RU2802143C1 - Method of treatment of biting lips and cheeks - Google Patents

Abstract

FIELD: medicine; dentistry.

SUBSTANCE: each section of the buccal mucosa with elements of hyperkeratosis on the right and left is treated with a Prometheus diode laser with a beam power of 0.8 W and a wavelength of 940 nm in continuous mode for 40 seconds. Then, gel with Fagodent bacteriophages is applied to these areas 3 times a day for a course of 2 weeks. In addition, every night and when playing sports for 1 month, mouth guards are put on for the upper and lower jaws.

EFFECT: method allows to accelerate the regeneration of tissues of the oral mucosa, to increase the effectiveness of the treatment of biting lips and cheeks, to reduce the treatment time, and helps to prevent malignancy of the process.

1 cl, 3 ex

Description

SUBSTANCE: invention relates to medicine, namely to dentistry, and can be used to treat cheek and lip biting. Diseases of the oral mucosa are currently a significant problem, as patients rarely notice the unusual appearance of the oral mucosa and, therefore, do not go to the dentist in the early stages of the disease.

A known method of treating cheek and lip biting with application to the oral mucosa of oil solutions of vitamins A, E, sea buckthorn oil, rose hips, multivitamins for local and general treatment [Therapeutic dentistry: textbook: in 3 hours / edited by G.M. . Barera. - M.: GEOTAR-Media, 2005. - Part 3. - 288 s]. The disadvantage of this method of treatment is the lack of influence on the cause of the development of biting of the cheeks and lips, the lack of monitoring of changes in the oral mucosa by hardware techniques in order to be alert during treatment.

A known method for the treatment of traumatic lesions of the oral mucosa in the process of orthodontic treatment, characterized in that the sharp elements of the braces are covered with a liquid filling material to prevent re-injury. Dry the eroded surface of the oral mucosa with a cotton swab. After that, an ointment of the following composition is applied to the affected area: 40% alcohol 1: 5 tincture of the herb drooping resin or rhizomes with roots of leuzea, marigold flowers, meadowsweet grass, taken in mass parts 3: 1: 1, respectively - 30 ml; vaseline, anhydrous lanolin, taken in mass parts 3:2, respectively - 68.0 g; essential clove oil -1.0 g; eucalyptus essential oil - 1.0 g. The treatment is carried out 2 times a day for 2-5 days [patent RU 2577240, 10.03.2016]. The disadvantage of this method of treatment is the presence of allergic reactions to the components of the medicinal ointment, the lack of monitoring of changes in the state of the oral mucosa with hardware techniques for the purpose of oncological alertness.

A known method for the treatment of chronic injuries of the oral mucosa, including the elimination of the traumatic agent, then carry out oral baths with fucus powder for 5-7 days. Additionally, Natalgin is administered orally 2 capsules 2 times a day for a course of 1 month [patent RU 2623053, 06/21/2017].

The prototype is a method for the treatment of chronic mechanical injury of the oral mucosa in patients suffering from insulin-dependent diabetes mellitus, which consists in the fact that at the first stage of treatment a gauze swab with a 5% solution of mexidol is applied to the lesion and the exposure is carried out with the Optodan apparatus with a magnetic nozzle in mode I with an exposure of 2 minutes, a course of 5-7 daily procedures. After that, at the second stage of treatment, a gauze swab soaked in Ozonide oil is applied to the site of the lesion, and exposure is carried out with the Optodan apparatus with a magnetic nozzle in exposure mode II for 2 minutes with a course of 5-7 daily procedures [patent RU 2661861, 07/19/2018 .]. The disadvantages of the technique are a long course of laser therapy, a large number of appointments with a dentist.

The task to be solved by this invention is the development of a method for the treatment of biting the cheeks and lips, providing cancer alertness, enhancing the therapeutic effect in the pathological focus of the oral mucosa.

The technical result when using the invention is to enhance the therapeutic effect by eliminating the traumatic effect and the complex therapeutic effect on the oral mucosa, preventing malignancy of the process, reducing the duration of treatment. The proposed method for the treatment of biting the cheeks and lips is as follows. At the diagnostic stage, autofluorescent stomatoscopy is used to assess the condition of the oral mucosa, to exclude the existing malignancy of the pathological process. The apparatus "AFS-400" is used, which has LEDs with a wavelength of radiation in the violet region of the spectrum (400 ± 10 nm). To assess the condition of the oral mucosa, it is illuminated with the AFS-400 apparatus for 2-3 minutes and a visual assessment of the color of endogenous tissue fluorescence is carried out. The normal mucous membrane of the mouth has a green glow, and the pathological areas of the oral mucosa have differences in the color of the glow. Autofluorescent stomatoscopy has a number of advantages in application in dentistry: non-invasiveness of the method, examination time of 2-3 minutes, high sensitivity of the method to pathological changes in the oral mucosa.

