MD996Z - Method for preventing dental caries in children with intellectual disabilities - Google Patents
Method for preventing dental caries in children with intellectual disabilities Download PDFInfo
- Publication number
- MD996Z MD996Z MDS20150045A MDS20150045A MD996Z MD 996 Z MD996 Z MD 996Z MD S20150045 A MDS20150045 A MD S20150045A MD S20150045 A MDS20150045 A MD S20150045A MD 996 Z MD996 Z MD 996Z
- Authority
- MD
- Moldova
- Prior art keywords
- enamel
- children
- cfu
- tooth
- teeth
- Prior art date
Links
- 208000002925 dental caries Diseases 0.000 title claims abstract description 43
- 238000000034 method Methods 0.000 title claims abstract description 26
- 201000006347 Intellectual Disability Diseases 0.000 title claims abstract description 6
- 210000003298 dental enamel Anatomy 0.000 claims abstract description 45
- 210000000214 mouth Anatomy 0.000 claims abstract description 20
- 241000218588 Lactobacillus rhamnosus Species 0.000 claims abstract description 14
- 239000000725 suspension Substances 0.000 claims abstract description 13
- 241000186016 Bifidobacterium bifidum Species 0.000 claims abstract description 11
- 229940002008 bifidobacterium bifidum Drugs 0.000 claims abstract description 11
- 239000006041 probiotic Substances 0.000 claims abstract description 11
- 235000018291 probiotics Nutrition 0.000 claims abstract description 11
- 229930002877 anthocyanin Natural products 0.000 claims abstract description 10
- 235000010208 anthocyanin Nutrition 0.000 claims abstract description 10
- 239000004410 anthocyanin Substances 0.000 claims abstract description 10
- 150000004636 anthocyanins Chemical class 0.000 claims abstract description 10
- 239000003504 photosensitizing agent Substances 0.000 claims abstract description 8
- 238000004334 fluoridation Methods 0.000 claims abstract description 7
- JPVYNHNXODAKFH-UHFFFAOYSA-N Cu2+ Chemical compound [Cu+2] JPVYNHNXODAKFH-UHFFFAOYSA-N 0.000 claims abstract description 6
- KRHYYFGTRYWZRS-UHFFFAOYSA-M Fluoride anion Chemical compound [F-] KRHYYFGTRYWZRS-UHFFFAOYSA-M 0.000 claims abstract description 6
- AXCZMVOFGPJBDE-UHFFFAOYSA-L calcium dihydroxide Chemical compound [OH-].[OH-].[Ca+2] AXCZMVOFGPJBDE-UHFFFAOYSA-L 0.000 claims abstract description 6
- 239000000920 calcium hydroxide Substances 0.000 claims abstract description 6
- 229910001861 calcium hydroxide Inorganic materials 0.000 claims abstract description 6
- 239000002775 capsule Substances 0.000 claims abstract description 5
- 239000012153 distilled water Substances 0.000 claims abstract description 5
- XLYOFNOQVPJJNP-UHFFFAOYSA-N water Chemical compound O XLYOFNOQVPJJNP-UHFFFAOYSA-N 0.000 claims abstract description 5
- RYGMFSIKBFXOCR-UHFFFAOYSA-N Copper Chemical compound [Cu] RYGMFSIKBFXOCR-UHFFFAOYSA-N 0.000 claims abstract description 4
- 239000010949 copper Substances 0.000 claims abstract description 4
- 229910052802 copper Inorganic materials 0.000 claims abstract description 4
- 210000004268 dentin Anatomy 0.000 claims abstract description 4
- 150000002500 ions Chemical class 0.000 claims abstract description 4
- 230000001678 irradiating effect Effects 0.000 claims description 6
- 230000000529 probiotic effect Effects 0.000 claims description 6
- 238000011321 prophylaxis Methods 0.000 claims description 3
- 239000003814 drug Substances 0.000 abstract description 2
- 230000003449 preventive effect Effects 0.000 description 20
- 241000194019 Streptococcus mutans Species 0.000 description 19
- 230000000694 effects Effects 0.000 description 15
- 244000005700 microbiome Species 0.000 description 15
- 230000009471 action Effects 0.000 description 12
- 238000012360 testing method Methods 0.000 description 10
- 230000001013 cariogenic effect Effects 0.000 description 9
- 230000000813 microbial effect Effects 0.000 description 9
- 239000002253 acid Substances 0.000 description 8
- 230000009467 reduction Effects 0.000 description 8
- 241000894006 Bacteria Species 0.000 description 7
- 230000002053 acidogenic effect Effects 0.000 description 7
- 230000001580 bacterial effect Effects 0.000 description 7
- 239000000126 substance Substances 0.000 description 7
- 206010020751 Hypersensitivity Diseases 0.000 description 5
- 241000194017 Streptococcus Species 0.000 description 5
- 241000194023 Streptococcus sanguinis Species 0.000 description 5
- 241000193987 Streptococcus sobrinus Species 0.000 description 5
- 230000000844 anti-bacterial effect Effects 0.000 description 5
- 230000006378 damage Effects 0.000 description 5
- 238000005115 demineralization Methods 0.000 description 5
- 230000002328 demineralizing effect Effects 0.000 description 5
- 230000001603 reducing effect Effects 0.000 description 5
- 210000001519 tissue Anatomy 0.000 description 5
- 208000027244 Dysbiosis Diseases 0.000 description 4
- 241000194024 Streptococcus salivarius Species 0.000 description 4
- 208000026935 allergic disease Diseases 0.000 description 4
- 230000000721 bacterilogical effect Effects 0.000 description 4
- 238000003745 diagnosis Methods 0.000 description 4
- 230000007140 dysbiosis Effects 0.000 description 4
- 230000009610 hypersensitivity Effects 0.000 description 4
- 244000000010 microbial pathogen Species 0.000 description 4
- 238000002428 photodynamic therapy Methods 0.000 description 4
- 238000002360 preparation method Methods 0.000 description 4
- 238000011160 research Methods 0.000 description 4
- 229940031003 streptococcus viridans group Drugs 0.000 description 4
- 230000002378 acidificating effect Effects 0.000 description 3
- 150000007513 acids Chemical class 0.000 description 3
- 230000015572 biosynthetic process Effects 0.000 description 3
- WUKWITHWXAAZEY-UHFFFAOYSA-L calcium difluoride Chemical compound [F-].[F-].[Ca+2] WUKWITHWXAAZEY-UHFFFAOYSA-L 0.000 description 3
- 229910001634 calcium fluoride Inorganic materials 0.000 description 3
- 230000002519 immonomodulatory effect Effects 0.000 description 3
- 229910001635 magnesium fluoride Inorganic materials 0.000 description 3
- 231100000915 pathological change Toxicity 0.000 description 3
- 230000036285 pathological change Effects 0.000 description 3
- 230000002165 photosensitisation Effects 0.000 description 3
- 230000002829 reductive effect Effects 0.000 description 3
- 108010062877 Bacteriocins Proteins 0.000 description 2
- FYYHWMGAXLPEAU-UHFFFAOYSA-N Magnesium Chemical compound [Mg] FYYHWMGAXLPEAU-UHFFFAOYSA-N 0.000 description 2
- 241001134658 Streptococcus mitis Species 0.000 description 2
- 239000003613 bile acid Substances 0.000 description 2
- 230000008859 change Effects 0.000 description 2
- 239000003795 chemical substances by application Substances 0.000 description 2
- 238000011109 contamination Methods 0.000 description 2
- 229910001431 copper ion Inorganic materials 0.000 description 2
- 239000013078 crystal Substances 0.000 description 2
- -1 fluoride ions Chemical class 0.000 description 2
- 210000001035 gastrointestinal tract Anatomy 0.000 description 2
- 229930195733 hydrocarbon Natural products 0.000 description 2
- 150000002430 hydrocarbons Chemical class 0.000 description 2
- 230000002262 irrigation Effects 0.000 description 2
- 238000003973 irrigation Methods 0.000 description 2
- JVTAAEKCZFNVCJ-UHFFFAOYSA-N lactic acid Chemical compound CC(O)C(O)=O JVTAAEKCZFNVCJ-UHFFFAOYSA-N 0.000 description 2
- 230000005923 long-lasting effect Effects 0.000 description 2
- 239000011777 magnesium Substances 0.000 description 2
- 229910001425 magnesium ion Inorganic materials 0.000 description 2
- 238000004519 manufacturing process Methods 0.000 description 2
- 238000012543 microbiological analysis Methods 0.000 description 2
- 230000005693 optoelectronics Effects 0.000 description 2
- 239000011241 protective layer Substances 0.000 description 2
- 238000011012 sanitization Methods 0.000 description 2
- 238000003786 synthesis reaction Methods 0.000 description 2
- 241000186000 Bifidobacterium Species 0.000 description 1
- 241000589875 Campylobacter jejuni Species 0.000 description 1
- 241000588724 Escherichia coli Species 0.000 description 1
- PXGOKWXKJXAPGV-UHFFFAOYSA-N Fluorine Chemical compound FF PXGOKWXKJXAPGV-UHFFFAOYSA-N 0.000 description 1
- 241000606768 Haemophilus influenzae Species 0.000 description 1
- 108060003951 Immunoglobulin Proteins 0.000 description 1
- 102000011782 Keratins Human genes 0.000 description 1
- 108010076876 Keratins Proteins 0.000 description 1
