RU2708615C1 - Method of treating chronic periodontitis - Google Patents

Abstract

FIELD: medicine.

SUBSTANCE: invention refers to medicine, namely to dentistry, and can be used for treating chronic mild periodontitis of mild and moderate severity. Presented method for treating chronic periodontitis is carried out using an oil solution based on a biologically active additive "Yagel" obtained by mixing components in the following composition, wt%: "Yagel" biologically active additive, dry residue – 65–66; oil solution of vitamin "A" – 34–35. Prepared solution is introduced directly into the pathological periodontal pocket and additionally applied by filling with oil solution and fixation for 25–30 minutes in the oral cavity of the individually manufactured dental tray, wherein the day procedure involves single application and application of the oil solution, the therapeutic course is 7–10 procedures, and for the prevention course is repeated 3–4 times a year with interval of 2–3 months according to the readings.

EFFECT: use of the present invention provides effective treatment of periodontitis due to prolonged antimicrobial action in a pathological periodontal pocket and promotes reverse development of an inflammatory destructive process of periodontium tissues.

1 cl, 4 tbl, 4 dwg

Description

The invention relates to medicine, namely to dentistry, and can be used in the treatment of chronic periodontitis of mild to moderate severity.

In the treatment of periodontal and oral mucosa diseases, auxiliary devices are used that allow applying drugs to the lesions and temporarily splinting the teeth, for example, it is known to use mouth guards made with the patient’s maxillary and mandibular dental arch (see RU No. 87905, class A61C5 / 00, published October 27, 2009). At the same time, mouthguards are made separately for the upper and lower jaws with overlapping not only teeth, but also the entire alveolar part of the mucous membrane, after which they are soldered along the occlusal surface.

A known method of treating periodontal disease and oral mucosa (see RU No. 2189218, class A61K 6/02, publ. 09/20/2002), in which for the treatment of gingival mucosa on the lesion is introduced ozonides for 15-25 minutes by applying on the gums soaked with Ozonide oil foam pad located in an individually made mouthguard. In this case, the course of treatment allows you to influence the main pathogenetic mechanisms of the development of periodontitis by increasing the accuracy of dosing of the drug substance according to activity.

The disadvantages of the known solution is the complexity of the procedures, since at the same time you need to make an individual mouthguard and foam padding. In addition, when modeling mouthguards on individual gypsum models, the thickness of the foam pad should be taken into account, which creates additional difficulties.

According to the method of treatment of periodontitis (see RU No. 2143258, class A61K 6/00, publ. 12/27/1999), the drug “Viferon” is introduced into the periodontium, previously introduced into the individual mouthguard, while “Viferon” is administered dosed for therapeutic reasons.

However, it is known that the drug “Viferon” does not have a direct antimicrobial and bacteriostatic effect in relation to periodontopathogenic microflora. Thus, the known solution does not directly affect the microflora of the pathological periodontal pocket, which is the main etiological factor, and contributes to the immunomodulating effect.

The problem to which the claimed invention is directed is expressed in a significant reverse development of the inflammatory and destructive process of periodontal tissues with the disappearance of symptoms of bleeding and swelling of the gums in patients with chronic periodontitis.

The technical effect obtained by solving the problem is expressed in the method of treating chronic periodontitis in patients with the external use of an oil solution based on the “Yagel” dietary supplement from the cladonia lichen thallus extract containing usnic acid, which has an antibiotic effect.

To solve this problem, a method of treating periodontitis using an oil solution based on the Yagel dietary supplement is based on assessing the prevalence of periodontitis, using a method to increase the effectiveness of treatment of inflammatory processes of periodontal tissues, and includes introducing an oil solution into the pathological periodontal pocket daily or every other day obtained by mixing the components in the following composition, in mass. %: BAA "Yagel", dry residue - 65-66; oily solution of vitamin "A" - 34-35. In this case, a one-time procedure for local and generalized lesions of periodontal tissues of an inflammatory and destructive nature of mild to moderate severity involves the direct injection of an oil solution once a day using a syringe with a cannula into a previously isolated pathological periodontal pocket. Next, the drug is additionally applied through an individually manufactured dental mouthguard, for which purpose, the mouthguard is pre-filled with an oil solution and fixed on the upper and / or lower jaw and kept for 25-30 minutes. When fixing in the oral cavity, the edges of the mouthguards overlap not only the dentition, but also the entire mucous membrane of the alveolar processes, which, in turn, contributes to a longer therapeutic effect of the agent in relation to periodontopathogenic microorganisms of the pathological periodontal pocket. The duration of the course is 7-10 procedures daily or every other day. At the end of the inflammatory process of periodontal tissues, according to indications, patients undergo surgical treatment methods, for example, open curettage or patchwork, and recommendations are given on oral hygiene.

