RU2582228C1 - Method of preventing and treating postoperative inflammation of the mouth - Google Patents

Abstract

FIELD: medicine.

SUBSTANCE: invention can be used for prevention and treatment of postoperative inflammation of the oral cavity. For this patient on the area of a postoperative wound is applied medicament for the collagen matrix by application of 20-30 minutes a day, while in use as a medicament Varnerin peptide at a concentration of 1 mg / ml, which is applied to the oral mucosa in the area of a postoperative wound the form of applications to the collagen film 1-2 times a day for a month.

EFFECT: method improves the efficiency of the prevention and treatment of postoperative inflammation of the mouth with the convenience of its use.

1 cl, 2 ex

Description

The invention relates to medicine, namely to orthopedic and surgical dentistry, and can be used for the prevention and treatment of inflammatory phenomena after operations on the maxillofacial region (MFA), dental implantation, bone grafting, tooth extraction, simple and complex, periodontal surgery.

A known method for the prevention and treatment of inflammation in the oral cavity after dental surgery (patent RU No. 2492851, from 09/20/2013), which consists in the fact that the patient after surgery every day at least 1 time per day and then up to three months on the area of the postoperative wound is applied a drug based on the Lactobacillus plantarum 8P-A3 strain (e.g. Lactobacterin) and / or B. bifidum (e.g. Bifidumbacterin) in a dose of at least 10 million live lactobacilli and / or bifidobacteria by application on a collagen sponge for 20-30 minutes .

This method of prevention and treatment of postoperative inflammation of the oral cavity has the following disadvantages: the use of antibiotics in a number of clinical cases is a necessity, but if known analogues with antibiotics are taken, their therapeutic effectiveness may be reduced; storage and transportation of the drug require a temperature not exceeding 10 ° C; their significant drawback is that the lyophilization process leads bacteria to suspended animation (inactive state). To return to an active physiological state, they need 8-10 hours, and during this time, most of the bacteria are removed from the human body. In addition, in the process of lyophilization, bacterial cells lose specific receptors that help them attach to surfaces, so their stay is even more reduced.

The use of a collagen sponge for applications of a drug in the oral cavity presents certain difficulties, since a collagen sponge 7–9 mm thick is commercially available. In the presence of such a thickness, it is difficult to fix and adapt stably on the oral mucosa.

The technical result of the proposed solution as an invention is to improve the method of prevention and treatment of patients with postoperative oral inflammation, ease of use.

These tasks are achieved due to the fact that it is proposed to use a low molecular weight cationic peptide warnerin (Russia, Perm) with a concentration of 1 mg / ml, belonging to the group of lantibiotics, inhibiting the growth of a wide range of gram-positive bacteria of various genera and families (staphylococci, streptococci, corynebacterium and bacilli) synthesized by bacteria Staphylococcus warneri KL-1, the molecular weight of which is 2999 daltons (RF patent No. 2200195, from 10.03.2003). The warnerin peptide has antibacterial, antifungal, antiendotoxic, immunoregulatory effects, is a permeability factor, enhancing the action of traditionally used antibiotics, has fast target cell killing, and high activity against antibiotic-resistant pathogens in the clinic. According to a new technical solution, the method for the prevention and treatment of postoperative inflammation of the oral cavity is carried out using the peptide warnerin, which can have a significant negative effect on the physiology of microbial biofilms formed by coagulase-negative staphylococci (S.epidermidisATCC 29887), practically preventing the development of bacterial films. The use of a collagen film as a carrier for the application of warnerin peptide allows it to be adapted on the mucous membrane of the oral cavity, without the possibility of displacement, since the film thickness is not more than 1 mm, it is well modeled on surfaces of any configuration, soft, plastic (e.g., collagen film for Applicall wound healing according to TU 9393-005-74079425-2009; manufacturing organization: MacMedi LLC).

Peptide warnerin for the prevention and treatment of postoperative inflammation of the oral cavity is used for the first time.

The method is as follows. The drug, made in the form of an aqueous solution based on the low molecular weight cationic peptide warnerin with a concentration of 1 mg / ml, is used as an application to the area of the postoperative wound on a collagen film up to 1 mm thick by soaking it before application. Therapy is carried out at least 1-2 times a day daily for 1 month. The duration of each procedure is 20-30 minutes.

