RU2739029C1 - Method for hygienic treatment and disinfection of removable dental, maxillofacial prostheses and splints - Google Patents

Abstract

FIELD: medicine.

SUBSTANCE: invention refers to orthopedic dentistry. Disclosed is a method for hygienic treatment and disinfection of removable dental, maxillofacial prostheses and splints by mechanical cleaning and disinfection with antibacterial preparations, characterized in that the disinfectant used is an aqueous solution based on a low-molecular weight cationic peptide of varnerin with concentration of 60 mg/ml, in which removable dentures or splints are immersed for 20-30 minutes with subsequent washing under running water; processing frequency in the peptide solution of varnerin makes 2-3 times a week.

EFFECT: invention provides inhibition of microbial film formation on complete and partial removable dentures, maxillofacial prostheses and splints.

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Description

The invention relates to medicine, namely to orthopedic dentistry, can be used for hygienic cleaning, disinfection, inhibition of the formation of a microbial film on partial, complete removable dentures, maxillofacial prostheses and splints.

The difficult fight against inflammation from the mucous membrane and soft tissue periodontium of the maxillofacial region is largely due to the presence of a microbial film on the structural material of the prosthesis, which determines its structure disintegration and increased resistance of microorganisms to the action of antibiotic drugs, factors of specific and nonspecific anti-infective defense of the human body. In addition, in the studies carried out by some authors, it was noted that after the imposition of prostheses made of acrylic plastics in the oral cavity, the amount of E. coli increases from 10 to 63%, yeast-like fungi - from 10 to 34%, pathogenic staphylococcus - from 10 to 22%, also increases the content of enterococcus, which is not normally observed [E.Ya. Vares, V.A. Nagorny and others. Molding thermoplastics of medical frequency - the road to dental orthopedics. Dentistry. 2004; No. 6: 53-54.].

In this regard, the search for methods and means to counteract the formation of microbial films on the structural material of removable dentures and splints is very relevant.

There is a known method of cleaning and disinfection of removable dentures (patent RU No. 2481818, dated 11/16/2019), which consists in the fact that removable dentures are treated with a disinfectant containing (wt%) sodium hypochlorite 0.3-0 , 6, sodium lauryl sulfate 0.3-0.5, polyvinylpyrrolidone 2.0-3.0, sodium silicate 0.2-2.0 and water up to 100. The specified disinfectant is applied with a toothbrush to the denture for 15-20 minutes followed by placing the prosthesis in a container with water, into which 3% hydrogen peroxide is poured from a dropper to conduct a chemical reaction with the release of active singlet oxygen, which has highly bactericidal properties. Solutions of sodium hypochlorite and hydrogen peroxide are taken in a ratio of 8: 1 by volume.

This method of cleaning and disinfecting removable dentures has a number of disadvantages: for the preparation of a disinfectant solution, which consists of six substances in certain concentrations, it becomes necessary to involve a pharmacist with the appropriate equipment, which entails additional material costs; all components of synthetic origin, to which an individual reaction of the body can manifest itself, sodium hypochlorite, with prolonged use, is capable of coloring polymer construction materials.

Thus, the optimal variant of inhibition of the formation of a microbial film on removable constructions of dentures and splints has not yet been presented.

The technical result of the claimed invention: inhibition of the formation of a microbial film on full and partial removable dentures, maxillofacial prostheses and splints, the use of a non-synthetic one-component substance, ease of preparation, no staining effect on structural materials of prostheses, ease of use, does not require the use of additional pharmaceutical equipment and attraction pharmacist.

This result is achieved due to the use of an aqueous solution of a low molecular weight cationic peptide warnerin with a concentration of 60 mg / ml (IEGM UB RAS, Russia) for the treatment of dentures and splints, followed by washing under running water.

The cationic peptide warnerin belongs to the group of lantibiotics, which has an inhibitory effect on the growth of a wide range of gram-positive bacteria of various genera and families (staphylococci, streptococci, corynebacteria and bacilli) synthesized by the bacteria Staphylococcus warneri KL-1, whose molecular weight is 2999 dalton , dated 10.03.2003). In addition to the antibacterial effect, the peptide warnerin has an antifungal effect and high activity against antibiotic-resistant pathogens in the clinic, as well as a negative effect on the physiology of microbial biofilms, practically preventing their development on a polymer construction material.

The method is carried out as follows. Removable partial, full, maxillofacial dentures and splints after preliminary cleaning with a toothbrush with a non-abrasive toothpaste, for example, Lacalut Aktiv (Germany), immersed for 20 minutes (splints and partial removable plate dentures) or 30 minutes (maxillofacial dentures) into a container filled with a previously prepared aqueous solution based on the low-molecular-weight cationic peptide warnerin (IEGM Ural Branch of the Russian Academy of Sciences, Russia), with a concentration of 60 mg / ml. After that, the structures of dentures and splints are washed in running water. Dentures and splints are processed at least 2-3 times a week.

