RU2112417C1 - Method for estimating periodontic tissues state - Google Patents

Abstract

FIELD: medicine. SUBSTANCE: method involves determining blood-filling degree from response to pulsating low frequency complex modulation electromagnetic field. To do it, diagnostic transducer is positioned in two points being root apex and gingival edge projection over maxilla and mandible. Response signal is converted into analog form as feedback voltage Vfb. The value of Vfb is used to calculate bioelectromagnetic reactivity index value. The value is between 1.0 and 1.1, normal state of blood circulation is diagnosed. EFFECT: enhanced accuracy of early stage diagnosis. 2 dwg , 1 tbl

Description

 The invention relates to methods of functional diagnostics and can be used in dentistry to assess the condition of periodontal tissues, to enable early diagnosis.

 To determine the functional state of periodontal tissues, reoperodontography and photoplethysmography are most often used (Epidemiology, Ethylogy, and Prevention of Periodontal Diseases. Report of the WHO Scientific Group (series of technical reports, No. 621). Geneva, 1980, p.66).

 The development of new simple non-invasive methods of functional diagnostics is an urgent task.

 Under the electrodiagnostics usually understand the study of the reaction of excitable tissues to electrical discharges.

 Typically, the diagnosis is established on the basis of medical history, objective examination, and especially radiography. The testing method is applied. It is believed that blood tests (white blood cell count, left shift of the formula, red blood cell morphology, hemoglobin level, elevated levels of globulins and fibrinogen) are of great importance in the diagnosis of periodontal and periodontal diseases. In order to diagnose focal disease, Remki's histamine test and Slauk's muscle-fibrillar test are used. To determine the localization of active stomatogenic foci, an Helen-Standel electrodermal test is used, and novocaine-caffeine test in the presence of pain is also used.

 In the practice of medical dental institutions, the method of metered vacuum is used. Of the special methods, you can specify radiological, capillary-microscopic, functional, etc.

 The use of electroacupuncture according to the method of R. Voll for diagnostics in dentistry is known. A distinctive advantage of electroacupuncture in comparison with classical acupuncture is the ability to obtain feedback (response) when exposed to biologically active points (BAP). This is achieved by measuring the electrical parameters of the BAT before and after exposure (puncture).

 The ohmic resistance of the BAP zone is measured when it is irritated by a constant electric current of 5.5 - 11.25 μA.

 After a substantially subthreshold electric exposure, the response of organs or systems of the human body is evaluated depending on the specific meridian of the measured BAT.

 In the case of the biologically normal energy state of the tested organ or system, an equilibrium arises between the supplied signal and the response, in which case the boom of the measuring device is stationary about 50 conventional units (which corresponds to a resistance of 100 kOhm. Scales of all devices (for example, Dermatron - Germany, Forecast , LADY, Almaz, Skat, Russian Fall, Biotest - Russia) are divided into 100 conventional units.The indicator of less than 50 units indicates degenerative processes, involution of organs or systems . At indices close to 0, the resistance of the BAP zone reaches 14,500 kOhm. An increase in the bioenergy level above 50 units indicates the presence of inflammation in the tested organ. The BAP electrical resistance significantly decreases, for example, at 90 conventional units the resistance is only 15 kOhm (" New in dentistry "issue. 1/94, p. 51).

 A well-known medical diagnostic universal controlled module (MEDIUM) is used in the form of a Diagnostic Specialized Complex (DSC-301) in dental practice and allows you to conduct a wide range of functional studies, including painless diagnosis of the condition of the tooth pulp, periodontal disease, the viability of the displaced tissues to close the maxillofacial defects -face area and others ("New in Dentistry", "Special Issue", 4/92, p.22-25).

 The known method of electrometric diagnostics in periodontics, using four electrodes, where the measuring circuit is separated from the exciting current circuit.

 To implement this method, a special measuring device with a tunable frequency of the exciting current in the range from 20 Hz to 20 kHz has been created. In this case, one electrode is fixed on the patient’s hand, and a 3-electrode sensor is placed on the gingival mucosa.

 The developed method allows you to detect local foci of pathological changes in periodontal and periodontal and monitor the effectiveness of their treatment ("New in Dentistry". Special issue 4/93, p.4-13).

