RU2708671C1 - Method of treating and preventing inflammatory dental pulp with retention of its vitality in prosthetic repair with non-removable orthopedic structures - Google Patents

Abstract

FIELD: medicine.

SUBSTANCE: invention refers to medicine, namely to dentistry, and can be used for prevention and treatment of inflammatory dental pulp phenomena. Method of treating and preventing pulp inflammation in prosthetic repair with non-removable prostheses, with preservation of its vitality, involving application on tooth preparation of tooth treated with antiseptic solution for crown, mixture obtained by mixing to produce temporary cement paste with 40 % alcohol tincture of phytocomposition 1:5, obtained by percolation method containing poplar buds, calendula flowers, Rhaponticum rootstock with roots, Bergenia crassifolia rootstock, wild chamomile flowers, taken in a certain amount, wherein the tooth tissue is prepared for a provisional or permanent crown, after obtaining a stable effect for 2–3 weeks, the tooth is restored to a permanent crown.

EFFECT: method described above is effective for treating and preventing pulp inflammation in prosthetic repair with non-removable dentures.

1 cl, 3 ex

Description

The invention relates to medicine, namely to dentistry and can be used for the prevention and treatment of inflammation of the tooth pulp.

In the event of defects in the dentition, the presence of anomalies in the structure of the shape of the teeth, in order to restore the functional and aesthetic component, they increasingly resort to solid cast, cermet and ceramic structures. Prosthetics on vital teeth are associated with a large volume of odontodiagnosis as a result of which a number of annoying factors act on the tooth pulp: vibration, temperature, cooling, drying, chemical exposure, microbial invasion [Guskov AV, Zimankov DA, Anvarhonova DB ., Darmograi V.N., Darmograi S.V., Filippova A.S. Inflammatory reactions of pulp and periodontium when using fixed structures with a large volume of odontodiagnosis / Clinical dentistry. 2018 - No. 4 - S. 56]. These factors can lead to inflammation of the tooth pulp, manifested in the form of discomfort, hypersensitivity, pain, and pulp death. The appearance of irreversible complications under orthopedic constructions is possible even after 6 months [Ahmad I. Aesthetics of indirect restoration / Irfan Ahmad; Per. from English - M .: MEDpress - inform, 2009. - 232 p.].

Preservation of vital pulp under a fixed construction has undeniable clinical and biological significance from the perspective of predicting long-term results [Zhadko S.I., Zhirov A.I., Zhirova V.G., Dikiy K.L. An experimental justification for the preservation of vital pulp with the use of fixed dentures / Institute of Dentistry. 2015 - No. 3 - S. 84].

In order to prevent inflammatory reactions of the pulp, it is customary to use varnish adhesives and provisional crowns that protect only from external stimuli after odontopreparation, but do not have an antimicrobial, anti-inflammatory and restorative effect on the tooth pulp.

In dental practice, methods of using phytocompositions for the treatment and prevention of dental diseases are known [patent for invention RU 2401663, published on 08.27.2010; patent for invention RU 2204375, published on 05.20.2003, patent for invention RU 2550970, published on 08.27.2014].

As a prototype, the patent for invention RU 2660545 was published on 07/06/2018., In which, as an ecdysteroid source, it is proposed to use rhizomes with safflower-like root, to give the collection a more pronounced anti-inflammatory and thickening pulp tissue of the collection component - the root of frangipani, and chamomile flowers will provide anti-inflammatory, emollient, bactericidal effect, and will also contribute to a more synergistic interaction of all components of the collection on the cavity p a.

The technical result of the invention is the creation of a universal additive for temporary cements, providing them with antimicrobial, analgesic, anti-inflammatory and reparative effects for the prevention and treatment of inflammatory phenomena in the pulp during prosthetics with fixed structures with a large preparation volume.

For this, we propose using a phytoecdysteroid-containing composition of the following composition, in mass parts: poplar buds - 2, calendula flowers - 2, rhizomes with roots of a leuzea - 3, rhizomes of frankincense - 1 and chamomile flowers - 2, obtained from this phytocomposition by percolation 40 % alcohol tincture (1: 5), which is added to the temporary cement until a paste is obtained.

