RU160596U1 - DEVICE FOR DIAGNOSTIC AND TREATMENT OF INITIAL CARIES OF TEETH - Google Patents

Abstract

A device for diagnosing and treating initial dental caries, including an electrodontotester, active and passive electrodes, a cable for connecting electrodes, characterized in that for the convenience of the treatment procedure, a removable mouthpiece electrode is used as a passive electrode, the tip of the active electrode is covered with cotton turunda soaked in a solution silver fluoride.

Description

DEVICE FOR TREATMENT OF INITIAL CARIES OF TEETH

The utility model relates to medical equipment, in particular to physiotherapeutic devices intended for the treatment of initial forms of dental caries.

It is known that early diagnosis of the pathology of hard tooth tissues allows you to stop the development of the process at the initial stage, which improves the quality of dental care [Sadovsky V.V. The use of high-tech methods in the diagnosis of dental diseases / V.V. Sadovsky, I.A. Belenova, B.R. Shumilovich // Institute of Dentistry. - 2008. - No. 1. - S. 74-75].

The choice of method and physiotherapeutic tools for the treatment of initial caries depends on the nature of the changes in the tooth tissues. At the stage of a white spot, treatment is carried out without preparation. Calcium and phosphorus ions are introduced into the demineralization site. For this purpose, apply a 10% solution of calcium gluconate, 1.5-3% solution of "Remodent". The tooth surface is dried, plaque is removed, and then cotton swabs moistened with remineralizing solution are applied to the lesion site for 15-20 minutes. The course of treatment consists of 15 procedures. With initial changes, the white spot disappears completely, with significant demineralization, the spot decreases in size, but does not disappear completely. Relapses are possible, in connection with which there is a need for re-treatment.

The programs for the prevention and treatment of initial forms of caries, in which the use of fluorides are primarily provided, are widespread. Despite attempts to develop prophylactic agents containing calcium, phosphates, various trace elements and other compounds, only fluorides have a proven high level of safety and effectiveness in preventing decay of deciduous and permanent teeth. Recommendations on the need for fluoride prevention of caries are contained in documents of the World Health Organization and guidelines of national dental associations. [E.E. Maslak, “Remineralization of hard tooth tissues for caries prophylaxis during dental admission”, // Dentist-practitioner, M., 2013. .-N 4.-C.54-56.]

Fluorine ions accumulate in the body mainly in the tissues of the tooth and bone tissue, forming poorly soluble fluorapatites. By stimulating the mineralization of tooth hard tissues, they contribute to the maturation and hardening of tooth enamel and protect the teeth from tooth decay. They also have a bactericidal effect against microorganisms that appear during tooth decay. In addition, sodium fluoride reduces bone resorption. The main use is sodium fluoride as a means for the prevention and treatment of dental caries. Fluorides can not only reduce the solubility of enamel in an acidic environment, stimulate remineralization, but also inhibit the metabolism of plaque bacteria (Gehring F., 1983; Shani S „Friedman M., Steinberg D., 2000).

Sodium fluoride is applied topically in the form of rinses and applications. For applications use 0.2, 2% sodium fluoride solutions, 1-2% sodium fluoride gel on 3% agar. On a tooth surface isolated from saliva and cleaned, apply for 4-5 minutes. swabs soaked in sodium fluoride solution. 5-7 applications of a 2% sodium fluoride solution per course twice a year can achieve 47% reduction in initial caries. The low reduction in initial caries is explained by the fact that the resulting layer of calcium fluoride on the tooth surface with this method of treatment is poorly retained on this surface [S. B. Ulitovsky, “The preventive role of aminofluorides in the prevention of dental caries” // Dental Review, M., 2008, No. 1 -C.10].

The disadvantage of using sodium fluoride in the form of applications is a low reduction in initial tooth decay as a result of the shallow penetration of fluoride ions into the hard tissues of the tooth.

Currently, dentists are increasingly using complex physical measurement methods in the diagnosis of caries. The traditional instrumental research - probing, is regarded as low confidence in the initial stages of enamel demineralization [Kuhnisch J. Die guantitative lichtinduzierte Fluoreszenzmessung eine zukuntinftige Methode fur den Zahnarzt. Quintessenz 2002; 53: 131-141].

The laser fluorescence method is embedded in the DIAGNOdent instrument (KaVo, Germany). During clinical trials, quite clear boundaries of the measured values were established that correspond to the stage of development of caries. For initial caries, these values range from 13 to 24 units. [G. Allais, Caries - diagnosis. Part 2. // New in dentistry. - 2008. - No. 4 (152). - S. 1-16]. The laser fluorescence method is an excellent tool for monitoring the development of caries. Comparison of the results of several measurements allows us to identify various stages of the process of demineralization of hard tissues. The disadvantage is the high cost of the device.

A known method for the diagnosis of dental caries - electrodontometry is the determination of the threshold of excitability of the nerve receptors of the pulp of the tooth at a minimum current. This method allows you to evaluate the qualitative and quantitative violations in the pulp of the tooth, which are noted during the carious process [L. Rubin "Electroodontodiagnosis" - M. - Medicine. - 1976. - 136 p.]

To implement this method, various devices have found their application: OD-2, EOM-1, EOM-3, IVN-1, etc., among which there is EOT-01 (electrodontotest of the state of the tooth pulp), model OSP 2.0 (determinant of the state of the tooth pulp ) with sound and digital indication.

