RU2793930C1 - Method for removing dental deposits - Google Patents

Abstract

FIELD: medicine; dentistry.

SUBSTANCE: invention is intended for use in the non-surgical treatment of acute and chronic forms of periodontitis. Treatment is carried out in two stages. At the first stage, granulations, areas of infected cement, and subgingival dental deposits are removed mechanically using a Gracie curette. At the second stage, the root surface is polished using abrasive replaceable nozzles on the Gracie curette, and the replaceable nozzle is put on the Gracie curette and inserted under the gum into the periodontal pocket of the treated tooth. Then it is moved along the root surface at an angle of 10 degrees. When the curette reaches the bottom of the periodontal pocket, it is set at an angle of 90 degrees to the root surface. Next, non-traumatic movements are performed with a curette with pressure on the tooth, and on the lingual and vestibular surfaces, oblique movements are made with the curette, and vertical movements are made on the proximal surfaces.

EFFECT: by to violation of the biofilm matrix, creation of a smooth surface of the tooth root, absence of microdefects in the dentin and cement of the tooth root, absence of traumatization of the periodontal soft tissues, it improves the quality of treatment and accelerates healing in the postoperative period.

1 cl, 1 ex

Description

The invention relates to medicine, namely to dentistry, and can be used in the non-surgical treatment of acute and chronic forms of periodontitis (according to the current international classification ICD-10) [1].

Periodontitis is an inflammatory process of the periodontal tissues, which leads to the destruction of the ligamentous apparatus of the tooth, destruction of bone tissue and early loss of teeth, which reduces the quality of human life [3, 4]. The high prevalence, tendency to progression, and ambiguous results of treatment make it possible to classify periodontal diseases as one of the most urgent problems of modern dentistry [5].

The etiology and pathogenesis of periodontal disease depends on the influence of many factors, the main of which is bacterial infection. Periodontal disease begins due to the presence of toxins secreted by microorganisms, the so-called endotoxins, which are secreted by gram-negative bacteria that are part of subgingival dental plaque.

Treatment of periodontitis is aimed at eliminating the bacterial focus, removing subgingival dental plaque and creating a smooth, biocompatible surface of the roots of the teeth.

A known method of removing dental plaque, in which complex therapy is carried out, including general (antibacterial, desensitizing) and local (removal of dental plaque, supra- and subgingival tartar, elimination of periodontal pockets, occlusal rehabilitation, splinting of teeth), therapeutic and preventive measures.

Removal of granulations, areas of infected cement, subgingival dental deposits is carried out mechanically using a Gracie curette. Periodontal burs are used for smoothing and final polishing of the tooth surface after removal of dental deposits. Burs have an elongated stem and a working part adapted to work in periodontal pockets [1]. The disadvantage of their use is the high risk of traumatizing the soft tissues of the periodontium, which significantly affects the further healing of the postoperative wound. Another disadvantage of periodontal burs is the incomplete smoothing of the root surface with complex anatomy, in particular, in the area of bifurcations.

Thus, the authors were faced with the task of developing a method for the treatment of periodontitis, which, along with high therapeutic efficiency, is characterized by a significant simplification of the treatment procedure.

The proposed method for removing dental deposits includes two stages. At the first stage, the removal of granulations, areas of infected cement, subgingival dental deposits is carried out mechanically using Gresy's curette. At the second stage, the root surface is polished using abrasive replaceable nozzles on the Grecy curette (patent RU 205049 U1, 2021). The replaceable tip is easily put on the Grecy curette and inserted under the gum into the periodontal pocket of the treated tooth. The curette moves along the root surface at an angle of about 10 degrees, the curette reaches the bottom of the periodontal pocket and is set at an angle of 90 degrees to the root surface. The curette performs smooth, sliding, non-traumatic movements with light pressure on the tooth. Curette movements are oblique on the lingual and vestibular surfaces, and vertical on the proximal ones. For better treatment of root surfaces, all degrees of abrasiveness are used consistently from coarse to superfine. Particles of aluminum oxide of various degrees of grinding with an average grain size of 15 microns to 30 microns act as an abrasive.

The abrasiveness of the nozzles is differentiated by color. Nozzles are intended for single use. The procedure is carried out with mandatory preliminary anesthesia. EFFECT: method provides improved treatment quality due to biofilm matrix disruption, creation of a smooth surface of the tooth root, absence of microdefects in the dentin and cement of the tooth root, absence of periodontal soft tissue traumatization, acceleration of healing in the postoperative period.

