Agent for treating pulp inflammation

FIELD: medicine.

SUBSTANCE: invention represents an agent for treating a pulp inflammation differing by the fact that it contains Bezornil ointment and Dycal ivory paste in ratio 1:1 blended until smooth.

EFFECT: invention provides relieving oedema and pain on the day of doctor's appointment, accelerating the pulp tissue regeneration process, creating the reparative dentin within 30 days, and ensures the higher clinical effectiveness in the pulp inflammations.

2 ex, 1 tbl

 

The invention relates to the field of medicine, namely to therapeutic dentistry.

The most common complication of caries process is the inflammation of the tooth pulp. Statistics show that patients with pulpitis in the structure of dental care by referral account for 14-20% and more depending on the region of the country (Ivanov B. C., Vinnichenko, Y. L., Ivanov P. V. Inflammation of the tooth pulp. Moscow: MIA, 2003. - C. 5). Ultimately, high-quality treatment of various forms of inflammation of the pulp prevents the development of chronostasis (Borovsky E. V., Ivanov B. C., Maximovskaya Y. M. preventive dentistry. - M.: Medicine, 1998. - S. 272-307).

Research of domestic and foreign authors proved the possibility of saving the pulp with reversible pulpitis (Borovsky E. V., 1997; Sevastyanova, I. K., 1999; A. S. Anokhin, 1988; Jureczko E. I., 1988; Radtke, 1978; C. F. Cox, 2001; Liu M., Pertl C. et al., 1994; Abrocoma M. F., 2004; and others). The best known methods of treatment of pulpitis, including extirpation of the pulp, often lead to the formation of foci of infection in the periodontal tissues. The prevalence of biological method of treatment with preservation of the entire pulp of the tooth does not exceed 5-7% among other methods of treatment of pulpitis (Anokhin, A. S. Treatment of pulpitis by the method of vital amputation with the use of lysozyme: author. Dis.... MD / MMC�. - M., 1988. - P. 20). So promising are the methods of treatment of pulpitis, which allow you to keep the pulp alive, and the method of vital amputation with preservation of the root part (Kamyshnikova I. O. Development and validation of the vital methods of treatment of pulpitis in the elderly: author. Dis.... MD / Cuba. state med. in-t im. Of The Red Army. - Krasnodar., 1992. - P. 18). However, despite the large number of developed methods of treatment of pulpitis and used drugs, the problem remains open.

Biological method of treatment of pulpitis is carried out in two visits. In the first visit to the open pulp imposed a temporary therapeutic material for a period of 1-2 days, when you visit in the absence of pain is replaced with a therapeutic strip, usually of calcium hydroxide (Borovsky E. V., Ivanov V. S., Maximovskaya Y. M., Maximovskaya L. N. Therapeutic dentistry. M., "Medicine", 1998. - P. 296). The goal of treatment at first visit - to relieve tension in the pulp through the provision of fluid outflow (through the perforations or dentinal tubules), as well as to eliminate the acute phase of inflammation. With this purpose as a therapeutic strip use antibiotics and enzymes (24-28 hours) glucocorticoids (up to 72 hours), which is not always possible to achieve success in the conservative treatment n�of Lipica (Dmitrieva L. A., Barash, A. G., Ershov N. And., Khalikov N. In. Comparative data use of lincomycin and lysozyme in the composition of the pastes for a biological method of treatment of pulpitis // Coll.: Prevention and treatment of dental diseases. - Alma-ATA. - 1985. P. 34-38.) It is shown that corticosteroids reduced excitability of the pulp cells and prevent the formation of fibrous tissue, necessary for the regeneration of the pulp (Burduli M. A. Morphological substantiation of treatment of various forms of acute pulpitis comprehensive three-step method: author. dis.... MD / TSMI. - Tbilisi, 1982. - S. 31), and a high concentration of antibiotics in the medical seal is able to cause necrosis of cells of the pulp (Comnow D. V. Comparative morphological characteristic reaction of the pulp to direct coverage treatment strips // Dentistry. - 1984. - No. 2. - P. 4-6). During the second visit the temporary medical strip is replaced by a constant (Danilevsky N. F., Sedelnikova L. F., Rajni J. I. Pulpitis. Kiev: Health. - 2003. - P. 44).