Closest to the claimed device is an electrodiagnostic apparatus "DentEst" company "GEOSOFT DENT" to remove the electrical potentials of tooth tissues. The “DentEst” apparatus kit includes: an electronic unit, a cable for connecting electrodes, batteries, 2 removable electrodes - an active and passive, passive electrode in the form of a dental mirror. [Operation manual "Electrodiagnostic apparatus" DentEst ", M., 2006]. A passive electrode, which is a dental mirror, is placed in the oral cavity, while ensuring good contact with the soft tissues of the oral cavity.

However, the use of this device may cause difficulties:

- carrying out a study of the electric potentials of tooth tissues, both hands of the dentist are occupied (one with a passive one and the other with active electrodes), therefore, an assistant is needed to register indicators;

- sterilization of the mirror is carried out by the cold method and is not possible at high temperatures in a dry oven, which also complicates the work of the doctor.

The disadvantage of the prototype is also limited functionality - the inability to prevent and treat initial caries.

EFFECT: development of a device having wider functional capabilities in comparison with devices for electrodontometry, allowing performing medical procedures to initialize the process of reduction of initial dental caries, increasing the speed of restoration processes in pathologically altered tooth enamel.

The structural diagram of the proposed device includes: 1 - an electrode-mouthpiece, which is a passive electrode; 2 - active electrode; 3 - holder of the passive electrode, 4 - holder of the active electrode, 5 - electrodontotester, 6 - flexible cables connecting the electrodes with the electrodontotester.

Diagnostics using the proposed device is as follows.

A method for diagnosing and treating initial caries with the apparatus we offer is as follows.

Perform professional oral hygiene to remove dental plaque. Isolate the tooth from the oral fluid with cotton rolls; Dry tooth surfaces with warm air.

To start the operation of the device, it is necessary to install a mouthpiece electrode, which is a passive electrode (1), in the patient's oral cavity, while ensuring good contact with the soft tissues of the oral cavity. At the tip of the active electrode (2), I wind a thin, dense cotton wool and moisten it with an electrically conductive solution of 2% silver fluoride.

Turn on the odontotester (5). The tip of the active electrode (2) is applied to the sensitive point of the tooth under study, for example, the middle of the incisal edge of the incisors, the apex of the canine tubercle, the apex of the premolar molars, and the apex of the medial buccal molar of molars. When receiving information from the patient that he feels the impact - “tingling,” “creeping creeps,” the digital indicators of the DentEst apparatus are recorded.

Diagnosis is carried out according to the following criteria. If the indicators about electrometry are in the range of 0-0.2 μA, then the enamel is intact, normally mineralized, the tooth is healthy. With indicator values from 0.21 to 7.9 μA, initial caries is diagnosed. With values from 8.0 to 27.7 μA - superficial caries; at values of 27.8-50 μA - average caries; more than 50.0 μA - deep caries.

For the treatment of caries, the procedure time is calculated based on the fact that during one session an amount of electricity equal to 100 μA / min should be obtained. The formula for calculating: Q = It, where I is the current strength, t is time. A second session is prescribed after 1-2 days. For the course of treatment, 5-6 sessions are performed using a 2% solution of silver fluoride.

The clinical results of the treatment of initial caries using the proposed device showed that a favorable treatment outcome — reduction of initial caries was 66.3%, whereas in the control group, which used tampons for application, tampons saturated with 2% sodium fluoride solution without using the DentEst apparatus, initial caries reduction was 47%.

The technical result was achieved by expanding the functionality of devices such as electrodontometers, through the use of moistened cotton turunda soaked in a 2% AgF solution (silver fluoride), which, when applied, will be a source of fluoride ions for hard tooth tissues. The presence of an electric field during the operation of the device will provide a deeper penetration of fluorine ions into the hard tissues of the tooth. The use of silver fluoride is also of interest in connection with its antiseptic activity. Thus, the compactness of the basic apparatus is maintained, its functionality is expanded, and the universality of diagnostic and treatment-and-prophylactic methods is created with initial caries of various localization. To improve the functionality of the device "DentEst" as a passive electrode, we propose to use a removable electrode - a mouthpiece, which is used for apex locator (Figure 2).

Thus, the developed device allows to improve the quality of treatment, accelerate the enamel mineralization during electrolytic dissociation of an aqueous solution of silver fluoride and the influence of microcurrent on the vestibular surfaces of the teeth due to the deep penetration of fluorine ions into the hard tissues of the tooth.

Description of the drawings.

FIG. 1 General view of the device

1 - a mouthpiece electrode representing a passive electrode by a sosby;

2 - active electrode;

3 - holder of the passive electrode;

4 - holder of the active electrode;

5 - electrodontotester;

6 - flexible cables.

FIG. 2 Detachable electrode mouthpiece

1 - a mouthpiece electrode representing a passive electrode by a sosby;

Claims (1)

A device for diagnosing and treating initial dental caries, including an electrodontotester, active and passive electrodes, a cable for connecting electrodes, characterized in that for the convenience of the treatment procedure, a removable mouthpiece electrode is used as a passive electrode, the tip of the active electrode is covered with cotton turunda soaked in a solution silver fluoride.

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