MD597Z - Method for treating the dental caries in children with intellectual disabilities - Google Patents

Method for treating the dental caries in children with intellectual disabilities Download PDF

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MD597Z
MD597Z MDS20120119A MDS20120119A MD597Z MD 597 Z MD597 Z MD 597Z MD S20120119 A MDS20120119 A MD S20120119A MD S20120119 A MDS20120119 A MD S20120119A MD 597 Z MD597 Z MD 597Z
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children
dental
drops
dental caries
carious
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MDS20120119A
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Romanian (ro)
Russian (ru)
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Аурелия СПИНЕЙ
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Государственный Медицинский И Фармацевтический Университет "Nicolae Testemitanu" Республики Молдова
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Abstract

The invention relates to medicine, in particular to dentistry and can be used for the treatment of dental caries in children with intellectual disabilities.Summary of the invention consists in that on the carious dental surfaces is applied a mixture containing 3% sodium hypochlorite, 0.1% BioR gel and 0.5% alkaline fuchsin in the ratio of 1:1:0.2, during 15…20 s, afterwards are removed the abnormal changed dental tissues, the carious cavity is treated antiseptically, is dried and irradiated with laser radiation of a wavelength of 0.85…0.98 µm, a frequency of 2000…3000 Hz, pulse power of 5 W, for 20…30 s, then on the irradiated surface are applied 1…2 drops of a suspension containing finely dispersed calcium hydroxide in distilled water, and then is carried out the second course of irradiation in the same regime, are applied 1…2 drops of a drug for deep fluoridation of enamel and dentin, which comprises a solution containing fluoride (F-) and copper (Cu2+) ions, and is carried out the third course of irradiation in the same regime.

Description

Invenţia se referă la medicină, şi anume la stomatologie şi poate fi utilizată pentru tratamentul cariei dentare la copiii cu dizabilităţi intelectuale. The invention relates to medicine, namely to dentistry and can be used for the treatment of dental caries in children with intellectual disabilities.

Este cunoscută metoda de tratament al cariei dentare care constă în înlăturarea ţesuturilor dentare dure alterate cu freza, prelucrarea antiseptică a cavităţii carioase, uscarea ei şi aplicarea preparatelor pentru fluorizarea profundă cu iradierea simultană cu lumină laser cu intensitate joasă, după care cavitatea carioasă este uscată şi obturată [1]. The method of treating dental caries is known, which consists of removing the altered hard dental tissues with a bur, antiseptic processing of the carious cavity, drying it and applying preparations for deep fluoridation with simultaneous irradiation with low-intensity laser light, after which the carious cavity is dried and filled [1].

Însă, această metodă nu este indicată copiilor cu dizabilităţi intelectuale, deoarece prepararea cavităţii carioase cu freza provoacă durere sau cauzează discomfortul, neliniştea copiilor şi refuzul tratamentului la stomatolog. În plus, în timpul preparării cavităţii carioase cu freza copiii cu deficienţe mintale pot efectua mişcări involuntare, astfel că apare pericolul traumării feţei şi a cavităţii orale a copilului. However, this method is not recommended for children with intellectual disabilities, as the preparation of the carious cavity with a bur causes pain or discomfort, anxiety in children and refusal of treatment at the dentist. In addition, during the preparation of the carious cavity with a bur, children with mental disabilities may make involuntary movements, thus posing a risk of trauma to the child's face and oral cavity.

În literatura accesibilă nu am găsit surse bibliografice care ar menţiona careva metode miniinvazive de tratament al cariei dentare elaborate special pentru copiii cu dizabilităţi intelectuale, care ar lua în consideraţie particularităţile evoluţiei clinice a cariei dentare şi a impactului maladiilor psiho-somatice grave asupra comportamentului copiilor în timpul tratamentului afecţiunilor dentare. In the accessible literature, we did not find any bibliographic sources that would mention any minimally invasive methods of dental caries treatment developed specifically for children with intellectual disabilities, which would take into account the particularities of the clinical evolution of dental caries and the impact of serious psychosomatic diseases on children's behavior during the treatment of dental diseases.

