treatment of chronic generalized periodontitis as a highly efficient, allowing to minimize the number of relapses and increase the period of remission. The method of treatment according to the inventive circuit has a pronounced clinical effect and has ample opportunities for the practice of dentistry.
SOURCES of INFORMATION
1. Anisimov, V. N. Melatonin: role in the body, the use in the clinic / V. N. Anisimov. - SPb.: System, 2007. - 39 p.
2. Alexandrov, M. T. Determination of antimicrobial activity of drugs used in treatment of patients with periodontal disease / M. T. Alexandrov, V. F. Prikulis, V. Y. Bogdanov [et al.] / / Dentistry. - 2009. - No. 2. - Pp. 13-15.
Method of treatment of chronic generalized periodontitis, including the impact on the affected area therapeutic diode laser HELBO" 2075 F/Theralite" photosensitize "HELBO Blue Photosensitizer", characterized in that after the laser treatment on the affected area of periodontal impose gingival adhesive bandage, for the preparation of which is used as an antioxidant "Melaxen", Kalanchoe juice, glucosamine hydrochloride, dimethyl sulfoxide, water�th dentin and solcoseryl dental adhesive paste in the following ratio of components,
|The juice of Kalanchoe||10-20|
|Solcoseryl dental adhesive paste||else|
SUBSTANCE: unit for photodynamic therapy of tumours of head and neck skin contains the laser radiation source with the light guide which regulates a light dose and a plate (8) on a frontal holder (6). The fixture for protection of healthy skin from laser radiation is designed as three parallel flat disks (15, 16) and is fastened with a possibility of fixing in a standard position through the transitional device (11) on the frontal holder (6). Disks (15, 16) have a common central axis. External disks (15) are rigidly connected to each other along the perimeter forming a blind cavity connected to the transitional device (11). The internal disk (16) is designed with smaller diameter compared external disks (15), fixed on the common central axis with a possibility of rotation and divided into equal sectors. In each sector the individual through hole (18) of pre-set diameter is made. The centres of holes are located from a rotation axis at a minimum allowable distance. In each external disk (15) there is a coaxial hole designed as a sector the central angle of which is equal to the central angle of the internal disk sector. The transitional device (11) is designed as metal parallel plates (12). Plates (12) have a shape of an equilateral triangle with depressions in their tops. In one of tops the hinge (9) of the metal rod connected with the plate (8) of the frontal holder (6) is fixed, in the second top - the hinge of the metal rod (10) connected with the adaptation for protection of healthy skin from laser radiation, and in the third top - the hinge of an additional metal rod (5) on which clamps (4) for fixing of the laser light guide are rigidly fixed. One clamp (4) is fixed on an additional metal rod (5) in such a way that the axis of rotation of lips of this clamp is at the level of hole sector top in external disks, and the axis of rotation of lips of another clamp (4) is located from the axis of rotation of lips of the first clip (4) at the distance equal to the radius (R) of the sector hole in external disks (15).
EFFECT: invention will allow to improve efficiency of treatment by elimination of possibility of impact on healthy skin around a tumour due to reliable fixing of the light guide.
SUBSTANCE: transcranial influence by a travelling pulse magnetic field with the induction of 35 mT, inversion frequency from 1 to 16 Hz, reversion time of 1 minute, is carried out. Then the eye is exposed to laser radiation with a wavelength of 0.633 mcm, in a mode of continuous radiation with the outlet power of 2.4 mW. On the first day the exposure to the magnetic field lasts 5 minutes, to the laser radiation - 1 minute. On the second day the exposure lasts 6 and 2 minutes, respectively. On the third day it lasts 7 and 3 minutes, respectively. From 4 to 10 day the exposure lasts 8 and 4 minutes, respectively. The influence is realised on each eye alternately.
EFFECT: method improves the microcirculation of the retina, reduces paravasal retina oedema, ensures the increase of the vision acuity and reduces the number of photopsias.
