RU2393850C1 - Method of treating teeth with destructive changes in furcation area of molars class i-ii after tooth floor perforation - Google Patents

Abstract

FIELD: medicine.

SUBSTANCE: invention refers to medicine, namely to dentistry, and can be used for treating the destructive changes in the furcation area of molars after tooth floor perforation. That is ensured by preparation of a carious cavity, management and root canal filling for cause. Thereafter, the tooth floor is coated with the daily changed preparation Calasept Iodo in dosage 0.05-0.1 ml, for 2 days. It is combined with exposure to a semiconductor laser of wave length 0.9 mcm, pulse power 2 Wt, frequency 2000 Hz and pulse duration 40-100 ns. The exposure covers the tooth floor directly vertically and is performed daily within the course of 2-3 procedures. Thereafter, a preparation Osteoplast in dosage 0.05-0.1 g. The perforation is closed with the material "Pro Root".

EFFECT: invention allows for effective reduction of inflammation, elimination of bone tissue resorption within molar furcation, osteogenesis within the furcation area.

1 ex, 2 dwg

Description

The invention relates to medicine, namely to dentistry, and is intended for the treatment of teeth with chronic destructive changes in the field of root furcation.

At present, the urgency of this problem, which is of general medical significance, is beyond doubt. Endodontic intervention, ending with perforation of the bottom of the tooth cavity, often leads to periodontal pathology, destructive changes in the area of root furcation, the appearance of foci of chronic infection in the oral cavity, decreased body reactivity, microbial sensitization, and ultimately leads to tooth loss. With periodontal changes, resorption of the alveolar bone can take place fairly quickly, without severe symptoms, the patient consults a doctor with severe inflammation, the appearance of the fistulous passage with detachable, tooth mobility.

A known method of surgical treatment of pronounced changes in the field of furcation of molars of III-IV classes using membrane technology, as well as various osteoplastic preparations (prof. Modina E.N., Molkova S.S., Starikova E.G., Doroshina NB , Sayapina I.I., Bolbat M.V. “Application of the Epi- Guide membrane and Cerasorb preparation at the surgical stage of treatment of destructive forms of periodontitis”).

There is a method of eliminating perforations of the bottom of the crown cavity or tooth root and treating chronic periodontitis resulting from perforations, which consists in filling the perforation hole with filling material, additionally trapezoid mucosal-periosteal flap is cut along the gingival margin, pathologically altered tissues on the tooth root surface are removed, a recess is formed around the perforation hole, which is filled with glass monomer cement or a light curing compomer, would be formed bone defect filling material based on hydroxyapatite (patent RU 2138996, 1999).

The prototype of the invention is a method of treating periodontitis complicated by perforation of the bottom of the tooth cavity, which consists in preparing a cavity and root canals, processing and filling the root canals, closing the perforation with an amalgam and then filling the tooth crown. In this case, before closing the perforation hole with an amalgam, it is treated once with an erbium laser with a wavelength of 2.940 nm, a frequency of 10 Hz and a pulse duration of 250 μs (patent RU 2238119, 2004). However, this method does not prevent relapse of the disease.

EFFECT: elimination of the focus of inflammation, elimination of bone resorption in the area of molar furcation and further restoration of bone tissue in the furcation zone.

The proposed method is as follows.

1. Identify the pathological process during the clinical and radiological examination of the teeth.

2. Remove the old fillings, revise the bottom of the tooth cavity in order to determine the cause of the destructive changes in the area of furcation.

3. When a perforation hole is found in the bottom of the tooth cavity, necrectomy of the damaged cement, granulation removal, drug treatment with a 3% hydrogen peroxide solution are performed.

4. Apply the preparation “Calsept Iodo” to the bottom of the tooth cavity with a daily shift for 2 days, at a dose of 0.05-0.1 ml (depending on the size of the perforation hole).

5. The laser device is treated with a semiconductor dental therapeutic ALST-01 Optodan with a wavelength of 0.9 μm, a laser pulse power of 2 W, a pulse repetition rate of 2000 Hz, a laser pulse duration of 40-100 ns directly vertically to the bottom of the tooth cavity , a course of 2-3 daily procedures (depending on the duration and extent of the lesion).

6. Enter the drug "Osteoplast" into the lesion through the perforation once in a dose of 0.05-0.1 g (depending on the amount of bone damage).

7. Cover the perforation with Pro Root.

8. Restore the crown of the tooth (orthopedic or therapeutic method).

9. Dispensary observation for several years.

The proposed method is illustrated by drawings: in Fig. 1 shows a 46 tooth with lesion of periodontal tissue in the furcation region on the targeted radiograph; figure 2 is the same in the control x-ray, when viewed 4 months after treatment.

Example. Patient I. On July 24, 2008, she complained of the periodic appearance of the fistulous passage with purulent discharge on the gum in the area of the 46 tooth. Diagnosis: chronic fibrotic periodontitis of the 46 tooth, chronic localized periodontitis in the region of the 46 tooth of moderate severity, class II according to the classification of the degree of involvement of furcation in the pathological process (figure 1). First visit: the old filling was removed, the audit of the bottom of the tooth cavity with the detection of a perforation hole, removal of the changed cement of the bottom of the tooth cavity, drug treatment with 3% hydrogen peroxide solution, 0.1 ml of Calcept Iodo was applied, a laser with a wavelength of 0 was assigned 9 μm, a laser pulse power of 2 W, a pulse repetition rate of 2000 Hz, a laser pulse duration of 40-100 ns, tooth closure with water dentin. Second visit: removal of a temporary filling, change of the Calcept iodo preparation, laser according to the method described above. Third visit: removal of a temporary filling, filling of the defect in the bifurcation area with Osteoplast material in an amount of 0.05 g, filling of the perforation with Pro Root material, therapeutic restoration of the crown part 46 of the tooth with permanent filling material. During the follow-up examination on November 3, 2008, no fistulous course was found, the gum in the area of the 46 tooth is pale pink, on the RVG in the furcation of the 46 tooth (figure 2) - significant positive changes compared with the image from July 24, 2008.

Claims (1)

A method for treating destructive changes in the furcation region of molars after perforation of the bottom of the tooth cavity, including preparation of the carious cavity, processing and, according to indications, root canal filling, laser treatment, closing of the perforation hole, characterized in that Calcept Iodo is additionally applied to the bottom of the tooth cavity at a dose of 0 , 05-0.1 ml, with a daily change of 2 days, the exposure is carried out by a semiconductor laser with a wavelength of 0.9 μm, a laser pulse power of 2 W, often that pulse repetition of 2000 Hz, the duration of the laser pulse 40-100 ns directly vertically to the bottom of the tooth cavity with a course of 2-3 daily procedures, before closing the perforation hole in the bone tissue destruction center, Osteoplast is administered once in a dose of 0.05-0.1 g, and closing the perforation hole is carried out with the material "Pro Root".

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