RU2635509C1 - Phytocomposition for oral care - Google Patents

Abstract

FIELD: medicine.

SUBSTANCE: phytocomposition for oral care of cancer patients suffering from concomitant diseases of teeth and gums and undergoing chemo- and radiation therapy is characterized by the powder of crushed medicinal plants: peppermint grass, tickseed grass, celandine grass, echinacea flowers, leaves and stems, yarrow grass, marigold flowers, tansy flowers, dropwort flowers, calamus root, plantain leaves, taken in equal proportions of 1:1. Powder is obtained by fractional grinding to particles passing through a 0.5 mm sieve. The phytocomposition can be made as a single dose of a powder with a weight of 3 g. The powder can be used in the form of an aqueous infusion obtained by adding 200 ml of boiling water to the 3 grams of powder. Water infusion can be used in the form of batch ice cubes. Powder is 100% natural, sufficiently fine grinding of plant raw materials in the production allows to shorten the extraction time.

EFFECT: composition allows to expand the range of dental and oral care products for cancer patients, providing a combined effect of prevention of dental deposits formation on the teeth and obturator surface with pronounced anti-inflammatory and therapeutic effect on gums and other soft tissues with accompanying various diseases of teeth, gums and hygienic cleaning of the obturator replacing tissue defect after surgical and orthopedic treatment of maxillofacial area cancer patients.

5 cl, 2 tbl

Description

The invention relates to medicine, namely to dentistry, and can be used for caring for teeth and oral cavity, for oral hygiene, in particular, in cancer patients.

Remediation of the oral cavity in patients with locally advanced cancer of the oral mucosa during therapy is associated with the occurrence of various complications, which is associated with both the underlying disease and the consequences of combined and complex treatment. Oropharyngeal candidiasis occurs in approximately 30% of cancer patients after chemotherapy. The material used for the manufacture of prosthetic structures comes into complex interaction with the tissues of the prosthetic bed and can have an adverse effect on the state of the oral cavity, causing the accumulation of microbes on the elements of the prosthesis and the formation of a biofilm. Therefore, mouth rinses play a significant role in preventing the development of purulent-inflammatory complications and oropharyngeal candidiasis.

After surgical and orthopedic intervention in the oral cavity, regular antimicrobial exposure through the use of rinses is necessary.

Various antiseptic compositions have been proposed for treating the oral cavity, consisting of chemical reagents, in particular chlorhexidine, triclosan, miramistin, the use of which causes serious objections when used in cancer patients, whose immunity is sharply reduced, and the sensitivity of the mucous membrane to irritating factors, on the contrary, is high.

Phyto-mouthwashes have advantages in the rehabilitation of cancer patients after surgical removal of the upper jaw tumor and orthopedic replacement of the bone defect with a synthetic obturator prosthesis compared to alcohol and chemical ones, which are contraindicated for these patients and can cause a relapse of the disease.

The main indications for the use of plant or phytocompositions in oncological processes in the oral cavity, jaws and adjacent tissues are complications of cytostatic and ionizing therapy: the manifestation of viral, bacterial, fungal, protozoal infections, including infectious and inflammatory processes; the formation of foci of inflammatory lesions of the mucous membranes of the respiratory and digestive organs, due to both inhibition of regenerative processes and infectious pathology; the occurrence of purulent-septic complications, trophic ulcers, erosions that require activation of regenerative processes (Bazanov G.A., Tkachev P.V., Khitrov A.A. Accompanying herbal medicine in oncology. Materials of the 2nd international scientific and practical conference 05/23/2015 Moscow - 2015, p. 22-27).

For a long time, rinses and infusions from plant materials, such as oak bark, sage leaves, chamomile flowers, marigold, tincture of St. John's wort, meadowsweet flowers and others, have been widely used for rinsing the oral cavity. Extracts of eucalyptus and sage have a local anesthetic, anti-inflammatory, antibacterial and regenerative effect on the mucous membranes of the mouth and throat. However, for their brewing or long boiling for the preparation of decoctions, time and special conditions are required, which are not in the dental clinic and which are difficult for cancer patients to perform. Herbal remedies have a physiological effect on the tissues of the oral cavity, stimulate regenerative processes, have an antimicrobial, anti-inflammatory, cancer protective effect, as well as hemostatic, detoxification and deodorizing effects.