11 dwg, 3 ex
SUBSTANCE: invention refers to medicine, namely to traumatology and orthopaedics, and can be used for treating proximal humeral injuries. That is ensured by three-staged complex therapeutic actions. At the first stage, setting of fracture and reduction of humeral head dislocation is followed by immobilising an extremity by continuous twenty-four hour brace fixation of the proximal humerus with Desault's bandage for the period of 4 weeks. From the first therapeutic day, the patient does daily 30-minute therapeutic exercises, including isometric, static and ideomotor exercises to strengthen his/her arm muscles and to improve the circulation. That is combined with a complex reparative drug therapy. At the first stage, the anti-inflammatory preparation Arthrofoon is administered orally, while vasodilators improving nicotinic acid, trental or complamin microcirculation are injected intramuscularly daily for 10 days. The enzymatic preparations Wobenzyme or Flogenzyme are also administered in a dose of 3 tablets three times a day for 3-4 weeks. The second stage starting two weeks after the beginning of the treatment involves electric stimulation (ES) by exposing the collar and shoulder muscles from the involved side for 30 minutes to electric signals generated by an electric myostimulation device. The ES procedure requires the patient to perform 15-minute active motions by a healthy arm, and for the following 15 minutes the patient is expected to tense and relax alternatively the muscles from involved side. The therapeutic exercises are also done. The drug treatment regimen of the second stage implies administering the preparations Calcemin or Calcemin Advance for six months. That is combined with 10 daily intramuscular injections of the preparation Milgamma 2 ml. At the third stage 4 weeks after the beginning of the treatment, control X-ray imaging is followed by removing the brace. Accompanied by the reparative drug therapy continued, the complex therapeutic actions provide local injection therapy in number of 8-10 daily procedures. The biologically active reflex areas nearby the involved joint are pre-exposed to focused red laser light, and the mixed preparations Alflutop, or other chondroprotector, vitamin B12, Contrykal or Lidase, Lidocaine are injected in the same areas. Two weeks after the brace has been taken off, the patient keeps doing the therapeutic exercises twice a week continuously. The drug therapy and local injections are repeated six months later. The brace is further required for the following year if the patient is supposed to bear occupational or sports physical loads.
EFFECT: method provides faster recovery of the extremity functionality, prevents posttraumatic degenerative process in the humeral joint, recurred dislocation formation, humeral instability and contractures by optimising the humeral para-articular tissue health, improving the quality of bone tissues, first of all, of the subchondral plate and humeral head.
2 cl, 1 dwg, 2 ex
SUBSTANCE: invention relates to medicine, namely to ophthalmology, and can be applied for the treatment of posterior uveitis. For this purpose sclerocompression, during which extreme parts of the eye bottom periphery near the toothed line of the retina are visualised through the eyelids, is created under conditions of drug mydriasis under ophthalmological control. Then laser-coagulation is performed by a contactless method. Coagulants are applied on the extreme periphery of the eye bottom, immediately in the zone of inflammation and on the boundary with healthy tissues. The diameter of the spot constitutes 100-350 mcm, with power of 400-1000 mW, impulse exposure of 0.1-0.3 sec. The general number of coagulants is 300 - 360.
EFFECT: method ensures the fast arrest of the inflammatory process with reaching stable remission with the minimal risk of addition of the secondary infection during manipulation.
1 ex, 4 tbl, 5 dwg
SUBSTANCE: surgical operation is preceded by administering antibacterial agents and electrical stimulation (ES) in a projection of an inferior dental foramen and a mental foramen. The electrical stimulation is ensured by Myovolna apparatus at voltage amplitude 20-30 V, current frequency 4-7 Hz, length 10 minutes in number of 10 daily procedures. That is followed by surgical removal of the filling material from the inferior dental canal. The surgical intervention is followed by administering antibacterial, immunocorrective, desensitising agents. That is combined with daily projection 10-minute exposure of an operated segment of the inferior dental canal to laser light generated by scanning laser emitter of Intradont apparatus for 12 days. The exposure is characterised by sequential scanning mode at frequency 10 Hz increased to 60 Hz for the last 2 days, at pulse laser light power 20Wt increased to 40 Wt for the last 2 days in the stochastic scanning mode.
EFFECT: method provides pain syndrome and numbness reduction of the involved skin regions in the preoperative period and optimises actions aiming at postoperative blood circulation recovery in the inferior alveolar system outpatiently, as well as reducing time of rehabilitation and recovery of the patients.
SUBSTANCE: carious cavity is prepared. Then it is treated instrumentally and antiseptically. A hole of an apical canal of a causative tooth is expanded. Methylene blue is introduced into the cyst through a root canal at a depth of 7-10 min. The cyst envelope is exposed to a laser light generated by a diode laser through the root canal for 30-60 s by means of a needle light guide. The exposure is continued from the vestibular or oral surface for 60.0-120.0 s by means of a plate light guide of intensity 0.5-1 W, wave length 625-630 nm in a pulse mode. Before the root canals of the causative tooth is hermetically sealed, Collap-An gel with metrogil 1.0-1.5 ml is introduced into the cyst.