- 206010025421 Macule Diseases 0.000 description 1
- 208000036831 Moderate mental retardation Diseases 0.000 description 1
- 208000032991 Profound mental retardation Diseases 0.000 description 1
- 241000607142 Salmonella Species 0.000 description 1
- 241000607768 Shigella Species 0.000 description 1
- 230000035508 accumulation Effects 0.000 description 1
- 238000009825 accumulation Methods 0.000 description 1
- 230000002411 adverse Effects 0.000 description 1
- 230000003042 antagnostic effect Effects 0.000 description 1
- 239000005557 antagonist Substances 0.000 description 1
- 230000000845 anti-microbial effect Effects 0.000 description 1
- 229910052586 apatite Inorganic materials 0.000 description 1
- 230000003115 biocidal effect Effects 0.000 description 1
- 230000033558 biomineral tissue development Effects 0.000 description 1
- 230000001680 brushing effect Effects 0.000 description 1
- 150000001720 carbohydrates Chemical class 0.000 description 1
- 235000014633 carbohydrates Nutrition 0.000 description 1
- 210000002421 cell wall Anatomy 0.000 description 1
- 230000007969 cellular immunity Effects 0.000 description 1
- 238000003776 cleavage reaction Methods 0.000 description 1
- 230000002860 competitive effect Effects 0.000 description 1
- 230000001472 cytotoxic effect Effects 0.000 description 1
- 230000003247 decreasing effect Effects 0.000 description 1
- 230000008021 deposition Effects 0.000 description 1
- 238000011161 development Methods 0.000 description 1
- 230000018109 developmental process Effects 0.000 description 1
- 230000008030 elimination Effects 0.000 description 1
- 238000003379 elimination reaction Methods 0.000 description 1
- 230000016674 enamel mineralization Effects 0.000 description 1
- 210000001842 enterocyte Anatomy 0.000 description 1
- 230000007515 enzymatic degradation Effects 0.000 description 1
- 230000002255 enzymatic effect Effects 0.000 description 1
- 210000002919 epithelial cell Anatomy 0.000 description 1
- 230000002349 favourable effect Effects 0.000 description 1
- 239000000835 fiber Substances 0.000 description 1
- 229910052731 fluorine Inorganic materials 0.000 description 1
- 239000011737 fluorine Substances 0.000 description 1
- 210000004051 gastric juice Anatomy 0.000 description 1
- 244000005709 gut microbiome Species 0.000 description 1
- 230000009931 harmful effect Effects 0.000 description 1
- 230000036039 immunity Effects 0.000 description 1
- 102000018358 immunoglobulin Human genes 0.000 description 1
- 229940072221 immunoglobulins Drugs 0.000 description 1
- 230000003308 immunostimulating effect Effects 0.000 description 1
- 238000010348 incorporation Methods 0.000 description 1
- 230000002401 inhibitory effect Effects 0.000 description 1
- 230000000968 intestinal effect Effects 0.000 description 1
- 238000011835 investigation Methods 0.000 description 1
- 230000007794 irritation Effects 0.000 description 1
- 239000004310 lactic acid Substances 0.000 description 1
- 235000014655 lactic acid Nutrition 0.000 description 1
- 150000002632 lipids Chemical class 0.000 description 1
- 230000007774 longterm Effects 0.000 description 1
- 230000007246 mechanism Effects 0.000 description 1
- 230000004060 metabolic process Effects 0.000 description 1
- 239000000203 mixture Substances 0.000 description 1
- 230000001095 motoneuron effect Effects 0.000 description 1
- 210000002200 mouth mucosa Anatomy 0.000 description 1
- 230000003505 mutagenic effect Effects 0.000 description 1
- 238000010606 normalization Methods 0.000 description 1
- 150000007524 organic acids Chemical class 0.000 description 1
- 235000005985 organic acids Nutrition 0.000 description 1
- 230000001717 pathogenic effect Effects 0.000 description 1
- 230000000149 penetrating effect Effects 0.000 description 1
- 230000035515 penetration Effects 0.000 description 1
- VSIIXMUUUJUKCM-UHFFFAOYSA-D pentacalcium;fluoride;triphosphate Chemical compound [F-].[Ca+2].[Ca+2].[Ca+2].[Ca+2].[Ca+2].[O-]P([O-])([O-])=O.[O-]P([O-])([O-])=O.[O-]P([O-])([O-])=O VSIIXMUUUJUKCM-UHFFFAOYSA-D 0.000 description 1
- 238000003359 percent control normalization Methods 0.000 description 1
- 230000035699 permeability Effects 0.000 description 1
- 230000002085 persistent effect Effects 0.000 description 1
- 230000002186 photoactivation Effects 0.000 description 1
- 230000007406 plaque accumulation Effects 0.000 description 1
- 230000002265 prevention Effects 0.000 description 1
- 230000008569 process Effects 0.000 description 1
- 230000000069 prophylactic effect Effects 0.000 description 1
- 108090000623 proteins and genes Proteins 0.000 description 1
- 102000004169 proteins and genes Human genes 0.000 description 1
- 230000017854 proteolysis Effects 0.000 description 1
- 230000007017 scission Effects 0.000 description 1
- 230000035945 sensitivity Effects 0.000 description 1
- 230000001148 spastic effect Effects 0.000 description 1
- 210000002784 stomach Anatomy 0.000 description 1
- 238000006467 substitution reaction Methods 0.000 description 1
- 230000001629 suppression Effects 0.000 description 1
- 238000001356 surgical procedure Methods 0.000 description 1
- 230000009885 systemic effect Effects 0.000 description 1
- 235000019168 vitamin K Nutrition 0.000 description 1
- 239000011712 vitamin K Substances 0.000 description 1
Landscapes
- Medicines Containing Antibodies Or Antigens For Use As Internal Diagnostic Agents (AREA)
- Pharmaceuticals Containing Other Organic And Inorganic Compounds (AREA)
Abstract
Description
Invenţia se referă la medicină, în special la stomatologie şi poate fi aplicată pentru profilaxia cariei dentare la copii cu dizabilităţi intelectuale. The invention relates to medicine, in particular to dentistry, and can be applied for the prophylaxis of dental caries in children with intellectual disabilities.
Este cunoscută metoda de profilaxie a cariei dentare care constă în igienizarea cavităţii orale şi aplicarea în calitate de fotosensibilizator a extractului antocianic 5,0%, iradierea suprafeţelor dinţilor se efectuează cu lumină LED cu lungimea de undă de 625…635 nm, puterea de 2,0…3,0 W şi expoziţia de 10…30 s, după irigarea cavităţii orale pe suprafaţa dinţilor se aplică 1…3 picături de soluţie Nr.1 Gluftored care conţine ioni de fluor, magneziu şi cupru, apoi se iradiază smalţul dinţilor cu lumină LED timp de 10…30 s, după care se aplică 1…3 picături de suspenzie Nr.2 Gluftored, care conţine suspensie microdispersă de hidroxid de calciu, şi se iradiază smalţul dinţilor cu lumină LED în acelaşi regim. Se efectuează 3…4 şedinţe preventive pe an [1]. The method of dental caries prophylaxis is known, which consists of oral cavity hygiene and application of 5.0% anthocyanin extract as a photosensitizer, irradiation of tooth surfaces is performed with LED light with a wavelength of 625…635 nm, power of 2.0…3.0 W and exposure of 10…30 s, after irrigation of the oral cavity, 1…3 drops of Gluftored solution No. 1 containing fluoride, magnesium and copper ions are applied to the tooth surface, then the tooth enamel is irradiated with LED light for 10…30 s, after which 1…3 drops of Gluftored suspension No. 2 are applied, which contains microdispersed calcium hydroxide suspension, and the tooth enamel is irradiated with LED light in the same regimen. 3…4 preventive sessions are performed per year [1].
Însă, această metodă, testată în condiţii clinice, nu este eficientă în prevenirea cariei dentare la copiii cu dizabilităţi, deoarece după distrugerea totală a microorganismelor acidogene - Streptococcus mutans, Streptococcus mitis, Streptococcus gordoni, Streptococcus sobrinus ş.a., în cavitatea orală se creează condiţii favorabile pentru restabilirea componenţei biofilmului cu capacitate cariogenă sporită în decurs de 7…10 zile, acesta din urmă constituind unul din factorii principali în apariţia cariei dentare. However, this method, tested in clinical conditions, is not effective in preventing dental caries in children with disabilities, because after the total destruction of acidogenic microorganisms - Streptococcus mutans, Streptococcus mitis, Streptococcus gordoni, Streptococcus sobrinus, etc., favorable conditions are created in the oral cavity for restoring the composition of the biofilm with increased cariogenic capacity within 7...10 days, the latter being one of the main factors in the occurrence of dental caries.
