RU2772295C1 - Method for prevention of alveolitis of jaw - Google Patents

Abstract

FIELD: medicine; dentistry.

SUBSTANCE: invention relates to medicine, namely dentistry; it can be used for the prevention of alveolitis of the jaw after removal of the tooth(teeth) or removal of the impacted and/or misplaced tooth(teeth). The method includes decontamination of the tooth (teeth) well, washing the well with an antiseptic composition heated to a temperature of 30-32°C, containing, as an active component, polyaminopropyl biguanide in the amount of 0.1 wt.%, with an exposure time of 55-65 seconds, performing a bone well with a blood clot, followed by squeezing and adaptation of edges.

EFFECT: efficiency of the prevention of alveolitis of the jaw is increased due to the use of a composition that does not have a locally irritating and toxic effect, has a high penetrating capability relatively to bacterial biofilms and the necessary bactericidal effect, and minimal invasiveness and simplification of the procedure, shortening the healing time.

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Description

The invention relates to medicine, namely to dentistry, and can be used to prevent the development of jaw alveolitis.

Despite the high level of development of dentistry, the risk of postoperative complications remains at a fairly high level. Extraction of teeth has been and remains the most common operation in the practice of a dentist-surgeon. The most common postoperative complication of tooth extraction is the development of alveolitis. The disease is an infectious-inflammatory process in the area of the tooth socket and its walls. Alveolitis usually begins 1-3 days after the extraction of the tooth(s) and can last 5 to 10 days.

According to a number of researchers, alveolitis (local osteitis) develops in 2-3% of cases after a simple extraction of teeth and in 20% after extraction of atypically located teeth. Bacteria play the main role in the development of the pathological process in the dental alveolus after tooth extraction. Despite the large number of drugs and methods for preventing and treating alveolitis, today it is not possible to completely eliminate the risk of its development. In this connection, the relevance of the search for the most effective method for preventing the development of inflammation in the post-extraction hole remains.

One of the key factors contributing to the decrease in the effectiveness of drugs used in medicine and, in particular, dentistry is the proven ability of bacteria to form a biofilm. Colonies of bacteria immersed in the extracellular matrix form the so-called biofilm or biofilm, which significantly reduces their susceptibility to drugs and allows for a long time to provide a chronic inflammatory process on the wound surface. Thus, there is a need to find a composition capable of destroying biofilm and affecting microorganisms and methods of its application.

The prior art patent RU 02391111 C1, publ. 06/10/2010, offering a method for the treatment and prevention of alveolitis of the jaw, based on the removal of fragments and areas of non-viable bone tissue from the hole of the extracted tooth, and the hole after tooth extraction is filled with a sterile collagen sponge soaked with bifidumbacterin prepared ex tempore.

The disadvantage of this method is the high risk of secondary infection of the wound, since the antiseptic treatment of the hole was not carried out, and the collagen sponge can serve as a breeding ground for bacteria.

Also, a method for the prevention of alveolitis is known, including surgical and medical treatment of the hole with its subsequent suturing, while in order to reduce the treatment time, the hole after surgical treatment is washed with a solution of a decoction of calamus rhizome, then the hole is filled with a KAU-1 sorbent and after suturing on the wound surface for 30 minutes, a swab is applied, moistened with a mixture of decoction of calamus rhizomes with a 0.25% solution of anestezin at a ratio of 1: 1, followed by treatment of the wound surface with this mixture for 2-3 days (SU 01810059 A1, publ. 23.04.1993).

The disadvantages of this method are: insufficient activity of decoction of calamus rhizomes against bacteria, not to mention biofilms, the need for constant production of a fresh solution, the need for long-term retention of the tampon.

In addition, a method for the treatment and prevention of alveolitis is known, which involves the use of an ointment containing anesthesin, crystalline iodine, an aqueous solution of potassium iodide, lanolin-vaseline base and distilled water, while it additionally contains solcoseryl dental adhesive paste and "Polysorb MP" (RU 2423103 C1 , published 07/10/2011).

The disadvantage of the described method is that its implementation using the above ointment, which includes crystalline iodine, which has a local irritant effect, can lead to chemical burns of tissues, as well as provoke an allergic reaction.

The technical result of the present invention is: increasing the effectiveness of the prevention of alveolitis of the jaw through the use of a composition that does not have a local irritating and toxic effect, minimal invasiveness and simplification of the procedure, reducing the healing time.

The technical result is achieved due to the fact that the method for preventing jaw alveolitis provides for the use of an antiseptic composition containing the active component polyaminopropyl biguanide, which ensures the elimination of bacteria and wound contents, as well as the destruction and prevention of biofilm formation.

Prevention of alveolitis is carried out as follows.

After the extraction of a tooth by the traditional method using forceps and elevators, or after the removal of impacted, dystopic teeth using additional instruments (eg, handpiece, burs), the tooth socket is decontaminated. Then, the well is washed with an antiseptic composition heated to a temperature of 30-32°C, containing polyaminopropyl biguanide as an active component in an amount of 0.1 wt. %, with an exposure time of 55-65 seconds. The bone hole is performed with a blood clot, pressing is performed, the edges are adapted. If necessary, suturing is performed.

In the composition used in the present invention, the composition containing as an active ingredient polyaminopropyl biguanide in the amount of 0.1 wt. %, may include any carriers and excipients suitable for pharmaceutical use. The composition may be prepared by any of the methods known in the art. As such a composition, a Prontosan solution can be used, which includes 0.1 wt. % polyaminopropyl biguanide. A similar composition is disclosed, for example, in document CN 110559312 A, 12/13/2019.

