RU164590U1 - REMOVABLE DENTISTRY WITH ELASTIC Lining - Google Patents

Abstract

A removable denture containing an acrylic base with artificial teeth and an inner layer of elastic silicone lining, characterized in that the composition for forming the silicone lining for the base includes a silicone polymer modified with the Miramistin therapeutic agent, which is introduced first into the filler and then into the silicone polymer.

Description

REMOVABLE DENTISTRY WITH ELASTIC Lining

The utility model relates to orthopedic dentistry and can be used to form an elastic lining in the manufacture of removable dentures with adverse clinical conditions of the prosthetic bed.

Under unfavorable anatomical and topographic conditions of the prosthetic bed - the presence of areas within the prosthetic bed with the acute form of the alveolar ridge, the sharp edges of the holes, significant tuberosity of the alveolar ridge, thinned, malleable mucous membrane, as well as increased pain sensitivity, the use of dentures with rigid bases becomes difficult. In these cases, the use of two-layer bases with an elastic lining facing directly to the tissues of the prosthetic bed is indicated. The use of a two-layer basis in removable dentures helps to accelerate adaptation to the prosthesis and preserve the oral mucosa.

The materials used for the manufacture of elastic linings are divided according to the method of polymerization and chemical composition. By the method of polymerization: hot curing and cold curing, as well as the chemical composition: acrylic plastics, silicone materials, polyvinyl chloride, fluororubber, polyisoprene, polyurethane. All these materials have their advantages and disadvantages.

Known removable prosthesis, including an elastic lining based on acrylic materials based on a copolymer of hydroxyethyl methacrylate and a mixture of acrylic monomers under the trade name Hydrokril. Acrylic elastic linings are technological and firmly fused with the base material. A significant disadvantage of acrylic materials can be considered their relatively rapid aging, manifested by a loss of elasticity [E.N. Zhulev, Materials Science in Orthopedic Dentistry, Nizhny Novgorod, 1997. S.46-47]. Today, silicone polymers and plasticized acrylic plastics for use in two-layer bases of dentures are most widely used.

The difference between silicone polymers (polysiloxanes) and polyvinyl chloride polymers and their biological inertness made it possible to widely use them in medical practice, including orthopedic dentists. In Russia, silicone base linings have been manufactured since 1963. They are characterized by stable performance and high adaptability to cold vulcanization. When used as linings in combined basic dentures, they are well wetted by saliva, and adhere tightly to the mucous membrane. They do not contain plasticizers, which, as a rule, are washed away and therefore retain plasticity for a number of years (Shteyngart MZ, Trezubov VN, Makarov K, N., “Dental prosthetics” Manual on dental materials science, Moscow, 1996). p.53).

The closest analogue of the utility model is a removable denture containing an acrylic base and a backing layer under the base formed from siloxane rubber (RU, utility model patent No. 45083, A61, C13 / 107, 2005). The technical result from the use of a utility model is to obtain a product with an extended service life. A removable denture contains an acrylic base and an elastic base lining formed from a composition based on siloxane rubber, and the composition for forming a lining layer under the base includes, in mass. hours:

Polydimethylmethylvinylsiloxane rubber - 100.0;

Filler - 16.2-25.8;

Silica hydride - 1-3;

Platinum catalyst - 5.10 ^-4 -5.10 ^-2 ;

3- (2-hydroxypropyl methacrylate) aminopropyl] -triethoxysilane - 1-3.

However, over time, long-acting soft pads become porous, ideal soil for the accumulation of bacteria appears, which often leads to inflammation of the oral mucosa, the appearance of bacterial prosthetic stomatitis, especially if the patient has conditions complicating prosthetics. Bacterial prosthetic stomatitis is caused by pathogenic microorganisms that accumulate on the surface of the denture.

The disadvantage of this analogue is that a removable denture containing an acrylic base and a lining layer under the base formed from siloxane rubber does not have antimicrobial activity in the oral cavity and, as a result, the appearance of bacterial prosthetic stomatitis.

The technical result, the achievement of which the creation of this utility model is aimed, is to reduce the adaptation time, a fundamentally new denture with a two-layer basis and the method of introducing the Miramistin preparation into the lining layer of a removable denture. In this case, Miramistin particles are evenly distributed over the entire lining layer of the prosthesis. The esthetics of the removable prosthesis is not disturbed.

The developed prosthesis makes it possible to increase the efficiency of jaw prosthetics in the complete absence of teeth in patients with unfavorable clinical conditions of the prosthetic bed, reduce the adaptation time, and provide antibacterial and antifungal effects.