Este de asemenea cunoscută metoda de prevenire a cariei dentare la copii de vârstă fragedă care constă în administrarea probioticelor Lactobacillus rhamnosus şi Bifidobacterium bifidum [2]. The method of preventing dental caries in young children is also known, which consists of administering the probiotics Lactobacillus rhamnosus and Bifidobacterium bifidum [2].
Însă, această metodă este eficientă doar la copiii de 1…3 ani, până sau în perioada de instituire a unei comunităţi microbiene constante în cavitatea orală. Aplicarea metodei menţionate la copii mai mari de 2…3 ani şi la persoane adulte fără distrugerea totală preliminară a biofilmului dentar nu este eficientă în prevenirea cariei dentare. However, this method is effective only in children aged 1…3 years, until or during the period of establishing a constant microbial community in the oral cavity. Applying the mentioned method to children older than 2…3 years and to adults without preliminary total destruction of the dental biofilm is not effective in preventing dental caries.
Problema pe care o rezolvă prezenta invenţie este elaborarea unei metode noi, eficiente de prevenire a cariei dentare la copii cu dizabilităţi şi risc carios extrem cauzat de activitatea sporită a tulpinilor bacteriene acidogene din biofilmul oral, majorarea efectului bactericid asupra tulpinilor bacteriene cu instalarea unui echilibru fiziologic constant între microorganismele prezente în biofilmul cavităţii orale şi majorarea rezistenţei smalţului dentar la atacul carios. The problem solved by the present invention is the development of a new, effective method for preventing dental caries in children with disabilities and extreme caries risk caused by the increased activity of acidogenic bacterial strains in the oral biofilm, increasing the bactericidal effect on bacterial strains by establishing a constant physiological balance between microorganisms present in the oral cavity biofilm and increasing the resistance of tooth enamel to carious attack.
Esenţa invenţiei constă în aceea că se efectuează igienizarea cavităţii orale, se aplică extractul antocianic de 5,0%, în calitate de fotosensibilizator, pe o perioadă de 10…20 min, ulterior se iradiază suprafaţa dinţilor cu lumină LED cu lungimea de undă de 625…635 nm, puterea de 2,0…3,0 W şi expoziţia de 10…30 s, se irigă cavitatea bucală cu apă distilată, apoi pe suprafaţa dinţilor se aplică 1…3 picături de soluţie pentru fluorizarea profundă a smalţului şi dentinei, care include ioni de fluor (F-) şi de cupru (Cu2+), ulterior se iradiază smalţul dinţilor în acelaşi regim, se aplică 1…3 picături de suspensie ce conţine hidroxid de calciu microdispersat, se iradiază repetat smalţul dinţilor în regimul menţionat, apoi suprafeţele dentare se badijonează cu o suspensie de probiotice ce conţine Lactobacillus rhamnosus şi Bifidobacterium bifidum şi se administrează, per os, o capsulă care conţine Lactobacillus rhamnosus, Bifidobacterium bifidum - 4,9 x 109 UFC, o dată pe zi, în decurs de 20 zile. The essence of the invention consists in performing oral cavity hygiene, applying 5.0% anthocyanin extract as a photosensitizer for a period of 10…20 min, subsequently irradiating the tooth surface with LED light with a wavelength of 625…635 nm, power of 2.0…3.0 W and exposure of 10…30 s, irrigating the oral cavity with distilled water, then applying 1…3 drops of solution for deep fluoridation of enamel and dentin, which includes fluoride (F-) and copper (Cu2+) ions, subsequently irradiating the tooth enamel in the same regimen, applying 1…3 drops of suspension containing microdispersed calcium hydroxide, irradiating the tooth enamel repeatedly in the aforementioned regimen, then the tooth surfaces are smeared with a probiotic suspension containing Lactobacillus rhamnosus and Bifidobacterium bifidum and a capsule containing Lactobacillus rhamnosus, Bifidobacterium bifidum - 4.9 x 109 CFU is administered orally, once a day, for 20 days.
Metoda dată este elaborată pentru prevenirea cariei dentare la persoanele cu risc carios majorat cauzat de activitatea sporită a tulpinilor bacteriene cariogene din biofilmul oral, stări de disbioză şi în cazul incapacităţii pacientului să efectueze igienizarea cavităţii orale (persoanele cu dizabilităţi intelectuale, neuro-motorii ş.a.). Metoda propusă de terapie fotodinamică cu aplicarea în calitate de substanţă fotosensibilizantă a extractului antocianic 5,0% asigură distrugerea totală a microorganismelor cariogene - Streptococcus mutans, Streptococcus mitis, Streptococcus gordoni, Streptococcus sobrinus ş.a. Extractul antocianic nu provoacă iritarea mucoasei cavităţii orale, reacţii alergice de tip lent sau imediat. Eficienţa metodei nu este influenţată de sensibilitatea microorganismelor patogene la preparatele antibacteriene, sunt distruse tulpinile microbiene antibiorezistente şi a celor persistente în biofilmele bacteriene. Eliminarea bacteriilor are loc foarte rapid, în câteva minute sau chiar secunde. Terapia fotodinamică are un spectru larg de acţiune asupra tuturor agenţilor patogeni microbieni, efectul antibacterian nu se reduce în timp în cazul aplicării şedinţelor repetate. Substanţa de fotosensibilizare (extractul antocianic 5,0 %) nu exercită acţiune citotoxică fără fotoactivare, nu exercită acţiune mutagenă, fapt care exclude probabilitatea selectării tulpinilor microbiene rezistente. Acţiunea bactericidă are un caracter local, nu exercită efect nociv asupra florei saprofite a întregului organism. This method is developed for the prevention of dental caries in people with increased caries risk caused by increased activity of cariogenic bacterial strains in the oral biofilm, dysbiosis states and in case of the patient's inability to perform oral cavity hygiene (people with intellectual, neuro-motor disabilities, etc.). The proposed method of photodynamic therapy with the application of 5.0% anthocyanin extract as a photosensitizing substance ensures the complete destruction of cariogenic microorganisms - Streptococcus mutans, Streptococcus mitis, Streptococcus gordoni, Streptococcus sobrinus, etc. Anthocyanin extract does not cause irritation of the oral mucosa, allergic reactions of slow or immediate type. The effectiveness of the method is not influenced by the sensitivity of pathogenic microorganisms to antibacterial preparations, antibiotic-resistant microbial strains and those persistent in bacterial biofilms are destroyed. The elimination of bacteria occurs very quickly, within a few minutes or even seconds. Photodynamic therapy has a broad spectrum of action on all microbial pathogens, the antibacterial effect does not decrease over time in the case of repeated sessions. The photosensitizing substance (anthocyanin extract 5.0%) does not exert cytotoxic action without photoactivation, does not exert mutagenic action, which excludes the likelihood of selection of resistant microbial strains. The bactericidal action is local in nature, does not exert a harmful effect on the saprophytic flora of the whole organism.
Aplicarea succesivă a iradierii cu LED (lungimea de undă 625…635 nm) şi a preparatelor pentru fluorizarea profundă a smalţului Gluftored potenţează efectul cariopreventiv al acestor manopere, aplicate separat, graţie acestui fapt se creează condiţii optime pentru penetrarea profundă a ionilor de fluor şi încorporarea lor în reţeaua cristalină a smalţului dentar, fapt care asigură majorarea rezistenţei ţesuturilor dentare dure la acţiunea factorilor acidogeni şi asigură un efect cariopreventiv. Efectul cariopreventiv este asigurat de cristalele de CaF2 şi MgF2 depuse la suprafaţa smalţului, care timp îndelungat (mai mult de 1 an) eliberează ionii de fluor (F-) în concentraţie înaltă şi care asigură remineralizarea zonelor de smalţ demineralizat, penetrând chiar şi zonele greu accesibile, susceptibile la carie. Astfel se formează apatita, îmbogăţită cu fluor, care duce la restabilirea deplină a zonei carioase. Fluorizarea profundă contribuie la remineralizarea pe o durată îndelungată de timp şi protecţia fibrelor de cheratină de proteoliză, care se manifestă prin reducerea considerabilă a solubilităţii şi permeabilităţii smalţului, majorarea microdurităţii smalţului, în plus provoacă reducerea numărului de microorganisme acidogene micşorând viteza de acumulare a plăcii bacteriene, astfel asigurând un efect carioprotector considerabil. The successive application of LED irradiation (wavelength 625…635 nm) and preparations for deep enamel fluoridation Gluftored potentiates the cariopreventive effect of these procedures, applied separately, thanks to this, optimal conditions are created for deep penetration of fluoride ions and their incorporation into the crystalline network of dental enamel, which ensures increased resistance of hard dental tissues to the action of acidogenic factors and provides a cariopreventive effect. The cariopreventive effect is ensured by CaF2 and MgF2 crystals deposited on the enamel surface, which for a long time (more than 1 year) release fluoride ions (F-) in high concentration and which ensure remineralization of demineralized enamel areas, penetrating even hard-to-reach areas susceptible to caries. Thus, apatite is formed, enriched with fluorine, which leads to the full restoration of the carious area. Deep fluoridation contributes to long-term remineralization and protection of keratin fibers from proteolysis, which is manifested by a considerable reduction in the solubility and permeability of enamel, an increase in the microhardness of enamel, and in addition, it causes a reduction in the number of acidogenic microorganisms, slowing down the rate of bacterial plaque accumulation, thus ensuring a considerable carioprotective effect.