It was unexpectedly found that the use of a composition heated to a temperature of 30-32°C containing 0.1 wt. % polyaminopropyl biguanide, allows you to increase its antiseptic effect, which contributes to a more effective destruction or prevention of biofilm formation and, as a result, a decrease or complete cessation of bacterial aggression and an accelerated regenerative process. At the same time, the use of a composition heated to a temperature below 30°C or above 32°C is not sufficiently comfortable and effective in terms of both its application (local irritant effect) and the activity of polyaminopropyl biguanide (insufficient effect on the elimination of bacteria).

In addition, it was unexpectedly determined that the exposure time of the specified composition, which is 55-65 seconds, also affects the possibility of achieving a technical result - increasing the effectiveness of the prevention of jaw alveolitis, since the specified exposure period is optimal in terms of the penetrating ability of the composition in relation to bacterial biofilms and necessary elimination of bacteria and wound contents.

The claimed invention is illustrated by the following clinical examples.

Brief description of the figures.

Fig. 1 - Hole after tooth extraction (example 1).

Fig. 2 - State of the well on day 3 (example 1).

Fig. 3 - Wells after tooth extraction (example 2).

Fig. 4 - Condition of the wells on day 3 (example 2).

Fig. 5 - Holes after tooth extraction (example 3).

Fig. 6 - State of the wells on day 3 (example 3).

Example 1. Patient K., 39 years old, came to the clinic to remove tooth 2.7. After the extraction of tooth 2.7 by the traditional method using forceps, the tooth socket was decontaminated. Then the wells were washed with an antiseptic solution, heated to a temperature of 32°C, containing 0.1 wt. % polyaminopropyl biuanide, with an exposure time of 55 seconds. The bone hole is made with a blood clot, pressed, the edges are adapted. When viewed on the 3rd day, active healing of the hole of the 2.7 tooth was noted, no inflammation was noted.

Example 2 Patient T., 43 years old, came to the clinic to remove teeth 4.4, 4.5, 4.7. After the extraction of teeth 4.4, 4.5, 4.7 by the traditional method using forceps and an elevator, the tooth sockets were decontaminated. The wells were washed with an antiseptic solution, heated to a temperature of 31°C, containing 0.1 wt. % polyaminopropyl biuanide, with an exposure time of 60 seconds. Bone holes are filled with blood clots, squeezed out, the edges are adapted. When viewed on the 3rd day, active healing of the holes of the teeth 4.4, 4.5, 4.7 was noted, no inflammatory phenomena were noted.

Example 3. Patient O., 36 years old, came to the clinic to remove teeth 3.4, 3.6. After the extraction of teeth 3.4, 3.6 by the traditional method using forceps and an elevator, the tooth sockets were decontaminated. The wells were washed with an antiseptic solution, heated to a temperature of 30°C, containing 0.1 wt. % polyaminopropyl biuanide, with an exposure time of 65 seconds. Bone holes are filled with blood clots, squeezed out, the edges are adapted. When viewed on the 3rd day, active healing of the holes of the teeth 3.4, 3.6 was noted, no inflammatory phenomena were noted.

Example 4. Patient Ya., 47 years old, came to the clinic to remove an unerupted wisdom tooth (impacted). After the tooth was removed using a bur and an elevator, the tooth socket was decontaminated. The wells were washed with an antiseptic solution, heated to a temperature of 32°C, containing 0.1 wt. % polyaminopropyl biuanide, with an exposure time of 65 seconds. The bone hole is made with a blood clot, squeezed out, the edges are adapted, a suture is applied. On examination on the 3rd day, there was an active healing of the tooth socket, no inflammation was noted. Patient Ya. did not give permission to take photographs and publish the treatment process and follow-up.

Example 5 Patient R., 21 years old, came to the clinic to remove an incorrectly located tooth 2.1 (dystopic). After the tooth was removed using boron, the tooth socket was decontaminated. The wells were washed with an antiseptic solution, heated to a temperature of 30°C, containing 0.1 wt. % polyaminopropyl biuanide, with an exposure time of 55 seconds. The bone hole is made with a blood clot, pressed, the edges are adapted. On examination on the 3rd day, active healing of the socket of the tooth 2.1 was noted, no inflammatory phenomena were noted. Patient R. did not give permission to take photographs and publish the treatment process and follow-up.

It should be noted that the claimed method for the prevention of alveolitis was used during the extraction of teeth in 27 patients who were within 10-12 days (with visits on days 3 and 10-12 after surgery) under the supervision of a surgeon of a dental clinic, while in all patients, including examples 1-5, after the removal of the tooth(s) was not observed the development of alveolitis. Thus, the claimed method allows to increase the effectiveness of the prevention of alveolitis through the use of a composition that does not have a local irritating and toxic effect, and also provides minimal invasiveness, simplification of the procedure and reduction of healing time.

Claims (1)

A method for the prevention of jaw alveolitis, including the removal of a tooth(s) or the removal of impacted(s) and/or dystopic(s) tooth(s), decontamination of the socket of the tooth(s), washing the socket with an antiseptic composition heated to a temperature of 30-32°C, containing as an active component polyaminopropyl biguanide in an amount of 0.1 wt.%, with an exposure time of 55-65 seconds, making a bone hole with a blood clot, followed by squeezing and adapting the edges.

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