RU2419437C1 - Method of treating dental hyperesthesia - Google Patents

Abstract

FIELD: medicine. ^ SUBSTANCE: invention relates to medicine, namely to dentistry, and can be applied for treatment of dental hyperesthesia. For this purpose medication of the following composition is applied: vaseline-lanolin base (4:1) - 80.0 g, potassium fluoride - 1.0 g, ecdysterone - 0.02 g, purified water - 20 ml, ethyl alcohol - 1 ml. Medication is placed in preliminarily prepared individual gum shields and introduced in oral cavity on carefully cleaned from dental deposit tooth surface. Procedure duration is 20-25 minutes. Procedures are carried out one time per day for 10 days, recommending patients to abstain from food and water during one hour after gum shield extraction. ^ EFFECT: invention ensures achieving normal tooth reaction on external irritants, which is conditional by restoration of their defects and strengthening of periodontium tissues, due to reparative, anti-inflammatory and anesthetic action of medication. ^ 2 tbl, 2 ex

Description

The invention relates to medicine, namely to dentistry and for the treatment of hypersensitivity to hard tissues of teeth, which is one of the urgent problems of modern dentistry.

According to recent studies, 40-70% of the population of our country aged 20 to 65 years have various forms of hyperesthesia of hard tissues of teeth. This pathology to date refers to diseases that are least successfully treatable.

The causes leading to the development of hyperesthesia of the hard tissues of the tooth are associated with the development of a defect in the tooth tissues (increased abrasion, erosion of the hard tissues of the tooth, wedge-shaped defects). Hyperesthesia of the hard tissues of the teeth often occurs with periodontal diseases, accompanied by exposure of the necks of the teeth and recession of the gums. Occupational factors, for example, among chemical workers, can contribute to the development of hyperesthesia.

Among the local factors, one can note the chemical effect of fruit juices, citrus, carbonated drinks with excessive consumption. Some mouthwashes with a pH below 5.0 may have the same effect. A factor contributing to the occurrence of hyperesthesia may be taking medications - aspirin, vitamin C, taking coarse, fibrous foods, frequent and overly intensive brushing of teeth with abrasive toothpastes, and the use of a hard toothbrush.

The mechanism of hyperesthesia is based on a hydrodynamic theory. According to this theory, the irritant that causes pain increases the flow of fluid from the dentinal tubules, which in turn leads to a change in osmotic pressure and an increase in the activity of nerve endings

Thus, the treatment of hyperesthesia can be carried out in two ways: firstly, by reducing the conductivity of the dentinal tubules due to their obturation (closure), and secondly, by reducing the excitability of nerve fibers.

At present, various preparations are widely represented on the dental market to reduce tooth hypersensitivity: chemical (varnishes, solutions, gels, etc.), physical (electrical pain relief, laser, etc.), physicochemical (electrophoresis with various drugs).

Despite the positive results of using various drugs in the treatment of tooth sensitivity in some cases, the therapeutic effect is short-lived.

All these drugs are designed mainly for the relief of pain and do not have a pronounced effect on periodontal tissue and teeth, as evidenced by the recurrence of the disease.

We set ourselves the goal of developing a new method of treating dental hyperesthesia using the drug we proposed, which would provide a beneficial effect on all pathological links in the development of the disease, was easy to manufacture in a pharmacy, relatively inexpensive and did not have undesirable consequences.

This goal is realized with the help of a medicinal composition, which is a petrolatum-lanolin base (4: 1), which includes potassium fluoride in an amount of 1%, ecdysterone - 0.02%. Potassium fluoride is dissolved in purified water, and ecdysterone in ethyl alcohol. Ecdysterone was used in the work. Potassium fluoride provides normal osmotic pressure in the dentinal tubules due to their obstruction and a decrease in the excitability of nerve fibers, and ecdysterone (ecdysten) has a powerful reparative, analgesic, anti-inflammatory effect, promotes the formation of capillaries in periodontal tissues, which leads to an improvement in its trophism.

Ecdisterone was obtained from the plants of the genera Smolevka, Ushanka, Blister and other representatives of the clove flora of Russia.

The drug was prepared as follows. To 80.0 g of the base was added 20 ml of a 5% aqueous solution of potassium fluoride and 0.02% ecdysterone dissolved in 1 ml of ethyl alcohol, after which the mixture was thoroughly homogenized. The drug is an ointment of a white color with a slightly yellowish tint, without taste and odor.

Clinical studies of the proposed method of treatment using herbal medicine was carried out at the Department of Therapeutic and Pediatric Dentistry of Ryazan State Medical University. Acad. I.P. Pavlova. 22 patients between the ages of 26 and 63 were treated with increased sensitivity of hard tissues (erosion, wedge-shaped defect, pathological abrasion). A total of 56 permanent teeth were examined and treated.

