RU2813153C1 - Method of complex treatment and prevention of inflammatory diseases of periodontal and oral mucosa in persons with iodine deficiency - Google Patents

Abstract

FIELD: medicine; dentistry.

SUBSTANCE: invention can be used for the treatment of inflammatory diseases of periodontal and oral mucosa caused by periodontopathogenic, anaerobic and conditionally pathogenic microflora of the oral cavity in persons with iodine deficiency. The patient is administered 100% Mageric beet powder, 1 tablespoon diluted in a glass of warm water, 1 time per day and 1 capsule of Spirulina Plus with Amla 2 times a day. Biomed Propolis toothpaste is used as toothpaste. The course of treatment is 1 month which is repeated after 3 months.

EFFECT: invention provides an increase in the therapeutic effect by reducing the degree of inflammation, significantly reducing periodontopathogenic, anaerobic and conditionally pathogenic microflora of the oral cavity, and increasing the iodine content.

1 cl, 1 tbl, 4 ex

Description

The present invention relates to medicine, namely dentistry, and can be used for the treatment and prevention of gingivitis, periodontitis, hyperplastic candidiasis and necrotizing ulcerative stomatitis.

According to WHO, caries and inflammatory diseases are among the most common diseases of the world population. These diseases lead to tooth loss, reducing a person’s quality of life. This is an incentive to find new, more effective and safe methods of prevention and treatment.

In the etiology of dental diseases, the main role belongs to the microflora of the oral cavity and its virulence. Also, a huge role belongs to the state of the human body and the presence of concomitant pathologies. Particularly great importance is attached to disorders of the functional state of the endocrine glands, since the formation and development of the dental system occurs in close connection and under the control of the endocrine system, especially the thyroid gland. Studying the influence of the functional state of the thyroid gland on the tissues of the dental system is also important due to the fact that iodinated hormones have a direct effect on the differentiation and proliferation of cells during ontogenesis, including the antenatal and postnatal periods of growth and development of the body. Among all pathologies of the endocrine system, diseases of the thyroid gland occupy a leading place, and iodine deficiency conditions are one of the most common non-infectious human diseases [H. Choudhry, Md. Nasrallah, 2018]. The range of manifestations of iodine deficiency conditions is quite wide and depends on the period of life. The most common manifestations of iodine deficiency at a young age, according to WHO (2001), are goiter and its complications, hypothyroidism, and cognitive impairment. Hypothyroidism contributes to an increase in the incidence of gingivitis and caries complicated by the formation of dental defects, changes in the structure of the relief of hard dental tissues, periodontitis, resorption of jaw bone tissue, sequestration of alveolar bone, marginal periodontitis, decreased resistance of tooth enamel as a result of depression of the mineralizing potential of saliva [S.V. Sirak et al., 2017; E.A. Bazikyan; N.Yu. Masyuk, I.V. Gorodetskaya, 2017; 2018; I.V. Gorodetskaya, N.Yu. Masyuk, 2018].

Currently, clinical recommendations for the treatment and prevention of inflammatory periodontal diseases and diseases of the oral mucosa use antiseptic agents, which are used for a limited time and can cause the development of allergic reactions and resistant forms of microorganisms. This determines the need to develop new methods of treatment and prevention that will stimulate the immune system and help normalize the microbiocenosis of the oral cavity. The use of products of natural origin is a promising method in the complex treatment of dental diseases, their complications and related processes.

There is a known method of treating periodontitis, characterized by the fact that a preparatory stage of treatment is carried out, including, among other things, drug treatment. In addition, starting from the first day of treatment, the liquid synbiotic Normoflorin®-D is administered orally, 20 ml in the morning and evening 20-30 minutes before meals for 30 days. Starting from the second week of treatment, this synbiotic is injected into each periodontal pocket in a dose of 0.2 ml - daily, once, 5 procedures, and supragingival applications of the synbiotic are applied in the area of each tooth for 10 minutes according to the same scheme [patent RU 2400243, 2010]. The disadvantage of this method is its low efficiency in iodine deficiency conditions.