A comparative analysis of the features of the claimed solution with known features indicates the conformity of the claimed solution to the criterion of "novelty."

The combination of essential features provides a solution to the stated technical problem, namely, increasing the effectiveness of treatment of periodontitis using the Yagel oil solution and manufactured individual dental mouthguards that provide a longer antimicrobial effect in the pathological periodontal pocket and contribute to the reverse development of the inflammatory and destructive process of periodontal tissues . In addition, this method of treatment is simple to perform and does not require much time for use, which is important for novice doctors.

Yagel dietary supplement (BAA) was developed at the Institute of Biological Problems of Cryolithozone SBI SB RAS (Yakutsk) and has a certificate of state registration of the Federal Service for Supervision of Consumer Rights Protection and Human Well-Being of the Russian Federation 77.99.23.3.U.3522.5 .08 dated 05/04/2008; TU 9219-002-36971185-08; sanitary-epidemiological conclusion of the Federal Service for Supervision of Consumer Rights Protection and Human Well-Being of the Russian Federation 77.99.03.003.T.000928.05.08 from 05/04/2008; certificate of state registration in the customs union of the Republic of Belarus, the Republic of Kazakhstan and the Russian Federation RU.77.99.11.003.E.051236.11.11 of 11/17/2011; RF patent 2006100978 dated 01.08.2007.

The drug "Yagel" is obtained from an extract of thalli of the lichens of the genus Cladonia and is recommended for use as a food supplement as a detoxicant of the body's internal media (blood, lymph, intercellular fluids, cell cytoplasm) from a wide range of endo- and exotoxins, as well as to reduce toxic post-toxic, narcotic effect of vodka products, without reducing their euphoric effect and as a corrector of metabolic disorders. At the same time, it normalizes blood sugar in patients with diabetes mellitus and cholesterol in patients suffering from atherosclerosis. In addition, it has a preventive effect against heart attacks and strokes, because exhibits antithrombin activity. Due to the high content in dietary supplements - derivatives of usnic and other lichen acids in the form of clathrate and lichen oligosaccharides it has an antibiotic effect. "Yagel" contains: the main active substances - amino-oligosaccharides, formed from amino-polysaccharides when they are treated with water in a medium of carbon dioxide in a supercritical fluid state, in addition, a complex of antioxidant substances (orselic, lecnoric, glyphoric, chiastic acids and quinones; vitamin B12, folic acid); natural antibiotics - usnic acids and their derivatives (see table 1).

The preparation of the oil solution is carried out by mixing the dry residue of dietary supplement "Yagel" with an oil solution of vitamin "A" to obtain a thick creamy consistency in the following percentage (wt.%):

dry residue "Yagel" - 65-66;

oily solution of vitamin "A" - 34-35.

A method for the treatment of chronic periodontitis using an oil solution based on "Yagel" consists of sequential measures. At the initial stage of treatment, a preliminary safety training is organized. At the same time, in order to increase the antibiotic effect of the Yagel oil solution against periodontopathogenic microorganisms, contingent conducts controlled cleaning based on the removal of tooth and subgingival deposits, instructing in the selection of oral hygiene products, as well as on the method of brushing teeth.

Simultaneously, impressions are taken from the patient and individual mouthguards based on silicone materials are made.

Further, in the medical institution, measures are taken for the direct treatment of chronic periodontitis, for which the pre-prepared Yagel oil solution is introduced into the periodontal pocket, for example, using a syringe with a cannula, after which the additional exposure of the drug is performed through individual dental mouth guards filled with oil solution, by fixing them in the oral cavity for 25-30 minutes.