Next, Doppler ultrasound of the mucous membrane of the lips and cheeks is carried out in order to assess the state of the microvascular bed according to the standard method for 10 minutes each section of the mucosa. Chronic pathological processes in the oral mucosa lead to a violation of the blood flow velocity, which entails a change in the activity of metabolic processes, a decrease in the effectiveness of the local effect of drugs.

In the oral cavity, the condition of the hard tissues of the teeth is assessed, the sharp edges of the teeth are polished with polishing burs. An impression is taken with an alginate mass from both jaws of the patient to conduct research and create an individual mouthguard for the dentition. Models of the upper and lower jaws of the patient are cast from plaster. According to individual models, kappas are made from a rigid plate 0.5 mm thick each for the upper and lower jaws by vacuum forming ProForm. Every night and when playing sports for 1 month, mouth guards are put on for the upper and lower jaws. In the area of biting the lips and cheeks on the oral mucosa with elements of hyperkeratosis, the buccal mucosa is treated on the right and left with a Prometheus diode laser with a beam power of 0.8 W and a wavelength of 940 nm in continuous mode, each section of the buccal mucosa is treated for 40 seconds. The Prometheus laser is designed for precision removal of pathological foci with minimal damage to soft tissues, with the possibility of taking a biopsy if necessary.

Then, on the area of the oral mucosa treated with a laser, a gel with bacteriophages for gums "Fagodent" is applied, which is used to normalize the microflora of the mouth. The Fagodent gel contains: a sterile suspension of phage particles in physiological saline; excipients: purified water, carbopol, calendula extract, katon. "Fagodent" contains a complex of 72 types of bacteriophages from the collection of LLC SPC "MicroMir", which inhibit the growth of current strains of the following pathogenic bacteria:

• Acinetobacter baumannii;

• Enterococcus faecalis;

• Staphylococcus aureus;

• Staphylococcus epidermidis;

• Staphylococcus warneri;

• Staphylococcus haemolyticus;

• Staphylococcus caprae;

• Staphylococcus mitis;

• Staphylococcus parasanguinis and others.

Fagodent gel is used 3 times a day after meals and brushing teeth, applied as an application to the buccal mucosa in the postoperative period, 1 ml of gel is applied to the buccal mucosa on each side, distributed with a finger without rinsing. The course of treatment using the Fagodent gel is 2 weeks after the treatment of the oral mucosa with the Prometheus laser. The application of the method allows to effectively increase the local treatment of biting the cheeks and lips due to complex therapy, reduce the treatment time, reduce the risks of complications and re-development of the pathology of the oral mucosa, and prevent malignancy of the process. Advantages of the proposed method for treating cheek and lip biting:

1. Does not cause allergic reactions.

2. Short terms of treatment.

3. Prolonged effect of therapy due to the use of a kappa.

4. Long period of remission.

5. Economic accessibility.

6. Prevention of malignancy of the pathological process.

The proposed method for the treatment of biting lips and cheeks is complex, its high efficiency is due to the synergistic interaction of the constituent components. Not only the traumatic factor is eliminated by grinding the sharp edges of the teeth, but also favorable conditions are created for restoring the integrity of the oral mucosa by mechanically protecting it with mouth guards in combination with the impact of a diode laser on the affected area of the oral mucosa and the positive effect of Fagodent gel on the oral microflora. This contributes to the rapid regeneration of tissues of the oral mucosa, reduction of treatment time, prolonged action of the treatment method.

Example 1

Patient K., 28 years old, complained of an unusual appearance of the cheeks on the right and left. From the anamnesis, it was revealed that the patient has been involved in weightlifting for 5 years. On examination, areas of chronic cheek injury in the region of 3.6 and 4.6 teeth were identified, which were slightly painful on palpation and had a weak red glow when using autofluorescent stomatoscopy. Doppler ultrasound of the buccal mucosa revealed a decrease in linear and volumetric velocities of tissue blood flow by 1.5 times on the right and left. The sharp edges of teeth 3.6 and 4.6 were polished in the oral cavity with polishing burs. An impression was made with an alginate mass from both jaws of the patient to conduct research and create an individual mouthguard for the dentition. Models of the upper and lower jaws of the patient are cast from plaster. According to individual models, kappas were made from a rigid plate 0.5 mm thick each for the upper and lower jaws by vacuum forming ProForm. The patient wore mouthguards on his teeth every night and during sports for 1 month. The center of cheek biting on the right and left was treated with a Prometheus laser. In the postoperative period, Fagodent gel was applied to the mucous membrane of the cheeks 3 times a day after meals in the morning and evening in the form of applications for a course of 2 weeks.