Problema pe care o rezolvă prezenta invenţie constă în elaborarea unei metode noi, eficiente de tratament a cariei dentare la copiii cu dizabilităţi intelectuale, prevenirea cariei secundare, majorarea efectului bactericid şi a capacităţii de formare a cristalelor, protejarea pulpei dentare de factori patogeni, prevenirea apariţiei durerii şi a discomfortului pacientului în timpul tratamentului. The problem solved by the present invention consists in developing a new, effective method for treating dental caries in children with intellectual disabilities, preventing secondary caries, increasing the bactericidal effect and crystal formation capacity, protecting the dental pulp from pathogenic factors, preventing the occurrence of pain and discomfort for the patient during treatment.

Esenţa invenţiei constă în aceea că după izolarea cavităţii carioase de acţiunea salivei şi uscarea ei, se aplică un amestec ce conţine hipoclorură de sodiu de 3%, gel BioR de 0,1% şi fuxină bazică de 0,5% în raport de 1:1:0,2, timp de 15…20 s, după care se înlătură ţesuturile dentare alterate, cavitatea carioasă se prelucrează antiseptic, se usucă şi se iradiază cu radiaţie laser cu lungimea de undă de 0,85…0,98 µm, frecvenţa de 2000…3000 Hz, puterea impulsului de 5 W, timp de 20…30 s, apoi pe suprafaţa iradiată se aplică 1…2 picături de suspensie ce conţine hidroxid de calciu microdispersat în apă distilată, după care se efectuează a doua şedinţă de iradiere în acelaşi regim, se aplică 1…2 picături de preparat pentru fluorizarea profundă a smalţului şi dentinei, care include o soluţie ce conţine ioni de fluor (F-) şi de cupru (Cu2+), şi se efectuează a treia şedinţă de iradiere în acelaşi regim. The essence of the invention consists in the fact that after isolating the carious cavity from the action of saliva and drying it, a mixture containing 3% sodium hypochlorite, 0.1% BioR gel and 0.5% basic fuchsin in a ratio of 1:1:0.2 is applied for 15…20 s, after which the altered dental tissues are removed, the carious cavity is treated with an antiseptic, dried and irradiated with laser radiation with a wavelength of 0.85…0.98 µm, a frequency of 2000…3000 Hz, a pulse power of 5 W, for 20…30 s, then 1…2 drops of a suspension containing microdispersed calcium hydroxide in distilled water are applied to the irradiated surface, after which a second irradiation session is performed in the same regime, 1…2 drops of a preparation for deep fluoridation of the enamel and dentin, which includes a solution containing fluoride (F-) and copper (Cu2+) ions, and a third irradiation session is performed in the same regimen.

Printre avantajele metodei propuse se enumeră faptul că a fost elaborată în special pentru copii cu dizabilităţi intelectuale, ţinând cont de particularităţile evoluţiei clinice a cariei dentare şi a impactului maladiilor psiho-somatice grave asupra comportamentului copiilor în timpul tratamentului afecţiunilor dentare. Among the advantages of the proposed method is the fact that it was developed especially for children with intellectual disabilities, taking into account the particularities of the clinical evolution of dental caries and the impact of serious psychosomatic diseases on children's behavior during the treatment of dental diseases.

Înlăturarea chimico-mecanică a ţesuturilor cariate nu provoacă durere, este suportată uşor de copiii cu dizabilităţi psiho-motorii, aplicarea în cavitatea carioasă a compoziţiei de hipoclorură de sodiu asigură dezintegrarea rapidă a dentinei ramolite, iar gelul BioR previne eventuala prelingere a hipoclorurii de sodiu din cavitatea carioasă pe mucoasa cavităţii orale şi preîntâmpină provocarea combustiei ei chimice, asigură înlăturarea deplină a efectelor iritante a hipoclorurii de sodiu, în plus, exercită o acţiune antiinflamatoare şi imunomodulatoare, prevenind nu numai iritarea mucoasei cavităţii orale, dar şi a pulpei dentare. Soluţia de fuxină bazică penetrează doar ţesuturile dentare dure demineralizate şi alterate, fapt care asigură vizualizarea suficientă a ţesuturilor afectate. The chemical-mechanical removal of carious tissues does not cause pain, is easily tolerated by children with psychomotor disabilities, the application of the sodium hypochloride composition into the carious cavity ensures the rapid disintegration of softened dentin, and the BioR gel prevents the possible leakage of sodium hypochloride from the carious cavity onto the oral mucosa and prevents its chemical combustion, ensures the complete removal of the irritating effects of sodium hypochloride, in addition, it exerts an anti-inflammatory and immunomodulatory action, preventing not only irritation of the oral mucosa, but also of the dental pulp. The basic fuchsin solution penetrates only demineralized and altered hard dental tissues, which ensures sufficient visualization of the affected tissues.