Aplicarea succesivă a extractului antocianic 5,0%, a iradierii cu LED şi a preparatelor pentru fluorizarea profundă a smalţului potenţează efectul cariopreventiv al acestor manopere aplicate separat, asigurând astfel eficacitatea înaltă a metodei propuse şi obţinerea efectului carioprotector într-o perioadă scurtă de timp, dar cu efect îndelungat, permite reducerea numărului de şedinţe preventive, economisirea timpului practicianului şi a cheltuielilor financiare. The successive application of 5.0% anthocyanin extract, LED irradiation and preparations for deep enamel fluoridation potentiates the cariopreventive effect of these separately applied procedures, thus ensuring the high effectiveness of the proposed method and obtaining the carioprotective effect in a short period of time, but with a long-lasting effect, allowing for a reduction in the number of preventive sessions, saving the practitioner's time and financial expenses.
Culturile de bacterii probiotice aplicate în cavitatea orală au capacitatea de a adera la suprafaţa dinţilor şi a se integra în comunitatea microbiană, acestea concurează, sunt antagonişti, prevenind creşterea şi înmulţirea microorganismelor cariogene. Culturile de Lactobacillus rhamnosus se menţin în cavitatea orală în decurs de 3 săptămâni după aplicarea lor. Efectul Lactobacillus rhamnosus asupra biofilmului oral se datorează proprietăţilor acestor tulpini de a produce substanţe bacteriocine cu efect de inhibare a creşterii tulpinilor de Streptococcus mutans, care exercită cel mai sporit efect cariogen din cauza producerii celei mai importante cantităţi de acizi organici, în special acid lactic, având cel mai înalt grad de ionizare şi care provoacă demineralizarea rapidă a smalţului dentar. În plus, Lactobacillus rhamnosus şi Bifidobacterium bifidum nu degradează enzimatic hidrocarbonaţii, fapt care reprezintă un mecanism eficient de prevenire a cariei dentare. Probiotic bacterial cultures applied in the oral cavity have the ability to adhere to the surface of the teeth and integrate into the microbial community, they compete, are antagonists, preventing the growth and multiplication of cariogenic microorganisms. Lactobacillus rhamnosus cultures are maintained in the oral cavity within 3 weeks after their application. The effect of Lactobacillus rhamnosus on the oral biofilm is due to the properties of these strains to produce bacteriocin substances with an inhibitory effect on the growth of Streptococcus mutans strains, which exert the greatest cariogenic effect due to the production of the most important amount of organic acids, especially lactic acid, having the highest degree of ionization and causing rapid demineralization of tooth enamel. In addition, Lactobacillus rhamnosus and Bifidobacterium bifidum do not enzymatically degrade hydrocarbons, which is an effective mechanism for preventing dental caries.
Administrarea per os a probioticelor la persoanele cu disbioză contribuie la normalizarea microflorei intestinale, modularea imunităţii locale şi sistemice. În tractul digestiv, datorită producerii bacteriocinelor, multiple tulpini de lactobacterii manifestă activitate antagonistă semnificativă faţă de microorganismele patogene şi condiţionat-patogene, asigurând rezistenţa tractului gastrointestinal. Probioticele manifestă acţiune antimicrobiană faţă de aşa microorganisme patogene ca: E. coli, H. influenzae, C. jejuni, S. aureus, H. pylori şi din genul Salmonella, Shigella, Streptococcus pe contul suprimării creşterii lor şi adeziunii la enterocite. Lactobacteriile participă în procesul de scindare enzimatică a proteinelor, lipidelor şi glucidelor complexe, metabolismul acizilor biliari, de asemenea în sinteza vitaminelor K şi grupei B. Lactobacteriile sunt capabile de a activa imunitatea celulară şi sinteza imunoglobulinelor. Proprietăţile imunostimulatoare ale lactobacteriilor sunt determinate de prezenţa în peretele lor celular a peptidoglicanilor şi acizilor teichoici, care posedă acţiune imunomodulatoare. Avantajele acestor tulpini de lactobacterii constau în aceea că ele posedă rezistenţă înaltă faţă de acţiunea sucului gastric şi acizilor biliari, astfel după 30 min de aflare în mediul acid al stomacului supravieţuiesc circa 80% din ambele microorganisme. Bacteriile probiotice au capacitatea de aderare la receptorii peretelui intestinal şi se menţin vii timp de 15…17 zile. Oral administration of probiotics to people with dysbiosis contributes to the normalization of intestinal microflora, modulation of local and systemic immunity. In the digestive tract, due to the production of bacteriocins, multiple strains of lactobacteria exhibit significant antagonistic activity against pathogenic and conditionally pathogenic microorganisms, ensuring the resistance of the gastrointestinal tract. Probiotics exhibit antimicrobial action against such pathogenic microorganisms as: E. coli, H. influenzae, C. jejuni, S. aureus, H. pylori and from the genus Salmonella, Shigella, Streptococcus due to the suppression of their growth and adhesion to enterocytes. Lactobacteria participate in the process of enzymatic cleavage of proteins, lipids and complex carbohydrates, the metabolism of bile acids, as well as in the synthesis of vitamins K and group B. Lactobacteria are able to activate cellular immunity and the synthesis of immunoglobulins. The immunostimulating properties of lactobacteria are determined by the presence of peptidoglycans and teichoic acids in their cell wall, which have immunomodulatory action. The advantages of these lactobacteria strains are that they have high resistance to the action of gastric juice and bile acids, so after 30 minutes in the acidic environment of the stomach, about 80% of both microorganisms survive. Probiotic bacteria have the ability to adhere to the receptors of the intestinal wall and remain alive for 15…17 days.
Doar combinarea terapiei fotodinamice, care asigură distrugerea totală şi eficientă a biofilmului oral, cu aplicarea locală şi administrarea per os a culturilor de probiotice asigură substituirea prin concurenţă a tulpinilor acidogene şi cu grad sporit de capacitate cariogenă cu tulpini saprofite, care nu provoacă degradarea enzimatică a hidrocarbonaţilor, contribuie la constituirea unei comunităţi microbiene fiziologice în cavitatea orală pe o perioadă îndelungată de timp, reduce sau previne stările de disbioză, exercită acţiune imunomodulatoare, asigurând astfel reducerea considerabilă a riscului carios şi majorând semnificativ efectul carioprotector. Only the combination of photodynamic therapy, which ensures the total and efficient destruction of the oral biofilm, with the local application and per os administration of probiotic cultures ensures the competitive substitution of acidogenic strains with a high degree of cariogenic capacity with saprophytic strains, which do not cause the enzymatic degradation of hydrocarbons, contributes to the establishment of a physiological microbial community in the oral cavity over a long period of time, reduces or prevents dysbiosis states, exerts an immunomodulatory action, thus ensuring a considerable reduction in the caries risk and significantly increasing the carioprotective effect.
Prin urmare, eficacitatea înaltă a metodei propuse şi obţinerea efectului carioprotector într-o perioadă scurtă de timp, dar cu efect îndelungat, permite reducerea numărului de şedinţe preventive, economisirea timpului practicianului şi a cheltuielilor financiare. Therefore, the high effectiveness of the proposed method and the achievement of the carioprotective effect in a short period of time, but with a long-lasting effect, allows reducing the number of preventive sessions, saving the practitioner's time and financial expenses.
Metoda revendicată este simplă şi rapidă în aplicare, nu provoacă efecte adverse şi disconfort pacienţilor. The claimed method is simple and quick to implement, does not cause adverse effects and discomfort to patients.
Rezultatul tehnic - majorarea eficacităţii prevenirii cariei dentare la copiii cu dizabilităţi intelectuale, majorarea efectului bactericid asupra tulpinilor acidogene fără a deteriora celulele epiteliale ale ţesuturilor cavităţii orale, substituirea prin concurenţă a tulpinilor acidogene şi cu grad sporit de capacitate cariogenă cu tulpini saprofite şi constituirea unei comunităţi microbiene fiziologice permanente, reducerea sau prevenirea stărilor de disbioză, exercitarea acţiunii imunomodulatoare şi reducerea considerabilă a riscului carios, majorarea capacităţii de formare a cristalelor şi mineralizarea smalţului, reducerea numărului şedinţelor preventive, economisirea timpului practicianului şi a cheltuielilor financiare. Technical result - increasing the effectiveness of preventing dental caries in children with intellectual disabilities, increasing the bactericidal effect on acidogenic strains without damaging the epithelial cells of the oral cavity tissues, competitively replacing acidogenic strains with high cariogenic capacity with saprophytic strains and establishing a permanent physiological microbial community, reducing or preventing dysbiosis states, exerting immunomodulatory action and considerably reducing the risk of caries, increasing the capacity for crystal formation and enamel mineralization, reducing the number of preventive sessions, saving the practitioner's time and financial expenses.
