RU2279279C1 - Method for treating periodontitis cases - Google Patents

Abstract

FIELD: medicine.

SUBSTANCE: method involves applying drug treatment to carious cavity and root canals with ozonized isotonic sodium chloride solution having ozone in concentration of 4500-6000 mcg/l. The solution is introduced into each root canal in the amount of 10-15 ml during 5-10 min.

EFFECT: enhanced effectiveness of treatment.

2 cl

Description

The invention relates to medicine and can be used in practical dentistry in the treatment of periodontitis.

The main criterion for the successful treatment of periodontitis is a thorough mechanical and drug treatment of the root canal, which provides for the complete elimination of residues of organic matter, gangrenous cells, as well as bacteria and toxins.

To achieve this goal, essential oils, phenol, nitrofuran series drugs, enzymes, antibiotics, sulfa drugs, non-steroidal anti-inflammatory drugs, immunomodulating drugs, and medicines containing an agent that inactivates the infectious microflora are used. As such an inactivating agent, an aqueous solution of polymethacrylic acid and sodium salt of polymethacrylic acid is used [RF Patent No. 2077312, A 61 K 6/02, published on 04/20/1997].

However, all of these tools have a number of individual and general disadvantages:

- bactericidal and bacteriological activity of these drugs for microorganisms located in the root canals, appears selectively;

- removal of material beyond the apical opening leads to severe toxic damage to periodontal tissues;

- many drugs have a sensitizing effect;

- prolonged use of antibiotics leads to the development of hypersensitivity and the emergence of resistant forms of microorganisms;

- a number of drugs stains the crown of the tooth.

The main common drawback of known drugs is the long treatment time, while the percentage of complications is quite large and varies from 6 to 30%, depending on the type of drug.

A known method of treating periodontitis by mechanical and drug treatment of the root canals with 4% alcohol tincture of propolis and leaving a tampon moistened with the same solution on the mouths of the canals. Subsequently, the root canal is filled with propolis paste with zinc oxide as a filler [RF Patent No. 2135115, A 61 C 5/04, published August 27, 1999].

The disadvantage of this method is the low efficiency in the treatment of teeth with difficult and impassable canals.

Closest to the proposed is a method for the treatment of periodontitis by mechanical and drug treatment of the carious cavity and root canals with their subsequent drying and filling. For drug treatment use an aqueous solution of sodium hypochloride (NaOCl) with a concentration of from 0.5% to 5.25%, but usually it is 2.5% [RF Patent No. 2210405, A 61 N 5/067, published 08/20/2003] . Sodium hypochlorite has the ability to dissolve living, necrotic and fixed tissues well, has a pronounced bactericidal effect, is an excellent lubricant and bleaching agent, is long-lasting and economically beneficial (Rosenfeld, EF, James, GA and Burch, BS: Vital pulp tissue response to sodium hypochlorite , J. Endod. 4: 140, 1978).

The disadvantage of this method is that its application should be limited by the space of the channel. The ingress of solutions outside the channel, especially under pressure, will lead to severe toxic effects, tissue damage, as well as acute pain and swelling. This forces specialists to significantly reduce the concentration of solutions used. However, a decrease in concentration leads to a significant deterioration in the effectiveness of treatment.

The technical result of the invention is to increase the efficiency and accelerate the treatment of periodontitis.

The technical result of the invention is achieved by the fact that in the method of treating periodontitis by mechanical and drug treatment of the carious cavity and root canals of the tooth, followed by drying and filling, a distinctive feature is that the drug treatment of the carious cavity and root canals of the tooth is carried out with an ozonized isotonic sodium chloride solution with a concentration ozone 4500-6000 μg / l, introducing it into each root canal of 10-15 ml for 5-10 minutes.

Drug treatment of the root canals of the tooth with an ozonated aqueous solution of sodium chloride can be carried out 2-7 times with an interval of 1-3 days with an intermediate filling with a temporary filling. The result is increased processing efficiency.

