RU2162354C1 - Method for treating patients suffering from chronic catarrhal gingivitis - Google Patents

Abstract

FIELD: medicine. SUBSTANCE: method involves treating gums daily during 4-5 days with defocused low temperature argon plasma flow produced at 30 A current intensity, 40 V voltage, gas pressure of 0.1-0.3 atm during 3 min at a distance of 15 cm from plasmatron to the surface under irradiation. EFFECT: enhanced effectiveness of treatment.

Description

 The invention relates to medicine, to the treatment of patients with chronic catarrhal gingivitis.

 Known methods for treating patients with chronic catarrhal gingivitis, when physical factors are included in the complex therapy: short-wave ultraviolet radiation (UV), helium-neon laser radiation (IGNL), etc.

 To irradiate the gums with short ultraviolet rays, the OH-7, OKUF-5M devices are used. The rays from the burner are brought to the irradiated surface using a tube. The time of the first procedure is -1-2 minutes, with each subsequent procedure, the duration of exposure is increased by 1 minute. In total, from 5 to 10 procedures are carried out for the course of treatment [O. Efanov, T. Dzanagova. Physiotherapy of dental diseases. - M .: Medicine, 1988.- 296 p.]. Short-wave ultraviolet radiation has a pronounced bactericidal effect, as well as a fungicidal and fungistatic effect on fungi of the genus Candida [Komarova L. A., Kiryanova V.V., Gorshkova G.I., Chilina G.A. On the fungicidal effect of integrated and selective ultraviolet radiation on yeast-like fungi of the genus Candida // Vopr. balneology. - 1993.- N 4.- S. 25-26].

 KUV causes a characteristic change in the structure of proteins and lipoids. At the same time, short ultraviolet rays do not have an erythema effect and cannot cause burns of the mucous membrane [Ivanov B.C. Periodontal Diseases.- M .: Medicine, 1998.- 296 p.].

Laser therapy for chronic catarrhal gingivitis is used to relieve inflammation. In order to provide an anti-inflammatory and analgesic effect, in this case, exposure to the gums of radiation of a helium-neon laser with a power density of 100-200 mW / cm ^{2 is used} at an exposure of 30 seconds to 5 minutes. The number of exposure fields 1-5, the duration of the total exposure 1-20 minutes; for a course of 1-14 procedures. The use of GINL in practical periodontology is based on the interaction of a powerful monochromatic laser beam with intracellular formations, as a result of which the course of biochemical reactions and the structure of molecules change. Small powers have a stimulating, analgesic and anti-inflammatory effect [Prokhonchukov A.A., Zhizhina N.A., Balashov A.N. and other Laser physiotherapy of dental diseases // Dentistry.- 1995.- T.74.- N 6. - P. 23-31; Ivanov BC Periodontal Diseases.- M .: Medicine, 1998.- 296 p.].

 There is a method of using in dentistry defocused low-temperature plasma flow of argon (PAP). This method is used in the treatment of chronic apical periodontitis. After traditional surgical treatment, the resulting bone cavity was exposed to defocused argon plasma for 5 minutes from a distance of 15 cm from the plasma torch nozzle to the wound surface at a current strength of 25-30 A, voltage 40 V, gas pressure 10-20 kPa, [Volchenkova G. IN. Combined methods of treating patients with chronic apical periodontitis of large and small molars using a plasma flow of argon .: Dis. Cand. honey. sciences. - Smolensk, 1998]. PAP was also used in the treatment of phlegmon of the maxillofacial region. Patients in the postoperative period, daily after washing the wound with antiseptic solutions, irradiated the purulent focus with a defocused argon plasma beam for 5 minutes from a distance of 15 cm from the plasma torch nozzle when the PCB was in cutting mode at a current strength of 60 A, voltage 40 V, gas pressure 0.1 -0.3 atm. [Kuzmina E.V. The use of a plasma flow of argon in the complex treatment of patients with phlegmons of the maxillofacial region and neck (clinical and experimental study) .: Dis. Cand. honey. Sciences. - Smolensk, 1997].

 However, all known methods of physiotherapeutic treatment in the complex therapy of chronic catarrhal gingivitis are not without drawbacks: the effect is on only one link in the pathogenesis, relatively low clinical effectiveness, and there is no long-term clinical effect.

 The essence of the invention lies in the fact that the patient in the "traditional" complex therapy of chronic catarrhal gingivitis, including the removal of non-mineralized tooth deposits and antiseptic treatment of the oral cavity, gums are irradiated with a defocused low-temperature argon plasma flow (current 30 A, voltage 40 V, gas pressure 0.1-0.3 atm) for 3 minutes from a distance of 15 cm from the plasma torch nozzle to the irradiated surface, 4-5 procedures per course.

 Such parameters of the effect of plasma flow on tissues provide the most pronounced anti-inflammatory, bactericidal and analgesic effect [Volchenkova G.V. Combined methods of treating patients with chronic apical periodontitis of large and small molars using a plasma flow of argon .: Dis. Cand. honey. Sciences. - Smolensk, 1998.].