At present, no method of treating periodontitis by polishing the surface of the tooth root with replaceable abrasive nozzles on the Gracie curette is known from the patent and scientific literature.

The data of clinical studies on the application of the proposed method for the treatment of periodontitis in volunteer patients were obtained on the basis of the Department of Dentistry, Penza State University. In order to study the therapeutic efficacy of the proposed method, a study group of 10 people (men and women aged 25-50 years) was recruited among patients who applied for dental care at a dental clinic from January to August 2021.

The proposed method is illustrated by the following example.

Patient M., 31 years old. He complained of bleeding gums while brushing his teeth, eating, pain in the gums, bad breath from the mouth.

Diagnosis: K05.31 Chronic generalized moderate periodontitis. Associated diseases: none.

Objectively: The mucous membrane in the area of the teeth of the upper and lower jaws is hyperemic, edematous, bleeds on probing, in the area of these teeth there are periodontal pockets 4-5 mm deep with serous-purulent exudate, tooth mobility of the 1st degree. Mullemann bleeding index - II. On 3D computed tomography in the area of the teeth of the upper and lower jaws, there is a horizontal resorption of bone tissue in the area of the interdental septa for 1/2 of the length of the root.

The treatment was carried out according to the proposed method.

Under infiltration anesthesia Sol. Ultracaini 4% -1.7 ml professional oral hygiene, SRP procedure (removal of subgingival dental plaque using Gracie curette and polishing of the root surface with a replaceable abrasive nozzle on the Gracie curette) was carried out. Conducted drug treatment of periodontal pockets (0.05% aqueous solution of chlorhexidine). Medical treatment of the mucous membrane. The patient was advised to:

1. Compliance with the rules of oral hygiene;

2. Mouth rinses with 0.05% aqueous solution of chlorhexidine for 5-7 days;

3. Painkillers for pain.

The patient was invited for re-examination on the 3rd, 7th and 14th day after the operation. Among the clinical criteria for the effectiveness of root surface treatment, we analyzed: 1) the degree of damage to periodontal soft tissues immediately after root surface treatment; 2) a test to determine the smoothness of the root surface using a bulbous periodontal probe. In a shorter period of time, clinical indicators improved, the postoperative period of the patient proceeded smoothly, the patient noted a decrease in pain on the second day, on the third day hyperemia and swelling of the gums disappeared. Healing took place according to the type of primary intention. The technical result is achieved by the fact that when using this nozzle on the Gracie curette, the SRP procedure becomes less invasive (traumatic), and the root surface is smoother.

Information sources:

1. www.mkbs10.ru - international classification of dental diseases ICD-C-3 based on ICD-10.

2. Romanova R.O., Gerashchenko S.M., Zyulkina L.A., Ivanov P.V., Kamyshov S.S., Nebylitsyn I.V. Replaceable nozzle with an abrasive coating on the Gracie curette for finishing the surface of the tooth root // Utility model patent 205049 U1, 06/24/2021. Application No. 2021111636 dated 04/23/2021.

3. Gerasimenko, M. Yu. Method of treatment of periodontitis: Pat. 2216365 Ros. Federation: IPC A61N5/067 / M. Yu. Gerasimenko, V. F. Prikuls, S. A. Rabinovich.

4. Bader, H. I. Adjunctive periodontal therapy: a review of current techniques / H. I. Bader // Dent. today. - 2010. - Vol. 29, No. 7. - P. 94-98. applicant and patent holder Mosk. region scientific research clinical in-t; dec. 281 14.03.02; publ. 11/20/03. - Access mode.

5. Pat. 269247 Russian Federation. A method for the treatment of periodontitis / L.A. Zyulkina, P.V. Ivanov, N.V. Bulkin - No. 2015148376; dec. 11/10/2015 publ. 05/12/2017, Bull. No. 14.

Claims (1)

A method for removing dental plaque, characterized in that the treatment is carried out in two stages, and at the first stage, mechanically using a Gracie curette, granulations, areas of infected cement, subgingival dental deposits are removed mechanically, at the second stage, the root surface is polished using abrasive replaceable nozzles on the curette Gracie, and a replaceable nozzle is put on the Gracie curette and inserted under the gum into the periodontal pocket of the treated tooth, then it is moved along the root surface at an angle of 10 degrees, when the curette reaches the bottom of the periodontal pocket, it is set at an angle of 90 degrees to the root surface, then the curette performs non-traumatic movements with pressure on the tooth, and on the lingual and vestibular surfaces, movements are made with a curette oblique, on the proximal surfaces they make vertical movements.