Metoda de prevenire a cariei dentare se realizează în modul următor: se efectuează igienizarea cavităţii orale, se aplică extractul antocianic de 5,0%, în calitate de fotosensibilizator, pe o perioadă de 10…20 min, ulterior se iradiază suprafaţa dinţilor cu lumină LED cu lungimea de undă de 625…635 nm, puterea de 2,0…3,0 W şi expoziţia de 10…30 s, se irigă cavitatea bucală cu apă distilată, apoi pe suprafaţa dinţilor se aplică 1…3 picături de soluţie pentru fluorizarea profundă a smalţului şi dentinei, care include ioni de fluor (F-) şi de cupru (Cu2+), ulterior se iradiază smalţul dinţilor în acelaşi regim, se aplică 1…3 picături de suspensie ce conţine hidroxid de calciu microdispersat, se iradiază repetat smalţul dinţilor în regimul menţionat, apoi suprafeţele dentare se badijonează cu o suspensie de probiotice ce conţine Lactobacillus rhamnosus şi Bifidobacterium bifidum şi se administrează, per os, o capsulă care conţine Lactobacillus rhamnosus, Bifidobacterium bifidum - 4,9 x 109 UFC, o dată pe zi, în decurs de 20 zile. The method of preventing dental caries is carried out in the following way: the oral cavity is sanitized, 5.0% anthocyanin extract is applied as a photosensitizer for a period of 10…20 min, then the tooth surface is irradiated with LED light with a wavelength of 625…635 nm, power of 2.0…3.0 W and exposure of 10…30 s, the oral cavity is irrigated with distilled water, then 1…3 drops of solution for deep fluoridation of enamel and dentin, which includes fluoride (F-) and copper (Cu2+) ions, are applied to the tooth surface, then the tooth enamel is irradiated in the same regimen, 1…3 drops of suspension containing microdispersed calcium hydroxide are applied, the tooth enamel is repeatedly irradiated in the aforementioned regimen, then the tooth surfaces are smeared with a probiotic suspension containing Lactobacillus rhamnosus and Bifidobacterium bifidum and a capsule containing Lactobacillus rhamnosus, Bifidobacterium bifidum - 4.9 x 109 CFU is administered orally, once a day, for 20 days.
Exemplul 1 Example 1
Pacientul A.I., 12 ani, instituţionalizat într-o instituţie rezidenţială pentru copii cu deficienţe mintale grave cu diagnosticul retardare mintală profundă, PCI, forma spastică. Copilul manifestă un comportament total necooperant (tipul Frankl 1), incontrolabil, capacitatea de comunicare fiind absentă. Diagnosticul: carie dentară de profunzime medie în dinţii 1.6, 2.6 şi 3.6. Rezistenţa smalţului la acţiunea acizilor foarte joasă (TRSA = 90%). A fost apreciat riscul carios extrem: testul CCPB - pozitiv; Streptococcus mutans - pozitiv; scorul PFRI = 5. Analiza bacteriologică a relevat valori ridicate ale numarului total de microorganisme în biofilmul oral - 107 UFC/ml. Identificarea bacteriilor din grupul Streptococcus viridans: Streptococcus mutans - 107 UFC/ml, Streptococcus gordoni - 107 UFC/ml, Streptococcus sobrinus şi Streptococcus sanguis - 106 UFC/ml. Au fost efectuate 2 şedinţe preventive după metoda descrisă. Copilul a suportat bine şedinţele preventive, fără a manifesta semne de discomfort în decursul lor. După 12 luni de la efectuarea şedinţelor preventive, semnele de demineralizare a smalţului şi hipersensibilitate a dinţilor nu s-au depistat, caria dentară de profunzime medie în dinţii 1.6, 2.6 şi 3.6 nu s-a extins în profunzime şi suprafaţă. Cavităţi cariate noi nu s-au format, ţesuturile dentare dure fără schimbări patologice. S-a constatat risc carios redus: testul CCPB - negativ; Streptococcus mutans - negativ; scorul PFRI = 2. Rezistenţa smalţului la acţiunea acizilor înaltă (TRSA = 30%). Cercetările optoelectronice cu analiza chimică a smalţului dinţilor intacţi 1.4 şi 2.4 extraşi din indicaţii ortodontice au evidenţiat prezenţa la suprafaţa smaltului sănătos a unui strat protector de globule de CaF2 şi MgF2. Analiza microbiologică a relevat micşorarea numarului total de microorganisme în biofilmul oral - 105 UFC/ml. Identificarea bacteriilor: Streptococcus sanguis - 104 UFC/ml şi Streptococcus salivarius - 105 UFC/ml, Streptococcus mutans, Streptococcus gordoni şi Streptococcus sobrinus nu au fost depistate. Patient A.I., 12 years old, institutionalized in a residential institution for children with severe mental deficiencies with the diagnosis of profound mental retardation, PCI, spastic form. The child exhibits a totally uncooperative behavior (Frankl type 1), uncontrollable, the ability to communicate is absent. Diagnosis: medium-depth dental caries in teeth 1.6, 2.6 and 3.6. Very low resistance of enamel to acid action (TRSA = 90%). Extreme caries risk was assessed: CCPB test - positive; Streptococcus mutans - positive; PFRI score = 5. Bacteriological analysis revealed high values of the total number of microorganisms in the oral biofilm - 107 CFU/ml. Identification of bacteria from the Streptococcus viridans group: Streptococcus mutans - 107 CFU/ml, Streptococcus gordoni - 107 CFU/ml, Streptococcus sobrinus and Streptococcus sanguis - 106 CFU/ml. Two preventive sessions were performed according to the described method. The child tolerated the preventive sessions well, without showing any signs of discomfort during them. After 12 months from the preventive sessions, signs of enamel demineralization and tooth hypersensitivity were not detected, the average depth of dental caries in teeth 1.6, 2.6 and 3.6 did not extend in depth and surface. New carious cavities did not form, hard dental tissues without pathological changes. Low caries risk was found: CCPB test - negative; Streptococcus mutans - negative; PFRI score = 2. High resistance of enamel to acid action (TRSA = 30%). Optoelectronic research with chemical analysis of the enamel of intact teeth 1.4 and 2.4 extracted from orthodontic indications revealed the presence on the surface of healthy enamel of a protective layer of CaF2 and MgF2 globules. Microbiological analysis revealed a decrease in the total number of microorganisms in the oral biofilm - 105 CFU/ml. Identification of bacteria: Streptococcus sanguis - 104 CFU/ml and Streptococcus salivarius - 105 CFU/ml, Streptococcus mutans, Streptococcus gordoni and Streptococcus sobrinus were not detected.
Exemplul 2 Example 2
Pacienta E., 10 ani. Diagnosticul: demineralizarea smalţului în zona precoletară a dinţilor 1.3, 1.2, 1.1, 2.1, 2.2, 2.3, 2.4, hipersensibilitatea dinţilor indicaţi de la excitanţi termici şi chimici, smalţ mat, la sondare se apreciază rugozităţi. Rezistenţa smalţului la acţiunea acizilor foarte joasă (TRSA= 90%). A fost apreciat risc carios extrem: testul CCPB - pozitiv; Streptococcus mutans - pozitiv; scorul PFRI = 5. Analiza bacteriologică a biofilmului dentar a relevat valori ridicate ale numărului total de microorganisme - 107 UFC/ml. Identificarea bacteriilor din grupul Streptococcus viridans: Streptococcus mutans - 107 UFC/ml şi Streptococcus sanguis - 106 UFC/ml. Au fost efectuate 4 şedinţe preventive după următoarea metodă: s-a igienizat cavitatea orală, pe suprafeţele dinţilor s-a aplicat în calitate de substanţă fotosensibilizantă extractul antocianic 5,0 % pe 10…20 min, apoi zona s-a iradiat cu lumină LED cu lungimea de undă de 625…635 nm, puterea de 2,0…3,0 W şi expoziţia de 10…30 s, după irigarea cavităţii orale cu apă distilată pe suprafaţa dinţilor s-au aplicat 1…3 picături de soluţie Nr.1 Gluftored care conţine ioni de fluor, magneziu şi cupru, ulterior s-a iradiat smalţul dinţilor cu lumină LED 10…30 s, după care s-au aplicat 1…3 picături de suspenzie Nr.2 Gluftored, care conţine suspensia microdispersă de hidroxid de calciu, şi s-a iradiat smalţul dinţilor cu lumină LED în acelaşi regim. Patient E., 10 years old. Diagnosis: enamel demineralization in the pre-cleft area of teeth 1.3, 1.2, 1.1, 2.1, 2.2, 2.3, 2.4, hypersensitivity of the indicated teeth to thermal and chemical stimuli, matte enamel, roughness is appreciated on probing. Very low resistance of the enamel to acid action (TRSA= 90%). Extreme caries risk was assessed: CCPB test - positive; Streptococcus mutans - positive; PFRI score = 5. Bacteriological analysis of the dental biofilm revealed high values of the total number of microorganisms - 107 CFU/ml. Identification of bacteria from the Streptococcus viridans group: Streptococcus mutans - 107 CFU/ml and Streptococcus sanguis - 106 CFU/ml. 4 preventive sessions were performed according to the following method: the oral cavity was sanitized, 5.0% anthocyanin extract was applied to the tooth surfaces as a photosensitizing substance for 10…20 min, then the area was irradiated with LED light with a wavelength of 625…635 nm, power of 2.0…3.0 W and exposure of 10…30 s, after irrigation of the oral cavity with distilled water, 1…3 drops of Gluftored solution No. 1 containing fluoride, magnesium and copper ions were applied to the tooth surface, subsequently the tooth enamel was irradiated with LED light for 10…30 s, after which 1…3 drops of Gluftored suspension No. 2 were applied, which contains the microdispersed suspension of calcium hydroxide, and the tooth enamel was irradiated with LED light in the same regime.