Iradierea laser cu lungimea de undă de 0,85…0,98 µm a cavităţii carioase, după înlăturarea dentinei ramolite, asigură distrugerea microorganismelor de la suprafaţa cavităţii carioase, precum şi a celor prezente în profunzime, în special în tubulii dentinari. Aplicarea succesivă a preparatelor pentru fluorizarea profundă a smalţului - Gluftored şi a iradierii laser potenţează efectul carioprofilactic al ambelor manopere, creează condiţii optime pentru depunerea în interiorul tubulilor dentinari a cristalelor de CaF2 şi MgF2, care asigură protejarea pulpei dentare de factori patogeni şi eliberarea în timp îndelungat a ionilor de fluor (F-) în concentraţie înaltă, fapt ce contribuie la remineralizarea zonelor de smalţ demineralizat şi previne formarea cariei secundare. Laser irradiation of the carious cavity with a wavelength of 0.85…0.98 µm, after removing the softened dentin, ensures the destruction of microorganisms on the surface of the carious cavity, as well as those present in depth, especially in the dentinal tubules. The successive application of preparations for deep enamel fluoridation - Gluftored and laser irradiation enhances the carioprophylactic effect of both procedures, creates optimal conditions for the deposition of CaF2 and MgF2 crystals inside the dentinal tubules, which ensure the protection of the dental pulp from pathogenic factors and the long-term release of fluoride ions (F-) in high concentration, which contributes to the remineralization of demineralized enamel areas and prevents the formation of secondary caries.

Metoda propusă de tratament al cariei dentare previne apariţia durerii, discomfortului pacientului în timpul tratamentului şi a cariei secundare, este simplă şi rapidă în realizare, fapt care permite utilizarea acestei metode la pacienţi cu dizabilităţi psiho-somatice. The proposed method of treating dental caries prevents the occurrence of pain, patient discomfort during treatment and secondary caries, is simple and quick to perform, which allows the use of this method in patients with psychosomatic disabilities.

Rezultatul tehnic constă în majorarea eficacităţii tratamentului cariei dentare la copiii cu dizabilităţi intelectuale, lipsa durerii şi a discomfortului pacientului în timpul tratamentului, majorarea efectului bactericid şi a capacităţii de formare a cristalelor, protejarea pulpei dentare de factorii patogeni, prevenirea apariţiei cariei secundare şi a complicaţiilor cariei dentare. The technical result consists in increasing the effectiveness of dental caries treatment in children with intellectual disabilities, the absence of pain and discomfort for the patient during treatment, increasing the bactericidal effect and crystal formation capacity, protecting the dental pulp from pathogenic factors, preventing the occurrence of secondary caries and complications of dental caries.

