RU206312U1 - DEVICE FOR PRECISE POSITIONING AND PROLONGED ACTION OF THE DRUG ON THE FOCUS OF THE ORAL MUCOSA INJURY - Google Patents

Abstract

The utility model relates to medicine, namely to dentistry, and can be used for precise positioning of a drug and prolonged action in the treatment of diseases of the oral mucosa. The device contains an individually made mouthguard (1), on which a working part (2) made of self-hardening acrylic plastic is fixedly placed in the projection of the COP lesion focus. Holes (4) are made on the working part to create a drug depot opposite the lesion. The use of the utility model increases the accuracy of applying the drug to the mucous membrane in any anatomical zone of the oral cavity, ensures the preservation of a high concentration of the drug in the area of the COP lesion for the period of application, reduces the patient's negative taste sensations from the drug, and increases the comfort from local therapy and wearing. devices in the oral cavity. 3 ill., 3 ex.

Description

The utility model relates to medicine, namely to dentistry, and can be used for precise positioning and providing a prolonged local action of the drug on lesions of the oral mucosa (OMP) in various diseases (for example, lichen planus, leukoplakia).

In COP diseases, the lesions have certain contours and localization. Accurate application and retention of the drug (to maintain concentration and activity) at the site of the lesion is of fundamental importance in the therapy of COP diseases.

Known device for the treatment of inflammatory diseases of the oral mucosa, containing a working part, which is made of dental impression material and made in the form of an impression, on one side of which the patient's teeth impression is modeled, and on the other - a depression. The height of the impression corresponds to the distance from the transitional fold of the upper teeth to the transitional fold of the lower teeth of the patient, the anterior border of the impression is the projection of the angle of the mouth (canine), the posterior border is the distal surface of 8 or 7 molars. The inner and outer edges of the impression are streamlined. A cotton pad or a rounded gauze napkin, soaked with a decoction of herbs, or with an applied ointment or gel, is placed in the depression of the impression. Then the cast is placed on the patient's cheek, with the medication recess located opposite the lesion of the mucous membrane. Depending on the stage of healing, the device with the drug placed in it is in the oral cavity from 15 minutes to 40 minutes, after which it is removed, washed and stored until the next treatment procedure (patent RU 2663327, 2018]).

The prototype of the utility model is a device for delivering a drug to the lesion of the oral mucosa, made of plastic and containing, with holes, a working part, motionlessly placed in the projection of the lesion (RU 2558468 C2, 08/10/2015).

The disadvantages of this device are

1) limited applicability (only after tooth extraction surgery);

2) the impossibility of creating a drug depot in the treatment of COP pathology in complex anatomical areas (for example, the retromolar region, the surface of the tongue).

3) The complexity and multi-stage manufacturing of the device.

The task of the utility model is to develop a device for precise positioning and ensuring prolonged action of the drug, which is stable in its geometric dimensions over time (does not shrink), and also ensures the creation of a drug depot in any anatomical zones in the oral cavity.

The technical result when using the utility model is to increase the accuracy of applying the drug to the mucous membrane in any anatomical zone of the oral cavity, to maintain a high concentration of the drug in the area of the COP lesion for the period of application, to reduce the patient's negative taste from the drug, to increase comfort from the local therapy and wearing the device in the oral cavity.

The essence of the utility model is illustrated by the following figures: FIG. 1 shows the proposed device, general view, where 1 is an individually made kappa, 2 is a working part; in fig. 2 - the proposed device fitted to the diagnostic model of the patient's upper jaw, where: 3 - the upper jaw; in fig. 3 - the proposed device, side view, where: 4 - holes (reservoirs) for creating a drug depot.

The proposed device contains an individually made mouthguard 1, on which, in the projection of the lesion focus of the COP, the working part 2 made of self-hardening acrylic plastic is stationary. On the working part, holes (reservoirs) 4 are made to create a drug depot opposite the lesion.

The proposed device is manufactured as follows.

Before manufacturing the device, the dentist takes impressions from the patient's upper and lower jaws, after which the control and diagnostic models (K DM) of the jaws are cast. On K DM, the dentist marks with a pencil the projection of the lesion of the mucous membrane - its size, shape. After that, the dental technician makes an individual mouthguard for the upper or lower jaw, depending on the location of the pathological focus (if the pathological focus is higher than the occlusal plane, then it is made on the upper jaw, if lower, then on the lower jaw), on which it forms the working part made of self-hardening acrylic plastic, in the area where the dentist has marked the projection of the lesion. Further, in the working part, a cutter drills holes (reservoirs) for the drug, facing towards the lesion. The final stage in the manufacture of the device is surface polishing and antiseptic treatment.

The use of the device is as follows: a dentist or the patient himself fill the reservoirs of the working part of the device with a drug, and then put the device on the patient's jaw; the time and frequency of wearing the device is determined by the dentist and depends on the diagnosis and the drug used.

The differences of the proposed device are that the materials used in the manufacture of the device, after hardening, do not shrink (retain their geometric dimensions over time); the working part, in which the holes (reservoirs) for the drug are drilled, can be located anywhere depending on the location of the lesion on the COP, both from the vestibular surface of the teeth, and from the palatal or lingual (if the lesions are localized on the mucous membrane the membrane of the palate, on the surfaces of the tongue, on the mucous membrane of the sublingual region).