A known composition for the prevention and treatment of inflammatory diseases of the gums, containing extracts of oak bark, cloves, eucalyptus and one of the extracts of chamomile, calendula, St. John's wort or sage, one of the extracts of rowan fruits or dill seeds, one of the extracts of coriander or caraway seeds. As a perfume, oils were introduced into the composition: grapefruit, lemon, mint, orange, anise in a ratio of 1: 1: 2.6: 5.3: 3.3. The composition also includes a derivative of procaine (procaine mandelate or procaine hydrochloride) [Patent RU No. 20111376, IPC A61K 7/16, 1994].

Known means for rinsing the oral cavity for the elderly and senile, characterized in that it is an aqueous extract of the herb Hypericum perforatum, rhizome of the hemorrhagic medicinal, fruits of juniper ordinary and leaves of coltsfoot taken in wt. h. 1: 1: 1: 1. [Patent RU No. 2295967, IPC A61K 36/739, A61K 36/28, 2007].

The introduction of foreign materials into the oral cavity - implants, prostheses, dividing plates - causes a change not only in the general and local immunological response, but also in microflora, with the appearance of pathogenic strains that form microbial biofilms on dental prostheses (Arutyunov S.D., Tsarev V .N., Ippolitov EV, Apresyan SV, Trefilov AG The formation of biofilms on temporary dentures: the ratio of primary microbial adhesion, coaggregation and colonization processes. Dentistry. 2012. V. 91. No. 5-1 . S. 5-10; Arutyunov S.D., I ppolitov EV, Pivovarov AA, Tsarev VN The effect of milling on the roughness and surface topography of basic dental polymethyl methacrylate polymer, as well as microbial adhesion. System analysis and control in biomedical systems. 2014. V. 13. No. 2 P. 339-346; Tsarev V.N. Microbiology and immunology of the oral cavity.M .: Practical medicine, 2013; Afanasyeva V.V., Arutyunov D.S., Deev M.S., Ippolitov E.V., Tsareva TV Clinical and microbiological aspects of the formation of microbial biofilms on structural materials used for repair and repair ebazirovaniya removable dentures. Russian Dental Journal. 2015. V. 19. No. 2. S.44-46; Didenko L.V., Avtandilov G.A., Smirnova T.A., Shevlyagina N.V., Tsarev V.N., Lebedenko I.Yu., Elinson V.M., Tiganova I.G., Romanova Yu .M., Ippolitov E.V. The study of the processes of colonization and persistence of microorganisms on artificial medical materials. Journal of Microbiology, Epidemiology and Immunobiology. 2015. No5. S.64-69).

All this requires improving the sanitation of the oral cavity, taking into account the characteristics of the body of an oncological patient who underwent chemotherapy and radiation therapy after surgery.

The closest technical solution is the composition of the mouthwash, where as an aqueous medium contains a decoction of herbs obtained by maceration of crushed plant material in a fluidized bed under vacuum in an aqueous medium, followed by preservation with an alcohol-containing composition. In addition, it contains a biologically active additive, a water-retaining additive, which is used as glycerin, an anti-caries additive, which uses sodium fluoride, a preservative, an antimicrobial additive, triclosan, a formative thickener, sodium carboxymethyl cellulose or a copolymer of methyl vinyl ether and maleic acid anhydride, 40 hydrogenated castor oil, flavoring agent - sodium saccharinate, softener - Trilon B, traditional target additives: coloring, flavoring obavku regulator pH, wherein the biologically active additive is a system of the CO ₂ extract of Siberian fir wood greens, aqueous-alcoholic or aqueous-spirtoglitserinovogo extract of vegetable raw materials and aloe juice at a specific ratio of components. Mouth rinse provides prevention of dental deposits on the surface of the teeth with a pronounced anti-inflammatory and therapeutic effect in various gum diseases (RU No. 2312657, 2006)

The main disadvantage of the known products based on herbal preparations is their lack of effectiveness: they do not have anti-flying, anticalculus action. In addition, the use of only one of the plant components in the rinse does not have the proper therapeutic and prophylactic effect if the consumer has a tendency to inflammatory diseases of the oral cavity, while others contain alcohol extracts, dyes, chemical perfumes that contribute to the development of cancer, and not eliminating them.

