RU2456955C1 - Method of orthopedic treatment of women after post-menopausal period by means of removable plate dentures - Google Patents

Abstract

FIELD: medicine.

SUBSTANCE: invention relates to medicine, namely to dentistry, and can be used in orthopedic treatment of women in post-menopausal period in case of complete or partial defects of dentitions by means of removable plate dentures. For this purpose cream "Ovestin" is applied on surface of denture basis in thin uniform 0.5-1.0 mm thick layer. Treatment is carried out daily once during 10 days from the moment of application.

EFFECT: method also ensures reduction of bleeding, keratinisation, improvement of microcirculation in mucosa of denture bed and as a result acceleration of socially-psychological adaptation of said contingent of patients.

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Description

The invention relates to medicine, namely to dentistry, and can be applied in the orthopedic treatment of postmenopausal women with complete and partial defects of the dentition with removable plate prostheses.

As a result of a genetically determined deficiency in the synthesis and secretion of hormones in the body of women in the postmenopausal period, processes occur that are characterized by a disorder of metabolism, tissue and organ functions, including the dentition. Violations caused by estrogen deficiency in women during this period of life are also characterized by changes in the mucous membrane, which are manifested by its thinning, atrophy of the epithelium and the development of inflammation. These circumstances have an adverse effect on the adaptation of women to removable laminar dentures.

There is a method of orthopedic treatment of postmenopausal women with removable plate prostheses using biopolymer films with Imudon immunocorrector for the adaptation period, which consists in placing an elastic film on the basis of a removable plate prosthesis after individual hygiene measures (Kalivrajiyan E.S. Evaluation of the effectiveness of the use of medicinal films with immunocorrector in removable prosthetics / Kalivrajiyan E.S., Primacheva N.V., Leshcheva E.A. et al. // Institute of Dentistry. - 2010. - No. 1. - P.40-41).

The disadvantage of this method is the rather rapid elimination of the drug from the mucous membranes of the oral cavity, as a result of which it is necessary to use it frequently - 2-3 times a day, lasting 7-10 days, then 2-3 times a week for 14 days, as well as shallow penetration of "Imudon" into the mucous membrane of the prosthetic bed due to hemodynamic disorders in it.

Closest to the claimed invention, the achieved result is a method of orthopedic treatment of postmenopausal women by using an adhesive agent "Tizol with propolis" (OOO "Olympus", Russia, RF patent No. 2177304). To improve the fixation of removable laminar dentures, the composition is applied with a brush to the previously cleaned fixing surface of a removable laminar denture, thereby strengthening the fixation and stabilization of the latter, which helps to reduce the adaptation time to them (Zheludev S.E. Adhesive products in orthopedic dentistry. - M. : Medical book. "Dentistry", 2007. - p.108).

Along with the positive effects of the use of this adhesive with bacteriostatic, local anesthetizing, dermatoplastic and antiviral effects due to its propolis, a number of disadvantages are highlighted, among which are possible allergic reactions to the components of the material and the insufficient prevalence of this drug on the market. In addition, the disadvantage of this method is the lack of influence on the pathogenetic links of postmenopausal dental disorders in women associated with estrogen deficiency.

The authors proposed a method of orthopedic treatment of postmenopausal women with removable plate prostheses by local application of Ovestin cream under the bases of prostheses.

The technical result of the proposed method is to increase the effectiveness of orthopedic treatment of postmenopausal women with removable plate prostheses due to the local use of estrogens.

The technical result is achieved by the fact that the Ovestin cream is applied daily and once within 10 days from the time of application of the prostheses on a thin, even layer of 0.5-1.0 mm on the inner surface of the denture bases.

The method of orthopedic treatment of postmenopausal women with removable plate prostheses is shown in figures 1 and 2. Figure 1 shows the dental formula of patient N. Figure 2 shows a questionnaire filled out by patient N.

The method is as follows.

Women of the early postmenopausal period of life (age from 49 to 55 years) who have not previously used removable plate prostheses are prescribed treatment with Ovestin.

The drug "Ovestin" (Organon Oss JSC, Holland) is used after hygienic measures in the oral cavity and cleaning of prostheses, they are applied on the inner surface of the denture bases and evenly distributed with a thin layer of 0.5-1.0 mm across it. Treatment is carried out daily once, during the first 10 days after the application of removable laminar dentures. "Ovestin" is an estriol-containing drug with a short duration of action. It causes increased proliferation of the epithelium, stimulates its blood supply, helps restore the epithelium during its atrophic changes and increases the resistance of the epithelium to infectious and inflammatory processes.

