RU2568837C1 - Method of treating periodontitis with use of lamifaren gel - Google Patents

Abstract

FIELD: medicine.

SUBSTANCE: invention concerns a method of treating inflammatory periodontal diseases involving administering Lamifaren therapeutic gel in an amount of 0.2-0.3 g into each gingival pocket of upper and lower jaws by means of a syringe with a blunt needle. With the gel left inside, 15 minutes later, the pockets are exposed by means of a point head at emission power 0.4 W, power density 18-20 J/cm², for 15-30 seconds each. After each procedure, the gingival surface with the residual gel is coated with Septopack therapeutic dressing for 4 hours. The therapeutic course involves 4 daily procedures: 2 procedures alternated for the upper and lower jaws. Lamifaren is also prescribed orally 20-30 minutes before a meal in a dose of 60 g 3 times a day during 30 days.

EFFECT: using the invention provides the higher therapeutic effect of the method and reduces the length of treatment.

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Description

The invention relates to medicine, namely to therapeutic dentistry, and can be used to treat inflammatory periodontal diseases.

The treatment of inflammatory periodontal diseases to this day continues to be one of the urgent problems of dentistry. There is a large arsenal of therapeutic and prophylactic agents. However, the frequency of this pathology does not decrease, but tends to increase.

In the etiotropic therapy of inflammatory periodontal diseases, antibiotics and antiseptics are widely used, but such antibacterial therapy can upset the balance of microflora in the oral cavity and also prevent the formation of the body's immune responses to pathogenic bacteria [Grigoryan AS, Grudyanov AI, Rabukina N. A., Frolova O.A. Periodontal disease. - M.: Medical News Agency, 2004, p. 239-289]. At the heart of pathogenetic treatment, a large role belongs to anti-inflammatory drugs, namely steroidal and non-steroidal drugs. Preference is given to ointments containing glucocorticosteroids (1% hydrocortisone, 0.5% prednisone), and official drugs, which include hormones ("Fluorocort", "Lorinden", "Hyoxysone", etc.), and non-steroid drugs ("Indomethacin" ”,“ Ketorolac ”,“ Diclofenac sodium ”), but these drugs cause irritation of the gastrointestinal tract, allergic reactions, development of anemia, leukopenia, hemorrhage are possible [Tsepov L.M., Nikolaev A.I., Mikheeva E.A. Diagnosis, treatment and prevention of periodontal disease. - M.: MEDpress-inform, 2008, p. 171-173].

A known method of treating periodontitis, characterized in that they carry out three-stage laser irradiation in therapeutic dosages, surgical treatment. Additionally, prior to laser therapy, drug application is performed. In this case, at the first stage, holisal gel is introduced into the pockets, and periodontal pockets of 4 mm or more in size are irradiated through a thin disposable light guide, and of a lesser depth, from the vestibular and oral surface of the alveolar process, for 5-7 days, the total time of one session 12 -20 minutes. In the second stage, during a patch operation, a mixture of gels of cholisal and pantovegin in a ratio of 1: 1 is applied to the folded flap and irradiated with a laser for 3-7 minutes. At the third stage, a vasoactive gel is applied to the region of the alveolar process of the upper and lower jaw, to the interdental spaces and to the exit points of the trigeminal nerve, laser irradiation in therapeutic dosages is carried out in the same areas, the number of procedures from 5 to 7, the total time of one session 12- 20 minutes [patent RU 2241507, 2004].

There is a method of treating chronic periodontitis, which consists in conducting a therapeutic complex treatment of teeth, which includes supragingival ultrasonic treatment of the surface of the teeth using the apparatus "Pyezon-master 400", polishing the teeth using the apparatus "Er-Flo S2", subgingival treatment of the roots of the teeth and rehabilitation of periodontal pockets with low-frequency ultrasound from the Vector apparatus, complete rehabilitation and closed curettage of periodontal pockets using a Prometey diode laser and photodynamic therapy. Photodynamic therapy is carried out as follows: the drug Photoditazine (gel 1%) is applied to the inflamed surfaces of the oral mucosa and periodontal pockets for 8-10 minutes, then the gel is washed off and the periodontal pocket is irradiated with laser radiation using a light guide for 1- 2 minutes (depending on pocket depth), using the following laser settings: wavelength 660 ± 5 nm, radiation power - 0.2 W, mode - continuous, total procedure time - up to 20-30 minutes. After the therapeutic complex dental treatment, starting from the next day, the patient is given a course of acupuncture, which includes acupuncture points E5 (da-in), E6 (jia-che), J24 (cheng-jian), GI4 (he-gu), E36 ( tsu-san-li). The exposure time for the points is 15-20 minutes. Acupuncture treatment course - 10 sessions. After completing the course of acupuncture, the patient is repeatedly subjected to subgingival treatment of the roots of the teeth and sanitation of periodontal pockets with low-frequency ultrasound from the Vector apparatus [patent RU 2460491, 2012].