It is known from the prior art to use ozonated distilled water and an isotonic saline solution of sodium chloride for the treatment of inflammatory periodontal diseases and for rinsing the oral cavity. The ozone concentration in the ozone-oxygen mixture ranged from 2000 to 2500 μg / l [Sorokina S.R. The use of ozonated solutions in the complex treatment of inflammatory periodontal diseases // Abstract. Dis. Cand. honey. sciences. Tver, 1997, 21 pp.]. The effectiveness of this treatment is due to the fact that ozone has bactericidal, anti-inflammatory and antihypoxic properties.

However, the prior art did not reveal the use of an ozonized isotonic physiological solution of sodium chloride with an ozone concentration of 4,500-6,000 μg / L supplied directly to the root canal under the stated treatment regimes for the treatment of periodontitis with the achievement of the indicated technical result.

In the claimed method, the efficiency of drug treatment of the carious cavity and root canals is increased, especially in the treatment of impassable canals, by reducing the concentration of anaerobic microflora in the dental canal, eliminating the occurrence of allergic reactions and irritating effects on periodontal tissues, eliminating the color change of the dental crown, and accelerating the treatment process. The claimed method involves the use of an agent having analgesic and hemostatic effect.

The main advantage of the method is that in the process of drug treatment at the indicated modes and concentrations of ozone, a freshly prepared ozonated sodium chloride solution, acting overwhelmingly on the infectious microflora, helps to remove dead organisms and necrotic decay products from the root canals, which prevents exacerbations in the post-filling period and reduces timing of regeneration in periodontal tissues.

The claimed method for the treatment of periodontitis does not provide for the use of toxic agents, as well as agents that can cause allergic reactions. Therefore, the method has no contraindications and can be used in medical practice for the treatment of children and pregnant women.

Example.

Patient R., born in 1977, turned to the department of cariesology and endodontics with complaints of constant aching pain and pain when biting in the area of 11, 12 teeth. From the anamnesis it was found that previously these teeth were treated for tooth decay. It has been objectively established that on the medial palatine surface 12 and the distal palatal 11 near the fillings there are carious cavities with softened pigmented dentin. After removal of old fillings and preparation of carious cavities, decay of the root pulp was detected. The patient was diagnosed with exacerbation of chronic apical periodontitis. A message of the carious cavity with the cavity of the tooth was detected on the targeted intraoral x-ray, as a result of which there was pulp necrosis, as well as an expansion of the periodontal gap and the formation of a periapical destruction site near the tips of the roots of 11, 12 teeth with fuzzy contours.

Under local infiltration anesthesia, the old fillings of 11 and 12 teeth were removed, the root canals were mechanically treated with manual and machine tools and the Sonic Air 1500 ultrasonic instrument (Micro-Mega). After that, the root canals were treated with an ozonized isotonic sodium chloride solution prepared on a Medozon ozonizer immediately before treatment; the concentration of ozone in the solution was 4500-6000 μg / L. For root canal irrigation, endodontic syringes were used, the amount of ozonized solution was 10-15 ml per root canal, the exposure time was 5-10 minutes. The procedure was repeated for three visits with a break of 1-3 days with an intermediate filling with a temporary filling. After that, the root canal was dried and filled using the lateral condensation method. After the first treatment of the root canals with an ozonized isotonic sodium chloride solution, the patient stopped complaining of aching pain and pain when biting.

The claimed method of treatment of periodontitis can increase the effectiveness of drug treatment of the carious cavity and root canals by reducing the concentration of anaerobic microflora. Freshly prepared ozonized sodium chloride solution, acting overwhelmingly on the infectious microflora, helps to remove dead microorganisms and necrotic decay products from the root canals, which prevents exacerbations in the post-filling period and reduces the regeneration time in periodontal tissues. The method is easy to use and economical.

Claims (2)

1. A method of treating periodontitis by mechanical and drug treatment of the carious cavity and root canals of the tooth, followed by drying and filling, characterized in that the drug treatment of the carious cavity and root canals of the tooth is carried out with an ozonized isotonic sodium chloride solution with an ozone concentration of 4500-6000 μg / l, introducing it into each root canal of 10-15 ml for 5-10 minutes. 2. The treatment method according to claim 1, characterized in that the drug treatment of the carious cavity and root canals of the tooth with an ozonated aqueous solution of sodium chloride is carried out 2-7 times with an interval of 1-3 days with an intermediate filling with a temporary filling.