EFFECT: method enables provides increasing clinical effectiveness, avoiding the complications by removing the cyst envelope completely that enables restoring the bone defect structure completely.
SUBSTANCE: invention refers to medicine, namely to pulmonology, and can be used for the correction of secondary mucociliary insufficiency (MCI) of the lower airway (LA) in the patients with bronchopulmonary diseases. A projection of bronchi and lungs in sub-clavian region, interscapular space and axillar region from both sides is exposed to a pulsed low-intensity infrared laser light at wave length of 0.89 mcm. A degree of mucociliary insufficiency is pre-determined. The exposure is characterised by an average-power emission of 3.75 mW at pulse repetition frequency 500 Hz. Degree 1 secondary mucociliary insufficiency of the lower airway requires 7 or 8 6-minute sessions. Degree 2 implies 7.5-minute sessions in number of 9 or 10. If observing degree 3, 11 or 12 daily sessions last for 9 minutes every day.
EFFECT: method enables increasing the clinical effectiveness in bronchopulmonary diseases by differentiating mode of the laser correction of MCI depending on a degree of manifestation that enables restoring the mucociliary transport.
5 tbl, 3 ex
SUBSTANCE: invention refers to medicine, namely to pulmonology, and can be used for the correction of secondary mucociliary insufficiency (MCI) of the upper airway (UA) in the patients with bronchopulmonary diseases. Mucous membranes of the nasal cavity from both sides are exposed to a low level red light laser therapy at wave length of 0.633 mcm in a continuous mode. That are preceded by diagnosing and determining degrees of the SMCI. Degree 1 secondary mucociliary insufficiency of the upper airway requires the laser light exposure at total power density (PD) 1.5 J/cm2 by 5 or 6 1-minute sessions. Degree 2 implies 1.5-minute sessions in number of 7 or 8 at total PD 2.25 J/cm2. If observing degree 3, 9 or 10 daily sessions last for 2 minutes every day at total PD 3.0 J/cm2.
EFFECT: method enables providing the higher clinical effectiveness by the differentiated use of LLLT depending on a degree of secondary MCI and restoring the mucociliary transport.
5 tbl, 4 ex
SUBSTANCE: invention can be used in laser therapy for treating persistent and septic wounds, fractures, arthropathies, as well as in cosmetology. A presented matrix laser emitter comprises laser diodes arranged as two lines in the same cavity, a static power supply unit adjusting voltage amplitude, and a controller specifying three pulse repetition frequencies, with a base frequency of 10000 Hz and an additive modulation frequency of 1000 Hz and 1333 Hz.
EFFECT: more effective biologically considerable action of the low-intensity laser emission applicable in laser therapy by optimising the arrangement of the laser light source and multi-frequency modulation.
4 cl, 4 dwg
SUBSTANCE: Candida yeast-like fungi are measured. Lamypharen biogel is used to cover approximate dental surfaces along the quadrants (1.2) and (3.4) or (1.5-1.8, 1.4-2.4, 2.5-2.8), (3.5-3.8, 3.4-4.4, 4.5-4.8), into a gingival surface, inflamed surfaces of a gingival crest or into a gingival pockets. The exposure makes 20 to 30 minutes. After the gel is removed by means of Alod - 01-GRANAT diode laser, the gingival papillas or gingival pockets are treated. If the measured Candida yeast-like fungus content is 105-107 CFU/tampon or CFU/ml, the exposure length makes 2 minutes. If the measured value is 103-104 CFU/tampon or CFU/ml, the exposure length is 1 minute. What is used is a laser light at wave length 662nm with a radiation power of 0.4Wt, a power density of 14-18 J/cm2 in a continuous mode. That is followed by Lamypharen biogel applications on the gingival mucosa, into the gingival pockets covered with a protective dressing for 1-2 hours. The therapeutic course makes 3 procedures. Besides, Lamypharen biogel is administered orally once a day 30 minutes before a meal in an amount of 20 g for 14-30 days depending on a severity of the disease.
EFFECT: reducing the inflammation and pathogenic microflora, prolonging the remission of the disease by enhancing the inflow of biological substances into a chronic inflammatory periodontal tissues.