The closest analogue of the invention is a method for the prevention and treatment of dental diseases of the teeth and oral mucosa, which consists in irradiating the surface of the gums and teeth with radiation in the optical range and, simultaneously with the irradiation, brushing the teeth using toothpaste. Simultaneously with brushing the teeth, the oral mucosa opposite the teeth is irradiated. Toothpaste with a photosensitizer is used as a toothpaste. Chlorophyll is used as a photosensitizer. The wavelength of radiation directed towards the teeth is chosen to be close to the excitation wavelength of the photosensitizer [patent RU 2456033, 2012]. The disadvantages of the prototype are its low effectiveness in iodine deficiency conditions, as well as labor intensity and impossibility of use in a large group of the population.

The objective of the invention is to develop a method for the treatment and prevention of inflammatory diseases of the periodontium and oral mucosa (gingivitis, periodontitis, hyperplastic candidiasis and necrotizing ulcerative stomatitis) in individuals with iodine deficiency.

The technical result when using the invention is to increase the therapeutic effect by reducing the degree of inflammation, significantly reducing periodontopathogenic, anaerobic and opportunistic microflora of the oral cavity, and increasing the iodine content.

The proposed method for the treatment and prevention of inflammatory diseases of the periodontium and oral mucosa caused by periodontopathogenic, anaerobic and opportunistic microflora of the oral cavity in persons with iodine deficiency is carried out as follows: a comprehensive dental examination is carried out, an index assessment of the condition of the hard tissues of the teeth and periodontium according to generally accepted indices ( KPU, RMA, IGR-U, SBI (Muhlemann).Preliminarily, before the start of treatment and preventive measures, a microbiological study of samples of oral cavity biotopes (dental plaque, oral fluid and the contents of the periodontal pocket) is carried out for the presence of periodontopathogenic, anaerobic and conditionally pathogenic microflora of the cavity persons with iodine deficiency take 100% MAGERIC beet powder (MAGERIC, Russia) 1 tablespoon (12 g) diluted in a glass of warm water (40°C), 1 time per day and 2 times per day 1 capsule of Spirulina Plus with Amla (Spirulina Plus Amla), Goodcare, India), brush teeth and oral cavity with Biomed Propolis toothpaste (Organic Pharmaceuticals LLC, Russia). The course of treatment is 1 month, a repeat prophylactic course is carried out after 3 months.

The method allows you to effectively influence the main pathogenetic mechanisms of the development of gingivitis, periodontitis, stomatitis in a short time, and obtain a lasting therapeutic effect due to the prolonged action of all components,

Dry extract of Beta vulgaris (biologically active food supplement 100% MAGERIC beet powder. 400 g, MAGERIC, Russia; contains a large amount of fiber, folic and pantothenic acid, carotenoids, potassium, iron, magnesium, manganese, iodine, cobalt, copper, zinc , phosphorus, sulfur, cesium, rubidium, chlorine, vitamins C, A, PP, B vitamins, as well as pectin and glucose. Due to this, it has a general strengthening property, improves digestion, stimulates intestinal motility and supports the immune system.

Spirulina platensis (biologically active food supplement Spirulina Plus with Amla (Spirulina Plus Amla, Goodcare, India) is a multicellular filamentous blue-green microalgae containing B vitamins (B ₁ B ₂ , B ₃ , B ₅ , B ₆ , B ₉ , B ₁₂ ), E (tocopherol), C, minerals and trace elements: potassium, calcium, magnesium, zinc, manganese, phosphorus, iron, microdoses of iodine, selenium, rare metals, which is very important for the body. Spirulina also contains phycocyanin, (stimulates the immune system), gamma-linolenic acid, chlorophyll promotes the restoration of liver cells and has an antitumor effect.Spirulina contains a full set of all essential amino acids - isoleucine, leucine, lysine, methionine, phenylalanine, threonine, tryptophan, valine, alanine, arginine, cystine, histidine, tyrosine, glutamic acid, as well as more than 2000 enzymes in microdoses [Ciferri, O. 1983. Spirulina, theedible organism. Microbiol. Rev. 47: 551-578.].

