RU2286816C1 - Method for treating patients with deep caries - Google Patents

Abstract

FIELD: medicine, stomatology.

SUBSTANCE: one should apply "dentin-sealing liquid" consisted of liquid 1 and liquid 2 and, also, additionally, one should apply gradual impact with low-intensity laser radiation upon dentin of prepared carious cavity after each impregnation with "dentin-sealing liquid", moreover, at first it is necessary to impregnate with liquid 2 and then - with liquid 1, then dentin should be again impregnated with liquid 2, moreover, "Aevit" is prescribed, as well. Thus, dentin-sealing liquid activated with laser radiation penetrates dentine canaliculi more deeply and gradual impact prolonged trace effect of laser radiation action.

EFFECT: higher efficiency of therapy.

4 dwg, 1 ex

Description

The invention relates to medicine, in particular to dentistry, and is intended for the complex treatment of patients with deep tooth decay.

Closest to the technical solution adopted for the prototype is a method for treating patients with deep tooth decay, taking into account the options for its course using bone-heparin preparation "Xidiphon" and physiotherapy using low-frequency ultrasound, consisting of the following steps. On the first visit after preparation, the carious cavity of the tooth is treated with a 2% solution of xidiphon for 30 seconds using ultrasound at a frequency of 24.5-28.5 kHz. Then, a cotton swab moistened with xidiphon is left in the carious cavity under a bandage of water dentin for 4 days. On the second visit to the patient, a temporary filling is replaced with a permanent one. The second option is possible when, on the first visit after drug treatment of the carious cavity with xidifon using ultrasound, a hydroxycalcium-containing drug is applied, for example, Contrasil varnish and a permanent seal [see Shumsky A.V., Elin V.A. A differentiated approach in the treatment of "deep" caries // Clinical Dentistry. - 2004. - No. 1 (29). S.20-22].

The disadvantage of the prototype is that therapeutic bone-heparin or hydroxide-calcium-containing gasket "Xidiphon" dissolve, leaving voids in place. A treatment pad containing calcium hydroxide, as a rule, does not adhere to tooth tissues, an insulating pad must be applied to it, which complicates the technology for treating deep caries, pads do not prevent the development of secondary caries, and do not eliminate the possibility of post-filling pain. Ultrasound does not stimulate crystallization and mineralization of hard tissues, has a number of general contraindications for use, patients are not prescribed drugs inside to enhance the clinical effect of treatment.

The objective of the invention is to increase the clinical effectiveness of treatment, prevention of secondary dental caries, enhancing the bactericidal and crystal-forming action of the mineralizing composition, protecting the pulp from harmful pathogenic factors, photobiostimulating blood circulation in the tooth pulp, energy-information exchange between biological (dentin fluid and blood) and dentin-sealing fluids, prevention of post-filling sensitivity and reduction of treatment time.

To solve this problem, a method for the treatment of patients with deep tooth decay, consisting of stages. The first stage: anesthesia, preparation of the cavity, washing, drying, wetting of the dentin of the cavity with liquid No. 2 of the dentin-sealing liquid (DGL) containing highly dispersed calcium hydroxide are performed, they are exposed to it with low-intensity laser radiation and the cavity is drained with an air stream. The second stage: the dentin-carious cavity is moistened with DGL No. 1 liquid containing magnesium fluoride, magnesium sulfate, copper sulfate II, sodium fluoride and distilled water, and they are exposed to it by low-intensity laser radiation, and the cavity is drained with a stream of air. The third stage: dentin, on which the fluids No. 2 and No. 1 of DGL are applied, is once again moistened with liquid No. 2, exposed to it with laser radiation, drained the cavity and a permanent filling is applied. The patient is prescribed inside "Aevit" 1 capsule 2 times a day after meals for 3-4 days.

The present invention allows to obtain the following technical result in the treatment of patients with deep tooth decay.

- Increases the effectiveness of treatment and preventive measures carried out by patients with deep tooth decay.

- Photobiostimulation is carried out by low-intensity laser radiation of microcirculation and trophic pulp of the tooth.

- An energy-informational exchange is carried out between biological fluids (dentin fluid and blood) and dentin-sealing fluid.

- The course of chemical reactions in the mineralizing liquid is activated, the volume of reacted reagents increases and their consumption decreases.

- Crystal formation in dentinal tubules of the teeth is intensified, their sealing, a permanent bactericidal effect and protection of the pulp from harmful pathogenic factors are observed.