Poplar buds (Gemmae Populi) have anti-inflammatory, antimicrobial, hemostatic, analgesic, disinfectant and antipyretic effects.

Calendula (Caléndula) is a strong bacteriostatic, anti-inflammatory, regenerative, emollient, wound healing, decongestant.

Rhizomes with roots of leuzea (Rhizomata cum radicibus rhapontici carthamoidis) are the most studied and richest phytoecdysteroids plant, which has stabilizing cell membranes, strengthens capillaries, antioxidant, anti-inflammatory, analgesic, antiseptic, sedative and other actions.

Rhizomes of bergenia (Rhizomata bergeniae) have a high content of tannins (up to 25-27%), anti-inflammatory, tightening tissue, antimicrobial and astringent action.

Pharmaceutical chamomile flowers (Flores chamomillae recutitae) have anti-inflammatory, emollient, bactericidal action, as part of the proposed composition, they will contribute to the synergistic interaction of all components of the collection on the oral cavity.

Tincture is a brownish liquid with a mild balsamic odor.

The shelf life of tinctures is 0.5 - 1 year. The tincture parameters are stable during storage.

Prevention and treatment of pulp inflammation is carried out as follows: under appropriate infiltration or conduction anesthesia, the hard tissues of the teeth are prepared for solid cast, metal-ceramic or all-ceramic constructions.

For the prevention of pulp burns, the preparation is carried out using air-water cooling; coarse and medium-sized diamond burs for enamel and fine and carbide burs for dentin are used with intermittent movements. In order to prevent pulp injury, it is recommended that the minimum thickness of suprapulpar dentin is kept at about 0.9-1 mm.

At the end of the preparation stage, casting and antiseptic tooth processing, provisional crowns are made using a pre-made silicone key or relocating plastic caps and other methods using self-hardening plastics such as Luxatemp-Plus (DMG), Snap (Parcell), Structur 2 SC (VOCO) and others, not having heating above 37 degrees during polymerization.

Fixation of provisional crowns is carried out on the surface of the prepared tooth pre-treated with an antiseptic using temporary cements: Temp bond NE (Kerr), Repin (Spofa), RelyX Temp NE (3M ESPE), (VladMiVA), Tempofiks (VladMiVA), Dentin powder (VladMIVA ), Orthofix-Aqua-K and others, which include, by thorough mixing, 40% alcohol tincture (1: 5) obtained by percolation of the following composition in mass parts: poplar buds - 2, calendula flowers - 2, rhizomes with roots levzea - 3, rhizomes of badan thick-leaved - 1 and chamomile flowers -governmental - 2. temporary cement solidification, removal is carried precipitated from the excess bits.

Fixation of provisional crowns is performed for 2-3 weeks to obtain a lasting effect. A provisional crown protects the tooth pulp from external stimuli. The proposed ecdysteroid-containing tincture, as part of temporary cement, has a pronounced anti-inflammatory, odontotropic, analgesic, regenerating and strengthening effect on the pulp, as well as an antimicrobial effect on the remaining microorganisms on the tooth tissues and penetrating through the marginal course.

At the end of each stage of orthopedic treatment (odontopreparation of a tooth, taking casts, fitting a metal or ceramic frame, temporary cementing of a permanent structure), the prepared tooth stump is treated with an antiseptic solution and the provisional crowns are fixed to the proposed paste until the next stage of prosthetics.

At the final stage of prosthetics, after preparatory measures, the crowns made are fixed to fluorine-containing glass ionomer cements, special composite cements of light or double curing, and other non-irritating tooth pulp materials for permanent fixation.

Clinical studies of the claimed method of treatment using phytoecdysteroid-containing composition was carried out in dental clinics of Ryazan. Orthopedic treatment was performed for 30 patients (of which 18 men and 12 women) aged 18 to 70 years.

Example 1

2.02.17g. I visit. Patient E., 26 I contacted a dental clinic complaining of an aesthetic defect in teeth 1.2,1.1, 2.1, 2.2.

Anamnesis of the disease: teeth 1.2,1.1, 2.1, 2.2. aesthetically disturbed from the moment of eruption in an irregular shape.

Anamnesis of life: Botkin's disease and other specific infections denied.