The Biomed Propolis toothpaste used (Organic Pharmaceuticals LLC, Russia) contains due to propolis a large amount of microelements (magnesium, potassium, sodium, iron, zinc, manganese, copper, cobalt, phosphorus, sulfur, antimony, aluminum, chromium, selenium, silicon, strontium, titanium, vanadium, tin and fluorine), B vitamins (B ₁ , B ₂ , B ₆ ), vitamins A, C, E, H and P, also amino acids: alanine, β-alanine, α (δ)-aminobutyric acid, arginine, asparagine, aspartic acid, valine, hydroxyproline, histidine, glycine, glutamic acid, isoleucine, lysine, leucine, methionine, ornithine, pyroglutamic acid, proline, sarcosine, series, tyrosine, threonine, tryptophan, phenylalanine, cystine and cysteine, flavonoids. the antifungal substance pinocembrin and, acting in a similar way, caffeic acid ester. The anti-inflammatory, immunomodulatory, analgesic, and antitumor properties of propolis have been proven.

The use of the method allows you to effectively increase the prevention and treatment of caries, inflammatory periodontal diseases and oral cavity diseases caused by the presence of cariogenic, periodontopathogenic and opportunistic flora, enhance the reparative process and increase the period of remission due to the complex effect on all links in the pathogenesis of these diseases. The use of the method contributes to a significant reduction in pathogenic microflora, provides the necessary physiological tissue and intracellular metabolic processes, thereby normalizing the functioning of the immune system and reparative processes.

Using the proposed method, dental diseases were treated and prevented in 120 patients diagnosed with iodine deficiency. The results are presented in the table.

The essence of the invention is illustrated by the following clinical examples.

Example 1. Patient U., 16 years old. Diagnosis: Mild iodine deficiency, iodine content in urine 84 mcg/l; chronic gingivitis, dental caries: 1.6, 2.6, 3.6, 4.4. Complaints: bleeding gums when brushing teeth, bad breath. Objectively: the mucous membrane of the marginal gum is swollen, hyperemic, with a cyanotic tint, soft plaque and supragingival dental deposits are visualized in the area of teeth 3.1, 3.2, 3.3, 4.1 4.2, 4.3. The index was IGR-U 2.4±0.7 (poor oral hygiene), RMA 27.3±1.6% (mild inflammation), probe test for bleeding was positive - grade 1. A gray-white coating is revealed on the back of the tongue, which is difficult to remove when scraped, and the presence of foamy oral fluid in the oral cavity (unstimulated saliva). A qualitative and quantitative assessment of the microflora was carried out: Porphyromonas gingivalis (402.9⋅10 ⁶ ), Treponema denticola (195.1⋅10 ⁴ ), Tannerella forsythensis (102.1⋅10 ⁴ ), Candida alb. (3⋅10 ⁵ ⋅CFU/ml), Streptococcus mutans (4⋅10 ⁵ ⋅CFU/ml).

The following manipulations were carried out: professional oral hygiene, sanitation of the oral cavity, for daily oral hygiene the use of Biomed Propolis toothpaste was prescribed, oral administration of 100% Mageric beet powder, 1 tablespoon (12 grams), diluted in a glass of warm water ( 40°C), 1 time per day and 2 times per day, 1 capsule of Spirulina Plus with Amla. The course of treatment is 1 month, repeated after 3 months.

At the same time, the patient received recommendations on individual oral hygiene and control of teeth brushing.