Exemple de realizare a invenţiei Examples of embodiments of the invention

Metoda de tratament al cariei dentare la copii cu dizabilităţi se realizează în modul următor: se efectuează igienizarea cavităţii orale, se izolează cavitatea carioasă de acţiunea salivei prin uscarea ei, se aplică un amestec ce conţine hipoclorură de sodiu de 3%, gel BioR de 0,1% şi fuxină bazică de 0,5% în raport de 1:1:0,2, timp de 15…20 s. După aceasta se înlătură ţesuturile dentare alterate, cavitatea carioasă se prelucrează antiseptic, se usucă şi se iradiază cu radiaţie laser cu lungimea de undă de 0,85…0,98 µm, frecvenţa de 2000…3000 Hz, puterea impulsului de 5 W, timp de 20…30 s. Apoi pe suprafaţa iradiată se aplică 1…2 picături de suspensie ce conţine hidroxid de calciu microdispersat în apă distilată, după care se efectuează a doua şedinţă de iradiere în acelaşi regim, se aplică 1…2 picături de preparat pentru fluorizarea profundă a smalţului şi dentinei, care include o soluţie ce conţine ioni de fluor (F-) şi de cupru (Cu2+), şi se efectuează a treia şedinţă de iradiere în acelaşi regim, apoi cavitatea carioasă se usucă şi se obturează. The method of treating dental caries in children with disabilities is carried out in the following way: the oral cavity is sanitized, the carious cavity is isolated from the action of saliva by drying it, a mixture containing 3% sodium hypochlorite, 0.1% BioR gel and 0.5% basic fuchsin in a ratio of 1:1:0.2 is applied for 15…20 s. After this, the altered dental tissues are removed, the carious cavity is treated with an antiseptic, dried and irradiated with laser radiation with a wavelength of 0.85…0.98 µm, a frequency of 2000…3000 Hz, a pulse power of 5 W, for 20…30 s. Then, 1...2 drops of suspension containing microdispersed calcium hydroxide in distilled water are applied to the irradiated surface, after which a second irradiation session is performed in the same regimen, 1...2 drops of preparation for deep fluoridation of enamel and dentin are applied, which includes a solution containing fluoride (F-) and copper ions (Cu2+), and a third irradiation session is performed in the same regimen, then the carious cavity is dried and filled.

Exemplul 1 Example 1

Pacientul C., 7 ani, instituţionalizat cu retardare mintală profundă, PCI în casa-internat pentru copii cu deficienţe mintale din or. Orhei. Diagnosticul: carie dentară de profunzime medie la dinţii 5.5 şi 8.5, hipersensibilitatea dinţilor la excitanţi termici şi chimici. Tratamentul cariei dentare a fost efectuat după metoda descrisă. Dintele a fost obturat cu materialul Fuji IX. Copilul a suportat bine şedinţa de tratament, fără a manifesta semne de discomfort în decursul ei. După 1 an de la efectuarea tratamentului, semne de inflamare, iritare a pulpei sau de carie secundară nu s-au depistat. Patient C., 7 years old, institutionalized with profound mental retardation, PCI in the boarding house for children with mental deficiencies in the city of Orhei. Diagnosis: medium-depth dental caries in teeth 5.5 and 8.5, hypersensitivity of the teeth to thermal and chemical stimuli. Treatment of dental caries was performed according to the described method. The tooth was filled with Fuji IX material. The child tolerated the treatment session well, without showing signs of discomfort during it. After 1 year after the treatment, no signs of inflammation, irritation of the pulp or secondary caries were detected.

Exemplul 2 Example 2

Pacienta A., 6 ani, instituţionalizată cu retardare mintală severă, PCI în casa-internat pentru copii cu deficienţe mintale din or. Hânceşti. Diagnosticul: carie dentară de profunzime medie la dinţii 7.4, 7.5, 8.4 şi 8.5. Tratamentul cariei dentare a fost efectuat după metoda descrisă. Dintele a fost obturat cu materialul Fuji IX. Copilul a suportat bine şedinţa de tratament. După 8 luni de la efectuarea tratamentului, semne de inflamare, iritare a pulpei sau de carie secundară nu s-au depistat. Patient A., 6 years old, institutionalized with severe mental retardation, PCI in the boarding house for children with mental deficiencies in the city of Hânceşti. Diagnosis: medium-depth dental caries in teeth 7.4, 7.5, 8.4 and 8.5. The treatment of dental caries was performed according to the described method. The tooth was filled with Fuji IX material. The child tolerated the treatment session well. After 8 months of treatment, no signs of inflammation, pulp irritation or secondary caries were detected.

Metoda propusă a fost aplicată pentru tratamentul cariei dentare la 74 copii cu dizabilităţi psiho-somatice în cadrul Catedrei Chirurgie O.M.F. Pediatrică, Pedodonţie şi Ortodonţie a USMF „Nicolae Testemiţanu” şi a instituţiilor rezidenţiale pentru copii cu dizabilităţi: casa-internat pentru copii cu deficienţe mintale din or. Hânceşti şi casa-internat pentru copii cu deficienţe mintale din or. Orhei. The proposed method was applied for the treatment of dental caries in 74 children with psychosomatic disabilities within the Department of Pediatric OMF Surgery, Pedodontics and Orthodontics of the "Nicolae Testemiţanu" State Medical University and residential institutions for children with disabilities: the boarding house for children with mental disabilities in the city of Hânceşti and the boarding house for children with mental disabilities in the city of Orhei.

