RU2283100C1 - Method for treating the cases of parodontitis - Google Patents

Abstract

FIELD: medicine.

SUBSTANCE: method involves administering therapeutic complex comprising 0.1% chlorhexidine bigluconate instillations once a day and gargles given 3 times per 7-10 days, biologically active additive Olexin is given at a dose of 15-20 drops/day before meals during 1 month, biologically active additive Rekicen-RD diluted in 100 ml of water is given at a dose of 1 spoon in the morning and in the evening during 10 days repeating the course in 10 days.

EFFECT: enhanced effectiveness of bactericide, anti-inflammatory, immunotropic and detoxication treatment.

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Description

The invention relates to medicine, namely to dentistry, and can be used to treat periodontitis.

Known methods of treating periodontitis using the local antiseptic agent “Chlorhexidine” (Tsepov L.M. Drug therapy in periodontology: from stereotypes and empiricism to reality / L.M. Tsepov, V.G. Morozov // Dentistry. - 1992. - No. 2. - P. 82-84).

The disadvantage of this method is the lack of anti-inflammatory, detoxifying and immunotropic effects.

The closest analogue is the use in the form of rinses and instillations of a 0.1% solution of chlorhexidine bigluconate as an antiseptic for the treatment of periodontitis (Barer G.M., Lemetskaya T.I. “Periodontal Diseases”, M., 1996, 85 pp.).

The disadvantages of this method is the lack of anti-inflammatory, detoxifying and immunotropic effects.

The invention is aimed at solving problems of increasing the effectiveness of the method of treatment of periodontitis.

Effect: along with bactericidal anti-inflammatory, immunotropic and detoxifying effects.

The objectives are achieved by the local use of an antiseptic - a 0.1% solution of chlorhexidine bigluconate, dietary supplement "Oleksin" as an immunotropic and anti-inflammatory agent and dietary supplement "Rekitsen-RD", as a detoxifying agent. This complex has not previously been used to treat periodontitis.

It is known that periodontitis is a complex disease, in the pathogenesis of which bacterial invasion, inflammation, endogenous intoxication, and also a decrease in the immunological resistance of the body play a role. Therefore, the treatment of periodontitis should be aimed at eliminating the pathogenic bacterial flora to limit the inflammatory process in the oral cavity, to reduce endotoxemia and increase the immunological resistance of the body.

“Chlorhexidine bigluconate” - a domestic preparation is manufactured by the Central European Pharmaceutical Company (patent No. 003590/01, dated 08.07.2004) in the form of an aqueous solution. The drug is one of the most effective local antiseptic agents; It has a fast and strong bactericidal effect on gram-positive and gram-negative bacteria, prevents the formation of plaque. Cationic groups of the drug bind to the anionic groups of the mucinous membrane of bacteria. The drug has a prolonged effect, which manifests itself after the cessation of rinsing. In the treatment of periodontitis, the drug is used in the form of a 0.1% aqueous solution for rinsing and instillation.

Oleksin dietary supplement is produced in the Perm Microorgan Biome branch of the Federal State Unitary Enterprise Microgen (patent No. 2132197 dated June 27, 1999) and is a hydrophilic concentrated extract from the leaves and flowers of common peach (Persica vulgaris Mill.). The extract contains flavonoids and their glycosides, tannin, phenolcarboxylic acids, porphyrins and polysaccharides. It has a wide range of pharmacological effects, including anti-inflammatory, anti-tumor, antioxidant and adaptogenic. Having an immunotropic effect, the drug increases the phagocytic activity of leukocytes, enhances the synthesis of antibodies and the production of T-lymphocytes. Apply 15-20 drops in an aqueous solution a day before meals. For the treatment of periodontitis has not been previously used.

Rekitsen-RD dietary supplement is produced in ZAO Yagodnoye, Kirov (TU 9295-003-05344371-99), a powerful enterosorbent whose dietary fiber binds toxic substances in the intestine, while saturating the body with microelements, vitamins B, PP, D, amino acids, pectin. The drug has anti-inflammatory, detoxifying, immunotropic and antioxidant effects. Diluted in water is used - 1 tablespoon in the morning and evening before meals for 10 days with a repeat of the course of appointments after 10 days. For the treatment of periodontitis was not used.

The method is as follows. A patient with periodontitis is prescribed a 0.1% solution of chlorhexidine bigluconate in the form of instillations 1 time per day and rinses 3 times a day for 7-10 days. At the same time, an aqueous solution of Oleksin dietary supplement is prescribed, 15-20 drops per day before meals for a month and Rekitsen-RD dietary supplement diluted in 100 ml of water - 1 tablespoon in the morning and evening before meals for 10 days with a repeat of the course after 10 days.

Examples of specific performance.

Example 1

Patient L., 38 years old,

02/13/04. Complaints of bleeding gums during brushing and itching in the gums. The history of somatic diseases is denied.

