RU2446786C1 - Polycomponent tooth paste for deep caries and acute local pulpitis - Google Patents

Abstract

FIELD: medicine.

SUBSTANCE: invention refers to dentistry, namely drug preparations for deep caries and acute local pulpitis. What is offered is a polycomponent tooth paste containing, wt %: calcium hydroxide - 10, calcium chloride - 5, titanium oxide - 3, hydrocortisone - 5, metronidazole - 5 and collagen - the rest.

EFFECT: tooth paste is flexible, exhibits high penetration ability, stimulates reparative function of pulp, dentinogenesis; it has no side effects.

Description

The invention relates to medicine and dentistry, in particular to medicines made in the form of a paste for the treatment of deep caries and acute focal pulpitis of the teeth.

The imposition of a medical pad is indicated only for reversible processes in the pulp [3]. For this purpose, medicinal pastes with odontotropic, anti-inflammatory, antimicrobial action are used [1].

After preparation of the carious cavity with deep caries, dentin patches open, which, due to the anatomical structure, have increased permeability. Since many materials can irritate the pulp, it is recommended that such areas be covered with a preparation containing calcium hydroxide [5].

Many multicomponent pastes for the treatment of deep caries and acute focal pulpitis are prepared ex tempore, for example, some authors recommended a paste of ethylene diamine acetate containing 0.25% ethonium in combination with a 25% solution of dimexide and aerosil as a filler [4].

A number of other authors for the treatment of deep caries offer 2% calcium-phosphate-fluorine-containing gel paste or ion-exchange resin containing 4.6% calcium, 2.8% phosphorus, 0.3% zinc, mixed in saline in a ratio of 1 : 2 [4].

Odontropic substances in the composition of pastes stimulate the formation of secondary dentin, glucocorticosteroids have an anti-inflammatory effect. Antimicrobial components are added to affect infected dentin [1].

However, such multicomponent pastes, as a rule, do not harden, do not have sufficient mechanical strength, and lose their activity relatively quickly [2].

The closest in technical essence and selected as a prototype is the composition of the multicomponent paste "Hypocal" [5], consisting of calcium hydroxide, water, calcium chloride and titanium oxide. Pasta is prepared by mixing the components. The disadvantages of this multicomponent paste is the low level of dentin and osteoinductive properties of the main components - calcium hydroxide and chloride, as well as their rapid dissolution in the tooth cavity due to the released dentinal fluid.

The task is: the creation of anti-inflammatory, odontotropic and antiseptic multicomponent paste with a pronounced therapeutic effect.

The problem is solved by inclusion in the composition of a multicomponent paste containing calcium hydroxide, calcium chloride and titanium oxide, hydrocortisone, metronidazole and collagen with the following components, wt.%:

Calcium hydroxide 10 Calcium chloride 5 Titanium oxide 3 Metronidazole 5 Hydrocortisone 5 Collagen Rest

The parameters introduced into the composition of the inventive paste components were determined empirically.

Characterization of the components of the paste.

Calcium hydroxide and calcium chloride possess odontotropic properties, have a remineralizing effect, stimulate the formation of substitution structures in dentin and pulp. Calcium hydroxide is used to calcify dentin. It is partially water soluble, dissociates and acts like an alkali. Due to the release of ions, this substance has a bactericidal effect until solidification. Applied to dentin, this mixture diffuses along the dentinal tubules and penetrates the pulp through a thin layer of dentin [5].

Since preparations containing calcium hydroxide are destroyed by the dentin fluid, collagen is included in the multicomponent paste, which can bind the dentin fluid and has a odontotropic effect.

Titanium oxide is added as a radiopaque component.

For antimicrobial effects on infected dentin, metronidazole, which has a wide spectrum of antimicrobial activity, is included in the composition of the multicomponent paste.

Hydrocortisone has an anti-inflammatory effect.

A comparative analysis with the prototype showed that the claimed composition of the multicomponent paste differs from the known one due to the introduction of the following components: collagen, metronidazole and hydrocortisone in a new ratio of components.

The analysis of known pastes, similar to the claimed paste in terms of therapeutic action, showed that this composition: collagen, metronidazole, calcium hydroxide, calcium chloride, titanium oxide, hydrocortisone have not been previously used in practice.

Multicomponent paste is prepared as follows.

The calculation is given per 100 g of product. The paste is prepared ex tempore on a sterile glass slide. First, 10 g of calcium hydroxide, 5 g of calcium chloride and 3 g of titanium oxide are mixed, 5 g of metronidazole and 5 g of hydrocortisone are added. The resulting mixture is thoroughly mixed with collagen.

The paste is stored in a dark bottle with a ground stopper, and a trowel is introduced into the cavity.

The proposed technical solution allows to obtain an inexpensive, cost-effective tool with high efficiency, as well as reduce the treatment time for deep tooth decay and acute focal pulpitis.

