RU2675736C1 - Method for treating periodontitis - Google Patents

Abstract

FIELD: medicine.SUBSTANCE: invention relates to medicine, namely to dentistry and periodontology and can be used for treating periodontitis. Method comprises professional oral hygiene in patient, scaling. Gingival pocket is treated by the distant-labile method in the constant laser radiation mode at a power of 0.5 W with non-initiated replaceable optical fiber for 60 s. At the final stage of treatment, during the last visit the interdental gingiva is stimulated by treating with a diode laser at a power of 0.3 W for 45 s in the constant radiation mode with a replaceable non-initiated optical fiber. Technique is contact-labile. Exposure is carried out by tingling the interdental gingiva along its length.EFFECT: method provides the increased periodontitis treatment efficacy due to the bactericidal and detoxification effect of the combined exposure using laser radiation.3 cl, 2 dwg, 1 ex

Description

The invention relates to methods of radiation therapy in dentistry and periodontology using a laser beam and is intended for use in the treatment of chronic inflammatory periodontal diseases.

The prior art method for the treatment of chronic generalized periodontitis (RU 2550957 C1, IPC A61K 6/06, A61K 31/10, A61K 31/4045, A61K 31/726, A61K 35/14, A61K 36/41, A61N 5/067, publ. May 20, 2015], which includes the treatment of the affected area with the HELBO 2075 F / Theralite therapeutic diode laser with the HELBO Blue Photosensitizer photosensitase. , for the preparation of which the antioxidant "Melaxen", Kalanchoe juice, glucosamine g are used drohlorid, dimethylsulfoxide, aqueous solkoseril dentin and dental adhesive paste in a ratio of components, proposed by the inventors.

The disadvantage of this method is its complexity and the high cost of treatment, requiring the use of a complex dental composition.

The closest invention to the claimed method and selected as a prototype is a method for the treatment of periodontitis patients (RU 2561890 C2, IPC A61N 5/067, A61K 31/409, A61K 31/444, A61K 39/00, A61P 1/02, A61M 31 / 00, A61C 3/06, A61C 17/20, publ. 06/27/2015), which consists in preliminarily conducted professional oral hygiene, photodynamic therapy, moreover, the PDT gel is introduced into the periodontal pocket, and the laser action performed, which is carried out by a diode laser in pulsed mode at a wavelength of 662 nm power - 0.3 watts, energy density - 75 J / cm ^2, olee 2 minutes per portion inflammation fiber immersed for the whole depth of periodontal pockets using the 1% Gel "Radodent". Moreover, after the end of the complex of therapeutic laser procedures, phage therapy is additionally carried out.

The disadvantage of this method is its complexity, high cost, due to the need to use the Radodent gel and preparations for phage therapy, as well as the long duration of treatment, which is tedious for patients and a dentist.

The problem to which the claimed invention is directed, is to develop a method for the treatment of periodontitis with high efficiency and low cost.

This problem is solved by the fact that according to the method, including professional hygiene of the patient’s oral cavity, removal of dental plaque, then the periodontal pocket is processed according to the distantly labile method in the regime of constant laser radiation at a power of 0.5 W with uninitiated interchangeable optical fiber for 60 seconds. At the final stage of treatment, in the last visit, the marginal part of the gum is stimulated by treating it with a diode laser at a power of 0.3 W for 45 seconds in constant radiation mode with a replaceable uninitiated optical fiber according to the contact-labile technique by pricking the marginal part of the gum throughout its duration.

The distant labile method of processing a periodontal pocket can be implemented by performing reciprocating and circular motions in a pocket with a permanently immersed replaceable optical fiber. The second variant of the implementation of the distantly labile technique includes the selection of operating points, in each of which the processing is carried out with permanently immersed replaceable optical fiber. Six points are distinguished from the molars, with four of them located on the approximate surfaces of the tooth, and two in the middle of the crown. In premolars, canines and incisors, four points are distinguished on the approximate surfaces of the teeth.