Survey results. The patient's appearance corresponds to age, the face is symmetrical, the nasolabial folds are unchanged, regional lymph nodes are without pathology. The attachment of the frenum of the upper and lower lips and tongue is normal, the bite is orthognathic. The mucous membrane of the oral cavity, lips, alveolar gums pink. Interdental papillae in the region of the anterior teeth of the lower and upper jaw are edematous, hyperemic, bleed when probed. A moderate amount of over- and subgingival dental deposits is determined.

Index assessment of the state of the organs of the oral cavity: KPU - 2 (0, 2, 0); Mon - 1.8; IG - 1.6; RMA - 21.1%; CPITN - 1.4.

Table 1 presents the pathophysiological parameters of the blood system. Evaluation of the leukocyte (inflammatory) reaction by the total number of blood leukocytes (OKL) and the nuclear shift index (INS). Integral assessment of the state of immunity by the absorption activity of blood neutrophils - the percentage of active phagocytes (PF) and phagocytic number (PS). Assessment of endotoxemia by leukocyte intoxication index (LII) and erythrocyte sedimentation rate (ESR).

Table 1 Indicator Norm Before treatment 2 weeks after treatment 1 month after treatment OKL (10 ⁹ / L) 4.0-9.0 7.7 5.2 5.9 INS 0.05-0.08 0.11 0.06 0,07 PF (%) 28-67 25 61 58 Ff 0.38-1.24 0.33 0.95 0.88 LII 0.75-1.50 1.95 1.35 1.47 ESR (mm / h) 0-12 eighteen 10 9

Diagnosis: Chronic generalized periodontitis of mild degree.

The treatment was carried out at the Department of Dental Medicine of the Faculty of Internal Medicine according to the traditional scheme: training in oral hygiene, removal of dental plaque. Recommended: 0.1% solution of chlorhexidine bigluconate in the form of instillations 1 time per day and rinses 3 times a day for 7-10 days, an aqueous solution of dietary supplement "Oleksin" 15-20 drops per day before meals for a month and dietary supplement " Rekitsen-RD ", diluted in 100 ml of water - 1 tablespoon in the morning and evening before meals for 10 days with a repeat of the course after 10 days.

After treatment, after 2 weeks, the patient notes the cessation of bleeding and itching in the gums, when examining the oral cavity, a pale pink dense gum is noted. Index assessment of the condition of the organs of the oral cavity: PI - 1.2; IG - 0.2; RMA - 4.8%; CPITN - 0.8.

1 month after treatment. No complaints. On examination of the oral cavity: the gums are dense, pale pink, all teeth are stable. Index assessment of the state of the organs of the oral cavity: PI - 1.1; IG - 0.3; RMA - 2.9%; CPITN - 0.8.

Example 2

Patient S., 46 years old,

12/20/02 Complaints of bleeding gums during brushing and spontaneous night bleeding of the gums, exposure of the necks of the teeth in the last two years, a very strong bad breath. The history of somatic diseases is denied.

Survey results. The patient's appearance corresponds to age, the face is symmetrical, the nasolabial folds are unchanged, regional lymph nodes are without pathology. The attachment of the frenum of the upper and lower lips and tongue is normal, the bite is orthognathic. The mucous membrane of the oral cavity, lips, alveolar gums pink. The interdental papillae in the region of the anterior teeth of the lower and upper jaw are edematous, hyperemic, and when bleeding lightly, they bleed heavily. A moderate amount of over- and subgingival dental deposits, exposure of the necks in the region of the lower anterior teeth is determined. Depth of periodontal pockets up to 4 mm. Teeth 32, 31 and 41 are mobile - I degree. On the orthopantomogram, the destruction of cortical plates and horizontal, uniform resorption of the interalveolar septa in the area of all teeth up to 1/3 of the root length are determined. Index assessment of the state of the organs of the oral cavity: KPU - 13 (0, 12, 1); PI - 2.2; IG - 1.5; RMA - 17.2%; CPITN - 1.8. Table 2 presents the pathophysiological parameters of the blood system.

table 2 Indicator Norm Before treatment 2 weeks after treatment 1 month after treatment OKL (10 ⁹ / L) 4.0-9.0 12.1 6.4 6.8 INS 0.05-0.08 0.16 0.06 0,07 PF (%) 28-67 twenty 54 42 Ff 0.38-1.24 0.29 0.73 0.66 LII 0.75-1.50 2.47 1.34 1.44 ESR (mm / h) 0-12 24 fourteen 9

Diagnosis: Chronic generalized periodontitis of moderate degree.

The treatment was carried out at the Department of Dental Medicine of the Faculty of Internal Medicine according to the traditional scheme: training in oral hygiene, removal of dental plaque. Recommended: 0.1% solution of chlorhexidine bigluconate in the form of installations 1 time per day and rinses 3 times a day for 7-10 days, an aqueous solution of VAD "Oleksin" 15-20 drops per day before meals for a month and dietary supplement " Rekitsen-RD ", diluted in 100 ml of water - 1 tablespoon in the morning and evening before meals for 10 days with a repeat of the course after 10 days.