The shelf life of the funds received is 6 months. The parameters of the tool are stable during storage. The tool is a light yellow mass. The inventive multicomponent paste is very plastic, easily inserted into the tooth cavity, has high penetrating ability, stimulates the reparative function of the tooth pulp. The paste stimulates dentinogenesis, is harmless and has no side effects.

The therapeutic effect of the claimed paste is tested in a clinic. Complications and side effects in patients were not identified. The way to use the paste is simple and affordable. The paste is well fixed even on the moistened surface of the walls of the cavity.

Examples of specific performance.

Clinical case 1. Patient I., 29 years old, outpatient card No. 419.

The patient complained of periodic short-term pain from mechanical, chemical, and thermal stimuli that quickly disappear with the removal of the latter in the region of the 35 tooth.

On examination of the 35th tooth, a deep carious cavity with overhanging edges of enamel filled with softened and pigmented dentin. Probing the bottom of the cavity is painful. Percussion is painless. EDI pulp 35 tooth - 10 μA.

Diagnosis: Deep caries of 35 teeth.

Treatment: After anesthesia, a cavity was prepared and antiseptic treated. A pre-prepared multicomponent paste 1 mm thick, which is evenly distributed throughout the bottom of the cavity in the projection of the pulp, is applied to the dentinal surface. Overlay of insulating gasket and temporary seal. On the second visit, after 7 days, the temporary filling was removed, the EDI of the tooth pulp 35 tooth - 6 μA, the application of an insulating pad under the permanent filling of composite material.

Clinical case 2. Patient K., 18 years old, outpatient card No. 876.

Complaints: for spontaneous pain from all types of irritants, night pain in the area of 46 tooth.

Objectively: when examining 46 teeth - a deep carious cavity with overhanging edges of enamel, filled with softened and pigmented dentin, as well as food debris. Probing the bottom of the cavity is painful. Percussion is painless. 46 tooth EDI - 18 μA.

Diagnosis: acute focal pulpitis of 46 teeth.

Treatment. Under conduction anesthesia, softened dentin was excavated, and multicomponent paste was applied.

After 12 days, the EDI of the pulp of 46 tooth is 6 μA, no complaints. An insulating gasket is applied and a permanent seal is installed.

Clinical case 3 (prototype). Patient D., 25 years old, outpatient card No. 987.

Complaints: night pain in 26 tooth. The tooth got sick a day ago.

Objectively: when examining 26 teeth, a deep carious cavity with overhanging enamel edges filled with softened and pigmented dentin. Probing the bottom and walls of the cavity is painful. Percussion is painless. EDI of the 26 tooth pulp - 12 μA.

Diagnosis: Acute focal pulpitis of 26 teeth.

Treatment in visit I: preparation and formation of the carious cavity. Hypocal multicomponent paste was applied (prototype). After 6 days, the EDI of the 26 tooth pulp is 14 μA, the patient complains of maintaining pain from all types of irritants.

Treatment in visit II: removal of a temporary filling, medical paste, antiseptic treatment of the cavity, the introduction of multicomponent paste. Imposition of a temporary seal for 14 days.

Treatment in visit III: EDI of 26 teeth of 6 μA, spontaneous night pains disappeared, the patient does not show complaints. An insulating gasket is applied and a permanent seal is installed.

The data obtained in clinical conditions allow us to recommend the developed multicomponent paste as a highly effective agent with anti-inflammatory, odontotropic and antiseptic therapeutic effect for the treatment of deep dental caries and acute focal pulpitis.

Information sources

1. Nikolaev A.I., Practical therapeutic dentistry / A.I.Nikolaev, L.M. Tsepov // St. Petersburg: St. Petersburg Institute of Dentistry, 2001. - P. 105.

2. Lukinykh LM, Caries of teeth / L.M. Lukinykh // Ed. NGMA, Nizhny Novgorod, 1996, p. 78.

3. Lukin L.M., Pulpit (clinic, diagnosis, treatment) / L. M. Lukin, L. V. Shestopalova // Publishing House. NGMA, Nizhny Novgorod, 1996, p. 22.

4. Yakovleva V.I., Diagnosis, treatment and prevention of dental diseases / V.I. Yakovleva, E.K. Trofimova, T.P. Davidovich, G.P. Proskviryak // Minsk, Izd. "Higher School", - 1994. - S. 145.

5. Helvig E., Therapeutic dentistry / E. Helvig, I. Klimek, T. Attin // Lviv: GalDent, 1999. - P.122.

Claims (1)

Multicomponent paste for the treatment of deep caries and acute focal pulpitis, including calcium hydroxide, calcium chloride, titanium oxide, characterized in that it additionally contains hydrocortisone, metronidazole and collagen, wt.%:
Calcium hydroxide 10 Calcium chloride 5 Titanium oxide 3 Metronidazole 5 Hydrocortisone 5 Collagen Rest