 Processing of gums with a plasma stream of argon has a pronounced bactericidal effect, quickly suppresses inflammation, normalizes microcirculation and homeostasis of periodontal tissues, normalizes the activity of enzyme and protective systems of the oral fluid.

 The method is as follows: after removal of non-mineralized tooth deposits and antiseptic treatment of the oral cavity, the gums are irradiated with a defocused low-temperature plasma stream of argon of the SUPR-M apparatus (current strength 30 A, voltage 40 V, gas pressure 0.1-0.3 atm) for 3 minutes from a distance of 15 cm from the plasma torch nozzle to the irradiated surface. The procedure is carried out daily. The total number of procedures per course is 4-5.

 Example 1. Patient Inchakova NS, born in 1963, honey. Map N157.

 Diagnosis: Chronic catarrhal gingivitis.

 On January 18-22, 1999, after removal of non-mineralized tooth deposits and antiseptic treatment of the oral cavity with 0.06% chlorhexidine bigluconate solution, the gums were irradiated with a defocused argon plasma beam for 3 minutes from a distance of 15 cm from the plasma torch nozzle at a current of 30 A, voltage 40 V, gas pressure 0.1-0.3 atm (5 procedures). During the procedure, the patient noted a slight sensation of warmth in the gums.

 As a result of the treatment, after the first procedure, a quick relief of inflammatory phenomena began, discomfort in the gums disappeared, bleeding decreased. On examination, January 25, 1999: the mucous membrane of the gums is pale pink, there are no inflammatory phenomena and bleeding. Polarography data of periodontal tissues indicate normalization of the oxygen balance of tissues: initial pO2 - 37.3 mm Hg; with an oxygen sample, the maximum pO2 is 168.2 mm Hg; time to reach maximum pO2 - 115.6 s; growth rate pO2 (SEC) - 100.6 mm Hg / min; the time to reach the initial pO2 is 130.6 s; pO2 reduction rate (CCK) -131.6 mm Hg / min .; SSK / SPK 50.8.

 Example 2. Patient Larionov P.P., born in 1973, honey. N433 card.

 Diagnosis: Chronic catarrhal gingivitis.

 02/15/1999, the removal of non-mineralized tooth deposits and antiseptic treatment of the oral cavity with a solution of chlorhexidine bigluconate 0.06%. From February 15, 1999 to February 18, 1999, the gums were irradiated with a defocused argon plasma beam for 3 minutes from a distance of 15 cm from the plasma torch nozzle at a current of 30 A, voltage 40 V, gas pressure 0.1-0.3 atm (4 procedures).

 During the procedures, the patient noted a slight warmth in the gums. As a result of the treatment, on the third day there was a relief of inflammatory phenomena in the periodontal tissues, bleeding decreased, discomfort in the gums disappeared. On examination 02/19/1999: the mucous membrane of the gums is pale pink, there are no inflammatory phenomena and bleeding, the state of oral hygiene is satisfactory. Polarography data of periodontal tissues indicate normalization of the oxygen balance of tissues: initial pO2 - 37.0 mm Hg; with an oxygen sample, the maximum pO2 is 164.1 mm Hg. Art. ; time to reach maximum pO2 -114.3 s; the growth rate of pO2 (SEC) is 99.3 mm Hg / min; the time to reach the initial pO2 is 136.3 s; pO2 (CCK) reduction rate -124.4 mm Hg / min; SSK / SPK -44.6.

 In the department of therapeutic dentistry of the Smolensk Regional Clinical Dental Clinic, this method was used in the treatment of 43 patients with chronic catarrhal gingivitis.

 All patients during the procedures noted a slight feeling of warmth in the gums. There were no unpleasant sensations or any undesirable effects. The beneficial effect of PAP on the course of the inflammatory process in periodontal tissues was revealed: already after the first procedure, rapid relief of inflammatory phenomena, reduction of bleeding, and the disappearance of unpleasant sensations in the gums began. Polarographic research data showed a normalization of the oxygen balance of periodontal tissues: an increase in the initial and maximum levels of partial pressure of oxygen in tissues (during an oxygen test), an increase in the time to reach maximum pO2, an increase in the rate of increase in pO2, etc.

 There was a reduction in the term for the relief of inflammatory phenomena in the gums by an average of 2-3 days compared with the action of IHNL and KUF.

 A method of treating chronic catarrhal gingivitis, including the inclusion of irradiation of the gums with a plasma stream of argon in the complex of therapeutic measures, is simple to implement, safe, and available for use in every dental medical institution.

Claims (1)

 A method of treating chronic catarrhal gingivitis, including the removal of non-mineralized tooth deposits, antiseptic treatment of the oral cavity and the use of a physiotherapeutic factor, characterized in that the gums are irradiated daily with a defocused low-temperature argon plasma stream obtained at a current of 30 A, voltage 40 V , gas pressure 0.1 - 0.3 atm, for 3 min from a distance of 15 cm from the plasma torch nozzle to the irradiated surface.