Using the proposed method for the prevention and treatment of postoperative inflammation of the oral cavity in comparison with the prototype provides a reduction in the number of possible postoperative inflammatory complications due to the use of the low molecular weight cationic peptide warnerin, which potentiates and enhances the effect of antibiotics, has an antibacterial effect on resistant S.epidermidis strains. A method for the prevention and treatment of postoperative inflammation of the oral cavity can be used in any dental office, department and clinic.

Examples of specific performance.

Example 1. Extract from the medical history No. 27, patient O., 18 years old.

Patient O., 18 years old, was treated in the Department of Maxillofacial Surgery with a diagnosis of a giant cell tumor of the upper jaw on the left (K06.81). From the anamnesis it was found out that for the first time I noticed a swelling of the upper jaw on the left in March 2013, I went to the dentist surgeon at the place of residence, was sent to the dental clinic of the PHMA. A consultation was conducted by an oncologist, ophthalmologist, otolaryngologist, orthopedic dentist, and an incision biopsy was performed in the upper jaw area on the left in the clinic. As a preoperative preparation, an denture denture for the upper jaw was made by an orthopedic dentist.

In October 2013, a tumor removal operation with partial resection of the upper jaw on the left.

Diagnosis: postoperative defect of the upper jaw on the left, partial secondary absence of teeth on the upper jaw (Kennedy class II), loss of chewing effectiveness (according to Agapov) 30%.

As an alternative anti-inflammatory treatment of postoperative complications, applications on a collagen film with a solution of warnerin peptide with a concentration of 1 mg / ml in the area of the surgical wound 2 times a day daily for 1 month after the intervention were prescribed. The duration of each procedure was 30 minutes.

At the control examination 4 weeks after the operation: the area of perforation of the mucous membrane with a bone edge in the projection of 2.5 teeth is epithelized, the oral mucosa in the area of the upper jaw defect on the left is pale pink, shiny, smooth, moist, without inflammatory phenomena.

Example 2. Extract from the medical history No. 22, patient M., 58 years old.

She complained of aesthetic dissatisfaction, tooth mobility, deterioration of fixation of the manufactured composite-jaw prosthesis, ingestion of liquid food, water in the nose. Previously, the patient was treated at the Oncology Center for osteogenic sarcoma of the upper jaw on the left. Combined treatment was carried out in the following volume - resection of the upper jaw on the left with orbital exentation, a course of radiation therapy.

Objectively: the face is asymmetric due to cicatricial changes in the soft tissues of the middle third of the face, the mucous membrane of the oral cavity has signs of inflammation (slight swelling, hyperemia), lack of body and alveolar bone with teeth of the upper jaw, oro-nasal communication on the left. Teeth 1.3, 1.4 have II degree mobility. The ratio of the jaws according to the orthognathic type.

Diagnosis: partial secondary absence of teeth on the lower jaw - Kennedy class I, defect in the body and alveolar process of the upper jaw, oro-nasal communication. Loss of chewing effectiveness (according to Agapov) - 92%, aesthetic, phonetic flaw.

The patient made a composite-maxillary denture on the upper jaw with an obstructing part. For the alternative treatment of inflammation of the oral mucosa and for prophylactic purposes, it is recommended to apply a solution of the low molecular weight cationic peptide warnerinas at a concentration of 1 mg / ml in the form of applications on a collagen film 1 time per day every day for 20 minutes for 1 month.

On re-examination after 4 weeks, the mucous membrane of the prosthetic bed is pale, wet, pink, with no signs of inflammatory nature.

Claims (1)

A method for the prevention and treatment of postoperative inflammation of the oral cavity by daily application of a collagen-based drug to a patient on the postoperative wound area by the application method for 20-30 minutes daily, characterized in that they use peptide warnerin with a concentration of 1 mg / ml, which is applied to the mucous membrane of the cavity mouth in the area of the postoperative wound in the form of applications on a collagen film 1-2 times a day for 1 month.