Copilul a suportat bine şedinţele preventive, fără a manifesta semne de discomfort în decursul lor. După aproximativ un an de la efectuarea şedinţelor preventive, maculele cretoase de pe suprafaţa smalţului şi hipersensibilitatea dinţilor s-au micşorat, însă au mai rămas zone de demineralizare a smalţului. Cavităţi cariate noi nu s-au format, ţesuturile dentare dure fără schimbări patologice. S-a constatat risc carios moderat: testul CCPB - pozitiv; Streptococcus mutans - pozitiv; scorul PFRI = 4. Rezistenţa smalţului la acţiunea acizilor înaltă (TRSA= 40%). Analiza bacteriologică după efectuarea şedinţei preventive a relevat distrugerea totală a microorganismelor din biofilmul dentar. La 10 zile după efectuarea şedinţei preventive, s-a observat că numarul total de microorganisme în biofilmul oral s-a restabilit în totalitate constituind 107 UFC/ml. Identificarea bacteriilor a depistat prezenţa Streptococcus sanguis - 106 UFC/ml, Streptococcus salivarius - 107 UFC/ml, Streptococcus mutans - 107 UFC/ml. Prin urmare, după 4 şedinţe preventive, s-a majorat rezistenţa smalţului dentar la acţiunea agenţilor acizi, iar gradul de contaminare microbiană a biofilmului oral nu s-a modificat esenţial, astfel efectul cariopreventiv înregistrat este de 1,29 ori mai redus, comparativ cu aplicarea metodei revendicate (Exemplul 1). The child tolerated the preventive sessions well, without showing any signs of discomfort during them. Approximately one year after the preventive sessions, the chalky macules on the enamel surface and the hypersensitivity of the teeth decreased, but areas of enamel demineralization remained. New carious cavities did not form, the hard dental tissues without pathological changes. Moderate caries risk was found: CCPB test - positive; Streptococcus mutans - positive; PFRI score = 4. High enamel resistance to acid action (TRSA = 40%). Bacteriological analysis after the preventive session revealed the total destruction of microorganisms in the dental biofilm. 10 days after the preventive session, it was observed that the total number of microorganisms in the oral biofilm was fully restored, constituting 107 CFU/ml. Bacterial identification revealed the presence of Streptococcus sanguis - 106 CFU/ml, Streptococcus salivarius - 107 CFU/ml, Streptococcus mutans - 107 CFU/ml. Therefore, after 4 preventive sessions, the resistance of tooth enamel to the action of acidic agents increased, and the degree of microbial contamination of the oral biofilm did not change significantly, thus the recorded cariopreventive effect is 1.29 times lower, compared to the application of the claimed method (Example 1).
Exemplul 3 Example 3
Pacientul N.M., 5 ani, instituţionalizat în Centrul Municipal de plasament pentru copii, Chişinău cu retardare mintală moderată, PCI. Diagnosticul: carie superficială în dinţii 5.1 şi 6.1. Rezistenţa smalţului la acţiunea acizilor foarte joasă (TRSA= 70%). A fost apreciat risc carios extrem: testul CCPB - pozitiv; Streptococcus mutans - pozitiv; scorul PFRI =5. Analiza bacteriologică a relevat valori ridicate ale numarului total de microorganisme în biofilmul dentar - 107 UFC/ml. Identificarea bacteriilor din grupul Streptococcus viridans: Streptococcus mutans - 106 UFC/ml şi Streptococcus sobrinus - 106 UFC/ml. Au fost efectuate 2 şedinţe preventive care au inclus igienizarea cavităţii orale şi badijonarea suprafeţelor dentare cu suspensia de Lactobacillus rhamnosus şi Bifidobacterium bifidum şi administrarea per os a unei capsule care conţine Lactobacillus rhamnosus GG-LGG®, Bifidobacterium BB-12® - 4,9 x 109 CFU, o dată pe zi, în decurs de 20 zile. Patient N.M., 5 years old, institutionalized in the Municipal Children's Placement Center, Chisinau with moderate mental retardation, PCI. Diagnosis: superficial caries in teeth 5.1 and 6.1. Very low enamel resistance to acid action (TRSA= 70%). Extreme caries risk was assessed: CCPB test - positive; Streptococcus mutans - positive; PFRI score =5. Bacteriological analysis revealed high values of the total number of microorganisms in the dental biofilm - 107 CFU/ml. Identification of bacteria from the Streptococcus viridans group: Streptococcus mutans - 106 CFU/ml and Streptococcus sobrinus - 106 CFU/ml. 2 preventive sessions were performed, which included oral cavity hygiene and brushing of dental surfaces with a suspension of Lactobacillus rhamnosus and Bifidobacterium bifidum and oral administration of a capsule containing Lactobacillus rhamnosus GG-LGG®, Bifidobacterium BB-12® - 4.9 x 109 CFU, once a day, for 20 days.
După 12 luni de la efectuarea şedinţelor preventive, semnele de demineralizare a smalţului şi hipersensibilitate a dinţilor nu s-au diminuat, totuşi caria dentară în dinţii 5.1 şi 6.1 s-a stopat în evoluţie. Cavităţi cariate noi nu s-au format, ţesuturile dentare dure fără schimbări patologice. S-a constatat risc carios moderat: testul CCPB - pozitiv; Streptococcus mutans - pozitiv; scorul PFRI =3. Rezistenţa smalţului la acţiunea acizilor s-a majorat neînsemnat (TRSA= 60%). Analiza microbiologică a relevat micşorarea numarului total de microorganisme în biofilmul oral care a constituit 106 UFC/ml. Identificarea bacteriilor: Streptococcus sanguis - 105 UFC/ml şi Streptococcus salivarius - 106 UFC/ml. Prin urmare, după 2 şedinţe preventive, s-a redus gradul de contaminare microbiană a biofilmului oral, însă rezistenţa smalţului dentar la acţiunea agenţilor acizi nu s-a modificat, astfel efectul cariopreventiv înregistrat este de 4,43 ori mai redus, comparativ cu aplicarea metodei revendicate (Exemplul 1). After 12 months of preventive sessions, the signs of enamel demineralization and tooth hypersensitivity did not diminish, however, the dental caries in teeth 5.1 and 6.1 stopped evolving. New carious cavities did not form, hard dental tissues without pathological changes. Moderate caries risk was found: CCPB test - positive; Streptococcus mutans - positive; PFRI score =3. The resistance of enamel to the action of acids increased insignificantly (TRSA = 60%). Microbiological analysis revealed a decrease in the total number of microorganisms in the oral biofilm, which constituted 106 CFU/ml. Identification of bacteria: Streptococcus sanguis - 105 CFU/ml and Streptococcus salivarius - 106 CFU/ml. Therefore, after 2 preventive sessions, the degree of microbial contamination of the oral biofilm was reduced, but the resistance of the tooth enamel to the action of acidic agents did not change, thus the recorded cariopreventive effect is 4.43 times lower, compared to the application of the claimed method (Example 1).
Tabel Table
Eficienţa măsurilor preventive în reducerea riscului carios The effectiveness of preventive measures in reducing caries risk
Loturile de cercetare/ nr de copii în lot Metode preventive/preparatele medicamentoase aplicate Gradul de risc carios* Eficienţa măsurilor preventive în raport cu lotul martor** iniţial după aplicarea măsurilor profilactice lotul 1 - 86 copii Terapia fotodinamică 3,6±0,17 0,9±0,17 75,00% lotul 2 - 83 copii Metoda revendicată 3,6±0,11 0,7±0,12 80,56% lotul 4 - 72 copii Aplicarea locală şi administrarea per os a probioticelor 3,4±0,21 3,1±0,14 5,56% lotul martor - 262 copii Igienizarea cavităţii orale 3,4±0,36 3,6±0,25 -Research groups/ no. of children in the group Preventive methods/medicinal preparations applied Degree of caries risk* Efficiency of preventive measures in relation to the control group** initially after application of prophylactic measures group 1 - 86 children Photodynamic therapy 3.6±0.17 0.9±0.17 75.00% group 2 - 83 children Claimed method 3.6±0.11 0.7±0.12 80.56% group 4 - 72 children Local application and oral administration of probiotics 3.4±0.21 3.1±0.14 5.56% control group - 262 children Oral hygiene 3.4±0.36 3.6±0.25 -
*Gradul de risc carios: *Degree of caries risk:
0,1…1,0 - risc carios redus: testul CCPB - negativ; Streptococcus mutans - negativ; scorul PFRI = 1- 2. 0.1…1.0 - low caries risk: CCPB test - negative; Streptococcus mutans - negative; PFRI score = 1- 2.
