Method of deep caries treatment

FIELD: medicine.

SUBSTANCE: opening of a carious cavity, ablation of overhanging enamel edges on the entire circumference, necrectomy and drug treatment with a 0.06% chlorhexidine solution are performed. The preparation "Lemifaren" is applied on walls and bottom of the carious cavity in a uniform 1 mm thick layer, which is left for 1 day under temporary filling. After the removal of the preparation irradiation in a pulse mode with the power of 5 W and frequency of 2000-3000 Hz is carried out for 5 min with the application of the laser apparatus ALST-01. After that, the cavity is restored with an account of functional and aesthetic parameters of the particular tooth.

EFFECT: effective treatment of deep caries prevents caries recurrences and pulp inflammation.

1 ex

 

The invention relates to medicine, namely to therapeutic dentistry, and can be used for the treatment of deep caries.

Delays and poor treatment of deep caries leads to infection and subsequent inflammation of tooth pulp and its necrosis and later to the development of periodontitis, which can result in serious complications such as inflammatory processes of the maxillofacial area. The outcome of treatment of deep caries depends not only on the quality of preparation of carious cavity, but also from therapeutic properties of the paste, which must possess antiseptic and anti-inflammatory properties and ability to stimulate the production of pulp substitution of dentin.

The closest analogue of the invention is a method of photodynamic therapy in the treatment of deep caries is described in Velichko, Irina Vladimirovna. The treatment begins with the examination and diagnosis, then conducted anesthesia and rapid processing overhanging edges of carious cavity turbine with a maximum tip all the rules of asepsis and antisepsis. After the completion of machining and isolate the tooth from saliva in patients of groups 1 and 2 carried out disinfection of carious cavities by the method of photodynamic therapy. The walls and bottom of the billet�internal cavity was coated with 0.5% gel Fotoditazin uniform layer, equal to 1 mm, which was left for 30 s. Then carried out the irradiation by a laser apparatus in continuous mode, the exposure time was in the group with 1-30, in the group 2-60 C. After which the cavity is thoroughly washed and proceed to the standard Protocol of the restoration of the cavity with consideration of functional and aesthetic parameters of a particular tooth. As the photosensitizer used the gel-penetrator light "Fotoditazin". To activate the photosensitizer used a semiconductor laser apparatus "Lotus-04", specially designed for photodynamic therapy in dentistry [Velichko, Irina Vladimirovna. Photodynamic therapy in the treatment of dental caries: the dissertation... of candidate of medical Sciences: 14.01.14 / Velichko, Irina Vladimirovna; [Place: FGU "the Central scientific research Institute of stomatology"].- Moscow, 2011.- 109: ill.]. It was found that under the influence of photodynamic therapy on the microflora of carious cavity within 60 seconds, there was complete destruction of pathogenic microorganisms. The use of photodynamic therapy in the treatment of caries activates microcirculation in the dental pulp due to increased regulatory effects on microvessels, leading to the normalization of blood flow in the microvasculature. Photodynamic therapy is effective at INF�lirovannye hard tissues of the tooth, that contributes to a more complete elimination of microorganisms, improving the adaptation of the filling material and prevent the development of secondary caries.

The disadvantage is that the gel used-the penetrator "Fotoditazin" has no antibacterial effect, phototoxic, no penetrate and sensitizer. He is not an independent drug and treatment is very expensive. While the us used the drug "Lamifiban" is more biologically active and independent drug; has a detoxifying, antibacterial and stimulant properties

The technical result - improving the efficiency of treatment of deep caries, prevention of recurrence of caries and inflammation of the pulp.

The proposed method is as follows.

1. Identify the pathological process during clinical and radiographic examinations of the teeth.

2. Under anesthesia produced the disclosure of carious cavities, removal of overhanging edges of enamel around the entire circumference, performed necrectomy and pharmacological treatment of 0.06% aqueous solution chlorhexidine.

3. On the sides and bottom of carious cavity preparation is administered "Lamifiban" uniform layer of 1 mm, which is left for 1 day; then cover the tooth with a temporary filling.

4. On the second visit to clean temporary p�ombu, the drug "Lamifiban" wash with distilled water.

5. The treatment is carried out with a laser device AALST-01 Optodan using continuous 2 mode (pulse) during 5 min power of 5 W and a frequency of 2000-3000 Hz.

6. Proceed to the standard Protocol of the restoration of the cavity with consideration of functional and aesthetic parameters of a particular tooth.

The proposed method is illustrated by the following clinical example.

Patient I., aged 28, came to the clinic of therapeutic dentistry with a diagnosis of deep caries of tooth 45. Indicators of electrogoniometry respectively to 10 μa. Thickness Napolitano dentin 1.4 mm. Under anesthesia revealed a carious cavity excised overhanging edges of enamel around the entire circumference, was performed necrectomy. Conducted drug treatment 0,06% solution chlorhexidine and drying with warm air, then on the sides and bottom of carious cavity was injected the drug "Lamifiban" a uniform layer of 1 mm, which was left for 1 day; then the tooth is closed with a temporary filling. On his second visit, he removed the temporary filling, the drug "Lamifiban" washed with distilled water, then carried out the irradiation by a laser apparatus using mode 2 (pulse) during 5 min power of 5 W and a frequency of 2000-3000 Hz. Subsequently applied insulating gasket Ionosit Baseliner and const�th seal Charisma. The rate of electrogoniometry after treatment 8 μa. After a month of treatment the patient had no complaints, elektrovojvodina 2 μa. At 3 months after treatment, the thickness Napolitano dentin 2.2 mm. During the inspection a year later, the rate of electrogoniometry equal to 2 μa, the thickness Napolitano dentin 2.3 mm, were no changes in the periapical tissues.

1. A method of treating deep caries involving the preparation of carious cavity, medicinal treatment, the introduction of the drug on the walls and bottom of cavity uniform layer of 1 mm, the laser, characterized in that impose the drug "Lamifiban" which I leave for 1 day under a temporary filling, then after removal of the drug irradiate the pulsed power of 5 W and a frequency of 2000-3000 Hz for 5 min.

2. A method according to claim 1, characterized in that the irradiation is carried out using a laser apparatus AALST - 01 Optodan.



 

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14 cl, 2 ex, 1 tbl

FIELD: medicine.

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4 tbl, 3 ex

FIELD: medicine.

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FIELD: medicine.

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1 tbl, 1 ex

FIELD: medicine.

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3 cl, 5 tbl, 5 ex

FIELD: medicine.

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FIELD: medicine, pharmaceutics.

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2 ex

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1 tbl, 2 ex

FIELD: medicine.

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4 tbl, 3 ex

FIELD: medicine.

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4 tbl, 2 ex

FIELD: medicine.

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11 dwg

FIELD: medicine.

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2 ex

FIELD: medicine, pharmaceutics.

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63 cl, 3 dwg, 1 tbl, 4 ex

FIELD: medicine.

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3 cl, 3 ex

FIELD: medicine.

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EFFECT: reducing the number of complications and the high efficacy of the anthelminthic treatment.

1 ex

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