The essence of the device lies in the fact that the plastic removable denture contains a base with artificial teeth and a silicone lining modified with the Miramistin therapeutic agent.

A removable denture with an elastic silicone lining in Fig. 1, which shows a sectional view of the prosthesis. The prosthesis consists of a base 2 with artificial teeth 1 and an elastic silicone lining 3 modified with Miramistin.

Miramistin is a drug belonging to the group of cationic antiseptics, surfactants (quaternary ammonium compounds) and having antimicrobial, anti-inflammatory and local immunoadjuvant effects. The drug is active against various pathogenic microorganisms, including viruses, fungi, bacteria and protozoa. It does not have a local irritant effect and allergenic properties. This medicine is registered by order https://ru.wikipedia.org/wiki/%D0%A4%D0%B5%D0%B4%D0%B5%D1%80%D0%B0%D0%BB%D1%8C% D0% BD% D0% B0% D1% 8F_% D1% 81% D0% BB% D1% 83% D0% B6% D0% B1% D0% B0_% D0% BF% D0% BE_% D0% BD% D0% B0% D0% B4% D0% B7% D0% BE% D1% 80% D1% 83_% D0% B2_% D1% 81% D1% 84% D0% and social development of Russia dated 13.12.2007 No. 4785-Pr / 07 . Manufacturer: http://www.rusmedserv.com/lekarstva/?srchPat%5b33%5d=2755 substance - powder, jars or bags Reg. No .: LS-001016. The drug was developed for astronautics.

With respect to Miramistin, high activity against bacteria, fungi, viruses, chlamydia and protozoa, including hospital multiresistant strains and microbial associations, has been confirmed. Miramistin’s ability to enhance local immunity and enhance regeneration processes has also been proven. The drug has a bactericidal effect against gram-positive and gram-negative bacteria, antifungal effect on the ascomycetes of the genus Aspergillus and the genus Penicillium, yeast fungi (Rhodotorula rubra, Torulopsis gabrata, etc.) and yeast-like (Candida albicans, Candida tropicalis, and Candidaruse. d.), dermatophytes, as well as other pathogenic fungi, for example, Pityrosporum orbiculare (Malassezia furfur), including fungal microflora with resistance to chemotherapeutic drugs (I.M. Makeeva, E.V. Borovsky, M.V. Matavkina, EA Brovenko “http://www.pharmateca.ru/ru/archive/article/12256” // Farmateka.-M, No. s3-13 / 2013, Art. p. 33-38).

The composition for forming a modified elastic lining consists of the following components:

As rubber, the composition may contain a polyorganosiloxane of the formula CH2 = CH [Si (R2) O] 4Si (R2) -CH = CH 2 with a viscosity of 500-300000 cP at 25 ° C.

Aerosil, silica powder, zinc oxide, diatomite can be used as a filler. In order to ensure uniform distribution of the modifying additive in the elastic lining, we suggested that before mixing the ingredients included in the silicone lining, saturate the filler (for example, Aerosil or diatomite) with Miramistin. For this, Miramistin powder is added to the required amount of filler in a ratio of 3: 1 and thoroughly mixed in a laboratory powder mixer for 10 minutes. Then, the modified filler is mixed with siloxane rubber and introduced into the composition to form the lining layer.

Pt complexes and compounds (platinum - 1.3 divinyltetramethyldisiloxane), metal carbonyls can be used as a platinum catalyst.

Silica hydride: organohydrosiloxane of the formula HO [Si (H) + єt0] 4-H.

As an adhesion promoter: 3 - [(2-hydroxypropylmethacrylate) aminopropyl] -triethoxysilane.

The manufacture of a removable denture with a modified elastic silicone lining is as follows.

Example 1. Composition No. 1. Polydimethylmethylvinylsiloxane rubber with a viscosity of 150,000 cP in an amount of 100.0 mass is loaded into a laboratory mixer. hours; modified aerosil (filler) containing Miramistin - 20.0 mass. h; organohydrosiloxane HO [Si (H) + єt0] 4-H - 3 wt. h. The components are mixed for 20 minutes, after which the resulting mixture is unloaded into a container. Then prepare Composition No. 2: polydimethylmethylvinylsiloxane rubber with a viscosity of 150,000 cP - 100.0 mass. hours, modified aerosil (filler) containing the drug Miramistin - 20.0 mass. h; 3 - [(2-hydroxypropylmethacrylate) aminopropyl] -triethoxysilane - 4 mass. h; - platinum catalyst - (platinum 1,3 divinyltetramethyldisiloxane) - 5.10-2 mass. h. All ingredients are stirred for 20 minutes, after which the resulting mixture is unloaded from the mixer. The resulting two compositions No. 1 and No. 2 are mixed in a ratio of 1: 1 until a homogeneous mass is obtained for 2-3 minutes. The composition is ready to form an elastic pad. Curing occurs in the patient’s oral cavity