 A known method for the diagnosis of dental diseases, including determining the response of the tooth to electrical exposure when the active electrode is placed on the tooth surface, the passive electrode to the acupuncture point on the patient’s body corresponding to the diseased tooth, the exposure is carried out by direct current of positive polarity with subsequent measurement of the conductivity between the electrodes, moreover, with its value of 0.18 - 0.37 μA, hyperestension of hard tissues is diagnosed, 0.38 - 2,399 μA - periodontal disease, 2.4 - 4.56 μA - chronic period nit, at 4.57 - 499 μA - alveolite (AS USSR N 1678316, priority 16.05.89, A 61 B 500).

 A known method for assessing the state of periodontal tissues, including an analysis of the level of blood supply to periodontal tissues (Ivanov V.S. Periodontal disease. -M .: Medicine, 1989, p. 82 prototype).

 Known methods for diagnosing periodontal tissues are quite complicated.

 An object of the invention is to simplify the method for assessing the condition of periodontal tissues. At the Department of Therapeutic Dentistry of the Ural Medical Institute, the possibility of using pulsed low-frequency complex-modulated electromagnetic field (INSEMP) to assess the functional state of periodontal tissues, based on its ability to change the characteristics of the spectrum of the response signal when interacting with the studied tissue site, depending on their blood supply and functional state, was studied.

 For research, we used the diagnostic and treatment complex with feedback intensity "Malachite-010P" (Bankov V.I., Methodological manual on the use of pulsed complex-modulated electromagnetic fields for treatment and diagnosis. Textbook. - Yekaterinburg: Ural Medical Institute, 1992, 24 sec. )

Its medical and technical characteristics:
pulse repetition rate control range F: (3 - 120 Hz) ± 10%;
range of regulation of the modulating frequency F _m : (0.03 - 1.2 Hz) ± 10%;
frequency deviation: not more than ± 5%;
polyharmonic frequencies per pulse: from 500 Hz and above;
limits for measuring the frequency F and F _m : 0.01 - 990 Hz;
limits of measurement of feedback parameters U _OS : 0.01 - 9.99 B;
measurement error of parameters: 2%;
induction (at a distance of 1 cm from the working surface of the inductor) depending on the shape of the inductor, its purpose and frequency used: up to 10 mT;
timer setting time limits: 1 - 99 min;
discreteness of setting the timer: 1 min;
number of outputs to inductors: 4 pcs.;
number of connected inductors: 1 - 8 pcs .;
operating mode: manual, semi-automatic and automatic with connection via a computer driver;
number of diagnostic sensors: 2-surface and deep;
time of continuous operation of the device: not limited;
instrument power: mains 220 V ± 10% 50 - 400 Hz;
power consumption (idling): 7 W;
degree of protection against electric shock: II class.

 The medical and diagnostic complex "Malachite-010P" was developed in accordance with the industry scientific and technical program "Studying the mechanism of the biological and therapeutic effects of magnetic fields in normal and pathological conditions."

 The solution to the issue of organizing feedback was begun by elucidating the "regulated mechanisms" of the effects of electromagnetic fields with a living organ. The formation of a response-signal of a living organ, the possibility of its detection and its analysis depends on the ability of elementary structures of an organ (ESO) to respond to the impact of EMF EMF. In practice, a simplified integral component of the response-signal of a living organ is used, namely, the analog form of signal representation. However, the entire process of regulating the feedback channel can be carried out using a more sophisticated apparatus for analyzing the signal spectrum: the presence of certain harmonics, their frequencies, the existence of phase or frequency modulation, etc., which implies the use of computer tools.

 The following are options for organizing feedback.

The operating conditions of the ISM EMF generators provide for the use of a feedback channel through which an analog signal is transmitted that does not exceed 10 mA in current. The level of the analog signal is set in accordance with the proportional changes in the complex current-feedback transfer coefficient:
K = J _OS / J _OUT
Where
K is the complex transmission coefficient (CCP);
J _OS - feedback current;
J _o - output current equal to J _n .

 It is known that the specifics of changes in some parameters of EMFs, obtained by exposure to a living organism, are used to determine the functional state of living organ tissues or for diagnostics (The use of constant magnetic fields in non-invasive electromagnetic methods for measuring blood flow. Tr. Institute of Electronics and Radio Engineering, 1980, vol. 68, No. 1, pp. 178-185).

 The properties of the ISM EMF were used to develop a method for assessing the condition of periodontal tissues. In this case, the principle of measuring the spectral density of the field (pulse) power was applied, which made it possible to analyze the signal response parameters and obtain information on the state of periodontal tissues.