Thus, the course of treatment of chronic periodontitis is 7-10 daily or every other day injections of the oil solution into the pathological periodontal pocket. At the end of the procedure, the patient is given recommendations on limiting food intake for 4-5 hours.

The claimed technical solution is illustrated by drawings, where figure 1 shows an image at the stage of manufacturing an individual dental mouthguard; figure 2 - the introduction of the oil solution "Yagel" in the pathological periodontal pocket through a syringe with a cannula; figure 3 - filling individual dental mouthguards with oil solution "Yagel"; figure 4 - making and fixing individual dental mouthguards with oil solution "Yagel" in the oral cavity.

A study of the effectiveness of the claimed technical solution was carried out in a clinical setting. A method for the treatment of chronic periodontitis was carried out in the age group of 35-50 years.

The first group: the introduction of the Yagel oil solution into the pathological periodontal pocket with the subsequent additional introduction of this solution into the manufactured individual dental mouth guard and its fixation in the oral cavity for 30 minutes - 24 people;

The second group: 19 people, for the treatment they used a foam pad impregnated with Ozonid oil located in an individually made dental mouthguard, followed by fixation in the oral cavity for 15-25 minutes (according to RU patent No. 2189218). It is also known that Ozonid oil has an anti-inflammatory, anti-allergic pharmacological effect and has bactericidal, antiviral and fungicidal properties; is a product of deep oxidation of unsaturated carboxylic acids of natural origin (see Certificate of Conformity No. ROSS RU.IM02.В14094, No. ROSS RU.ME48.B01663, No. POCC RU.PK12.V02491, No. ROSS RU.PK12.B02492, No. ROSS RU. PK12.V02493). Composition: a solution of ozonides of unsaturated carboxylic acids (natural origin) in oil.

A third control group was also formed, where treatment and preventive measures were not carried out - 13 people.

The treatment results were evaluated by clinical, laboratory, instrumental diagnostic research methods and examined in the dynamics of the intensity and severity of the inflammatory and destructive process of periodontal tissues in patients.

Initial organizational activities included the analysis and assessment of the prevalence and intensity of periodontal diseases among the population of the Republic of Sakha (Yakutia) (see table 2).

For microbiological research, material from the pathological periodontal pocket (inflammatory focus) was obtained using a tampon that was placed in the Amiesa liquid transport medium. The primary inoculation of the material was carried out on anaerobic blood agar, Chocolate agar and Saburo medium. Incubation of crops was carried out at a temperature of 37 ⁰ C for 24-48 hours. At the same time, plates with anaerobic hemagar were incubated in sealed containers with gas generators to create an anaerobic atmosphere “GENbag Anaer” from BioMerieux (France). Crops on “Chocolate” agar were also placed in airtight containers, but with gas generators for microbagophiles GENbag Microaer from BioMerieux (France). To count the number of microorganisms in the inoculum, the sowing was carried out according to the method of Melnikov-Tsarev: a swab was used to inoculate the test material on the 1st sector of the Petri dish with nutrient medium. After this, a d3 mm bacteriological loop performed 4 line seeding from the 1st sector to the 2nd, similarly, from the 2nd sector to the 3rd, burning the loop after reseeding of each sector. The number of bacteria in the material was determined using the table (see table 3).

The average number in statistical processing was expressed in log CFU, where 101 CFU = 1 log CFU (CFU - colony forming unit, microbial cell). Identification of the selected cultures was carried out by time-of-flight mass spectrometry using a Vitek-MS analyzer (BioMerieux, France).

As the results of the study show, the microbiological characteristics of the microflora of the pathological periodontal pocket are represented by gr (+), gr (-) microorganisms and fungal flora of the genus Candida. Moreover, before treatment, the quantitative and qualitative composition of microorganisms in the gum tissue did not differ in all groups (P> 0.05). Microorganisms isolated from the periodontal pocket during periodontitis Streptococcus oralis, Streptococcus sanguis, Candida dubliniensis, Neisseria mucosa, Neisseria sicca, Neisseria elongata, Human parainfluenza viruses, Gr. Adiatiens.