A positive result provided by the above disclosed set of features of the invention is to increase the effectiveness of the method of treatment of periodontitis and providing a wide range of its preventive effects. In particular, due to the fact that the laser radiation penetrates well to the depth of periodontal pockets and is absorbed by pigmented tissue (melanin, hemoglobin), the method has the following properties:

- has pronounced bactericidal and detoxifying effects;

- allows you to reduce the drug load on the body;

- characterized by ease of execution;

- there is the possibility of using it as a monomethod;

- It goes well with other methods of traditional treatment of periodontal diseases, increasing their effectiveness;

- prolongs remission;

- is minimally invasive.

The method is illustrated by drawings, where in FIG. 1 shows a diagram of a distantly labile technique for processing a periodontal pocket 1 of a molar of the lower jaw 2, by performing reciprocating and circular motions in a pocket with a permanently immersed interchangeable optical fiber 3; in FIG. 2 shows a diagram of a distantly labile methodology for processing a periodontal pocket, which includes the selection of operating points 4, in each of which the processing is carried out by constantly immersed replaceable optical fiber 3.

The course of treatment of the proposed method is from 3 to 5 days, depending on the clinical picture. In this case, the procedures are performed daily or every other day in a dental office.

The implementation of the method will consider an example.

Patient A, 25 years old, came to the clinic complaining of bleeding gums during brushing and eating, as well as itching and burning in the gums.

Objectively: the mucous membrane of the oral cavity is hyperemic, swollen, in the area of the frontal group of teeth hypertrophy of the interdental papillae. When probing, the gingival mucosa bleeds. Depth of periodontal pockets 5 mm. On the orthopantomogram, an uneven decrease in bone growth throughout, the truncation of the interalveolar septa by 1/2. PI index = 6.0, CPITN = 3 points.

Diagnosis: chronic generalized periodontitis of moderate severity. Treatment: professional hygiene, drug therapy, treatment of periodontal pockets with a diode laser in the form of three procedures according to the proposed method.

At the first visit, the patient was treated with periodontal pockets of all teeth (30 teeth) by performing reciprocating and circular movements in a pocket with a permanently immersed replaceable optical fiber. The treatment of each tooth was performed for 60 seconds. The laser radiation power was 0.5 watts.

At the second visit, after 3 days, periodontal tissue was monitored. The mucous membrane of the oral cavity in the gingival region is slightly swollen and slightly hyperemic, inflammation is practically absent. Then, professional oral hygiene was monitored, and periodontal pockets of all teeth (30 teeth) were processed as described above.

In the third visit, after 5 days, periodontal tissue was monitored. The mucous membrane of the oral cavity is physiological in color, moderately moistened, without pathological changes. Index indicators are normal. There are no inflammation phenomena. Then, the treatment of periodontal pockets of all teeth (30 teeth) was repeated, after which the marginal part of the gum was stimulated by treating it with a diode laser at a power of 0.3 W for 45 seconds in constant radiation mode with a replaceable uninitiated optical fiber using a contact-labile technique by pricking the marginal part gums throughout.

Claims (3)

1. A method of treating periodontitis, including professional hygiene of the patient’s oral cavity, removing dental plaque, measuring the depth of periodontal pockets in the traditional way at several points with a graduated probe and preparing laser interchangeable optical fibers for use, characterized in that the periodontal pocket is processed according to a distantly labile technique in the regime of constant laser radiation at a power of 0.5 W by uninitiated replaceable optical fiber for 60 s; at the final stage of treatment, the marginal part of the gum is stimulated on the last visit by treating it with a diode laser at a power of 0.3 W for 45 s in the constant radiation mode using a replaceable uninitiated fiber according to the contact-labile technique by pricking the marginal part of the gum throughout its duration. 2. A method for the treatment of periodontitis according to claim 1, characterized in that the distantly labile method of processing the periodontal pocket is carried out by performing reciprocating and circular motions in the pocket with a permanently immersed replaceable optical fiber. 3. A method for the treatment of periodontitis according to claim 1, characterized in that the distantly labile technique is carried out by isolating the operating points, in each of which the processing is constantly immersed with replaceable optical fiber for 12 ÷ 15 s, while six points are distinguished from the molars, four of which are located on the approximate surfaces of the tooth, and two in the middle of the crown; in premolars, canines and incisors, four points are distinguished on the contact surfaces of the teeth.

Images