Examination of the patient after 1 month showed that the mucous membrane of the cheeks had a pale pink color, a green glow during autofluorescent stomatoscopy. The indicators of ultrasonic Dopplerography of the buccal mucosa corresponded to the normal ones: the linear blood flow velocity Vas=0.71 cm/s, the volumetric tissue blood flow velocity Qam=0.52 ml/min.

Example 2

Patient Zh., 27 years old, complained of biting his cheeks. From the anamnesis, it was revealed that the patient is engaged in weightlifting for 8 years. On examination, areas of chronic cheek injury were found in the area of teeth 3.6, 3.7, 4.6 and 4.7, which were slightly painful on palpation and had a weak red glow when using autofluorescent stomatoscopy. Doppler ultrasound of the buccal mucosa revealed a decrease in linear and volumetric velocities of tissue blood flow by 1.6 times on the right and left. The sharp edges of teeth 3.6, 3.7, 4.6, and 4.7 were polished in the oral cavity with polishing burs. An impression was made with an alginate mass from both jaws of the patient to conduct research and create an individual mouthguard for the dentition. Models of the upper and lower jaws of the patient are cast from plaster. According to individual models, kappas were made from a rigid plate 0.5 mm thick each for the upper and lower jaws by vacuum forming ProForm. The patient wore mouthguards on his teeth every night and during sports for 1 month. The center of cheek biting on the right and left was treated with a Prometheus laser. In the postoperative period, Fagodent gel was applied to the mucous membrane of the cheeks 3 times a day after meals in the morning and evening in the form of applications for a course of 2 weeks.

Examination of the patient after 1 month showed that the mucous membrane of the cheeks had a pale pink color, a green glow during autofluorescent stomatoscopy. The indicators of ultrasonic dopplerography of the buccal mucosa corresponded to the normal ones: linear blood flow velocity Vas=0.75 cm/s, tissue blood flow volumetric velocity Qam=0.54 ml/min.

Example 3

Patient B., 29 years old, complained of biting his cheeks. The examination revealed areas of chronic cheek injury in the area of 3.5, 3.6, 3.7, 4.5, 4.6 and 4.7 teeth, which were mildly painful on palpation and had a weak red glow when using autofluorescent stomatoscopy. Doppler ultrasound of the buccal mucosa revealed a decrease in linear and volumetric velocities of tissue blood flow by 1.5 times on the right and left. The sharp edges of teeth 3.5, 3.6, 3.7, 4.5, 4.6, and 4.7 were polished in the oral cavity with polishing burs. An impression was made with an alginate mass from both jaws of the patient to conduct research and create an individual mouthguard for the dentition. Models of the upper and lower jaws of the patient are cast from plaster. According to individual models, kappas were made from a rigid plate 0.5 mm thick each for the upper and lower jaws by vacuum forming ProForm. The patient wore mouthguards on his teeth every night for 1 month. The center of cheek biting on the right and left was treated with a Prometheus laser. In the postoperative period, Fagodent gel was applied to the mucous membrane of the cheeks 3 times a day after meals in the morning and evening in the form of applications for a course of 2 weeks.

Examination of the patient after 1 month showed that the mucous membrane of the cheeks had a pale pink color, a green glow during autofluorescent stomatoscopy. The indicators of ultrasonic dopplerography of the buccal mucosa corresponded to the normal values: linear blood flow velocity Vas=0.78 cm/s, tissue blood flow volumetric velocity Qam=0.56 ml/min.

Claims (1)

A method for treating cheek and lip biting, including laser exposure and application of a drug to the lesion, characterized in that when exposed to a laser, each section of the buccal mucosa with elements of hyperkeratosis on the right and left is treated with a Prometheus diode laser with a beam power of 0.8 W and a wavelength of 940 nm in continuous mode for 40 s, after which these areas are treated as a medicine The Fagodent bacteriophage gel is applied 3 times a day for a course of 2 weeks, while every night and when playing sports for 1 month, mouth guards are put on for the upper and lower jaws.