After treatment, after 2 weeks, when examining the oral cavity, a pale pink dense gum is noted. Teeth 32, 31 and 41 without pathological mobility. Index assessment of the condition of the organs of the oral cavity: PI - 1.2; IG - 0.2; RMA - 2.3%; CPITN - 1.2.

1 month after treatment. No complaints. On examination of the oral cavity: the gums are dense, pale pink, all teeth are stable. The depth of periodontal pockets decreased by 1.5 - 2 mm. Index assessment of the state of the organs of the oral cavity: PI - 1.1; IG - 0.3; RMA - 1.8%; CPITN - 0.87.

Example 3

Patient M., 49 years old,

09/15/03 Complaints of pain and bleeding of the gums, exposure of the necks of the teeth and tooth mobility, inability to take solid food due to tooth mobility and pain in the gums, bad breath. A history of bronchial asthma.

Survey results. The patient's appearance corresponds to age, the face is symmetrical, the nasolabial folds are unchanged, regional lymph nodes are without pathology. The attachment of the frenum of the upper and lower lips and tongue is normal, the bite is orthognathic. The mucous membrane of the oral cavity is pink. The mucous membrane of the gums in the area of the interdental papilla, the edge and alveolar processes of the upper and lower jaw is stagnantly hyperemic. The tops of the gingival papillae are round, loose, swollen. Profuse deposition of soft plaque, supra- and subgingival tartar. Periodontal pockets with a depth of 5-6 mm, with purulent hemorrhagic discharge. Teeth mobility 24, 25, 33, 32, 31, 41. 42, 43, 44 - II degree. On the orthopantomogram, the resorption of the interalveolar septa in the area of teeth 14, 23, 24, 25, 26, 32, 31.41, 42, 45 to 2/3 of the root length is determined, in the area of teeth 26, 35, 36 and 47 bone pockets are determined. Index assessment of the state of the organs of the oral cavity: KPU - 13 (0, 7, 6); PI - 4.5; IG - 3.4; RMA - 42.3%; CPITN - 2.3. Table 3 presents the pathophysiological parameters of the blood system.

Table 3 Indicator Norm Before treatment 2 weeks after treatment 1 month after treatment OKL (10 ⁹ / L) 4.0-9.0 16,2 12.5 10.1 INS 0.05-0.08 0.21 0.13 0.09 PF (%) 28-67 13 22 twenty Ff 0.38-1.24 0.17 0.31 0.28 LII 0.75-1.50 3.07 2.12 1.91 ESR (mm / h) 0-12 27 17 fourteen

Diagnosis: Chronic generalized periodontitis of a severe degree in the acute stage.

The treatment was carried out at the Department of Dental Medicine of the Faculty of Internal Medicine according to the traditional scheme: training in oral hygiene, removal of dental plaque. Recommended: 0.1% solution of chlorhexidine bigluconate in the form of instillations 1 time per day and rinses 3 times a day for 7-10 days, an aqueous solution of dietary supplement "Oleksin" 15-20 drops per day before meals for a month and dietary supplement " Rekitsen-RD ", diluted in 100 ml of water - 1 tablespoon in the morning and evening before meals for 10 days with a repeat of the course after 10 days.

After treatment after 2 weeks, there is a decrease in bleeding and the disappearance of soreness of the gums, a decrease in tooth mobility. When examining the oral cavity, a pale pink dense gum is noted, the gingival papillae in the area of the teeth 23, 24, 25, 32, 31, 41, 42 are hyperemic. Depth of periodontal pockets decreased by 2 - 3 mm. Detachable from periodontal pockets scanty, serous. Tooth mobility 33, 32, 31, 41, 42-1 degrees. Index assessment of the state of the organs of the oral cavity: PI - 3.4; IG - 0.3; RMA - 12.8%; CPITN - 1.5.

It is recommended to continue taking an aqueous solution of dietary supplement "Oleksin" 15-20 drops per day before meals until the end of the course.

The direction for orthopedic treatment is given.

1 month after treatment. Patient M. has no complaints. She underwent orthopedic treatment.

When examining the oral cavity: a pale pink dense gum, the depth of periodontal pockets 4-5 mm, the mobility of the teeth 32, 31, 41 - I degree is determined. Index assessment of the state of the organs of the oral cavity: PI - 3.4; IG - 0.5; RMA - 6.3%; CPITN - 1.4.

Claims (1)

A method of treating periodontitis by using a 0.1% solution of chlohexidine bigluconate in the form of instillations and rinses, characterized in that the patient is additionally prescribed a complex of dietary supplements "Oleksin" at a dose of 15-20 drops per day before meals for a month, dietary supplement "Rekitsen- RD ", diluted in 100 ml of water, 1 tablespoon in the morning and evening before meals for 10 days with a repetition of the course after 10 days.