S-au obţinut rezultate pozitive: obturaţiile sunt prezente, fără semne de carie secundară sau de inflamare şi iritare a pulpei dentare. În perioada de observaţie, de la 1 până la 2 ani, nu s-au înregistrat complicaţii şi efecte adverse. Positive results were obtained: the fillings are present, without signs of secondary caries or inflammation and irritation of the dental pulp. During the observation period, from 1 to 2 years, no complications and adverse effects were recorded.

1. RU 2286816 C1 2006.11.10 1. RU 2286816 C1 2006.11.10

Claims (1)

Metodă de tratament al cariei dentare la copiii cu dizabilităţi intelectuale, care constă în aceea că pe suprafeţele dentare cariate se aplică un amestec ce conţine hipoclorură de sodiu de 3%, gel BioR de 0,1% şi fuxină bazică de 0,5% în raport de 1:1:0,2, timp de 15…20 s, după care se înlătură ţesuturile dentare alterate, cavitatea carioasă se prelucrează antiseptic, se usucă şi se iradiază cu radiaţie laser cu lungimea de undă de 0,85…0,98 µm, frecvenţa de 2000…3000 Hz, puterea impulsului de 5 W, timp de 20…30 s, apoi pe suprafaţa iradiată se aplică 1…2 picături de suspensie ce conţine hidroxid de calciu microdispersat în apă distilată, după care se efectuează a doua şedinţă de iradiere în acelaşi regim, se aplică 1…2 picături de preparat pentru fluorizarea profundă a smalţului şi dentinei, care include o soluţie ce conţine ioni de fluor (F-) şi de cupru (Cu2+), şi se efectuează a treia şedinţă de iradiere în acelaşi regim.Method of treating dental caries in children with intellectual disabilities, which consists in applying a mixture containing 3% sodium hypochlorite, 0.1% BioR gel and 0.5% basic fuchsin in a ratio of 1:1:0.2 to the carious tooth surfaces for 15…20 s, after which the altered dental tissues are removed, the carious cavity is treated with an antiseptic, dried and irradiated with laser radiation with a wavelength of 0.85…0.98 µm, a frequency of 2000…3000 Hz, a pulse power of 5 W, for 20…30 s, then 1…2 drops of a suspension containing microdispersed calcium hydroxide in distilled water are applied to the irradiated surface, after which a second irradiation session is performed in the same regimen, 1…2 drops of a preparation for fluoridation are applied deep treatment of enamel and dentin, which includes a solution containing fluoride (F-) and copper (Cu2+) ions, and a third irradiation session is performed in the same regimen.
MDS20120119A 2012-08-16 2012-08-16 Method for treating the dental caries in children with intellectual disabilities MD597Z (en)

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Cited By (5)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
MD734Z (en) * 2013-07-12 2014-09-30 Государственный Медицинский И Фармацевтический Университет "Nicolae Testemitanu" Республики Молдова Method for treating chronic marginal periodontitis
MD735Z (en) * 2013-07-12 2014-09-30 Государственный Медицинский И Фармацевтический Университет "Nicolae Testemitanu" Республики Молдова Method for the treatment of dental caries
MD745Z (en) * 2013-07-12 2014-10-31 Государственный Медицинский И Фармацевтический Университет "Nicolae Testemitanu" Республики Молдова Method for prophylaxis of dental caries
MD746Z (en) * 2013-07-12 2014-10-31 Государственный Медицинский И Фармацевтический Университет "Nicolae Testemitanu" Республики Молдова Method for disinfection of the root canal
MD996Z (en) * 2015-04-01 2016-08-31 ОП ГОСУДАРСТВЕННЫЙ МЕДИЦИНСКИЙ И ФАРМАЦЕВТИЧЕСКИЙ УНИВЕРСИТЕТ им. НИКОЛАЯ ТЕСТЕМИЦАНУ РЕСПУБЛИКИ МОЛДОВА Method for preventing dental caries in children with intellectual disabilities

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