The diagnosis of hyperesthesia of hard tissues of teeth was made on the basis of a survey of patients and the results of an objective examination.

To assess the state of oral hygiene, a simplified index of oral hygiene OIH-S was used (Greene J., Vermillion J., 1969). For this purpose, the vestibular surfaces of 16, 11, 26, 31 teeth and lingual surfaces of 36 and 46 teeth were examined. The absence of plaque was assessed as “O”, the presence of soft plaque covering not more than 1/3 of the tooth surface was assessed as “1”, the presence of plaque covering from 1/3 to 2/3 of the tooth surface was evaluated as “2” , the presence of soft plaque covering more than 2/3 of the tooth surface was rated as "3".

The determination of tartar was carried out using a dental probe in a similar way. The values of the hygiene index was determined by the following formula:

Evaluation Criteria:

The value of IGR-U Grade IGR-U Oral hygiene assessment 0-0.6 low good 0.7-1.6 average satisfactory 1.7-2.5 tall unsatisfactory > 2.5 very tall bad

The hygiene index was determined at the initial examination and when a poor hygiene condition of the oral cavity was detected before treatment, dental plaque was removed.

To objectively assess the severity of hyperesthesia of hard tissues of teeth, we studied the reaction of tooth tissues to mechanical stimuli, temperature stimuli, and air flow.

In the study of the reaction of a tooth to mechanical irritation, a touch of a sensitive tooth surface for several seconds was applied by a dental probe. If this irritation caused a pain reaction in the patient, then the presence of hyperesthesia was recorded.

The reaction of tooth hard tissues to temperature stimuli was evaluated using irrigation of teeth from a syringe with water at a temperature of 30 ° C. The use of water at this temperature is explained by the fact that with functional enamel deficiency of the first degree, pain in the tooth occurs under the influence of a cold stimulus, the temperature of which is below 37 ° C (Lukomsky I.G., 1955).

In order to study the reaction of the tooth to the air flow, an air stream was used from the air gun of the dental unit at a distance of 0.5-1 cm and at an angle to the surface of the tooth under study for 2-3 seconds.

For a more complete assessment of the state of hard tissues of the teeth and accurate diagnosis, the indices were calculated. To assess the prevalence of increased sensitivity of the teeth, the prevalence index of dental hyperesthesia (IRHI) was used (Shtorina GB, 1986). The calculation of the index was made in% according to the formula:

Hyperesthesia was considered generalized if the distribution index exceeded 25%. With index values from 3.1% to 25%, a limited form of hyperesthesia of the hard tissues of the teeth was diagnosed.

For an objective assessment of the state of sensitivity of hard tissues of teeth, we used the index of intensity of hyperesthesia of the teeth (IIIG) (Shtorina GB, 1986). The index was calculated by the formula:

The index was calculated in points and evaluated based on the following indicators: 1 point - the presence of sensitivity only to temperature stimuli; 2 points - the presence of sensitivity to temperature and chemical stimuli; 3 points - the presence of sensitivity to temperature, chemical and mechanical irritants.

To assess the state of tooth sensitivity in dynamics when using a herbal preparation, we used the tooth sensitivity index L.Yu. Orekhova-S.B. Ulitovsky (Index SZ O-U),

SZ-U index (%) = Sum (a1 + ... + an) / 5N * 100%,

where is the sum of the quantitative estimates of the criteria;

a - the number of points according to the first criterion;

an is the number of points by the nth criterion;

n is the number of criteria used in the index;

5 - the number of evaluated parameters within each criterion.

Evaluation Criteria:

* 81-100% - a very serious condition;

* 61-80% - serious condition;

* within 41-60% - a relatively compensated state of moderate degree of sensitivity of the teeth;

* with an index index of 21-40%, the condition is compensated, but against the background of the existing compensated mild degree of tooth sensitivity;

* at an assessment of 20% - a tooth (group of teeth) is healthy with normal, natural sensitivity to external stimuli.

To determine the effectiveness of the desensitizing effect of the drug, the following index was used:

The effectiveness of SZ (%) = [(I1-In) × 100] / I1, where

I1 - a digital indicator of the SZ O-U index, determined at the first visit;

In is a digital indicator of the SZ O-U index, determined during the nth visit. Evaluation of the results:

Estimated parameters,% Correspondence of the results of calculating the effectiveness of tooth sensitivity according to the estimated parameters of the index of NW Orekhova-Ulitovsky 20,0 Very low tooth sensitivity 20.1-40.0 Low tooth sensitivity 40.1-60.0 Moderate tooth sensitivity 60.1-80.0 High tooth sensitivity 80.1-100.0 Very high tooth sensitivity

The treatment of hyperesthesia of hard tissues of teeth using the drug was carried out according to the following method. First, the surface of the teeth was thoroughly cleaned of plaque, then, in pre-made individual mouthguards, the developed preparation was placed and introduced into the oral cavity for 20-25 minutes. After removing the mouthguards from the oral cavity, patients were advised to refrain from eating food and water for one hour. The course is 10 days, the procedure is carried out 1 time per day.