The results obtained in the group with the Yagel oil solution indicate its antibiotic action against Streptococcus oralis, Streptococcus sanguis, Candida dubliniensis, Neisseria elongata, Neisseria sicca, Neisseria mucosa, Gr. Adiatiens, H. parainfluenzae, which determine the basis of clinical efficacy (see table 4). Due to this, starting from 2 days, the reverse development of the inflammatory process of the marginal gum was determined, which is characterized by a significant decrease in edema and hyperemia of the mucous membrane of the marginal gingival region, which confirms its pronounced clinical effect.

In the microbiological study, the group with Ozonid oil also determined quantitative and qualitative changes in the types of periodontopathogenic microorganisms. This, in turn, is associated with the antibiotic effect of the Ozonid oil (see table 4). Moreover, starting from 3 days, the reverse development of the inflammatory process of the periodontal pocket is determined, which is clinically characterized by a significant decrease in edema and hyperemia of the mucous membrane of the marginal gingival region, which also confirms its clinical effect.

The satisfactory results of the treatment measures in the treatment of chronic periodontitis are explained by the positive effect of the antibiotic components contained in the Yagel oil solution.

For comparison, the clinical efficacy of the group with the Yagel oil solution is characterized by a similar antimicrobial effect of the Ozonid oil, therefore, dynamic changes in periodontal tissues in the form of the reverse development of the inflammatory process are noted starting from 2 days and significant significant differences are obtained in the studied parameters compared with the control group (P <0.05).

Thus, the pronounced antibiotic properties of the Yagel oil solution make it possible to use it in dentistry, in particular, when treating periodontitis, which improves the effectiveness of treatment of inflammatory periodontal diseases, and also prevents their complication and the development of a chronic focus of infection in the oral cavity.

Table 1

The dry residue composition of the product "Yagel" based on the extract of thalli lichens of the genus "Cladonia"

No.
p / p The name of indicators Concentration (%) one Amino Oligosaccharides 98,49916 2 Vitamin B 12 0.00004 3 Folic acid 0,0008 4 Usnic Acid Salt 1,5

table 2

The prevalence and intensity of periodontal disease in the population of the Republic of Sakha (Yakutia)

Age
groups Spread
injured
% CPI% healthy bleeding over- and subgingival
howling cam. pathologist. periodontal pocket 15-19 91.26 ± 0.05 8.74 ± 0.59 36.23 ± 2.46 48.23 ± 0.43 6.80 ± 0.60 20-34 95.14 ± 0.03 4.86 ± 0.62 29.13 ± 0.46 47.69 ± 0.34 18.32 ± 0.53 35-44 97.43 ± 0.01 2.57 ± 0.63 15.50 ± 0.55 42.21 ± 0.37 39.72 ± 0.39 45-54 98.88 ± 0.007 1.12 ± 0.64 6.07 ± 0.61 31.41 ± 0.44 61.40 ± 0.25 65-74 62.42 ± 0.24 0.17 ± 0.65 4.71 ± 0.62 12.22 ± 0.57 45.32 ± 0.35 Age groups CPI (SEXTANT) healthy bleeding sup- and subdesn.
a rock pathologist.
periodontium
pocket unaccounted for
sextants 15-19 0.42 ± 0.03 2.22 ± 0.02 2.87 ± 0.02 0.45 ± 0.03 0.04 ± 0.03 20-34 0.20 ± 0.03 1.80 ± 0.02 2.80 ± 0.02 1.09 ± 0.03 0.11 ± 0.03 35-44 0.11 ± 0.03 1.05 ± 0.03 2.37 ± 0.02 2.14 ± 0.02 0.33 ± 0.03 45-54 0.03 ± 0.03 0.37 ± 0.03 1.27 ± 0.03 3.04 ± 0.01 1.29 ± 0.03 65-74 0.01 ± 0.03 0.13 ± 0.03 0.60 ± 0.03 3.10 ± 0.01 2.16 ± 0.02