It is shown that part of the pastes calcium hydroxide in different formulations normalizes the acid-alkaline balance inflamed pulp (Kolips A., Rask-Andersen M., The blood capillaries in the subodontoblastic region of the human dental pulp as demonstrated by freerrefracturing // Acta odontol.Scand. - 1983. - No. 6. - P. 333-341). This component provides antiseptic, local and immunocorrective platinocyanide properties (G. J. mo UNT Glass ionomer cements and future research. // Am.J.Dent. - 1994. - №7(5). - P. 286-292). According to some research-based pastes of calcium contribute to the formation of irregular dentin (Sirak A. G., Sirak S. V. Morphofunctional changes in the dental pulp of experimental animals in the treatment of deep caries and acute focal pulpitis using the developed pharmaceutical compositions. // Modern problems of science and education. - 2013. - No. 2), but do not provide relief of inflammation due to the low antimicrobial activity, which makes their use limited (Salov V. A. // Comparative study of pharmaceutical compositions in the treatment of deep caries using the method of redintegratio: author. dis.... Cand. honey. Sciences. - SPb., 1997. - 16 p.; Tstmeda, Y. A histopathalogical study of direct pulp capping with adhesive resins / Y. Tstmeda, Hayakava, N. Yamamoto // Br J Oral Maxillofac Surg. - 2008. - Vol.36. - P. 429-433). It is known that a paste containing calcium hydroxide, it is advisable to apply only in the chronic stage of inflammation of the pulp. (Grigorieva N. And. Clinical justification of the choice of material for the biological treatment of pulpitis by the method and by the method of vital amputation: Dis.... Cand.honey.Sciences. - M., MMA. Sechenov, 2008 - 109 S.).

The hydrate of calcium oxide as an active ingredient included in the composition of the pastes "Dycal', "Kelmarin" et al. found that when using the paste "Dycal' successful medical�tion was only 82.3% of cases, due to the low microbial activity and possible stressful effects of this material on the pulp of the tooth. (Salov V. A. // Comparative study of pharmaceutical compositions in the treatment of deep caries using the method of redintegratio: author. dis. ... candidate. honey. Sciences. - SPb., 1997. - 16 p.). This paste is selected as a prototype.

The object of the invention is to increase the effectiveness of treatment of inflammatory diseases in the dental pulp.

The technical result consists in the removal of edema and pain on the day of the visit to the doctor, to speed up the process of regeneration of pulp tissue, education substitution of dentin within 30 days.

This is due to the fact that the product includes ointment "Bezornil" and paste "Dycal ivory", mixed until a homogeneous mass in a 1:1 ratio.

Known ointment "Bezornil" (Reg. beats MOH No. 012011/01-2000 dated 13.06.2000) and paste "Dycal ivory" (Carver No. 3 62004009). The composition of the ointment "Bezornil" are borneol, calamine (ZnCO3), pearls, amber, artificial musk, artificial bezoar; pasta "Dycal ivory is durable, samootverzhenij, radiopaque material based on calcium hydroxide, which comprises: a base paste - 1,3-Butyleneglycol disalicylate, zinc oxide, calcium phosphate, calcium tungstate, iron oxide pigments and catalyst paste - calcium hydroxide, N-ethyl-o/p-toluene sulfonamide, o�led zinc, titanium dioxide, zinc stearate. The tool is composed by mixing ready-made pharmaceuticals: ointment "Bezornil" and paste "Dycal ivory" in 1:1 ratio until smooth. Material clinical observations were the result of the examination and treatment of 10 patients aged from 20 to 40 years.

The ideal ratio of the selected position is 1:1, since a larger amount of the ointment "Bezornil tool does not freeze because of the presence of ointment bases, and the primary content of the paste Dycal ivory" tool froze for 10 seconds, not enough time to make the tooth cavity.