1,1…2,0 - risc carios moderat: testul CCPB - pozitiv; Streptococcus mutans - pozitiv; scorul PFRI = 3. 1.1…2.0 - moderate caries risk: CCPB test - positive; Streptococcus mutans - positive; PFRI score = 3.
2,1…3,0 - risc carios crescut: testul CCPB - pozitiv; Streptococcus mutans - pozitiv; scorul PFRI = 4. 2.1…3.0 - increased caries risk: CCPB test - positive; Streptococcus mutans - positive; PFRI score = 4.
3,1…4,0 - risc carios extrem: testul CCPB - pozitiv; Streptococcus mutans - pozitiv; scorul PFRI = 5. 3.1…4.0 - extreme caries risk: CCPB test - positive; Streptococcus mutans - positive; PFRI score = 5.
** Eficienţa măsurilor preventive a fost apreciată prin estimarea indicelui de reducere a riscului carios (Rrc) după următoarea formulă: ** The effectiveness of preventive measures was assessed by estimating the caries risk reduction index (Rrc) according to the following formula:
Rrc = rcM - rcC / rcM x 100%, Rrc = rcM - rcC / rcM x 100%,
în care: rcM - riscul carios în lotul martor şi rcC - riscul carios în lotul de cercetare. where: rcM - caries risk in the control group and rcC - caries risk in the research group.
Metoda propusă a fost aplicată pentru prevenirea cariei dentare la 83 de copii cu dizabilităţi psiho-somatice în cadrul Catedrei chirurgie oro-maxilo-facială pediatrică, pedodonţie şi ortodonţie, USMF ”Nicolae Testemiţanu” şi al instituţiilor pentru copii cu dizabilităţi: Centrul municipal de plasament pentru copii, Chişinău, Centrul de reabilitare pentru Copii, Centrul pilot de pedagogie curativă “Orfeu”, şcoala auxiliară nr. 5 şi nr. 6 din municipiul Chişinău. Rezultatele sunt pozitive: reducerea vitezei de acumulare şi a capacităţii cariogene a plăcii microbiene, reducerea numărului total de microorganisme în biofilmul oral de la 107 UFC/ml la 104 UFC/ml, doar la 9 copii s-a identificat Streptococcus mutans - 104 UFC/ml şi la 2 copii - 105 UFC/ml. The proposed method was applied to prevent dental caries in 83 children with psychosomatic disabilities within the Department of Pediatric Oral-Maxillofacial Surgery, Pedodontics and Orthodontics, USMF "Nicolae Testemiţanu" and institutions for children with disabilities: Municipal Children's Placement Center, Chisinau, Children's Rehabilitation Center, Pilot Center for Curative Pedagogy "Orfeu", auxiliary school no. 5 and no. 6 in Chisinau. The results are positive: reduction of the accumulation rate and cariogenic capacity of microbial plaque, reduction of the total number of microorganisms in the oral biofilm from 107 CFU/ml to 104 CFU/ml, only in 9 children was Streptococcus mutans identified - 104 CFU/ml and in 2 children - 105 CFU/ml.
A crescut numărul de copii (de la 34 la 81) la care s-a identificat Streptococcus salivarius 104 UFC/ml - 105 UFC/ml, microorganismul cu cea mai redusă capacitate cariogenă din grupul Streptococcus viridans. Investigaţiile efectuate în cadrul studiului au demonstrat că riscul carios în raport cu nivelul iniţial s-a redus de 5,14 ori. Majorarea gradului de mineralizare a smalţului dentar este demonstrată prin mărirea considerabilă a rezistenţei smalţului la acţiunea acizilor, reducerea frecvenţei şi intensităţii cariei dentare cu 31% comparativ cu lotul martor, depozitarea la suprafaţa smaltului a unui strat protector de globule de CaF2 şi MgF2, depistat prin cercetările optoelectronice cu analiza chimică a smalţului a 28 dinţi intacţi extraşi din indicaţii ortodontice. În perioada de observaţie, care a durat 2 ani, nu s-au înregistrat complicaţii şi efecte secundare. Riscul carios s-a redus cu 80,56% în raport cu lotul martor (vezi tabelul). The number of children (from 34 to 81) in whom Streptococcus salivarius 104 CFU/ml - 105 CFU/ml was identified, the microorganism with the lowest cariogenic capacity in the Streptococcus viridans group, increased. Investigations carried out within the study demonstrated that the caries risk compared to the initial level was reduced by 5.14 times. The increase in the degree of mineralization of dental enamel is demonstrated by the considerable increase in the resistance of enamel to the action of acids, the reduction in the frequency and intensity of dental caries by 31% compared to the control group, the deposition on the enamel surface of a protective layer of CaF2 and MgF2 globules, detected by optoelectronic research with chemical analysis of the enamel of 28 intact teeth extracted for orthodontic indications. During the observation period, which lasted 2 years, no complications and side effects were recorded. The caries risk was reduced by 80.56% compared to the control group (see table).
1. MD 745 Y 2014.03.31 1. MD 745 Y 2014.03.31
2. Кисельникова Л.П., Вагеманс Н.В. Современные возможности профилактики кариеса зубов у детей раннего возраста. Педиатрия,2010, 89(5), p. 130-136 2. Kiselnikova L.P., Vagemans N.V. Sovremennye vojvodstvo profliktiki kariesa zubov y detei rannygo agesta. Pediatrics, 2010, 89(5), p. 130-136
Claims (1)
Priority Applications (1)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| MDS20150045A MD996Z (en) | 2015-04-01 | 2015-04-01 | Method for preventing dental caries in children with intellectual disabilities |
Applications Claiming Priority (1)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| MDS20150045A MD996Z (en) | 2015-04-01 | 2015-04-01 | Method for preventing dental caries in children with intellectual disabilities |
Publications (2)
| Publication Number | Publication Date |
|---|---|
| MD996Y MD996Y (en) | 2016-01-31 |
| MD996Z true MD996Z (en) | 2016-08-31 |
Family
ID=55235466
Family Applications (1)
| Application Number | Title | Priority Date | Filing Date |
|---|---|---|---|
| MDS20150045A MD996Z (en) | 2015-04-01 | 2015-04-01 | Method for preventing dental caries in children with intellectual disabilities |
Country Status (1)
| Country | Link |
|---|---|
| MD (1) | MD996Z (en) |
Cited By (1)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| CN108048347A (en) * | 2017-12-06 | 2018-05-18 | 河北然生物科技有限公司 | Lactobacillus rhamnosus, lactobacillus rhamnosus preparation and application thereof |
Citations (19)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| US5388987A (en) * | 1990-04-17 | 1995-02-14 | Cheval Freres, Sa | Laser beam dental instrument |
| MD597F1 (en) * | 1996-02-28 | 1996-11-29 | Univ De Stat Din Moldova | Method of beans treatment before planting |
| MD746F1 (en) * | 1996-11-29 | 1997-06-30 | Univ De Stat Din Moldova | Titanate lanthanum La2Ti2O7 polycrystalline ceramics process |
| MD735F1 (en) * | 1996-09-05 | 1997-06-30 | Inst De Fiziol A Plantelor Al | The diagnostics method of the vine sorts frost resistance |
| MD745F1 (en) * | 1996-02-27 | 1997-06-30 | Boris Stehman | Combined dust collector |
| MD734F1 (en) * | 1996-03-20 | 1997-06-30 | Univ De Stat Din Moldova | Process for mineral feeding up of seedlings in the nursery garden |
| RU2120250C1 (en) * | 1992-05-12 | 1998-10-20 | Александр Николаевич Бондаренко | Method for treating the cases of pulpitis |
| MD916G2 (en) * | 1996-12-09 | 1998-12-31 | Институтул Национал Де Фармачие | Ungent for stomatologic deseases treatment |
| UA29724U (en) * | 2007-09-24 | 2008-01-25 | Анна Васильевна Киндрат | Method for topical treatment of acute deep caries in children and adolescents |
| UA31628U (en) * | 2008-01-08 | 2008-04-10 | Харьковский Государственный Медицинский Университет | Method for treating caries in young children |
| UA43057U (en) * | 2009-04-03 | 2009-07-27 | Государственное Учреждение "Институт Стоматологии Академии Медицинских Наук Украины" | Method for preventing and treating hard tissues of teeth in children with infantile cerebral paralysis in setting of health resort treatment |
| RU2376014C1 (en) * | 2008-09-24 | 2009-12-20 | Государственное образовательное учреждение высшего профессионального образования "Нижегородская государственная медицинская академия Росздрава" (ГОУ ВПО "НИЖГМА РОСЗДРАВА") | Method for prophylaxis of milk teeth caries in children with formed milk occlusion |