Objective research data: teeth 1.2,1.1, 2.1, 2.2 are intact, have an anomaly of the “awl-shaped” incisor structure, tooth 2.2 has an anomaly of position

Orthognathic bite.

Data from additional studies: on the x-ray of the teeth 1.2, 1.1, 2.1, 2.2, the pulp cavity and periodontium are intact. The condition of the teeth periodontal tissues is normal. EDI - 1.2 - 6 μA, 1.1 - 9 μA, 2.1 - 6 μA, 2.2 - 7 μA.

Diagnosis: anomaly of the shape of the teeth 1.2, 1.1, 2.1, 2.2.

Treatment: an impression of the upper and lower jaw was obtained for wax modeling of the poor structure.

6.02.17g II visit

No complaints. Continuation of treatment.

Treatment: Received an auxiliary silicone key from a model with wax modeling (Wax up) using a silicone compound “Speedex”. The color of the temporary and permanent design on the scale "Vita" - A2. Direct modeling in the oral cavity (Mock-up) was carried out using the material “luxatemp-Plus”, color A2. Under infiltration anesthesia of a 2% solution of Ultracaine, teeth 1.2, 1.1, 2.1, 2.2 were prepared under all-ceramic crowns E-MAX with the formation of a circular gum ledge. The stumps of teeth 1.2, 1.1, 2.1, 2.2 are treated with 3% sodium hypochlorite solution. A working two-layer impression of the A-silicone “Hydrorise” mass from the upper jaw, an auxiliary impression of the C-silicone “Speedex” mass from the lower jaw was obtained. The registration of central occlusion. Color determination and manufacture of temporary plastic crowns with luxatemp-Plus material, A2 color, in a direct manner, for teeth 1.2, 1.1, 2.1, 2.2 which are fixed using Tempofix bezugenolny cement with a herbal preparation.

Recommended: next visit after 14 days.

02.26.17g III visit: no complaints.

Objectively: the plastic crowns on the teeth 1.2, 1.1, 2.1, 2.2 without defects, the gums in the teeth 1.2, 1.1, 2.1, 2.2 are pale pink, densified, there is no bleeding when probing.

Additional research data: EDI -1.2 - 7 μA, 1.1 - 9 μA, 2.1 - 8 μA, 2.2 - 9 μA.

Treatment: All-ceramic crowns were tried using the Liquid strip glycerin gel. Preparation of crowns by etching with hydrofluoric acid, applying silane and adhesive. Cofferdam and antiseptic tooth processing were performed. Etching and applying adhesive to teeth 1.2, 1.1, 2.1, 2.2. Fixation of crowns using “Variolink esthetic DC Refill”, removal of surplus, application of glycerin gel to the surface of the composite, polymerization by photochemical reaction. Final removal of excess cement, removal of rubber dam.

Recommended: next visit after 6 months.

The control:

No complaints were reported 6 months after treatment.

There were no complaints 12 months after treatment.

Example 2

March 7, 2017 I visit. Patient A., 33 years old. I went to the dental clinic with a complaint about a violation of chewing and an aesthetic defect.

Medical history: tooth 1.5 was removed due to a root fracture damaged 6 months ago.

Anamnesis of life: Botkin's disease and other specific infections denied.

Objective research data: the mucous membrane in the region of the missing tooth 1.5 and adjacent teeth 1.4 and 1.6 are pale pink. On the distal surface of tooth 1.6 there is an IROPZ filling - 0.2 tooth 1.4 intact.

Orthognathic bite.

Diagnosis: partial adentia.

Data from additional studies: Tooth EDI 1.4 - 4 μA, 1.6 - 6 μA.

Treatment: An auxiliary two-layer impression was obtained using the Speedex silicone mass. Under infiltration anesthesia of a 4% Ubistesin solution, teeth 1.4 and 1.6 were prepared under a zirconia crown with the formation of a circular gingival ledge. The stumps of teeth 1.4, 1.6 are treated with 3% sodium hypochlorite solution. A working two-layer impression of the A-silicone “Hydrorise” mass from the upper jaw, an auxiliary impression of the C-silicone “Speedex” mass from the lower jaw was obtained. The registration of central occlusion. Color determination and fabrication of temporary plastic crowns using luxatemp-Plus material, color A2, in a direct manner, for teeth 1.4 and 1.6 which are fixed using Orthofix-Aqua K cement mixed with a herbal preparation.