An object of the invention is to expand the range of products for the care of teeth and oral cavity after surgical and orthopedic interventions in the oral cavity of cancer patients, which prevent the formation of microbial film and dental deposits and thereby prevent the development of purulent-inflammatory processes after surgery and chemo-radiation therapy.

An advantage of the present invention is that the powder from a mixture of medicinal plants has no contraindications for use by patients with an oncological profile, and sufficiently fine grinding of plant materials in production reduces the extraction time by obtaining a larger contact surface of the plant material with hot water in which extraction, 100% natural, deodorization, taste and smell provide herbal ingredients with oncoprotective effect.

The problem is solved in that the herbal composition for caring for the oral cavity is a powder of ground medicinal plants: peppermint (grass), string (grass), celandine (grass), echinacea (flowers, leaf, stem), yarrow (grass), calendula (flowers), tansy (flowers), meadowsweet (flowers), calamus (root), plantain (leaf), taken in equal proportions 1: 1, a single dose of powder is 3 grams.

The formulation per 100 g and 1 dose is presented below:

The powder is used in the form of water infusion, as well as in the form of portioned ice cubes. The phytocomposition of the powder of the crushed plant is prepared with extempo hot water (1 dose - 3 g pour 200 ml of boiling water). The infusion retains its biological activity during the day and helps to dissolve the microbial film on the teeth and the obturator. When re-brewing also exhibits antimicrobial activity, achieving maximum effect.

A feature of the proposed composition is that finely ground vegetable raw materials consisting of dried plants are used as the medium. The inventive rinse composition to achieve a specific therapeutic and prophylactic effect during its use has the following essential features: qualitative and quantitative ratio of ingredients, their bioavailability for the body when used externally after grinding and brewing.

The specified combination of components provides the claimed rinse with a pronounced antimicrobial activity, provides stimulation of metabolic and trophic processes in periodontal tissues, prevents the formation of bacterial plaque on the surfaces of the oral cavity and obturator, has an antimicrobial, including antifungal, antioxidant and wound healing effect, helping to cleanse the mucous cavity mouth from accidental pathogenic flora and helminths and the restoration of the usefulness of local protective immunity .

The use of a phytocomposition in the form of a rinse for the oral cavity does not cause the appearance of brown plaque, since it does not contain oak bark, St. John's wort and nettle, which contain coloring substances. In addition, even with accidental ingestion of the rinse aid, its components can have a positive effect, including oncoprotective, in contrast to chemical rinse aid. A phytocomposition with a minimum concentration of active ingredients creates the possibility of prolonged action and protection and restoration of local immunity and the composition of the normal microflora of the mucosa, its integrity and elimination of dysbacteriosis, dissolving the biofilm on the teeth, mucosa and obturators, and has good adhesion to the oral mucosa, lack of irritating effect and discomfort for the patient, safe and easy to use

The infusion contains biologically active substances: phytoncides, flavonoids, essential oils, polysaccharides with antiseptic, anti-inflammatory, cancer protective and regenerating and pronounced cleansing effects.

The inventive rinse composition to achieve a specific therapeutic and prophylactic effect during its use has the following essential features: qualitative and quantitative ratio of ingredients, their bioavailability for the body when used externally after grinding and brewing.

The claimed composition allows you to expand the range of products for the care of teeth and oral cavity in cancer patients of the maxillofacial region, providing a combined effect of preventing the formation of dental deposits on the surface of the teeth and obturator with a pronounced anti-inflammatory and therapeutic effect on the gums and other soft tissues with various concomitant diseases of teeth, gums and hygienic cleaning of the obturator, replacing a tissue defect after surgical and orthopedic treatment of cancer FIR patients with maxillofacial area.

The invention is illustrated by the following example.

A phytocomposite of the powder of the crushed plants of the specified formulation was prepared by pouring extemporo with hot water (1 dose - 3 g pour 200 ml of boiling water). The infusion retains its biological activity during the day and promotes the dissolution of the microbial film on the teeth and the obturator due to the newly formed plant enzymes formed during cooling of the infusion, and when re-brewed, it increases its antimicrobial activity, achieving the maximum effect.

