RU2454199C1 - Method of treating complicated forms of caries - Google Patents

Abstract

FIELD: medicine.

SUBSTANCE: invention relates to medicine, namely to dentistry and is intended for treatment of complicated forms of caries. Trepanation of tooth is carried out. Oral cavity processing is carried out by apparatus, made in form of two subsystems: one subsystem contains needle, which by means of hoses is connected with electromagnetic valve and reservoir with drug solution, another contains needle, which by means of hoses is connected with reception vessel and vacuum suction unit. Antiseptic processing is carried out by method of hydraulic blow by alternate supply into tooth cavity of flow of drug solution and atmospheric air through nozzle, on upper edge of which preliminarily correcting mass is applied. After antiseptic processing vacuum drying and stopping of tooth canal are performed.

EFFECT: method makes it possible to carry out of processing of endodental cavities, prevent aggravation in periodontitis tissues due to washing cavity by method of hydraulic blow with simultaneous removal of purulent-necrotic content and waste drug solution.

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Description

The invention relates to medicine, namely dentistry.

A known method of treatment of periodontitis, consisting in trepanation of the tooth, destruction through the root canal of the cystic membrane and removal of pulp decay using a vacuum of 0.8-1.0 MPa for 5-10 minutes, flushing the channel with an antiseptic and filling (copyright certificate No. 1306573, IPC A61C 5/02).

The disadvantages of the method are inadequate extraction and drug treatment of cystic and intracanal contents, which leads to the possibility of exacerbation of the disease and the duration of treatment.

A known method of treating chronic periodontitis by trepanation of the tooth, opening the canal, instrumental processing, washing the canal and filling it. Moreover, after opening the tooth canal, a successive abundant washing with a medicinal solution under vacuum is carried out, while purulent necrotic contents and spent medicinal solution are removed and vacuum dried. The method is carried out using an apparatus for endocanal treatment of endodontic cavities (certificate for utility model No. 15168).

The disadvantages of the method are inadequate extraction and the possibility of injury to the teeth and the jaw tissue, the duration of treatment.

The closest is a method of treating periodontitis with an apparatus for endocanal treatment of endodontic cavities (Patent for the invention No. 2361543), which consists in trepanation of a tooth, removal of purulent-necrotic contents and spent drug solution by vacuum, vacuum drying and filling. After processing the cavity, removing the decay of the pulp, instrumental and antiseptic treatment of the canal, the canal is washed with a vacuum method of limited processing (VMOO), in which one needle of the apparatus, connected through a hose to the receiving capacity, is inserted to the apical opening, and the second at the level of the crown attached to a special container with a piston filled with a medicinal solution, provide simultaneous evacuation of purulent-necrotic contents and removal of spent mortar pa. Then the root canal and the apapical region are washed with a vacuum-jet method (HSR), in which one needle of the device, connected through a hose to a container with a medicinal solution, is inserted onto ½ of the root canal, and the second connected to the receiving container is installed at the level of the crown part, tightly fixed them in the tooth by means of a plastic mass, provide simultaneous evacuation of purulent-necrotic contents and removal of the spent solution, vacuum dried, then the root canal is filled with any known uro nya art method, the beginning of its filling produces vacuo.

The disadvantages of the method are the insufficient extraction of the contents of the root canal, the duration of the preparation of the instrument and the VMOO and HSR.

To reduce the time and improve the quality of cleaning, flushing and removal of the contents of the channel, a method for treating complicated forms of caries using a modified apparatus design is proposed.

A method for the treatment of complicated forms of caries is trepanation of the tooth, instrumental treatment of the carious cavity of the tooth, removal of pulp decay, washing with a medicinal solution and purulent necrotic contents and spent medicinal solution, drying and filling.

Moreover, after instrumental treatment, a specially designed nozzle of the apparatus is placed in the canal, a corrective mass of silicone impression material is applied to the edge of its upper surface, and antiseptic treatment of the tooth cavity is carried out by the method of hydraulic shock by alternating flow of the drug solution and atmospheric air into the tooth cavity. The device contains needles connected by hoses with a container with a medicinal solution, an electromagnetic valve, a receiving vessel, and a vacuum aspirator. New in the apparatus used to implement the method of treating complicated forms of caries is the implementation of the apparatus in the form of two separate subsystems (in the prototype all elements are connected to one system), the nozzle design and the installation of an electromagnetic valve in front of the container with the drug solution. The nozzle consists of sterile needles soldered together at the base and hermetically fixed in a conical rubber seal.

Figure 1 shows a diagram of an apparatus for the treatment of complicated forms of caries. Figure 2 - nozzle of the apparatus.