The use of the proposed method of hygienic processing and disinfection of removable partial, full, maxillofacial prostheses and splints, in comparison with the prototype, provides an antibacterial effect and a pronounced decrease in the formation of bacterial films, which was proved by us, in accordance with the principles of evidence-based medicine, in previous studies [Shulyatnikova O.A., Rogozhnikov G.I., Rogozhnikov A.G. Prospects and possibilities of using the low molecular weight cationic peptide warnerin in the practice of a dentist (experimental clinical study). Dentistry problems. # 2. 2017 (13). from. 70-75. doi: 10.18481 / 2077-7566-2017-13-2-74-79; Rogozhnikov G.I., Shulyatnikova O.A., Korobov V.P., Lemkina L.M. Experimental and laboratory study of the formation of the STAPHYLOCOCCUS EPIDERMIDIS 33 microbial film on a polymer dental construction material with nanosized titanium dioxide introduced into the composition. Dentistry problems. 2017. No. 1. from. 41-45.]

Examples of specific implementation.

Example 1. Extract from case history No. 77, patient L., 48 years old. She complained of aesthetic dissatisfaction, missing teeth, impaired chewing and speech, poor fixation of old dentures.

Objectively: the type of face according to Bauer is muscular. There is no asymmetry of the left and right halves of the face. The skin is of a physiological color. Visible mucous membranes are moist and shiny. The height of the lower third of the face is reduced, the chin is protruding; the chin and nasolabial folds are pronounced. Red border of lips without pathological changes. The corners of the mouth are down.

Diagnosis: complete secondary adentia of both jaws, upper jaw - 2nd class according to Schroeder, lower jaw - 3rd class according to Keller, anomalies of soft tissue attachment in the oral cavity due to complicated caries and periodontitis. The ratio of the jaws is progenic.

The patient received complete removable plate prostheses. For the purpose of alternative treatment of inflammation of the oral mucosa and for prophylactic purposes, it is recommended to immerse it in a container filled with an aqueous solution based on the low molecular weight cationic peptide warnerin with a concentration of 60 mg / ml for 20 minutes. Then rinse the structure of the jaw prosthesis in running water. It is recommended to process the prosthesis at least 2-3 times a week.

On re-examination after 3 weeks, the mucous membrane of the prosthetic bed is pale, moist, pink, without signs of an inflammatory nature.

Example 2. Extract from case history No. 150, patient A., 57 years old. She complained of aesthetic dissatisfaction, mobility of teeth, deterioration of fixation of the manufactured complex-jaw prosthesis, ingestion of liquid food, water in the nose. Previously, the patient was treated at an oncological dispensary for osteosarcoma of the upper jaw on the left. The combined treatment was carried out in the following volume - resection of the upper jaw on the left with exenteration of the orbit, 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 oral mucosa has signs of inflammation (slight edema, hyperemia), the absence of a body and alveolar ridge with the teeth of the upper jaw, oronasal communication on the left. Teeth 1.3, 1.4 have grade II mobility. The ratio of the jaws according to the orthognathic type.

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

The patient received a complex-jaw prosthesis for the upper jaw with an occlusive part. For the purpose of alternative treatment of inflammation of the oral mucosa and for prophylactic purposes, it is recommended to immerse it in a container filled with an aqueous solution based on the low-molecular cationic peptide warnerin with a concentration of 60 mg / ml for 30 minutes. Then rinse the structure of the jaw prosthesis in running water. It is recommended to process the prosthesis at least 2-3 times a week.

On re-examination after 4 weeks, the mucous membrane of the prosthetic bed is pale, moist, pink, without signs of an inflammatory nature.

Example 3. Extract from the case history No. 137, patient B., 45 years old. Addressed with complaints of aesthetic dissatisfaction, violation of chewing.

Objectively: Bauer's type of face is muscular. The skin of the face is of a physiological color, turgor is normal, there are no scars, rashes and other pathological elements. The chin and nasolabial folds are moderately pronounced. The lips close without tension. The corners of the mouth are not down, no seizure. During a conversation, the teeth of the upper jaw are visible by 1-2 mm, while smiling - by 4-6 mm.

Diagnosis: partial absence of teeth in the lower jaw due to complicated caries, grade 2, subclass 1 according to Kennedy, loss of chewing efficiency according to Agapov = 34%, mucous membrane according to Suppla type 1, orthognathic bite.

The patient received a clasp prosthesis for the lower jaw with support-retaining clasps for 35, 47.45 teeth.

For the purpose of alternative treatment of inflammation of the oral mucosa and for prophylactic purposes, it is recommended to immerse the prosthesis in a container filled with an aqueous solution based on the low molecular weight cationic peptide warnerin with a concentration of 60 mg / ml for 20 minutes. Then rinse the structure of the jaw prosthesis in running water. It is recommended to process the prosthesis at least 2-3 times a week.

On re-examination after 3 weeks, the mucous membrane of the prosthetic bed is pale, moist, pink, without signs of an inflammatory nature.

Thus, the proposed method makes it possible to provide cleaning and disinfection of removable dentures, maxillofacial prostheses and splints without the use of special equipment in a dental office, department, clinic, and also at home.

Claims (1)

A method of hygienic treatment and disinfection of removable dentures, maxillofacial prostheses and splints using mechanical cleaning and disinfection with antibacterial drugs, characterized in that an aqueous solution based on a low molecular weight cationic peptide warnerin with a concentration of 60 mg / ml is used as a disinfectant, into which removable dentures or splints for 20-30 minutes, followed by rinsing under running water; the frequency of treatment in a solution of warnerin peptide is 2-3 times a week.