A follow-up examination was carried out after a month, six months, a year and a year and a half. Examination: no complaints, repeated examination of the oral microflora showed a 4-8-fold decrease in opportunistic microorganisms with normalization of the microbial composition of the oral cavity with a predominance of normal flora. Objectively: the oral mucosa is pale pink. IGR-U 0.4±0.03 (good level of oral hygiene). Probe test for bleeding (PBI 0), PMA index - negative. There were no signs of secondary caries. The iodine content in urine is 178 mcg/l. The achieved treatment result lasted for 18 months.

Example 2. Patient Zh., 18 years old. Diagnosis: Moderate iodine deficiency, iodine content in urine 32 mcg/l; chronic periodontitis, dental caries: 1.4, 2.7, 3.6, 4.7. Complaints: bleeding gums when brushing teeth, bad breath. Objectively: the mucous membrane of the marginal gum is swollen, hyperemic, with a cyanotic tint, soft plaque and supragingival and subgingival dental deposits in the area of the teeth are visualized. The index was IGR-U 2.8±0.7 (poor level of oral hygiene), RMA 55.6±2.3% (average degree of inflammation), probe test for bleeding was positive - grade 2. The depth of the periodontal pocket is 4.8 mm. A gray-white coating is revealed on the back of the tongue, which is difficult to remove when scraped, and the presence of foamy oral fluid in the oral cavity (unstimulated saliva). A qualitative and quantitative assessment of the microflora was carried out: Porphyromonas gingivalis (494.6⋅10 ⁶ ), Treponema denticola (226.5⋅10 ⁴ ), Tannerella forsythensis (143.5⋅10 ⁴ ), Candida alb. (3⋅10 ⁶ ⋅CFU /ml), Streptococcus mutans (4⋅10 ⁶ CFU/ml).

The following manipulations were carried out: professional oral hygiene, treatment of caries, for daily oral hygiene the use of Biomed Propolis toothpaste was prescribed, oral administration of 100% Mageric beet powder, 1 tablespoon (12 grams), diluted in a glass of warm water (40 °C) 1 time a day, and 2 times a day 1 capsule of Spirulina Plus with Amla. The course of treatment is 1 month, repeated after 3 months.

At the same time, the patient received recommendations on individual oral hygiene and control of teeth brushing.

A follow-up examination was carried out after a month, six months, a year and a year and a half. Examination: no complaints, repeated examination of the oral microflora showed a 4-8-fold decrease in opportunistic microorganisms with normalization of the microbial composition of the oral cavity with a predominance of normal flora. Objectively: the oral mucosa is pale pink. IGR-U 0.6±0.05 (good level of oral hygiene). The Mulleman-Cowell index (PBI) was 0.3±0.1, the PMA index was 6.3±0.4%. There were no signs of secondary caries. The iodine content in urine is 162 mcg/l. The achieved treatment result lasted for 18 months.

Example 3. Patient Zh., 19 years old. Diagnosis: Moderate iodine deficiency, iodine content in urine 36 mcg/l; hyperplastic candidiasis of the oral cavity. Complaints: itching, burning, coating on the tongue. Objectively: the oral mucosa is swollen, hyperemic, soft plaque and supragingival dental deposits are visualized in the area of teeth 3.1, 3.2, 3.3, 4.1 4.2, 4.3. The tongue is swollen, and there are tooth marks on the lateral surface. A gray-white coating is revealed on the back of the tongue, which is difficult to remove when scraped, revealing hyperemic mucosa.

The presence of foamy oral fluid in the oral cavity (unstimulated saliva) is noted. The index was IGR-U 2.9±0.7 (poor oral hygiene), RMA 47.3±2.2% (average degree of inflammation), probe test for bleeding was positive - grade 2. A qualitative and quantitative assessment of the microflora was carried out: Porphyromonas gingi-valis (412.2⋅10 ⁶ ), Treponema denticola (210.2⋅10 ⁴ ), Tannerella forsythensis (112.4⋅10 ⁴ ), Candida alb. (12⋅10 ⁷ ⋅CFU/ml), Streptococcus mutans (4⋅10 ⁵ ⋅CFU/ml).