Clinical example

The treatment was carried out according to the claimed method.

Patient P., 50 years old, came on September 14, 2010 with the goal of rational prosthetics.

Complained of a partial lack of teeth, difficulty chewing food, impaired diction and phonation.

Past and concomitant diseases according to the patient: hepatitis, tuberculosis, sexually transmitted diseases were not sick. An allergic history is not burdened. Surgery was performed for uterine fibroids in 2002 (surgical menopause).

The development of this disease: the teeth are removed gradually, the last about three weeks ago. I have not used removable laminar dentures before.

External examination: the severity of nasolabial and chin folds, a slight decrease in the height of the lower part of the face.

The figure 1 presents the dental formula of the patient N.

In the oral cavity: the mucosa is pale pink in color, without visible pathological changes. 2.3 was previously under the crown. Artificial plastic crowns 2.1, 2.2 do not fulfill the anatomical shape of the teeth and do not reach the edge of the gums by 1-1.5 mm. Artificial stamped crown 4.7 with areas of erasure of decorative spraying does not reach the gingival margin by 0.8-1 mm, mobility I degree.

Diagnosis: partial absence of teeth in the upper jaw Kennedy class 1; partial absence of teeth in the lower jaw Grade 2, subclass 3 according to Kennedy; irrational artificial plastic 2.1, 2.2 and stamped steel with decorative spraying 4.7 crowns.

Treatment: sawing and removing artificial plastic crowns 2.1, 2.2 and stamped crowns 4.7; made new artificial plastic crowns on 2.1, 2.2, 2.3 and 4.7. The prosthetic treatment of the partial absence of teeth on the upper and lower jaws was carried out in the traditional way with partial removable laminar dentures.

After applying removable plate prostheses, an Ovestin course was prescribed for ten days. The drug was applied once a day on the inner surface of the denture bases and was evenly distributed on it.

The examination was carried out before applying the prosthesis, after two weeks, after one and three months.

In addition, the patient during the observation period entered data into the questionnaire (figure 2), which made it possible to judge the timing of adaptation to removable laminar dentures.

The local use of estrogens when using removable plate prostheses had a beneficial effect on the tissue of the prosthetic bed, leading to a decrease in the papillary-marginal alveolar (PMA) index by two weeks of using prostheses, amounting to 8.3% and its stabilization by the first month of observation 8.3 % in relation to the initial level equal to 16.6%. Despite the annoying effect of removable laminar dentures on the teeth, the local application of 0.1% estriol cream after applying the dentures contributed to a decrease in the Mülemann gum bleeding index (points) by the second week of 0.25 compared with the outcome of 0.75 and stabilization of the study indicator to the first month of observations, amounting to 0.25. The results of a cytological study indicated an increase in the degree of maturation of epithelial cells with 425 units. up to 456 units by the month of observation and a decrease in the keratinization index from 78% in the end to 70% by the month of observation. The results of ultrasonic Doppler flowmetry of the microvasculature of the mucous membrane of the prosthetic bed indicated a positive trend in tissue perfusion enhancement by the second week of observation at all control points, equal to 21.95 pf. units in relation to the initial value of 17.28 pF. units, and stabilization of the indicator by the month of observation of 21.02 pf. units

Analysis of the questionnaire filled out by the patient indicated the onset of full adaptation to removable laminar dentures by the thirteenth day of wearing dentures, which allows us to judge the high efficiency of the proposed method.

The claimed method treated 18 patients with a good clinical result.

Thus, the claimed method is highly effective, since the local use of estrogen in postmenopausal women under the bases of removable plate prostheses leads to an improvement in the clinical and laboratory parameters of the tissues of the prosthetic bed and a reduction in the time for adaptation to them.

An advantage of the proposed method over the known ones is that the claimed method favorably affects the condition of the gums and the mucous membrane of the prosthetic bed and helps to reduce the time for adaptation to removable laminar dentures in postmenopausal women. And this, in turn, has a positive effect not only on improving comfort when using the prosthesis, but also on accelerating the socio-psychological adaptation of this patient population.

Claims (1)

The method of orthopedic treatment of postmenopausal women with removable plate prostheses by using a therapeutic agent, characterized in that the Ovestin cream is applied on the inner surface of the prosthesis bases in a thin even layer of 0.5-1.0 mm daily and once within 10 days from the time of application dentures.

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