Recommended: next visit after 14 days.

03/26/2017 II visit: no complaints at the time of the visit. After the odontopreparation procedure, the patient noted the presence of paroxysmal night pain in the teeth 1.4, 1.6 lasting about half an hour. The day after the installation of temporary crowns, the patient noticed a significant improvement - the absence of pain in the area of teeth 1.4, 1.6.

Objectively: the plastic crowns on the teeth 1.4, 1.6 without defects, the gums in the teeth 1.4, 1.5, 1.6 are pale pink, tightened, there is no bleeding when probing.

Data from additional studies: EDI of the tooth 1.4 - 12 μA, 1.6 - 14 μA.

Treatment: fitting of a frame made of zirconium dioxide of artificial crowns was carried out. The color of the ceramic mass was determined using the standard color “Vita” - B2. The teeth were treated with 3% sodium hypochlorite solution. Installation of temporary plastic crowns for teeth 1.4, 1.6, which are fixed using temporary cement "Orthofix - Aqua K" mixed with a herbal preparation.

Recommended: next visit after 14 days.

04/14/2017 III visit: no complaints. Lack of pain in the area of the prepared teeth.

Objectively: the plastic crowns on the teeth 1.4, 1.6 without defects, the gums in the teeth 1.4, 1.5, 1.6 are pale pink, tightened, there is no bleeding when probing.

Data from additional studies: Tooth EDI 1.4 - 8 μA, 1.6 - 10 μA.

Treatment: the ceramic-metal construction of the teeth 1.4, 1.5, 1.6 was checked in the oral cavity. Artificial crowns restore interdental contact points and occlusal contacts with antagonist teeth. The tooth stumps were treated with a 3% sodium hypochlorite solution. A temporary fixation of permanent artificial crowns was carried out using temporary “Repin” cement mixed with a herbal preparation.

Recommended: next visit after 7 days.

06/17/2017 IV visit: no complaints. The patient notes the absence of pain and discomfort.

Objectively: permanent ceramic-metal crowns on teeth 1.4, 1.6 and intermediate parts in the tooth area 1.5 without defects, the gums in the tooth area 1.4, 1.5, 1.6 are pale pink, densified, there is no bleeding when probing.

Additional studies: tooth EDI 1.4 - 9 μA, 1.6 - 10 μA.

Treatment: a check of the artificial all-ceramic structure in the oral cavity was performed. Color and shape satisfy the patient. The tooth stumps were treated with a 3% sodium hypochlorite solution. The artificial crowns were permanently fixed using the Maxcem elite double-cured composite cement.

Recommended: next visit after 6 months.

The control:

No complaints were reported 6 months after treatment.

There were no complaints 12 months after treatment.

Example 3

November 4, 2018 I visit. Patient D., 40 years old. I went to the dental clinic with a complaint of a defect in the dentition, difficulty chewing food.

Medical history: teeth 4.5,4.6. were removed, due to the destruction of the crown of the tooth, more than 6 years ago.

Anamnesis of life: Botkin's disease and other specific infections denied.

Objective research data: the mucous membrane in the area of the missing tooth 4.5, 4.6 and neighboring teeth 4.4 and 4.7 are pale pink. On the occlusal surface of tooth 4.7 there is an IROPZ filling - 0.2. Tooth 4.4 is intact.

The bite is straight.

Additional research data: EDI — 4.4 - 3 μA, 4.7 - 5 μA.

Diagnosis: partial adentia. Treatment: An auxiliary two-layer impression was obtained using the Speedex silicone mass. Under infiltration anesthesia of a 2% solution of Ultracaine, the preparation of teeth 4.4 and 4.7 was performed under ceramic-metal crowns with the formation of a circular subgingival ledge. Antiseptic toothbrushing 4.4, 4.7 with 3% sodium hypochlorite solution. A working two-layer impression was made of Speedex C-silicone mass from the lower jaw, an auxiliary impression from the Orthoprint alginate mass from the upper jaw. Color determination and manufacture of temporary plastic crowns using Luxatemp handmix material, color A3.5, in a direct manner, for teeth 4.4, 4.7, which are fixed using Temp bond NE temporary cement with a herbal preparation.

