GB2131293A

GB2131293A - Composition containing dextran for use in medical treatment

Info

Publication number: GB2131293A
Application number: GB08234504A
Authority: GB
Inventors: Roy Mitchell
Original assignee: Individual
Current assignee: Individual
Priority date: 1982-12-03
Filing date: 1982-12-03
Publication date: 1984-06-20
Also published as: GB2131293B

Abstract

A pasty composition comprising collagen or other collagen-type gelatinous material, dextran and an aqueous saline solution or the like is useful as a dressing in the treatment of dry sockets following tooth extraction or for other medical purposes.

Description

SPECIFICATION Composition for use in medical treatment The present invention relates to a composition for use in medical treatment, particularly but not exclusively in dentistry as a dressing for treatment of dry sockets following tooth extraction.

In dentistry a not uncommon sequel to tooth extraction is the development of a dry socket. One to three days post-extraction there is partial or complete disintegration of the blood clot. Any remaining clot is heavily contaminated. Large areas of the lamina dura are necrotic and osteocyte lacunae are empty. The inflammatory process spreads to the surrounding marrow spaces and often to the periosteum. A heavy subepithelial inflammation is seen in the gingiva. Necrotic tissue is found in the marrow spaces closest to the alveolus. In the marrow space thrombosis, the presence of polymorphonuclear leukocytes and mononuclear cells present a picture of a localised acute or subacute osteomyelitis. Extensive osteoclastic activity is seen and the repair process is delayed.Granulation tissue starts to grow into the alveolus from the perforations in the lamina dura and the healing process progresses from the base of the socket.

In man, fibrinolytic alveolitis presents two problems: namely persistent pain and delayed healing.

At present many non-physiological dressings acting as a mechanical barrier and antiseptic are used with or without a curettage of the socket. They include obtundant materials such as eugenol or oil of cloves mixed into a paste with zinc oxide, or Whitehead's varnish (benzoin, storax, balsam of Tolu, iodoform, solvent ether) placed on ribbon gauze. More recently the dextran polymer Debrisan has been advocated, but its use in the mouth has presented isolation problems and patients are requested to return daily for a change of packing.

The present invention seeks to provide an improved dressing for this purpose.

According to the invention there is provided a composition useful as a dressing in medical treatment, comprising collagen-type gelatinous material, dextran and an aqueous solution of a physiologically harmless electrolyte.

Preferably the gelatinous material comprises collagen. The collagen may be of heterogeneous origin and may be soluble or insoluble or may be a mixture of soluble and insoluble material in any proportion. The use of a mixture of soluble and insoluble collagen in proportions by weight from 2:1 to 1 :2, especially about equal proportions, is particularly desirable. However, other gelatinous materials having a structure similar to that of collagen, namely polypeptide strands of molecularweight in the region of 105, may also be used.

The dextran to be used is a glucose polymer of chain-like structure and is obtainable in a variety of molecular weights. Preferably the material used has a molecular weight in the range 60,000 - 90,000, for example Dextran 70 with a molecular weight of 70,000.

The aqueous solution is preferably a saline solution for antiseptic purposes, but other electrolyte solutions which do not harm the patient may be used.

The composition may, if desired, contain other ingredients, for various purposes. For example, glycerol may be present to act as an emulsifier or lubricant.

For best results the composition is desirably applied in the form of a paste with sufficient of the aqueous solution to achieve the desired pasty consistency. Suitably about 45 - 50% by weight of the aqueous solution is used. The major proportion of the solid material should be the collagen-type, for example 75 - 90% by weight of the solid material, with the dextran suitably constituting 10 to 25% by weight of the solid material.

Particularly preferred compositions have the following constitution by weight: insoluble collagen 20-25% e.g. 22% soluble collagen 20-25% e.g. 22% dextran 5-10% e.g. 8% normal saline solution 45-50% e.g. 48% It will be appreciated that, although the composition used as a dressing will contain the aqueous electrolyte solution, the aqueous solution can be mixed with the other ingredients just before use, so that the invention also includes a composition comprising simply the collagen-type material and the dextran prior to addition of water.

In use to treat the dry socket condition in dentistry the composition is applied, suitably as a stiff paste, direct to the area of denuded bone. When used for this purpose it has the following advantages: 1. It relieves pain.

2. It is non-irritant to surrounding tissues.

3. It is incorporated or absorbed.

4. It is antiseptic.

5. It is a good bone sealant.

6. It is stable in oral fluids.

7. It does not undergo volume change when exposed to blood/saliva.

8. It is non-antigenic.

9. It is easy to apply.

10. Its use necessitates only a one visit treatment.

The composition may also be used outside dentistry for other medical purposes. For example, it would be of value in achieving haemostasis in bleeding bone, where it would act as a bone sealant, in orthopaedic, neuro-surgical or other related surgical fields. It would also have uses for patients with bleeding diathesis for local control of bleeding from bone. It would also act as a space filler in bony cavities when cyst-like lesions are removed in the above and similar surgical disciplines.

CLAIMS (Filed on 30.11.83) 1. A composition useful as a dressing in dental or other medical treatment, comprising collagen-type gelatinous material, dextran and an aqueous solution of a physiologically harmless electrolyte.

2. A composition as claimed in claim 1, wherein the ratio by weight of the gelatinous material to the dextran in the composition is from 3:1 to 9:1.

3. A composition as claimed in claim 1 or 2, wherein the composition is in the form of a paste containing 45 to 50% by weight of the aqueous solution.

4. A composition as claimed in any of claims 1 to 3, wherein the gelatinous material is collagen.

5. A composition as claimed in any of claims 1 to 4, wherein the collagen is a mixture of soluble collagen and insoluble collagen in a ratio by weight of from 1:2 to 2:1.

6. A composition as claimed in any of claims 1 to 5, wherein the dextran has a molecular weight of 60,000 to 90,000.

7. A composition as claimed in any of claims 1 to 6, which also contains glycerol as an emulsifier/ lubricant.

8. A composition as claimed in claim 1 and substantially as hereinbefore described.

9. A composition comprising collagen-type gelatinous material and dextran and being capable of forming a composition as claimed in any of claims 1 to 8 on addition of an aqueous solution of a physiologically harmless electrolyte.

**WARNING** end of DESC field may overlap start of CLMS **.

Claims

**WARNING** start of CLMS field may overlap end of DESC **. The composition may also be used outside dentistry for other medical purposes. For example, it would be of value in achieving haemostasis in bleeding bone, where it would act as a bone sealant, in orthopaedic, neuro-surgical or other related surgical fields. It would also have uses for patients with bleeding diathesis for local control of bleeding from bone. It would also act as a space filler in bony cavities when cyst-like lesions are removed in the above and similar surgical disciplines. CLAIMS (Filed on 30.11.83)

1. A composition useful as a dressing in dental or other medical treatment, comprising collagen-type gelatinous material, dextran and an aqueous solution of a physiologically harmless electrolyte.