RU2008037C1 - Method for introducing medicines into parodontium tissues - Google Patents

Abstract

FIELD: medicine. SUBSTANCE: method involves positioning flat piezoceramic plates between tooth rows and connecting them with gungivial electrodes on both sides of mucous membrane of alveolar process so that current is fed to the electrodes during periodical active compression of plates when jaws are closed within the time required for the medicinal ions to penetrate into the depth of parodontium tissues. EFFECT: simpler method for performing medicinal electrophoresis. 2 dwg

Description

 The proposed method relates to medicine, can be used in therapeutic dentistry for physiotherapy of periodontal tissue diseases.

 A known method of introducing periodontal drugs by electrophoresis under the influence of direct current from external sources (devices AGN-32, AGN-33, "Stream" -1, etc.).

The disadvantage of this method include:
- the need to have an external network, special equipment;
- there may be a violation of oral hygiene when using conductive wires that come in contact with objects outside the oral cavity and can serve as sources of infection;
- the possibility of burns with electric current of the oral mucosa, the possibility of breakdown of the transformer and the supply of voltage dangerous to the patient's life.

Piezoceramics are known (I. A. Glazmak. Piezoceramics - M.: Energy, 1972, 288 p.), Which under the influence of external forces are capable of generating electrical energy. The frequency of the impact of efforts can be from a few hertz and higher, the force - up to several thousand Newtons per cm ² . In this case, the pulse energy is up to 450 watts.

 To obtain the required current strength, you can make a current source of several elements. Thus, it is possible without the use of an electric network or galvanic cells to obtain the modes necessary for drug electrophoresis. As a prototype, a method for administering drugs to periodontal tissues by electrophoresis was selected.

 The aim of the method is to increase the effectiveness of treatment of periodontal diseases by creating a depot of drug ions in the periodontium without using an external electric network and special physiotherapeutic equipment, to increase the safety of patient treatment, and to reduce the likelihood of infection of the patient’s oral cavity.

 The goal is achieved in that the proposed method eliminates the inherent disadvantages of the method of drug electrophoresis and is characterized in that piezoceramic plates connected to the gingival electrodes are placed between the teeth of the upper and lower jaws, periodically squeezing the plate with the teeth to achieve the movement of drug ions deep into the tissues of the periodontium.

 The method of administration is illustrated in FIG. 1 and 2.

 Piezoceramics 1 in the form of a plate or several interconnected plates is located between the dentition 2, connected by flexible wires 3 to the gingival electrodes 4, superimposed on the mucous membrane of the gums 5 on both sides of the alveolar process 6.

 The method is as follows: a sterile gauze pad moistened with a solution of the drug is placed on a previously sterilized lead plate of the active electrode, the gauze pad of the passive electrode is moistened with tap water. The electrodes 4 are placed on the mucous membrane of the gums 5 on both sides of the alveolar process 6 of the upper or lower jaw, piezoceramics 1 is inserted between the teeth 2 of the upper and lower jaws. The patient closes his teeth, lips and begins to make active chewing movements, periodically pressing the piezoceramic. The exposure time is proportional to the required depth of penetration of the drug into the periodontal tissue.

The proposed method allows you to:
- apply it in dental, mobile rooms without special physiotherapeutic equipment, without an external electric network, which is especially convenient in schools, on the site, in the countryside, field conditions.

- piezoceramics, gingival electrodes with flexible wires are sterilized, which excludes infection of the patient;
- eliminates the possibility of negative damaging effects of direct current on the mucous membrane of the oral cavity and the body as a whole;
- increases the effectiveness of treatment of periodontal diseases, creating a depot of the drug directly in the periodontium;
- the patient is actively involved in the treatment procedure.

 With the proposed method, the transverse arrangement of the electrodes on the alveolar process of the jaw of the patient is used. One electrode, located in the vestibular surface of the jaw, has a size of 1 x 10 cm, the other from the oral surface, 1 x 4 cm in size. The active electrode was moistened with a drug substance.

 A clinical experiment was performed on patient V., aged 50, suffering from chronic generalized periodontitis of moderate severity for 5 years. Previously, he repeatedly took courses of anti-relapse treatment. Complaints of bleeding gums when brushing your teeth, eating hard foods, sometimes spontaneous, bad breath, periodic swelling and soreness of the gums.