Recommended: next visit after 14 days.

11/22/2018 II visit: no complaints. The patient noted the presence of increased tooth sensitivity after the stage of single preparation for 3 days. After 3 days, after the installation of temporary crowns, the patient noticed a significant improvement - the lack of sensitivity in the area of teeth 4.4, 4.7.

Objectively: plastic crowns on teeth 4.4, 4.7. without defects, gums in the area of teeth 4.4, 4.7. pale pink, tightened, no bleeding when sensing.

Additional research data: EDI — 4.4 - 6 μA, 4.7 - 9 μA.

Treatment: fitting of the metal frame of the artificial crown on the stump of the teeth 4.4, 4.7. The color of the ceramic mass was determined using the standard Vita color - A3.5. The teeth were treated with 3% sodium hypochlorite solution. Installation of temporary plastic crowns for teeth 4.4, 4.7, which are fixed using temporary cement “Temp bond NE” mixed with a herbal preparation.

Recommended: next visit after 7 days.

December 3, 2018 III visit: no complaints. Lack of pain in the area of the prepared teeth.

Objectively: plastic crowns on the teeth 4.4, 4.7 without defects, the gums in the area of the teeth 4.4, 4.7 are pale pink, tightened, there is no bleeding when probing.

Additional research data: EDI — 4.4 - 6 μA, 4.7 - 9 μA.

Treatment: the ceramic-metal construction of the teeth 4.4, 4.5, 4.6, 4.7 in the oral cavity was checked. Artificial crowns restore interdental contact points and occlusal contacts with antagonist teeth. Cultured teeth were treated with 3% sodium hypochlorite solution. Temporary fixation of permanent artificial crowns was carried out using temporary cement “Temp bond NE” mixed with a herbal preparation.

Recommended: next visit after 7 days.

01/26/2019 IV visit: no complaints. The patient notes the absence of pain and discomfort.

Objectively: permanent ceramic-metal crowns on teeth 3.5, 3.7 and intermediate parts in the tooth area 4.5, 4.6 without defects, the gums in the tooth area 4.4, 4.5, 4.6, 4.7 are pale pink, densified, there is no bleeding when probing.

Additional research data: EDI — 4.4 - 5 μA, 4.7 - 7 μA.

Treatment: the design of artificial ceramic-metal constructions of teeth 4.4, 4.5, 4.6, 4.7 in the oral cavity was checked. Color and shape satisfy the patient. The tooth stumps were treated with a 3% sodium hypochlorite solution. The artificial crowns were permanently fixed using Fuji I glass ionomer cement.

Recommended: next visit after 6 months.

The control:

No complaints were reported 6 months after treatment.

There were no complaints 12 months after treatment.

Thus, the patented method for the treatment and prevention of inflammation of the tooth pulp with a phytoecdysteroid-containing composition, when prosthetics are fixed with orthopedic constructions, in order to preserve its vitality, ensures the preservation of the pulp with pronounced capillary-strengthening, anti-inflammatory, regenerative and other types of action, while maintaining the effect for a long time. During the treatment, not a single case of unwanted side effects was detected.

Claims (1)

A method for the treatment and prevention of inflammatory phenomena of the pulp during prosthetics with fixed prostheses, while maintaining its vitality, including applying to the prepared tooth tissue treated with an antiseptic solution under the crown, a mixture obtained by mixing temporary cement with 40% alcohol tincture of phytocomposition 1: 5, obtained by the method of percolation containing poplar buds and calendula flowers, characterized in that to obtain tinctures use a phytocomposition containing poplar buds 2 wt. hours, calendula flowers 2 wt. o'clock, rhizome with the roots of Leuzea 3 wt. o'clock, the rhizome of the frankincense 1 wt. including chamomile flowers 2 wt. h. , while the tooth tissue is prepared under the provisional or permanent crown, after receiving a lasting effect, the tooth is restored with a permanent crown for 2-3 weeks.