4 cl, 5 ex
SUBSTANCE: invention refers to medicine, namely to dentistry. A formulation for retrograde filling of root canals contains calcium oxide, aluminium oxide and silicone oxide, each of which is prepared by separate baking, processing and functional additives, and an X-ray contrast extender - zirconium oxide. The processing additive contains plasticising and water-retaining ingredients in the form of compounds of cellulose and/or its esters and/or polysorbates, as well as whitening inert ingredients in the form of titanium dioxide. As the functional additive, the formulation contains bactericidal ingredients of dioxidine, and/or metronidazole, and/or silver, and/or copper-calcium hydroxide, and anti-inflammatory ingredients in the form of glucocorticosteroids specified in hydrocortisone acetate and/or dexamethasone. The formulation can additionally contain calcium salts.
EFFECT: combination of the ingredients of the formulation in certain quantitative content provides a high prolonged alkalinity of the material of approximately pH 12, a flow characteristic of the material of 25-26 mm used to fill the root canal tightly, a setting time of the material within 10-20 minutes controlled by a dentist in the mouth cavity, an after-setting higher compression strength of not less than 40 MPa, a lower solubility of the material of no more than 1,5% and a high radio density of the material.
2 cl, 8 ex
FIELD: medicine, pharmaceutics.
SUBSTANCE: groups of inventions refers to dental cement systems. The presented cement system contains an aqueous hydrating liquid and a powder material which substantially consists of a non-organic cement system and has an ability to form a complex, chemically bound material with non-organic and organic phases with the properties appropriate to fix an implant to another implant and/or tooth or bone tissue. The powder cement to be applied in said system contains 40-60 wt % of calcium aluminate, 8-15 wt % of polyacrylic acid, 0.5-5 wt % of tartaric acid, 25-45 wt % of strontium-fluoro-aluminium-silicate glass and 2.5-10 wt % of strontium fluoride. The hydrating liquid to be applied in the system containing 10-200 mM of LiCl, 0.2-0.4 wt % of trisodium nitrilotriacetic acid and deionised water up to 100%. Besides, what is presented is a kit comprising said cement system; a capsular mixing system containing such cement system, and using the cement system to fix an implant to another implant and/or tooth or bone tissue.
EFFECT: system and material according to the invention are well-shaped, hydrophobic, incompressible, have stable prolonged properties, make stable thin layers with minimal microleakage.
11 cl, 5 tbl, 6 ex
FIELD: medicine, pharmaceutics.
SUBSTANCE: invention relates to medicine, namely to orthopedic dentistry and can be used for fixation of undetachable constructions of dental prostheses. Composition for fixation of undetachable constructions of dental prostheses contains mixing liquid in percent by weight: phosphorus oxide -41%, zinc oxide - 10%, aluminium oxide - 4.5%, the remaining part - water to 100%, and mixture of powders, which contains in percent by weight: magnesium oxide - 10-11%, bismuth oxide - 3-3.5%, silicon oxide - 3-3.5%, aluminium oxide - 0.5%, chromium - 0.5%, silicon nanoparticles - 0.1-0.3%, zinc oxide - to 100%.
EFFECT: application of composition makes it possible to increase quality of fixation of undetachable constructions of dental prostheses due to increase of strength, increase of adhesive ability, resistance to oral fluid impact, reduction of film thickness and reduction of heat emission.
SUBSTANCE: invention refers to medicine, namely to dentistry, and can be used for treating the destructive changes in the furcation area of molars after tooth floor perforation. That is ensured by preparation of a carious cavity, management and root canal filling for cause. Thereafter, the tooth floor is coated with the daily changed preparation Calasept Iodo in dosage 0.05-0.1 ml, for 2 days. It is combined with exposure to a semiconductor laser of wave length 0.9 mcm, pulse power 2 Wt, frequency 2000 Hz and pulse duration 40-100 ns. The exposure covers the tooth floor directly vertically and is performed daily within the course of 2-3 procedures. Thereafter, a preparation Osteoplast in dosage 0.05-0.1 g. The perforation is closed with the material "Pro Root".
EFFECT: invention allows for effective reduction of inflammation, elimination of bone tissue resorption within molar furcation, osteogenesis within the furcation area.
1 ex, 2 dwg
FIELD: medicine; dentistry.