| MD3904G2 (en) * | 2008-05-07 | 2009-12-31 | Валериу ФАЛА | Composition for biosoluble medicated film for treatment of parodentium affections and of lesions of tunica mucosa of mouth (variants) |
| MD3905G2 (en) * | 2008-05-07 | 2010-01-31 | Валериу ФАЛА | Remedy of durable action in the form of gel for treatment of parodentium affections (variants) |
| MD3938G2 (en) * | 2008-05-07 | 2010-02-28 | Валериу ФАЛА | Method for treating the migratory periodontitis |
| MD424Z (en) * | 2010-09-06 | 2012-05-31 | Валериу ФАЛА | Method for treatment of periodontium diseases |
| MD569Z (en) * | 2011-03-29 | 2013-07-31 | Дорин ИСТРАТИ | Method of regenerating the roots of immature permanent teeth in children |
| MD582Z (en) * | 2012-07-09 | 2013-08-31 | Государственный Медицинский И Фармацевтический Университет "Nicolae Testemitanu" Республики Молдова | Method for preventing the dental caries in children with intellectual disabilities |
| MD597Z (en) * | 2012-08-16 | 2013-09-30 | Государственный Медицинский И Фармацевтический Университет "Nicolae Testemitanu" Республики Молдова | Method for treating the dental caries in children with intellectual disabilities |
-
2015
- 2015-04-01 MD MDS20150045A patent/MD996Z/en not_active IP Right Cessation
Patent Citations (19)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| US5388987A (en) * | 1990-04-17 | 1995-02-14 | Cheval Freres, Sa | Laser beam dental instrument |
| RU2120250C1 (en) * | 1992-05-12 | 1998-10-20 | Александр Николаевич Бондаренко | Method for treating the cases of pulpitis |
| MD745F1 (en) * | 1996-02-27 | 1997-06-30 | Boris Stehman | Combined dust collector |
| MD597F1 (en) * | 1996-02-28 | 1996-11-29 | Univ De Stat Din Moldova | Method of beans treatment before planting |
| MD734F1 (en) * | 1996-03-20 | 1997-06-30 | Univ De Stat Din Moldova | Process for mineral feeding up of seedlings in the nursery garden |
| MD735F1 (en) * | 1996-09-05 | 1997-06-30 | Inst De Fiziol A Plantelor Al | The diagnostics method of the vine sorts frost resistance |
| MD746F1 (en) * | 1996-11-29 | 1997-06-30 | Univ De Stat Din Moldova | Titanate lanthanum La2Ti2O7 polycrystalline ceramics process |
| MD916G2 (en) * | 1996-12-09 | 1998-12-31 | Институтул Национал Де Фармачие | Ungent for stomatologic deseases treatment |
| UA29724U (en) * | 2007-09-24 | 2008-01-25 | Анна Васильевна Киндрат | Method for topical treatment of acute deep caries in children and adolescents |
| UA31628U (en) * | 2008-01-08 | 2008-04-10 | Харьковский Государственный Медицинский Университет | Method for treating caries in young children |
| MD3904G2 (en) * | 2008-05-07 | 2009-12-31 | Валериу ФАЛА | Composition for biosoluble medicated film for treatment of parodentium affections and of lesions of tunica mucosa of mouth (variants) |
| MD3905G2 (en) * | 2008-05-07 | 2010-01-31 | Валериу ФАЛА | Remedy of durable action in the form of gel for treatment of parodentium affections (variants) |
| MD3938G2 (en) * | 2008-05-07 | 2010-02-28 | Валериу ФАЛА | Method for treating the migratory periodontitis |
| RU2376014C1 (en) * | 2008-09-24 | 2009-12-20 | Государственное образовательное учреждение высшего профессионального образования "Нижегородская государственная медицинская академия Росздрава" (ГОУ ВПО "НИЖГМА РОСЗДРАВА") | Method for prophylaxis of milk teeth caries in children with formed milk occlusion |
| UA43057U (en) * | 2009-04-03 | 2009-07-27 | Государственное Учреждение "Институт Стоматологии Академии Медицинских Наук Украины" | Method for preventing and treating hard tissues of teeth in children with infantile cerebral paralysis in setting of health resort treatment |
| MD424Z (en) * | 2010-09-06 | 2012-05-31 | Валериу ФАЛА | Method for treatment of periodontium diseases |
| MD569Z (en) * | 2011-03-29 | 2013-07-31 | Дорин ИСТРАТИ | Method of regenerating the roots of immature permanent teeth in children |
| MD582Z (en) * | 2012-07-09 | 2013-08-31 | Государственный Медицинский И Фармацевтический Университет "Nicolae Testemitanu" Республики Молдова | Method for preventing the dental caries in children with intellectual disabilities |
| MD597Z (en) * | 2012-08-16 | 2013-09-30 | Государственный Медицинский И Фармацевтический Университет "Nicolae Testemitanu" Республики Молдова | Method for treating the dental caries in children with intellectual disabilities |
Non-Patent Citations (1)
| Title |
|---|
| Кисельникова Л.П., Вагеманс Н.В. Современные возможности профилактики кариеса зубов у детей раннего возраста. Педиатрия,2010, 89(5), p. 130-136 * |
Cited By (2)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| CN108048347A (en) * | 2017-12-06 | 2018-05-18 | 河北然生物科技有限公司 | Lactobacillus rhamnosus, lactobacillus rhamnosus preparation and application thereof |
| CN108048347B (en) * | 2017-12-06 | 2020-06-02 | 河北一然生物科技有限公司 | Lactobacillus rhamnosus, lactobacillus rhamnosus preparation and application thereof |
Also Published As
| Publication number | Publication date |
|---|---|
| MD996Y (en) | 2016-01-31 |
Similar Documents
| Publication | Publication Date | Title |
|---|---|---|
| Motallaei et al. | The current strategies in controlling oral diseases by herbal and chemical materials | |
| UA76696C2 (en) | Combination of lactic acid bacteria and its use for prevention and treatment of infections and inflammatory conditions | |
| KR20160067311A (en) | A pharmaceutical composition comprising extracts of sterculia lychophora for preventing, improving or treating disease of oral cavity | |
| Mohsin et al. | The effects of a dentifrice containing propolis on Mutans Streptococci: a clinico-microbiological study | |
| Stašková et al. | Stomatology Perspective | |
| El-Sharkawy | Evaluation of the antimicrobial effect of pomegranate extract on Streptococcus mutans | |
| Anani et al. | Evaluation of the remineralization and antibacterial effect of natural versus synthetic materials on deep carious dentin: a randomized controlled trial | |
| MD582Z (en) | Method for preventing the dental caries in children with intellectual disabilities | |
| Hegde et al. | Non fluoridated remineralization agents in dentistry | |
| Sainulabdeen et al. | Antibacterial activity of triclosan incorporated glass ionomer cements–an in vitro pilot study | |
| TWI511748B (en) | Oral care composition containing deoxysaccharide antimetabolites | |
| MD597Z (en) | Method for treating the dental caries in children with intellectual disabilities | |
| MD996Z (en) | Method for preventing dental caries in children with intellectual disabilities | |
| KR20160129526A (en) | Composition for preventing a biofilm formation comprising glycyrrhetinic acid | |
| Premkishore et al. | Effect of honey and aqueous ginger extract against Streptococcus mutans isolated from extracted carious deciduous teeth | |
| Imani et al. | Evaluation of antibacterial effect of the orthodontic composite containing propolis nanoparticles in rat as an animal model | |
| Thaweboon et al. | Effect of an essential oil-containing mouth rinse on VSC-producing bacteria on the tongue | |
| Al-Timimi et al. | Effect of thymus vulgaris extract on streptococci and mutans streptococci, in comparison to chlorhexidine gluconate (in vivo study) | |
| Petrushanko et al. | Therapeutic potential of lactobacilli-based drug in the treatment of generalized periodontitis | |
| George et al. | Effectiveness of propolis, probiotics and chlorhexidine on streptococcus mutans and candida albicans: An in-vitro study | |
| KR102400815B1 (en) | Composition for preventing a biofilm formation comprising Amentoflavone | |
| Chęcińska-Maciejewska et al. | Role of oral microbiome in preventing caries, stomatitis and periodontitis | |
| RU2808191C1 (en) | Method of chronic periodontitis treatment | |
| KR20170051006A (en) | Oral composition containing both isopropylmethylphenol and oral tissue astringent | |
| KR102750523B1 (en) | Composition for Inhibiting Biofilm Formation and for Preventing or Treating Dental Disease |
Legal Events
| Date | Code | Title | Description |
|---|---|---|---|
| FG9Y | Short term patent issued | ||
| KA4Y | Short-term patent lapsed due to non-payment of fees (with right of restoration) |