The implementation of the utility model is illustrated by the following examples.

Example 1. Patient M., male, age 38 years.

Complaints: tightness of the mucous membrane of the lip, painful sensations when taking solid, spicy and hot food.

Objectively: external examination without features. The skin of the face, neck, hands is of a physiological color, without visible pathological changes. The configuration of the face is within the limits of physiological asymmetry and proportionality. Regional lymph nodes are painless. The nasolabial, chin folds are moderately expressed. The red border of the lips is dry, physiological in color. The mucous membrane of the hard and soft palate is pale pink, shiny, moistened with saliva, on the hyperemic and edematous mucous membrane of the upper lip on the right, whitish-gray papules, polygonal, flat, ranging in size from 0.5 to 2 mm, merging into a pattern in the form fern leaves, which do not rise above the level of the mucous membrane, are not removed when scraped with a spatula, painless on palpation, there is an erosion of 3 by 3 mm, with uneven edges, on palpation there is a sharp soreness.

Based on complaints, anamnesis, differential diagnosis, clinical examination, OAK, data of additional research methods (luminescent, autofluorescent), the diagnosis was made: lichen planus (LP), erosive form.

As a local therapy, it was decided to make a device for accurate positioning and prolonged action of the drug on the lesion of the oral mucosa, for which the dentist took impressions from the patient's upper and lower jaws, after which control and diagnostic models (CDM) of the jaws were cast ... On the MDM, the dentist marked with a pencil the projection of the lesion (erosion of the LP) of the mucous membrane of the upper lip on the right - its size, shape. After that, a dental technician made an individual mouthguard for the upper jaw, in the projection area using self-hardening acrylic plastic, a working part was made, the boundaries of which were 5 mm larger than the projection of the lesion, in which holes (reservoirs) were drilled to create a drug depot. The device has been polished and antiseptically treated.

Before each use of the device, an antiseptic treatment of the erosion surface was carried out. The patient was instructed to use the device, was assigned to wear the device 3 times a day for 30 minutes for 10 days, and the gum balm “Asepta with propolis” was prescribed as a medicine for filling the holes (reservoirs) of the device.

After 10 days, complete epithelialization of the LPL erosion is noted, the patient notes the ease of use of the device, complete wearing comfort. By creating a concentration of the drug in the area of the lesion with the help of the reservoirs of the working part of the device, a good therapeutic effect is achieved, and material costs for treatment are reduced.

Example 2. Patient N., gender - female, age 52 years.

Complaints: a painful ulcer on the lateral surface of the tongue on the right, the sharp edge of the crown of tooth 4.6, appeared 1 week ago.

Objectively: external examination without features. The skin of the face, neck, hands is of a physiological color, without visible pathological changes. The configuration of the face is reduced in the lower third. Regional lymph nodes are not palpable, except for the occipital. The severity of the nasolabial, chin folds. The red border of the lips is dry, physiological in color. The mucous membrane of the hard and soft palate, cheeks, lips is pale pink, shiny, moistened with saliva; on the hyperemic lateral surface of the tongue on the right, a round ulcer is noted, surrounded by an inflammatory infiltrate, covered with a gray bloom, sharply painful on palpation, 8 by 11 mm in size. The crown of tooth 4.6 does not meet medical and biological criteria, it has a sharp gingival margin.

Based on complaints, anamnesis, differential diagnosis, clinical examination, the diagnosis was made: traumatic ulcer of the lateral surface of the tongue on the right.

The treatment consisted in the removal of the traumatic factor - removal of the artificial crown of the tooth 4.6; manufacturing of a device for precise positioning and prolonged action of the drug on the lesion of the oral mucosa. For this, the dentist took casts from the patient's upper and lower jaws, after which the control and diagnostic models (CDM) of the jaws were cast. On the CDM on the palatal and lingual surfaces of the dentition, the dentist marked with a pencil the projection of the lesion focus (traumatic ulcer) of the mucous membrane of the lateral surface of the tongue on the right - its size, shape. After that, the dental technician made an individual mouthguard for the upper jaw, in the area of the projection of the lesion, using self-hardening acrylic plastic, a working part was made, the boundaries of which were 5 mm larger than the projection of the lesion, in which holes (reservoirs) were drilled to create a depot of the drug. The device has been polished and antiseptically treated.

The patient was instructed to use the device, was assigned to wear the device 2 times a day for 40 minutes for 14 days, Kamistad gel (in the morning) and an oil solution of vitamin A (in the evening) were used as a medicine to fill the holes (reservoirs) of the device.

After 14 days, complete epithelialization of the traumatic erosion of the tongue is noted, the patient notes the ease of use of the device, complete wearing comfort. Due to the creation of drug concentration in the area of the lesion with the help of the reservoirs of the working part of the device, a good therapeutic effect is achieved, material costs for treatment are reduced, while wearing the device, the risk of retraumatization of the lesion (mechanical protective effect) of erosion is reduced.

Claims (1)

An individually manufactured device for delivering a drug to the lesion of the oral mucosa (COP), containing a working part with holes for creating a drug depot opposite the lesion, characterized in that the working part, the boundaries of which are larger than the projection of the lesion, is made of self-hardening acrylic plastic and is motionlessly placed on an individual mouthguard in the projection of the lesion focus.

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