RU2255726C1 - Method for treating parodontium diseases in women with natural and surgical menopause - Google Patents

Abstract

FIELD: medicine, stomatology.

SUBSTANCE: therapy suggested should be performed due to applying a thin layer of 0.1%-butyric estradiol solution followed by a 5-min-long ultrasound treatment of the target surface. The method provides complex therapy and prophylaxis of parodontium diseases due to local substitution hormonotherapy with estradiol-containing solution.

EFFECT: higher efficiency of therapy.

1 ex

Description

The invention relates to medicine, namely to dentistry, and can be used for the prevention and treatment of periodontal lesions in women with natural and surgical menopause.

There is a method of treating periodontal disease by local application of antiseptic solutions in the form of instillations (Barer G.M., Lemetskaya T.I. Periodontal disease. Clinic, diagnosis and treatment. Textbook. - M .: VUNMTS, 1996. - 86 S.) .

However, the known method has the following disadvantages: it has a symptomatic effect (painkiller, anti-inflammatory), without affecting the pathogenesis of periodontal diseases in women during the menopause, and the use in the form of instillations provides a short-term effect and a rapid loss of activity of drugs due to washing off with saliva.

The closest positive result to the claimed object is a method of treating periodontitis by topical application of the Metrogil-Dent gel containing metronidazole (an antiprotozoal drug) and chlorhexedine (antiseptic) to prevent infectious complications (Grudyanov A.I., Dmitrieva N.A. , Ovchinnikova VV Dependence of the antimicrobial effectiveness of the drug “Metrogil-Dent” on the duration of local administration in inflammatory lesions of the periodontium. // Periodontology. - 2001. - No. 1-2. - P.32-36).

However, the known method does not take into account the pathogenesis of periodontal diseases, requires the use of large doses and their long-term local administration.

The authors propose a new method for the treatment of inflammatory periodontal diseases in women during menopause (natural and surgical) with local replacement therapy using a 0.1% oily solution of estradiol, which provides a pathogenetic effect.

A positive result of the claimed invention is to increase the effectiveness of complex treatment and prevention of periodontal lesions in women with natural and surgical menopause due to local hormone replacement therapy with an estradiol-containing solution.

A positive result is achieved by the fact that for the implementation of local replacement estrogen therapy of periodontal diseases using a 0.1% oily solution of estradiol. The method is as follows: a 0.1% solution of estradiol is applied in a thin layer on the mucosa of the alveolar processes from the vestibular and oral surfaces, and to facilitate the penetration of the drug into the periodontium and accelerate the onset of the drug, an additional 5 minute ultrasonic treatment of the target surface with the UT-1.02C device is used pulse mode 2-4 ms and an intensity of 0.05 W / cm ² . A continuous course of such applications is carried out daily for 10 days, after which they are repeated after a weekly interval, occupying a total monthly cycle. Control examinations on the removed indicators of dental status were carried out before the start of the application procedures and two weeks after the end of the cycle.

Using the proposed method for the treatment of inflammatory periodontal diseases in women with natural and surgical menopause, it is possible to achieve a significant improvement in the condition of periodontal tissues according to the results of an experimental check carried out on the basis of the Department of Orthopedic Dentistry of the Altai State Medical University and the Department of Therapeutic Dentistry of the Omsk State Medical Academy, the proposed course of local estradiotherapy caused a significant decrease in periodontal depth pockets, the degree of bleeding of the gums, the intensity of inflammation (Schiller-Pisarev test) and the prevalence of the pathological process (papillary-marginal-alveolar index), a significant decrease in the indicators of the complex periodontal index (CPI) and the need for treatment of periodontal disease (CPITN), in addition the proposed method of treatment contributed to a significant increase in the relative density of alveolar bones of both the lower and upper jaws, determined using a modified micro otometra MF-4.

Clinical example: Patient Panova Lyudmila Ivanovna, 54 years old, complained of sharp bleeding of the gums that occurs when brushing teeth and eating, occasionally bad breath, the appearance of gaps between the front teeth.

The patient was referred from a antenatal clinic with postovariectomy syndrome, the operation was performed in 1999, she refused general hormone replacement therapy. The first manifestations in the oral cavity began to appear 2-3 months after the operation. I did not receive treatment from a periodontist.

An objective study showed: the bite is orthognathic, teeth 24, 35, 36 and 45 are missing, the KPU index is 12, KPU-16, dental plaque cariogenicity is 1.76, the Green-Vermillion hygiene index is 0.8, the Schiller-Pisarev test is 2 points (brown staining), PMA index - 18.66%, periodontal pockets depth on the upper jaw in the anterior and lateral sextants 3 mm, on the lower jaw in the anterior and right lateral - 2 mm, and the left lateral - 3 mm, KPI - 1.33, CPITN - 0.33, chewing power according to Agapov - 72.

On the orthopantomogram of 10.26.2002, a thickening of the bone tissue is visualized due to the coarse, thickened bone beams of the upper and lower jaws. Conclusion: osteosclerosis.

The relative density of the alveolar bones of the upper jaw was 66.6%, and the lower - 81.2%.

The patient was prescribed local replacement estradiolotherapy according to the above procedure.

Two weeks after the last manipulation, the patient did not complain, and an objective examination of the oral cavity showed that the cariogenicity of plaque decreased to 1.28, the Schiller-Pisarev test to 1 (light brown), the PMA index to 6.9%, the periodontal depth pockets in the anterior sextants of both jaws - 1 mm, in the lateral sextants of the upper and lower jaws - 2 mm, KPI - 1.0, CPITN - 0.2.

On the orthopantomogram of June 16, 2003, the x-ray picture is unchanged.

The relative bone density in the upper jaw increased by 31.8%, and in the lower - by 16.3%.

The advantage of local estradiol therapy for periodontal diseases in women with natural and surgical menopause is its pathogenetic effect, based on the fact that estrogens contribute to remodeling of connective tissue due to the presence of specific receptors in periodontal disease, thereby compensating for the deficiency of steroid sex hormones in the menopausal period. The method can be used in dental clinics and specialized centers.

Claims (1)

A method of treating periodontal diseases in women with natural and surgical menopause by local therapy, characterized in that a 0.1% oily solution of estradiol is applied to the mucous membrane of the alveolar processes with a subsequent five-minute ultrasonic treatment of the target surface.