 Table 3

Calculation table for determining the number of bacteria in the test material

The number of colonies by sector Quantity, CFU Sector 1 Sector 2 Sector 3 1-6 No growth No growth <1000 (up to 10 ³ ) 8-20 No growth No growth 1000 (10 ³ ) 21-30 No growth No growth 5000 (10 ^3-4 ) 31-60 No growth No growth 10.000 (10 ⁴ ) 70-80 No growth No growth 50,000 (10 ^4-5 ) 100-150 5-10 No growth 100,000 (10 ⁵ ) A very large number 20-30 No growth 500,000 (10 ^5-6 ) A very large number 40-60 No growth 1,000,000 (10 ⁶ ) A very large number 100-140 10-20 5.000.000 (10 ^6-7 ) A very large number A very large number 30-40 50,000,000 (10 ⁷ ) A very large number A very large number 60-80 100,000,000 (10 ⁸ ) A very large number A very large number 80-140 1,000,000,000 (10 ⁹ )

Table 4

Comparative characteristics of the antimicrobial activity of the Yagel oil solution in the treatment of periodontitis

Types of microorganisms Quantity, CFU before treatment The number of CFU after treatment Reindeer moss Ozonide Reindeer moss Ozonide Streptococcusoralis ⁵ 10 ⁵ 10 ⁵ 10 ⁴ 10 ³ Streptococcusoralis ⁶ 10 ⁶ 10 ⁶ 10 ⁵ 10 ⁵ Streptococcusoralis ⁷ 10 ⁷ 10 ⁷ 10 ⁶ 10 ⁵ Streptococcusoralis ⁸ 10 ⁸ 10 ⁸ 10 ⁶ 10 ⁵ Streptococcusoralis ⁷ 10 ⁷ 10 ⁷ 10 ⁶ 10 ⁵ Streptococcusoralis ⁷ 10 ⁷ 10 ⁷ 10 ⁶ 10 ⁵ Streptococcusoralis ⁷ 10 ⁷ 10 ⁷ 10 ⁶ 10 ⁶ Streptococcusoralis ⁷ 10 ⁷ 10 ⁷ 10 ⁶ 10 ⁶ Streptococcusoralis ⁷ 10 ⁷ 10 ⁷ 10 ⁶ 10 ⁶ Streptococcussanguis ⁷ 10 ⁷ 10 ⁷ 10 ⁶ 10 ⁶ Streptococcussanguis ⁷ 10 ⁷ 10 ⁶ 10 ⁶ 10 ⁴ The average concentration for the genus Streptococcus 10 ^6.81 10 ^6.72 10 ^5.72 10 ^5.09 Candida dubliniensis ⁷ 10 ⁸ 10 ⁷ 10 ³ 10 ⁴ Candida dubliniensis ⁵ 10 ⁷ 10 ⁷ 10 ⁴ 10 ³ Average concentration for the genus Candida 10 ^7.5 10 ⁷ 10 ^3,5 10 ^3,5 Neisseriasicca ⁹ 10 ⁹ 10 ⁷ - 10 ³ Neisseriasicca ⁸ 10 ⁷ 10 ⁶ 10 ³ 10 ⁴ Neisseriaelongata ⁸ 10 ⁸ 10 ⁶ - 10 ³ Neisseriamucosa ⁷ 10 ⁷ 10 ⁷ 10 ³ 10 ⁴ Average concentration for the genus Neisseria 10 ^7.75 10 ^6.5 10 ^1,5 10 ^3,5 H. parainfluenzae ⁷ 10 ⁷ 10 ⁷ - - Gr. Adiatiens ⁶ 10 ⁶ 10 ⁶ - -

Claims (4)

A method for the treatment of chronic periodontitis, including the introduction of medications, characterized in that the oil solution is based on the biologically active additive "Yagel", obtained by mixing the components in the following composition, in wt.%: dietary supplement "Yagel", dry residue - 65-66, oily solution of vitamin "A" - 34-35, why the prepared solution is injected directly into the pathological periodontal pocket and is additionally applied by filling in the solution and fixing for 25-30 minutes in the oral cavity of an individually manufactured dental mouthguard, while the daily procedure includes a single application and application of the solution, the course of treatment is 7- 10 procedures, and for prevention the course is repeated 3-4 times a year with an interval of 2-3 months according to indications.

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