Example 2. Composition No. 1. In a laboratory mixer load polydimethylmethylvinylsiloxane rubber with a viscosity of 200,000 cP in an amount of 100.0 mass. hours; modified aerosil (filler) containing the drug Miramistin - 22.0 mass. h; organohydrosiloxane HO [Si (H) + єt0] 4-H - 4 wt. h. The components are mixed for 20 minutes, after which the resulting mixture is unloaded into a container. Then prepare Composition No. 2: polydimethylmethylvinylsiloxane rubber with a viscosity of 200,000 cP - 100.0 wt. S. hours, modified aerosil (filler) containing the drug Miramistin - 22.0 mass. h; 3 - [(2-hydroxypropylmethacrylate) aminopropyl] -triethoxysilane - 3 mass. o'clock; - platinum catalyst - (platinum 1,3 divinyltetramethyldisiloxane) - 5.10-3 mass. h. All ingredients are stirred for 20 minutes, after which the resulting mixture is unloaded from the mixer. The resulting two compositions No. 1 and No. 2 are mixed in a ratio of 1: 1 until a homogeneous mass is obtained for 2-3 minutes. The composition is ready to form an elastic pad. Curing occurs in the patient’s oral cavity.

Patients of the main group were made of prostheses with a silicone lining above the specified composition, containing an aerosil filler modified with the Miramistin therapeutic drug. in the amount of 20 m.h. to the total volume of the silicone pad with a ratio of m.h. : Aerosil., Miramistin 3: 1. In the control study group, an elastic silicone lining without Miramistin was used to relocate prostheses.

Patients of both groups underwent microbiological examination of scrapings from the inner surface of the prosthesis base at the beginning of prosthetics and after a month of using the prosthesis.

A bacterial study of the oral mucosa was carried out according to the methods of order No. 535 of the USSR Ministry of Health dated April 22, 1985 “On the unification of microbiological (bacteriological) research methods used in clinical diagnostic laboratories of medical institutions”. Identification of isolated microorganisms was carried out by conventional methods.

When conducting a bacterial study, all microorganisms grown on nutrient media were taken into account. When assessing the quantitative and qualitative contamination of the mucous membrane of the prosthetic bed and the inner surface of the prosthesis base, it was found that the following types of pathogenic and conditionally pathogenic microorganisms are seeded in patients of the main and control groups: Str.mutans Str.viridans, Staph.aureus, Candida albicans.

The composition of the microbial flora and the degree of dissemination of the prostheses of the main group are presented in table 1.

Table 1.

The results of microbiological studies in patients of the main group, the frequency of allocation (%).

The name of the microorganism The first days of prosthetics After one month of using the prosthesis Str.mutans fourteen 12 Str.viridans 16 13 Staph.aureus fifteen eleven Candida albicans twenty 16

Table 1 shows that in patients of the main group, on the 30th day of using the prosthesis, the number of colonies of pathogenic flora significantly decreased. The degree of contamination of the test material also decreased.

In the control group of the studied patients, the growth of pathogenic and conditionally pathogenic flora revealed before prosthetics remained practically at the same level with insignificant changes.

The proposed removable denture with a modified silicone lining Miramistin was used in prosthetics of 22 patients. We observed patients after prosthetics for 7, 14 days and after one month. The treatment results are good - in all cases, the level of pathogenic microflora of the oral cavity decreased according to microbiological research. All patients showed a positive trend. All this allowed to reduce the number of visits for prosthesis correction, to reduce the time for adaptation to prostheses by 5-6 days. Using the proposed removable denture can reduce the inflammatory response of the mucosa of the prosthetic bed. This is confirmed on the basis of the clinical picture and the survey conducted in the patients we observed. An improvement in individual quality of life was manifested in a decrease in pain sensitivity while wearing the prosthesis and while chewing.

The utility model can be used in the clinic of orthopedic dentistry in the manufacture of prostheses to restore lost teeth, chewing function, articulation of speech.

Description to drawings

Figure 1. Sectional view of the prosthesis

1 - artificial teeth

2 - basis acrylic

3 - modified elastic silicone lining

Claims (1)

A removable denture containing an acrylic base with artificial teeth and an inner layer of elastic silicone lining, characterized in that the composition for forming the silicone lining for the base includes a silicone polymer modified with the Miramistin therapeutic agent, which is introduced first into the filler and then into the silicone polymer.

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