RU2053817C1 - Method for treatment of parodontium diseases and mucous membrane of oral cavity - Google Patents

Abstract

FIELD: medicine. SUBSTANCE: method for treatment of parodontium disease and mucous membrane of oral cavity is carrier out in three periods: during the first period, inflammation is eliminated with the use of laser light with wave length of 0.63 mcm in doses of 15-25 J/sq.cm (2-3 procedures); during the second period, inhibition of proliferation of tissue cells is effected with use of laser light in doses of 35-45 J/sq.cm (5-8 procedures); during the third period; for successful epithelization of tissue surface, use is made of 2-3 procedures of laser light in doses of 2-5 J/sq.cm. Relation between total time of irradiation in the first period and the total irradiation time in the second period is selected from the range of 1/15-1/25, and relation of the total irradiation time in the third period to that of the second period is selected from the range of 1.5-1/8. Before each procedure in the second period, the surface of the irradiated tissue is treated with 2% solution of methylene blue. Control of condition of irradiated tissues is effected by characteristics of rheo-, photoplethysmography and microscopy of smear prints. EFFECT: higher efficiency. 2 cl

Description

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

 Known methods of treatment using laser light (Prokhonchukov A.A. Zhizhina N.A. Lasers in dentistry. M. Medicine, 1986, S. 93-101). From this work it is clear that a wide range of therapeutic effects of laser light provides an impact on many of the leading links of the pathogenetic chains of various diseases and causes a high therapeutic effect. However, the information carried out is somewhat general in nature and does not contain all comprehensive data, including those obtained recently after the publication of this work and necessary for more effective treatment of periodontal and oral mucosa diseases.

 A known method of treating diseases of periodontal and oral mucosa with laser light [2] It includes multiple irradiation of periodontal tissues and oral mucosa affected by pathological processes with helium-neon laser light with a wavelength of 0.63 μm and provides stimulation of regenerative processes in these tissues. The disadvantage of this method is the long duration of the course of treatment; in addition, after treatment, excessive tissue proliferation may occur, resulting from the proliferation of tissue cells.

 The objective of the invention is to reduce the duration of the course of treatment and inhibition of cell proliferation of tissues in order to prevent its excessive proliferation (relapse of diseases).

 The specified medical (technical) effect is achieved by the fact that in the process of treating periodontal and oral mucosa diseases of an inflammatory-productive nature (for example, hypertrophic gangivitis, papillomatosis, lichen planus, etc.) they repeatedly irradiate pathologically altered tissues with laser light; however, according to the invention, light of a helium-neon laser (CGNL) is used for irradiation, and the course of treatment is carried out in 3 periods.

In the first period, to eliminate the inflammatory reaction, which is expressed in hyperemia, exudation, edema, tissue alteration, CFNL is used in doses of 15 to 25 J / cm ² .

After the elimination of inflammation, in the 2nd period of treatment, aimed at inhibiting the proliferation of tissue cells, apply SNF in doses from 35 to 45 J / cm ² .

In the third period of the course of treatment, to ensure the processes of resolving pathological elements, completely epithelizing the surface of tissues, for example, to eliminate erosion, radiation of CNNL tissues is carried out in doses of 2 to 5 J / cm ² .

 In addition, to enhance the effect of CGNL on tissues in the 2nd treatment period, to enhance the processes of inhibiting cell proliferation, before each irradiation procedure, the surface of the irradiated tissue is smeared with a 2% solution of methylene blue.

 During the course of treatment, the ratio of total time in the first period to total time in the second period is selected from the interval from 1/15 to 1/25, and the ratio of total time in the third period to total time in the second period is selected from the interval from 1/5 to 1 /8.

 Monitoring the condition of the irradiated tissue is carried out throughout the course of treatment according to one of the three available methods: rheo- or photoplethysmography, or microscopy of smears of the mucous membrane.

 Below are the results of clinical studies confirming the feasibility of the invention.

 According to the proposed method, a group of patients (52 people) was treated with periodontal and oral mucosal diseases, namely: with hypertrophic gingivitis, papillomatosis, cheilitis, leukoplakia and lichen planus.

 The control group (46 people) with the above diseases and identical indicators by age and sex underwent treatment according to the proposed methodology. A laser physiotherapeutic unit ULF-01 (Yagoda) with a helium-neon laser with a wavelength of 0.63 μm, commercially available by the domestic industry, was used as a source of SGBL.

In the first group, the full course of treatment ranged from 6 to 12 procedures; in the first period of treatment, the dose of CNNL was from 12 to 24 J / cm ² , in the second period from 32 to 44 J / cm ² and in the third from 1.8 to 4.8 J / cm ² .