Seaweeds and preparations based on them have found widespread use in dentistry in the treatment of periodontal diseases. The growing popularity of algae is due to a number of objective reasons. Algae-based drugs usually act softer than synthetic ones, they have fewer undesirable side effects, including almost no allergic reactions [A. Grudyanov. Comments on scientific reports on periodontology. - Dentistry. 1996. - 2. - P.28-30]. The presence of alginic acid in the composition of algae of Laminaria Angustat, the rich composition of trace elements and biologically active substances allows them to be used for the prevention and treatment of periodontal diseases.

The closest analogue of the invention is a method for the treatment of chronic periodontitis, including oral sanitation, removal of dental plaque, selective grinding (polishing) of teeth, curettage of periodontal pockets and photodynamic therapy using 1% Photoditazine gel. Gel "Photoditazine" is applied to the inflamed surface of the oral mucosa and periodontal pockets (at the rate of 0.1 ml per 1 cm ² surface) for 20 minutes. Then the gel is washed off and laser irradiated, the following laser settings are used: wavelength 662 nm, continuous mode, energy density 80-100 J / cm ² , treatment 3 times a week, only 4-5 procedures [Medical technology "Photodynamic therapy of periodontal diseases", registration certificate FS - 2006/062 dated May 05, 2006, applicant of CJSC "BETA-GRAND", Authors: Krechina E.K., Efremova N.V. Central Research Institute of Dentistry of Roszdrav, p. 5-7]. The disadvantage of this method is that "Photoditazine" acts only as a photopentitor and a photosensitizer, has an indirect effect, without a therapeutic effect. When using this method, the duration of remission is on average 2-3 months, taking into account the hygiene of the patient.

The objective of the invention is to increase the effectiveness of local treatment of periodontal diseases.

The technical result when using the invention is to increase the therapeutic effect and reduce the treatment time.

The proposed method for the treatment of periodontitis is as follows. Closed curettage and antiseptic treatment of periodontal pockets are performed. Then directly into each periodontal pocket with the help of a syringe with a blunt needle, the therapeutic gel “Lamifaren” is injected in an amount of 0.2-0.3 g. After 15 minutes, without removing the gel, photodynamic therapy with Alod-01- “Granat” is performed with a power radiation of 0.4 W, energy density of 18-20 J / cm ² , wavelength of 662 nm, the mode is used - continuous (to increase the efficiency of exposure). Photodynamic therapy is carried out with a point nozzle, an exposure of 15-30 seconds per pocket. Then, on the gingival surface, without removing the remnants of the gel, a Septopont treatment dressing by Septodont is applied for 4 hours after each procedure, followed by removal. The course of treatment is 4 daily procedures: 2 procedures alternately on the upper and lower jaw. Also, "Lamifaren" is prescribed orally, 20-30 minutes before meals, 60 g 3 times a day for 30 days.

Lamifaren has a complex of medicinal properties: antimicrobial, antifungal, antiviral, wound healing, anti-inflammatory, anti-toxic, absorbent, hemostatic, immunomodulating, analgesic, as it has many natural components. It contains a large number of trace elements and macronutrients, vitamins and polysaccharides. Even when applied to the gums, without a physiotherapeutic effect, Lamifaren already has a therapeutic effect. The composition of the drug ranges: alginic acids - not less than 1.68 g, iodine - not less than 1.0 mg, fucoidan, kelp, mannitol, chromium, copper, iron, vanadium, selenium, silicon, zinc, calcium, magnesium, fiber , plant sterols, chlorophyll, vitamins (A, B1, B2, B12, C, D).

The uniqueness of the drug Lamifaren is that all the components contained in it are in a biologically active form. Alginic acids have anti-inflammatory, antifungal, wound healing, decongestant, immunostimulating, hemostatic effect; fucoidan - a multivalent biomodulator, has immunomodulatory, antibacterial, antiviral, anti-inflammatory effects; kelp - a powerful anticoagulant; iodine has pronounced antimicrobial properties; chlorophyll is rich in oxygen, promotes the flow of oxygen into tissues, and has an anti-toxic effect. These natural components for treatment are used simultaneously and complement the effect of each other when introduced directly into the pathological gingival pocket.

The drug Lamifaren based on the alga Laminaria has previously been used in gynecology in pregnant women in the treatment of iodine deficiency conditions [patent No. 2275922], in nephrology as a method of treating dysmetabolic nephropathy in children [patent No. 2352348], in dermatology as a method of treating patients with exudative psoriasis [patent No. 2412684 ], in ophthalmology as a method of treating ulcerative keratitis [patent No. 2381018], a method of treating degenerative eye diseases [patent No. 2389454], in oncology as a method of preventing repeated malignant neoplasms and gross ubtsevaniya skin after surgical treatment for the prevention of skin cancer, e.g. age [Patent №2391987].