The drug efficacy was evaluated by clinical examination, which included subjective and objective data: the presence or absence of complaints of pain in the treated tooth, the response to temperature stimuli, percussion of the tooth. By EDI was carried out by measuring thresholds elektrovojvodina treated pulp of the tooth in the dynamics. Conducted radiological monitoring of the state of preapical fabrics treated tooth. A survey of patients carried out after the first finding means in the cavity of the tooth showed no complaints of pain after 12 hours. For an objective assessment of the functional state of the pulp of the tooth before and after treatment used absolute EIT�termination thresholds elektrovojvodina and changes their dynamics in remote and the coming time of treatment (table. 1).

Table 1
PatientsdiagnosisData EDI to treatment, MCAData EDI 7 days, MCAData EDI 18 months, MCA
B. N.Chronic pulpitis34Of 15.36,1
G. Y.Chronic pulpitis31,923,46,4
B. L.Acute pulpitis2412,86,5
J. L.Acute pulpitisA 21.510,48,9
L. G.Acute pulpitis289,57,1

After 30 days of treatment x-ray examination revealed no changes in the periodontium; in the field of fit of therapeutic agent to the pulp of the tooth clearly �anthuriums layer of newly formed dentin.

The advantage of the use of the product (containing the calcium and borneol) in a 1:1 ratio over other medications in the treatment pulpit is the one-stage patient comes to the doctor, the disappearance of pain symptoms within 12 hours. This product has a decongestant, local anti-inflammatory and mestnoanesteziruushim action. Through diverse actions pasta has a more pronounced anti-inflammatory effect.

The proposed remedy containing ointment "Bezornil" and pasta "Dycal ivory", taken in the ratio 1:1 and mixed to a homogeneous condition, use the following:

in one visit the patient under local or conductor anesthesia produce dissection of the cavity, carefully removed all softened and diseased hard tissues of the tooth; in the absence of communication of the cavity with the cavity of the tooth of the latter is opened, the cavity thoroughly dried, the outdoor horn of the pulp by the method of direct coating applied the proposed facility, the excess is removed from the plots fit and the edges of the cavity and is hermetically sealed permanent seal.

Clinical example No. 1.

Patient B., 55 years old. Complained of pain from thermal stimuli in the area 35 of the tooth. An objective examination found�dinner deep carious cavity of the II class according to Black tooth 35, when probing the cavity bottom soreness, EDI data 30 μa, when x-rays preapical tissue is not changed. Diagnosis: chronic fibrous pulpitis. After mechanical and pharmacological treatment of the tooth cavity on the exposed pulp horn has left the proposed facility and closed permanent filling material from a photosensitive polymer. In the analysis of immediate results of treatment: the disappearance of pain after about 12 hours, EDI data 15 µa (7 days), when x-rays preapical tissue is not changed.

In the analysis of remote results of treatment (18 months): subjectively: the tooth is not worried; these x-ray: not detected changes in the periodontium; in the field of fit of therapeutic agent to the pulp of the tooth clearly contoured layer of newly formed dentin; EDI data to 6.1 mA.

Clinical example No. 2.

Patient L., 33 years. Filed a complaint on spontaneous acute pain and pain from a stimulus in 2 days in the field 23 of the tooth. When viewed objectively: a deep carious cavity of the II class according to Black in the area 23 of the tooth, when probing painful when exposed to cold water tooth occurs long the pain is pulsating in nature. Data EDI 23 μa when x-rays preapical tissue is not changed. Diagnosis: acute focal pulpitis. P�held the following mechanical and pharmacological treatment of the tooth cavity on the exposed pulp horn has left the proposed facility and closed permanent filling material from a photosensitive polymer. In the analysis of immediate results of treatment (7 days): the disappearance of pain in the first day, EDI data 12 mA, when x-rays preapical tissue is not changed. In the analysis of remote results of treatment (1.5 years): subjectively: the tooth is not worried; these x-ray: not detected changes in the periodontium; in the field of fit of therapeutic agent to the pulp of the tooth clearly contoured layer of newly formed dentin; EDI data 7.1 mA.

Agent for the treatment of inflammation of the dental pulp, containing calcium hydroxide, characterized in that it comprises the ointment "Bezornil" and paste "Dycal ivory" in the ratio of 1:1, mixed to a homogeneous condition.



 

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