- 23 с в области

- 36 с. Определяли количество десневой жидкости.An objective study determined hypermia and swelling of the gingival papillae, gingival margin, Schiller-Pisarev ++ test, hygiene index 2, 6, dental deposits soft and hard, pocket depth 4-4.5 mm, periodontal index 3.6. The time of formation with a gamma

- 23 s in the field

- 36 p. The amount of gingival fluid was determined.

 When x-ray examination, the height of the interalveolar septa is reduced from 1/3 to 1/2 the length of the roots. Bacteriological examination of the detachable pocket revealed Staphylococcus aureus. A clinical and biochemical blood test was performed. The treatment was complex: local, general, as the physiotherapeutic method, the proposed method of introducing the drug into the periodontium was used.

 For clinical trials, 2% p-p potassium iodide was used, which wetted the gauze pad of the active (cathode) electrode.

 Distilled water was used as a solvent; it is well known that it contributes to the good dissociation of most drugs.

 With periodic compression of the jaws with a force of about 3 kg (300 n), determined by a gnatodynamometer, with a frequency of 20-25 times per minute, the current strength was 4 mA, the voltage was 36 V. A brown gauze overlay was observed under the anode. A solution of potassium iodide was chosen due to the fact that iodine ions can be used as an indicator, the movement of iodine is accompanied by discoloration of the gauze pad, in addition, the drug helps to intensify metabolism in the periodontium, has an active effect on the microflora of the oral cavity.

увеличилось до 56 с, в области

до 82 с. Количество жидкости снизилось вдвое. При повторном бактериологическом исследовании выявлена сапрофитная флора полости рта.The drug was administered on the upper and lower jaw alternately daily. The course was 20 procedures. After treatment, the condition of periodontal tissues improved significantly. Gum bleeding stopped, hygiene index 1.4, Schiller-Pisarev test became negative, hematoma formation time in the region

increased to 56 s in the region

up to 82 s. The amount of fluid halved. Repeated bacteriological examination revealed saprophytic flora of the oral cavity.

- 65 с, в области

- 90 с. Содержание аскорбиновой кислоты в крови повышалось, а значит насыщение ею тканей пародонта улучшилось.Patient M., 20 years old, complained of periodic bleeding of the gums. Based on generally accepted clinical and radiological data, he was diagnosed with moderate catarrhal gingivitis. After removal of dental plaque and several anti-inflammatory therapy procedures in the form of applications, 5% ascorbic acid was applied by the proposed method. The course was 10 sessions, after which the condition of the gum mucosa is good, the color is pale pink, the Schiller-Pisarev test is negative, the hygiene index is 1.2, the hematoma formation time increased and amounted to

- 65 s, in the region

- 90 s. The content of ascorbic acid in the blood increased, which means that the saturation of periodontal tissues with it has improved.

 To introduce periodontal tissues, we also used 2.5% p-p calcium glycerophosphate, 10% calcium chloride, 1% nicotinic acid, and distilled water was used as a solvent. The method was used in the treatment of 20 patients with inflammatory diseases of periodontal tissues. Side effects were not observed. Patients felt good during the procedure, periodic compression of the jaws did not cause fatigue, negative emotions.

 The main advantage of the method compared to the known electrophoresis of medicinal substances is certainly the possibility of carrying it out outside the physiotherapy room, without special equipment, without an external electric network, and is available in dental offices of schools, health centers, in rural areas and even at home.

 But the proposed method of drug administration requires further detailed clinical and laboratory research, quantification, comparison of long-term results of treatment effectiveness. (56) Efanov O.I. and Dzanagova T.F. Physical therapy of dental diseases. M., 1980, p. 8-19.

Claims (1)

 METHOD FOR ADMINISTRATION OF MEDICINES IN PERIODONTAL TISSUE, including drug electrophoresis, characterized in that, in order to simplify the method, flat piezoelectric ceramics placed between the dentition and connected to the gingival electrodes on the mucous membrane of the alveolar process on both sides are used as a current source while the current flows to the electrodes with active periodic compression of the plates during the closure of the jaws for the time required for the penetration of drug ions ov deep into periodontal tissues.

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