The proposed method was treated a group of patients from 240 patients with periodontitis. After the closed curettage, antiseptic treatment of periodontal pockets was carried out, then Lamifaren gel in the amount of 0.2-0.3 g was introduced into the periodontal pockets using a needle with a blunt end every day, alternating the upper and lower jaws, after 15 minutes, without removing residues gel, photodynamic therapy was performed on an Alod-01-Granat apparatus with a radiation power of 0.4 W, an energy density of 18-20 J / cm ² , a wavelength of 662 nm, and an exposure of 15-30 seconds per pocket. Then, on the gingival surface, without removing the remnants of the gel, a Septopack dressing was applied for 4 hours, after each procedure, every day, with subsequent removal. At the same time, the course of treatment was 4 days, 2 procedures for each jaw. Also, "Lamifaren" was administered orally, 20-30 minutes before meals, 60 g 3 times a day, 30 days.

When examining patients, the following indexes were used to assess the condition of periodontal tissues: gingivitis index (PMA), hygiene index (GI), and bleeding index [L.M. Tsepov, A.I. Nikolaev, EA Mikheeva “Diagnosis, treatment and prevention of periodontal diseases” - M: MEDpress-inform, 2008, p. 60-66]. The diagnosis of diseases was carried out in accordance with the international classification of diseases ICD-10 C. The high efficiency of the proposed method of treatment can be judged by the proposed clinical examples and the results of the studies (table).

Example 1. Patient M., 39 years old, complained of soreness, bleeding gums, which intensified the last 4 months. During examination, the following are revealed: the gum is hyperemic, swollen, minor deposits of tartar. Diagnosed with periodontitis of moderate severity. The PMA index is 35%, the bleeding index is 2.19, and the hygiene index is 2.2. Closed curettage of periodontal pockets and antiseptic treatment were performed. The treatment according to the proposed method was prescribed: the introduction of Lamifaren gel in the periodontal pockets of the upper and lower jaw, and after 15 minutes, without washing off the gel, photodynamic therapy was performed on the Alod-01-“Granat” device with an exposure of 15-30 seconds per pocket. Then, on the gingival surface, without removing the remnants of the gel, a Septopack dressing was applied for 4 hours, after each procedure, followed by removal. The treatment was carried out for 4 days, 2 procedures for each jaw. Lamifaren was also prescribed orally, 20-30 minutes before meals, 60 g 3 times a day, 30 days.

During the examination, a significant improvement was noted: the gum is pale pink, dense, does not bleed, PMA - 1.6%, bleeding index 0.3, hygiene index - 0.3.

Example 2. Patient B., 35 years old, complained of pain in the gums, recurrent bleeding of the gums, bad breath. An objective examination: pronounced cyanosis of the interdental gingival papillae, loose fit to the teeth. The gums bleed when touched, periodontal pockets 3-4 mm deep. A significant amount of dental deposits above and subgingival. GI indices - 2.2; the bleeding index is 2.17, the PMA index is 34.1%. Diagnosis: chronic generalized periodontitis of moderate severity.

Closed curettage and washing of pathological pockets with an antiseptic was performed. The treatment was prescribed according to the proposed method: the introduction of Lamifaren gel into the pathological pockets every day and after 15 minutes the photodynamic therapy was performed on the Alod-01- “Granat” device. Exposure time is 15-30 seconds per pocket. Then, without removing the remnants of the gel, a Septopack dressing was applied on the gingival surface for 4 hours, after each procedure, followed by removal. The treatment was carried out for 4 days, alternating the upper and lower jaws, 2 procedures for each jaw. Lamifaren was also prescribed orally, 20-30 minutes before meals, 60 g 3 times a day, 30 days.

The examination showed a significant improvement: the gum is pale pink, dense, does not bleed, PMA - 1.6%, bleeding index 0.3, hygiene index 0.5.

Thus, the results of clinical examples show that the application of the proposed method using a therapeutic gel Lamifaren normalizes indices for assessing the status of periodontal tissues and reduces treatment time.

Claims (1)

A method of treating periodontitis, including introducing an algal gel into the periodontal pockets of the upper and lower jaws, a subsequent exposure to laser radiation with a wavelength of 662 nm, the mode is continuous, characterized in that the gel "Lamifaren" is used as an algal gel, which is introduced into the periodontal pocket in an amount of 0.2-0.3 g, after 15 minutes irradiation is carried out using a point nozzle with a radiation power of 0.4 W, an energy density of 18-20 J / cm ² , an exposure of 15-30 seconds for each pocket, then for The gingival surface, without removing the gel residues, is applied to the Septopack treatment dressing for 4 hours after each procedure, the treatment course is 4 daily procedures: 2 procedures are alternately applied to the upper and lower jaws, in addition, Lamifaren is additionally prescribed orally for 20- 30 minutes before meals, 60 g 3 times a day for 30 days.