To assess the condition of the microbiocenosis of the oral cavity (dento-jaw prosthesis and prosthetic bed) in oncological patients, the method of aerobic and anaerobic cultivation of inoculum taken with a sorbent swab was used, followed by identification by a complex of morphological, cultural and biochemical properties (Manual edited by Labinskaya A .S., Kostyukova N.N., 2014). To evaluate quantitative seeding, we used the method of circular seeding on a solid nutrient medium based on cardiac cerebral agar (Columbia, HimediaGlans) taking into account the results on a Scan-500 automatic colony counter (Ippolitov E.V. Monitoring the formation of microbial biofilms and optimizing the diagnosis of inflammatory periodontal diseases Abstract of thesis ... of a doctor of medical sciences M .: First MGMU. - 2016. - 47 p .; Tsarev, VN Laboratory diagnosis of anaerobic (non-clostridial) infection / In kN: Guide to medical microbiology // Edited by A.S. L Abinskaya, N.N. Kostyukova. - M .: Binom. - 2013. - Book 3. - T. 1. - P. 439-454).

Oncological patients with dento-maxillary prostheses against the background of an unsatisfactory state of oral hygiene, revealed in our and other studies, showed an extremely high level of microbial contamination. So, the microbial number was 10 ^9-11 CFU, while the norm for this age group was 10 ^6-7 CFU. To prove the effectiveness of using our phytocomposite for preparing rinse infusion, we compared the results of treatment in patients using the phytocomposite infusion (subgroup A), for oral hygiene and for cleaning prostheses and not using it (subgroup B). We determined a decrease in the level of microbial contamination significantly to 10 ^5-6 CFU. In subgroup B, the patients of which, according to the questionnaire, did not carry out systematic hygienic measures, no significant changes in the level of microbial contamination were observed (10 ^9-11 CFU) in the control period for 12 months after treatment (Table 1).

According to the qualitative (species) composition, in the microbial biofilm of the prosthesis predominantly staphylococcal and staphylocidal associations were distinguished, the frequency of isolation of fusobacteria and other obligate anaerobes, mainly of periodontopathogenic group, was also significant (80%). Somewhat less often, but also with a frequency not typical for normal oral microbiocenosis, representatives of the families of enterobacteria and non-fermenting gram-negative bacteria were isolated. It was found that in subgroup A, after regular hygiene measures using the claimed phyto rinse, there was a tendency to a certain decrease in the frequency of excretion of staphylococcus, enterococcus, fusobacteria, candida fungi, enterobacteria and non-fermentative bacteria. The rate of release of salivary streptococci and lactobacilli, representatives of the normal (stabilizing) microbiota, increased slightly. At the same time, no positive changes were noted in subgroup B (Table 2).

Thus, as a result of our study, it was confirmed that in cancer patients there is a significant deterioration in the hygienic state of the oral cavity and in the dentofacial prosthesis, which can be characterized as a typical dysbiotic shift. Moreover, in patients who did not receive sufficient (full) hygienic oral care (subgroup B), the presence, and in some cases even exacerbation of the revealed dysbiosis, was noted. In subgroup A with a systematic full-fledged hygienic treatment (using the claimed phyto-rinse), dysbiotic shifts partially stopped, which was expressed in a decrease in the degree of microbial contamination and some normalization of the composition of the microbiocenosis (a decrease in the proportion of microbes of the periodontopathogenic group, candida fungi and an increase in the proportion of salivary streptococci and lactobtsi).

Claims (5)

1. Phytocomposition for oral hygiene in cancer patients suffering from concomitant diseases of the teeth and gums and undergoing chemotherapy and radiation therapy, characterized in that it is a powder of ground medicinal plants: peppermint grass, string grass, celandine grass, flowers, leaves and the stem of Echinacea, yarrow flowers, calendula flowers, tansy flowers, meadowsweet flowers, calamus root, plantain leaf, taken in equal proportions 1: 1, while the powder was obtained by fractional grinding to particles, etc. passing through a sieve of 0.5 mm. 2. Phytocomposition for oral hygiene according to claim 1, where a single dose of powder is 3 g. 3. Phytocomposition for oral hygiene according to claim 1 and 2, where the powder is used in the form of an aqueous extract. 4. Phytocomposition for oral hygiene according to claim 3, where the aqueous infusion is obtained by pouring 3 g of powder with 200 ml of boiling water. 5. Phytocomposition for oral hygiene according to claim 3, where the aqueous infusion is used in the form of portioned ice cubes.