SUBSTANCE: invention describes a composition of dental filling material or implant material, alternatively a composition for tooth or bone cohesion to dental filling material or implant material respectively, including water-based hydration fluid, and powder material with binding phase consisting mainly of calcium-based cement composition. After saturation with fluid reacting with binding phase, the powder material can be hydrated and form ceramic material bound chemically. According to the invention, the claimed powder material and/or hydration fluid include water-soluble phosphate or phase producing water-soluble phosphate, so that the composition can form apatite in the process of hydration. The invention also concerns the powder material and hydration fluid as such, implant material and method of achieving cohesion.
EFFECT: faster tooth or bone recovery.
38 cl, 1 tbl, 11 dwg, 3 ex
FIELD: medicine; stomatology.
SUBSTANCE: invention concerns self-hardening glass carbomer composition resulted from processing of fluorine-doped silica glass (a) poly (dialkylsiloxane) with chain-terminal hydroxyl group where alkyl groups contain 1-4 carbon atoms, (b) acid water solution and (c) release of processed fluorine-doped silica glass from acid water solution. Glass carbomer composition does not show any compression or expansions that is important property for packing of high durability and wear resistance. Composition is also characterised by lower scuffing and wear sensitivity, higher hardness, more smooth surface, higher color fastness, good matching, e.g., with bone tissue and lower water sensitivity.
EFFECT: composition has good hardness and reliability.
11 cl, 3 tbl, 1 ex
SUBSTANCE: ingredients are hardened in situ to produce solid biocompatible material capable of left in organism for a long time.
EFFECT: enhanced effectiveness in recovering mechanical strength of skeleton after cancer diseases; reduced risk of complications.
27 cl, 1 dwg
FIELD: composite materials for stomatology.
SUBSTANCE: proposed composite material has porous inorganic nonmetallic matrix and second material. Bending strength of matrix is no less than 40 Mpa as determined according to ISO 6 872; second material is just organic material which at least partially fills pores of matrix; elasticity modulus E of composite material is equal to or exceeds 25 Gpa determined according to ISO 10 477. Properties of proposed composite are between properties of ceramic and plastic materials, for example, friability is below that of ceramic materials but attrition resistance is higher as compared with that of polymers filled with inorganic materials. Specification describes method of production and application of material.
EFFECT: enhanced efficiency and reliability.
13 cl, 4 ex
FIELD: medicine; medical engineering.
SUBSTANCE: raw material briquette has one or several powder-like binding agents. It is capable of producing chemically bound ceramic product after being saturated with liquid reacting with the binding agents. The raw material briquette preferentially has solid phase consolidation degree of 56-67% by volume. It also has one or several admixtures compensating expansion usable for giving long-term size stability properties to the material. Binding phase of one or several powder-like binding agents is made react with liquid capable reacting with the binding agents. A powder-like body comprising the binding agents is compressed to produce raw material briquette so that the powder-like body is exposed to high external pressure and low temperature enough for produce compact bound raw material briquette without agglomeration reaction taking place in consolidation phase. Raw material briquette solid phase consolidation degree preferentially makes up 56-67% by volume. One or several admixtures compensating expansion usable for giving long-term size stability properties to the material are added to the powder-like body. Dental instrument for introducing the raw material briquette into cavity has cylindrical envelope and rod enclosed into the envelope movable in axial direction. Instrument-sealing body has solid porous material selected from group composed of porous ceramic material, porous polymer material, porous metal material, porous wood material, porous ceramic material preferentially composed of hard wood, preferentially of birch.
EFFECT: improved long-term size stability properties.
35 cl, 12 dwg
SUBSTANCE: method involves carrying out reaction between binding phase of one or several powder-like binding agents and liquid making reaction with those binding agents. Some quantity of powder containing said binding phase, is suspended in the liquid so that all powder grains are brought in close contact with the liquid. Then, ceramic slurry obtained in this way is dried to withdraw redundant reacting liquid and condense the material during final drying before letting the material harden in reaction between said binding phase and remaining liquid. One or several additives compensating expansion are added to said powder before suspending or in the course of suspending the powder in the liquid to give long-term size stability properties to the material.
EFFECT: high quality of dentistry material, electronic circuit carrier or micromechanical material of long-term size stability obtained with the method.
28 cl, 1 dwg, 3 tbl
FIELD: medicine, pharmaceutics.
SUBSTANCE: invention relates to pharmaceutical industry, namely to means, possessive immunomodulating action. Method of human immunomodulation by application of live suspension of chlorella of strain Chlorella vulgaris IGF No C-111 with concentration 8-10 millions cell/ml in quantity 200 ml per day for adult human.
EFFECT: method makes it possible to increase human immunity effectively.