The following manipulations were carried out: professional oral hygiene, treatment of candidiasis: fluconosole 50 mg for 14 days, treatment of caries, for daily oral hygiene the use of Biomed Propolis toothpaste was prescribed, oral administration of 100% Mageric beet powder 1 tablespoon was prescribed (12 grams), diluted in a glass of warm water (40°C) once a day, and 2 times a day, 1 capsule of Spirulina Plus with Amla. The course of treatment is 1 month, repeated after 3 months.

At the same time, the patient received recommendations on individual oral hygiene and control of teeth brushing.

A follow-up examination was carried out after a month, six months, a year and a year and a half. Examination: no complaints, repeated examination of the oral microflora showed a 4-8-fold decrease in opportunistic microorganisms with normalization of the microbial composition of the oral cavity with a predominance of normal flora. Objectively: the oral mucosa is pale pink. IGR-U 0.4±0.03 (good level of oral hygiene). Probe test for bleeding (PBI 0), PMA index - negative. There were no signs of secondary caries. The iodine content in urine is 147 mcg/l. The achieved treatment result lasted for 18 months.

Example 4. Patient A., 17 years old. Diagnosis: Moderate iodine deficiency, iodine content in urine 33 mcg/l; ulcerative necrotic stomatitis. Complaints: pain when eating, bad breath, change in the appearance of the gums. Objectively: the oral mucosa is swollen, hyperemic, a large amount of necrotic grayish-green plaque is visualized in the area of teeth 3.6, 3.7, 3.8. After its removal, irregularly shaped ulcers with a bleeding bottom are noted. The tongue is swollen, and there are tooth marks on the lateral surface. A gray-white coating is revealed on the back of the tongue; when scraped, the unchanged mucous membrane is easily exposed. The index was IGR-U 2.9±0.8 (poor oral hygiene), RMA 68.3±3.4% severe inflammation), probe test for bleeding was positive - grade 2. A qualitative and quantitative assessment of the microflora was carried out: Porphyromonas gingivalis (512.2⋅10 ⁶ ), Treponema denticola (452.5⋅10 ⁴ ), Tannerella forsythensis (112.4⋅10 ⁴ ), Candida alb. (5⋅10 ⁵ ⋅CFU/ml), Streptococcus mutans (6⋅10 ⁵ ⋅CFU/ml).

The following manipulations were carried out: professional oral hygiene, treatment of candidiasis: fluconosole 50 mg for 14 days, treatment of caries, for daily oral hygiene the use of Biomed Propolis toothpaste was prescribed, oral administration of 100% Mageric beet powder 1 tablespoon was prescribed (12 grams), diluted in a glass of warm water (40°C) once a day, and 2 times a day, 1 capsule of Spirulina Plus with Amla. The course of treatment is 1 month, repeated after 3 months.

At the same time, the patient received recommendations on individual oral hygiene and control of teeth brushing.

A follow-up examination was carried out after a month, six months, a year and a year and a half. Examination: no complaints, repeated examination of the oral microflora showed a 4-8-fold decrease in opportunistic microorganisms with normalization of the microbial composition of the oral cavity with a predominance of normal flora. Objectively: the oral mucosa is pale pink. IGR-U 0.4±0.03 (good level of oral hygiene). Probe test for bleeding (PBI 0), PMA index - negative. There were no signs of secondary caries. The iodine content in urine is 132 mcg/l. The achieved treatment result lasted for 18 months.

Claims (1)

A method for the treatment of inflammatory diseases of periodontal and oral mucosa caused by periodontopathogenic, anaerobic and conditionally pathogenic microflora of the oral cavity in persons with iodine deficiency, including the use of toothpaste for brushing teeth, characterized in that the patient is administered 100% Mageric beet powder, 1 tablespoon, warm water diluted in a glass, 1 time per day and 1 capsule of “Spirulina Plus with Amla” 2 times a day, and Biomed Propolis toothpaste is used as a toothpaste, and the course of treatment is 1 month, repeated after 3 months .