Example 1

Patient S., 38 years old, turned to the Department of Therapeutic and Pediatric Dentistry of Ryazan State Medical University with complaints of short-term pain from cold, sour teeth in the upper and lower jaws.

Objectively revealed: 1.3, 1.4, 3.3 in the cervical region a slight decrease in the hard tissues of the tooth, the surface is smooth, dense, probing is painful, the reaction to a cold stimulus is painful.

IGR-U = 1.9, therefore, the hygiene index is unsatisfactory.

IRGZ = 11%, limited hyperesthesia.

IIHP = 1.6 points, hyperesthesia of the II degree.

AES OU = 28%, mild tooth sensitivity.

Diagnosis: hyperesthesia of the teeth of the II degree.

The treatment with the drug.

At the second visit after the end of the course of treatment with the drug: no complaints, tooth sensitivity is absent from all types of irritants, satellite O-U = 19% - the teeth are healthy, with a natural sensitivity to external irritants.

Efficiency of SZ = 67.8%, high efficiency of the desensitizing effect of the drug.

1 month after treatment: no complaints, tooth sensitivity absent, AES O-U = 19% - healthy teeth, with natural sensitivity to external stimuli.

Efficiency of SZ = 63.6%, high efficiency of the desensitizing effect of the drug.

6 months after treatment: no complaints, tooth sensitivity missing, satisfactory satellite = 17% - healthy teeth, with natural sensitivity to external stimuli. Efficiency of SZ = 63.1%, high efficiency of the desensitizing effect of the drug.

Example 2

Patient K., 42 years old, turned to the department of therapeutic and pediatric dentistry at Ryazan State Medical University with complaints of short-term pain from acidic, the presence of a cosmetic defect in the teeth on the upper jaw.

History: abuse of fruit juices and citrus fruits.

Objectively: 1.1, 2.1 - on the vestibular surface an oval-shaped defect within the enamel; when probing, the bottom is firm, smooth.

IGR-U = 0.8, therefore, the hygiene index is satisfactory.

IRGZ = 7.4%, limited hyperesthesia.

IIHZ = 1.2 points, hyperesthesia of the II degree.

AES OU = 31%, mild degree of tooth sensitivity.

Diagnosis: 1.1, 1.2 erosion, hyperesthesia of teeth of the II degree.

The treatment with the drug.

At the second visit (10 days) after the end of the course of treatment with the drug: no complaints, tooth sensitivity is absent from all types of irritants, AES O-U = 11% - the teeth are healthy, with a natural sensitivity to external irritants.

Efficiency of SZ = 74.3%, high efficiency of tooth sensitivity.

1 month after treatment: no complaints, tooth sensitivity absent, AES O-U = 11% - healthy teeth, with natural sensitivity to external stimuli.

Efficiency of SZ = 74.1%, high efficiency of tooth sensitivity.

6 months after treatment: no complaints, tooth sensitivity absent, AES O-U = 11% - healthy teeth, with natural sensitivity to external stimuli. Efficiency of SZ = 71.4%, high efficiency of tooth sensitivity.

Our results allow us to conclude that the patented method of treating hyperesthesia of the teeth ensures the normal response of teeth to external stimuli by restoring their defects and strengthening periodontal tissues due to the patented reparative, anti-inflammatory, analgesic effect of the drug.

Literature

1. Darmogray V.N. Pharmacognostic study of some species of the clove family and prospects for their use in medical practice: dis. in the form of scientific. doc. Dr. Pharmac. sciences. / V.N. Darmograi. - Ryazan, 1996 .-- 91 p.

2 Kuzmina E.M. Hypersensitivity of teeth. / E.M. Kuzmina. - M .: MGMSU, 2003 .-- 63 p.

3. Leontiev V.K. On the mechanisms of tactile sensitivity of teeth. / V.K. Leontiev, N.N. Shurupova. // Institute of Dentistry. - 2002. - No. 1. - S. 32-34.

Claims (1)

A method of treating hyperesthesia of the teeth, which consists in the fact that the drug, which is the following composition: petrolatum-lanolin base (4: 1) - 80.0 g, potassium fluoride - 1.0 g, ecdysterone - 0.02 g, purified water - 20 ml, ethyl alcohol - 1 ml, placed in pre-made individual mouthguards and put into the oral cavity on the tooth surface thoroughly cleaned from plaque for 20-25 minutes once a day for 10 days, recommending that patients refrain from eating food and water one hour.