- The time of the trace effect of the action of low-intensity laser radiation is extended when it is stepped on the mineralizing composition and tooth.

- Prevention of post-filling sensitivity and secondary dental caries is being carried out.

- There is a growth of crystals of dentin-sealing liquid, acquiring a geometrically regular shape, more closely spaced, their size increases, which increases the effect of mineralization of hard tissues and sealing of the dentinal tubules of the tooth.

To explain the proposed method of treatment, in terms of illustrating the activation of crystal formation in liquid No. 1 of DGL by low-intensity laser radiation, a list of microcrystallogram figures is given. After laser activation of the liquid, the crystals acquired a geometrically regular shape (figures 2, 3 and 4), a close and orderly arrangement (figures 2 and 3), in comparison with crystals where there was no laser activation of the liquid (figure 1).

The method is as follows. Anesthesia is performed and a carious cavity of the patient’s tooth is prepared. The tooth is isolated from saliva. The cavity is drained with a stream of air. Using the applicator, the bottom of the cavity is moistened with DGL No. 2 liquid, irradiated with low-intensity laser radiation, drained, then the cavity is moistened with DGL No. 1 liquid, re-exposed to laser radiation, drained the cavity, re-introduced DGL No. 2 liquid, exposed to laser radiation, drained and sealed. Aevit is prescribed to the patient.

There is a specific example of the use of the invention. Extract from the medical history of the patient Sh.A., 18 years old, 12.12.04. After examining the patient using the main and additional methods, the diagnosis was made: Deep caries 46. A plan of treatment and preventive measures was drawn up. Anesthesia was performed with the introduction of Sol. Septanest ad Adrenalinee 1: 200000 - 1.7 ml and preparation of the tooth. The dentin of the cavity was moistened using an applicator with liquid No. 2 DGL, the cavity was irradiated with laser radiation in an exposure of 30 seconds. After 1 minute, the cavity was drained by a stream of air. Then, the bottom dentin of the cavity was moistened with DGL No. 1 liquid; it was irradiated with laser radiation at an exposure of 30 sec. After 1 minute, the cavity was drained with a stream of air and liquid No. 2 DGL was applied to the bottom of the cavity, laser irradiation was carried out in the exposure for 15 seconds. After 1 minute, the cavity was drained with a stream of air and a permanent seal made of Filtek Z 250 with a lining of Vetrimer was applied. The patient was prescribed Aevit 1 capsule 2 times a day after meals for 3-4 days. The apparatus of laser therapy APT - Smile-01, which generates laser radiation with a wavelength of 0.64 microns, operates in continuous mode. The average radiation power at the output of the main fiber-optic cable was 15 mW.

Control inspection the next day. The patient has no complaints. The seal is in satisfactory condition. Inspection after 3 months 03/01/05. No complaints. The seal is in satisfactory condition, the gum is pale pink. Tooth percussion is painless. Indicators of electroodontometry 3 μA. On the roentgenogram there are no pathological changes in the region of the apex of the root 46.

Thus, the present invention allows to obtain the following technical result in the treatment of patients with deep dental caries.

- Increases the effectiveness of treatment and preventive measures carried out by patients with deep tooth decay.

- Photobiostimulation is carried out by low-intensity laser radiation of microcirculation and trophic pulp of the tooth.

- An energy-informational exchange is carried out between biological fluids (dentin fluid and blood) and dentin-hermetic fluid.

- The course of chemical reactions in the mineralizing liquid is activated, the volume of reacted reagents increases and their consumption decreases.

- Crystal formation in dentinal tubules of the teeth is intensified, their sealing, bactericidal effect and protection of the pulp from harmful pathogenic factors.

- The time of the trace effect of the action of low-intensity laser radiation with its step-by-step action on the mineralizing compositions and tooth is lengthening.

- Prevention of post-filling sensitivity and secondary recurrent tooth decay is being carried out.

- There is a growth of crystals of dentin-sealing liquid, acquiring a geometrically regular shape, more closely spaced, their size increases, which increases the effect of mineralization of hard tissues, and sealing of the dentinal tubules of the teeth.

Claims (1)

A method for treating patients with deep tooth decay, including the use of a “dentin-sealing liquid” consisting of two fluids No. 1 and No. 2, characterized in that they also use a step-by-step exposure to low-intensity laser radiation on the dentin-prepared carious cavity after each wetting of it “dentin” -sealing liquid ", at the same time it is first wetted with liquid No. 2, then with liquid No. 1, then again dentin is moistened with liquid No. 2, and also Aevit is prescribed.

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