 The ratio of the total irradiation time in the first period to the total irradiation time in the second period was from 1/14 to 1/23 and the ratio of the total irradiation time of the third period to the total time of the second period was from 1/5 to 1/8. the third period, as a rule, was limited to 2 procedures.

 In 9 patients from the first group, before each procedure, the irradiated tissue areas were smeared with a 2% solution of methylene blue.

 In both groups of patients, the state of the irradiated mucous membrane and periodontium was monitored throughout the course of treatment according to blood circulation indices using photoplethysmography.

 A comparison of the results obtained in the control group with the results of the first group showed a reduction in the first group of treatment duration by 1.5-2 times. Lubrication of the surface of irradiated tissues with a 2% solution of methylene blue further reduces the duration of treatment by 10-15%. The long-term results of the treatment in the first group showed that in patients with hypertrophic gingivitis and papillomatosis, no relapses were observed within the follow-up period of up to 1 year.

 PRI me R. Patient M-to V.V. 22 years old. Diagnosis: hypertrophic gingivitis complicated by chronic mechanical trauma to the gingival margin of the lower jaw from the buccal side on the left.

 Using reoparodontography (RPG), the diagnosis was clarified: the presence of inflammation with a pronounced vascular exudative component, which caused significant swelling of the gum tissue.

On a laser physiotherapeutic unit ULF-01 with a radiator on a helium-neon laser with a wavelength of 0.63 μm, 3 procedures were performed in doses of 20 J / cm ² to eliminate traumatic inflammation of the gingival margin, and the inflammatory reaction was stopped a day after. To inhibit the proliferation of the gingival margin, 3 procedures were performed in doses of 35 J / cm ² daily, and then to improve epithelialization of the mucous membrane of 2 procedures in doses of 3 J / cm ² .

 In the course of treatment, effectiveness was also monitored by RPG indicators. By the end of treatment, RPG values returned to normal, which served as the basis for the timely completion of treatment.

 2 weeks after completion of the course of treatment, the gingival margin returned to normal at the level of the necks of the teeth, there is no edema, the gums are pale pink, there are no complaints.

 PRI me R 2. Patient M-va MS 58 years old. Diagnosis: lichen planus, erosive form with localization in the soft palate on the right. Suffers from a disease for more than 3 years; concomitant disease chronic gastritis. The previous drug treatment of CPL did not give results, twice the disease recurred.

At the UVL-01 installation, 3 procedures were performed at doses of 20 J / cm ² every other day after stopping erosive inflammation of the mucous membrane, then 8 procedures at doses of 40 J / cm ² every other day with preliminary application of the irradiation field with a 25% aqueous solution of methylene blue (to enhance the inhibitory effect of CGNL on cell proliferation) and then to stimulate the epithelization of the mucosal surface of the 3 CGNL procedure in doses of 5 J / cm ² (every other day).

 At the same time, treatment of chronic gastritis was recommended. Using photoperiodontography (FPG), the effectiveness of treatment was monitored. Normalization of PPG indicators by the end of treatment was the basis for its completion. During repeated examinations, the PPG dynamics indicators were within the age norm. When viewed after a month, the condition of the mucous membrane returned to normal, erosion, hyperemia, no complaints.

 At repeated control examinations after 6, 12, 16 months, no relapses were found.

 Thus, the practical implementation of the invention provides the ability to achieve the above medical (technical) result.

Claims (2)

1. A METHOD FOR TREATING PERIODONTAL DISEASES AND THE Mucous membranes of the Oral cavity, including repeated irradiation of the affected tissues with laser light with a wavelength of 0.63 μm, characterized in that light using a helium-neon laser is used, the course of treatment is carried out in three periods, while the first period to eliminate the inflammatory responses of tissues to laser light applied doses of 15 - 25 J / cm ² in the second period to inhibit the proliferation of tissue cells - in doses of 35 - 45 J / cm ² and the third period to complete epithelization of the irradiated surface tissues carry out 2 - 3 irradiation procedures in doses of 2 - 5 J / cm ² , while the ratio of the total irradiation time in the first period to the total irradiation time in the second period is selected from the interval 1/15 - 1/25, the ratio of the total irradiation time in the third period to the total irradiation time in the second period is selected from the interval 1/5 - 1/8, and the state of the tissues is monitored throughout the entire course of treatment according to the indications of rheophotoplethysmography, microscopy and smear prints.  2. The method according to claim 1, characterized in that before each irradiation procedure in the second period, the surface of the irradiated tissue is smeared with a 2% solution of methylene blue.