The apparatus contains a nozzle 3, consisting of sterile injection needles 1 and 2, which are soldered together at the base and hermetically fixed in a conical rubber seal 12, on the upper edge of the surface of which a corrective mass 13 is applied, which provides sealing of the treated cavity. The first subsystem contains a needle 1, which is connected by a hose 4 to a solenoid valve 8 and a hose 6 with a capacity of 9 with a medicinal solution. The second subsystem contains a needle 2, which is connected by a hose 5 to a receiving vessel 10 and a hose 7 with a vacuum aspirator 11 of the type OX-10 or ALP-02, creating a vacuum of up to 1.0 MPa.

The method is as follows.

Tooth trepanation is carried out by the usual method, while the drill processes and forms the cavity, and then using the “endodontics set”, the decay of the pulp is removed and the canal is instrumentally and medically treated. For the treatment of acute periodontitis in the stage of exudation and chronic periodontitis in the acute stage, the apical opening is opened. Only the appearance of pus or exudate from the canal can serve as an indicator that the apical aperture has been opened. A corrective mass 13 is applied along the upper edge of the rubber seal 12 and the nozzle 3 is placed in the channel. The mass hardens and provides a seal. Turn on the vacuum aspirator 11. A vacuum is created in the tooth cavity due to the operation of the vacuum aspirator. A drug treatment is performed with a medicinal solution, which from the vessel 9 (due to the difference in atmospheric pressure and rarefaction) enters the tooth cavity through a hose 6 to the solenoid valve 8, through a hose 4 to the needle 1 into the tooth cavity and flushes pus, necrotic tissue, chips after channel processing with endodontic instruments. The spent solution through the needle 2, the hose 5 is removed into the receiving vessel 10. The electromagnetic valve 8 is turned off. There is a supply of atmospheric air without pressure through the hose 4 to the needle 1. After some time, turn on the electromagnetic valve 8, there is a supply of the drug solution after the air plug, which is pumped out by vacuum through the needle 2. At this time, the drug solution, accelerating through the hose 4, through the needle 1 enters the endodontic cavity, the effect of water hammer is formed. Alternately turning the solenoid valve on and off, they alternate the supply of atmospheric air and the drug solution, which allows you to get the effect of regular water hammer, thereby ensuring maximum cleaning of the treated cavity. Drying and root canal filling is carried out by any methods known in the art.

Example No. 1. Patient M., 29 years old. Diagnosis: suppurative cystogranuloma of 21 teeth. The tooth is intact. Subjected to treatment in the described manner. The treatment was carried out with chlorhexidine for 7 minutes at a pressure of 1.0 MPa. After drying with vacuum, the canal was sealed with sealer with gutta-percha by the cold lateral condensation method without serious consequences. After filling, no complaints were received from the patient.

Example No. 2. Patient I., 35 years old. Diagnosis: festering radicular cyst of 11 tooth. Diagnosed by x-ray. An operation is proposed, which the patient refused. Was subjected to treatment in the described manner. The treatment was performed without anesthesia with chlorhexidine for 7 minutes at a pressure of 1.0 MPa. After drying, the root canal was sealed with gutta-percha with cold lateral condensation method painlessly. Observation of the patient. After 3 months, an x-ray shows the growth of bone beams in the cystic cavity. There were no complaints from the patient.

Abundant washing of the endodontic cavity with a drug solution under vacuum by the method of hydraulic shock with the simultaneous removal of purulent-necrotic contents and spent drug solution provides a better treatment of endodontic cavities. This can significantly reduce treatment time, prevent exacerbation in the tissues of periodontitis.

Claims (1)

A method of treating complicated forms of caries, consisting of trepanation of the tooth, instrumental treatment of the carious cavity of the tooth, removal of pulp decay, washing with a medicinal solution, removing purulent-necrotic contents and spent medicinal solution, drying and filling using an apparatus containing needles, a container with a medicinal solution, electromagnetic valve, receiving vessel, vacuum aspirator, interconnected by hoses, characterized in that after instrumental processing of the tooth cavity an apparatus made in the form of two subsystems, one of which contains a needle, which is connected by hoses to an electromagnetic valve and a container with a medicinal solution, the second subsystem contains a needle, which is connected by hoses, to a receiving vessel and a vacuum aspirator, perform antiseptic treatment by the method of hydraulic shock by alternating flow into the tooth cavity the flow of the drug solution and atmospheric air through the nozzle, which is placed in the tooth cavity, consisting of sterile needles of the subsystems, are soldered x with each other at the base and hermetically fixed in a cone-shaped rubber sealant, on the upper edge of which a correction mass is previously applied.

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