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INVENTION
Russian Federation Patent RU2271212
Method of surgical treatment of periodontitis
Name of the inventor: Shumsky Alexander (RU); Maksim Yurchenko (RU)
The name of the patentee: Alexander Shumsky (RU); Maksim Yurchenko (RU)
Address for correspondence: 443058, Samara, ul. Victory, 90, kv.170, MY Yurchenko
Starting date of the patent: 2004.01.22
The invention relates to medicine, namely, to stomatology and may be used in the surgical treatment of periodontitis. The method includes the classical surgery by Widman, wherein before laying the flap patient bled in an amount of 10-20 ml and then it is centrifuged for 11-13 minutes at 2400-2800 revolutions per minute, whereby blood is separated into three fractions: red blood cells, plasma rich in platelets and plasma with low content of platelets and the plasma with a high content of platelets removed from the tube and mixed with a powder of beta-tricalcium phosphate in a ratio of 1: 3, then the resulting mixture was placed in the defect and grafts fixed seams. The process ensures the absence of the need for additional surgery on the donor site, does not cause allergic reactions, is safe in terms of infection transfer risk, easy to use.
DESCRIPTION OF THE INVENTION
The invention relates to medicine, namely, to stomatology and may be used in the surgical treatment of periodontitis.
Currently, it periodontitis distributed very widely. Known methods of treatment of this disease with the use of osteoinductive and osteoconductive preparations (A.S.Artyushkevich, EKTrofimova, S.V.Latysheva "Clinical Periodontology", Minsk, 2002, s.261-267). Osteoinductive materials stimulate the growth of new bone, which makes them an advantage over osteokonduktorami (materials, are the framework for the newly formed bone).
Currently, the practice following osteoinduktory common:
1. autobone. From the donor area of the patient's bone is sawed block or chip and placed in the defect.
2. demineralized bone matrix. The donor is the other person, usually taken cadaveric material.
3. Brefokost. The bag material is processed by a special technique.
4. Biositally soaked in blood plasma. Osteoconductive ceramic impregnated with blood plasma containing growth factors.
The following examples can be used osteokonduktorov From:
1. Hydroxyapatite.
2. Beta-tricalcium phosphate.
3. Biositally.
For the prototype of the invention adopts the method of surgical treatment of periodontitis by Widman (A.S.Artyushkevich, E.K.Trofimova, S.V.Latysheva "Clinical Periodontology", Minsk, 2002, p.248) using osteoinductive materials. The known method is as follows. Make two vertical incisions within 4 teeth, limiting forming portion of the flap. These incisions begin in the gingival margin, and terminate in the alveolar mucosa. Then connect the horizontal vertical sections, which is carried out, several departing from the gingival margin. The same incisions made on the lingual surface of the alveolar bone. Muco-vadkostnichnye otseparovyvayut flaps, exposing a marginal part of the alveolar process. Clipping a marginal part of gums removed by curette. The roots of the teeth thoroughly treated. Then flatten unevenness drill bone teeth area. The classic version of the operation ends with the flaps are laid in place and fix the seams.
However, the known method has several disadvantages. When using autologous bone requires additional traumatic intervention on the donor site. The use of glass-soaked blood plasma, is limited due to the complexity of manufacture of the product technology. When using demineralized bone matrix and brefokosti there is a risk of infection and allergic reactions.
The essence of the inventive method is that the operation is carried out classical Widman, but before laying flaps bled from the ulnar vein in an amount of 10-20 ml, centrifuged, for example, a centrifuge "EVA20" "Hettich" firm (Germany) for 11 -13 minutes at 2400-2800 revolutions per minute. As a result, blood is separated into three fractions: erythrocytes, plasma rich in platelets and plasma low in platelets. Platelet removed from the tube and mixed with a powder of beta-tricalcium phosphate at a ratio of 1 part of platelets to 3 parts of beta-tricalcium phosphate. The resulting mixture was placed in the defect, after which the flaps are fixed seams.
Method is as follows
The patient makes two vertical incisions within 4 teeth, limiting forming portion of the flap. These incisions begin in the gingival margin, and terminate in the alveolar mucosa. Then connect the horizontal vertical sections, which spend several departing from the gingival margin. The same incisions made on the lingual surface of the alveolar bone. Mucoperiosteal flaps otseparovyvayut, exposing a marginal part of the alveolar process. Clipping a marginal part of gums removed by curette. The roots of the teeth thoroughly treated. Then flatten unevenness drill bone teeth area. Thereafter, blood is taken from the patient's ulnar vein in an amount of 10-20 ml, centrifuged at for 11-13 minutes at 2400-2800 revolutions per minute centrifuge "EVA20" "Hettich" firm (Germany). As a result, blood is separated into three fractions: erythrocytes, plasma rich in platelets and plasma low in platelets. Platelet removed from the tube and mixed with a powder of beta-tricalcium phosphate at a ratio of 1 part of platelets to 3 parts of beta-tricalcium phosphate. The resulting mixture was placed in the defect region, the flaps are fixed seams.
Clinical example.
In the dental office a polyclinic №15 MTN Samara 11/03/02, the patient appealed with complaints V. tooth mobility, bleeding gums, bad breath. On examination discovered tooth mobility of II degree, swollen gums, bloodshot. In the teeth of considerable deposits of tartar. On the X-ray visible bone resorption up to 1 / 2-2 / 3 the length of the roots of teeth. The diagnosis "III periodontal disease severity." Removed dental plaque and performed by Widman flap operation described above using our methodology consistently in multiple visits in all teeth. On the second day there was no swelling, redness and a small seal platelets. Sutures are removed on the fifth day. After 3 months significantly decreased tooth mobility, gum tight, with no signs of inflammation, pathological periodontal pockets are absent. The control radiograph 3 months later, we observed the absence of bone pockets, increasing the height of bone 2-3 mm.
Fashion statement treated 16 patients. The results confirmed its efficiency.
Thus, the proposed method has the following advantages: no need for additional surgery on the donor area, does not cause allergic reactions, is safe in terms of infection transfer risk, easy to use.
CLAIM
A method of surgical treatment of periodontitis, comprising classical surgery by Widman, characterized in that before placing the flap in the patient blood is taken in an amount of 10-20 ml and then it is centrifuged for 11-13 minutes at 2400-2800 revolutions per minute, whereby blood is separated into three fractions: erythrocytes, plasma rich in platelets and plasma with low content of platelets and the plasma with a high content of platelets removed from the test tube and mixed with a powder of beta-tricalcium phosphate at a ratio of 1: 3, then the resulting mixture was placed in the defect and patches fix seams.
print version
Publication date 06.01.2007gg
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