 Comparison of the weighted powers of the numerous harmonic components of the EMF EMF pulses with the nature of the organ response signal made it possible to diagnose the state of the organ tissues by analyzing the appearance or disappearance of one or another “harmonics” interacting with the tissue. This method is called "determination of bioelectromagnetic reactivity (BEMR) of living tissues."

 Clinical scales of BEMR indices have been developed that indicate the state of tissues and determine the degree of their vital activity (for example, The role of a comprehensive assessment of peripheral hemodynamics and some indicators of tissue metabolism in the choice of surgical tactics for obliterating diseases. Avtoref.dis.kand.med.nauk - Sverdlovsk, 1968, 18 s.).

 Consider a standard example.

 In FIG. Figure 1 shows the ratio of the absolute values of BEMR and their indices for the areas of muscle masses of the upper limb (fingers and hand).

 High levels of BEMR were noted in the area of muscle arrays and projections of the superficial location of the great vessels, which made it possible to construct a graphoanalytic relationship (Fig. 2) between the sensor indices and the developed clinical scale of BEMR indices that indicate the state of the soft tissues of the organ and determine the degree of their viability. On a scale, the limits of compensation had fluctuations from 1.1 to 0.65, subcompensations from 0.65 to 0.35, decompensations from 0.35 to 0.25. A score below 0.25 indicates tissue destruction.

 To construct the control law according to the system “the functional state of living organ tissues - electromagnetic field parameters”, it was assumed that the initial value S (ω) is a function that is the Fourier transform of the correlation function B (τ) of the random signal And (τ).

For simplicity and ease of programming, conventional notation and a description system for the BASIC language were used. Let the reaction of living organ tissue systems to the action of the energy ISM EMF S (ω) (we assume as x (t)) be described by the nonlinear transfer characteristic of the random process B (τ) (we accept as Y (x)). Moreover, by X _o we denote the constant feedback component τ _os , X ₁ the harmonic amplitude A, then the harmonic effect of the energy of the field spectrum takes the form X (t) = X ₀ + X ₁ sinωt.

The described algorithm:
1. We set the initial constant component X ₀ , the amplitude X ₁ , the number of intervals of the splitting of the pulse period at the time of analysis N in the number of initial harmonics M included in the spectrum.

2. Divide the period X (t) T into N parts: Δt = T / N at T = 1, we find t ₁ = Δt; X ₁ = X ₀ + sin (2π) for i = 100.

3. We turn to the subroutine for calculating the transfer characteristic y (x), ie we find the value Y ₁ = Y (X ₁ ).

и энергетические компоненты гармоник.4. We consider the changes Y ₁ (t) on each small time interval Δt linear, we calculate the constant component of the reaction A ₀ ;

and energy components of harmonics.

Знак "минус" у какой-либо величины Ak_c указывает на поворот фазы гармоники и на соответствующий "уход" ПС в область отрицательных или положительных значений.5. We find the absolute values of the density of the spectrum (PS) due to the reaction of a nonlinear system of random processes in living tissues:

The minus sign for any Ak _c value indicates the rotation of the harmonic phase and the corresponding PS “departure” to the region of negative or positive values.

 When installing a feedback sensor (a diagnostic sensor in the area of a pathological focus or an organ under investigation), the parameters of the operating EMF EMF were calculated automatically using the feedback unit according to the corresponding calculation algorithm and exponential regulation law.

We examined 18 people of both sexes aged 18 - 55 years with an intact periodontium. The measurements were carried out in the area of each tooth at two points - the projection of the apex of the root and gingival margin on the upper and lower jaws. 864 measurements taken. The average readings are presented in the table. It was found that the average values of U _os in the alveolar gingival region are smaller, and the BEMR index is correspondingly larger than when measured at the gingival margin, which is associated with the level of blood supply intensity. The average value of U _OS in the region of the lateral group of teeth is lower than in the region of the anterior group of teeth along the alveolar gum and gingival margin. Index values range from 0.9 - 1.1, which corresponds to normal blood circulation.

Claims (1)

 A method for assessing the condition of periodontal tissues, including analyzing the level of blood supply to periodontal tissues, characterized in that the level of blood filling is determined by the response of periodontal tissues to an impact of a pulsed low-frequency complex modulated electromagnetic field, for which a diagnostic sensor is placed on the periodontal tissue at two points - the projection of the apex of the root and gingival edges on the upper and lower jaws, convert the response signal into an analog form - the feedback voltage and by its indicators determine Dex of bioelectromagnetic reactivity of periodontal tissue, corresponding to the level of blood supply and when its value is in the range of 0.9 - 1.1, normal blood circulation is diagnosed.

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