RU2133630C1 - Method of orthodontic treatment of anomalies in position of separate teeth - Google Patents

Abstract

FIELD: medicine, particularly, stomatology. SUBSTANCE: method includes treatment in five stages with use of laser light under different conditions. Used in the method is apparatus of novel generation which is distinguished by its parameters. EFFECT: reduced terms of treatment.

Description

 The invention relates to medicine, namely to dentistry, and can be used for orthodontic treatment of anomalies of the position of individual teeth at a mass outpatient appointment in dental offices and clinics.

 A known method of orthodontic treatment using light of a helium-neon laser with a wavelength of 0.63 μm (1) to relieve inflammatory processes, normalize microcirculation, increase the resistance of periodontal tissues in the process of orthodontic treatment.

 For severe inflammation, the anti-inflammatory parameters of a helium-neon laser with a wavelength of 0.63 μm and a power flux density of 150 mW / cm for 2 minutes per field are used. In case of congestion, atrophic gingivitis, stimulating parameters from 1 to 50 mW / cm are used with an exposure of 1-2 minutes on the field. In one procedure, they affect 4 fields. The total exposure time is not more than 10 minutes, the number of procedures is 10-14.

 The specified method (1) has a number of disadvantages: a laser installation of the ULF-01-Yagoda type, adopted for the indicated purposes, is very energy-consuming, bulky (height 1.5-1.8 cm, 70-150 kg); high cost and significant operating costs to some extent hinder their use; the light of a galium-neon laser with a wavelength of 0.63 μm penetrates into the depths of tissues by only a few mm. In addition, the establishment of the necessary parameters of laser light is carried out using a large number of buttons and toggle switches (up to 10-15).

 The development of modern science and technology, especially in the conversion of the defense industry, has led to the creation of a new laser technology that is more technically advanced and more effective in terms of medical indicators.

 One of such methods is pulsed laser physiotherapy (2) using a new generation laser device "Optodan", which has other distinctive qualities, including therapeutic ones (3).

 The device has a fundamentally new type of laser semiconductor emitter that generates laser light in the infrared range with a wavelength of 0.85-0.95 microns, power up to 4 W, in a pulsed mode with a frequency of 0.08-2 kHz. This provides a higher prophylactic and therapeutic efficacy in comparison with previously issued similar emitters. The laser beam penetrates the tissue to a depth of 6 cm. The length of the tip (the manipulator of the apparatus) is reduced by 2-3 times, which greatly facilitates the irradiation of hard-to-reach areas of the oral cavity. Laser device "Optodan" with an automated control system is extremely easy to use (3).

 In the present invention, the tasks are solved - increasing the therapeutic effectiveness and prevention of complications, reducing the time of orthodontic treatment of anomalies in the position of individual teeth and, accordingly, the overall economic effect due to lower treatment costs compared to the known method (1).

 The indicated effect (technical and medical) is achieved by the fact that the treatment is carried out in 5 consecutive stages.

The method is as follows:
before starting orthodontic treatment in the presence of inflammatory phenomena on the mucous membrane of the oral cavity and lips that impede the onset of hardware treatment, or when performing surgical procedures according to orthodontic indications (plastic frenum of the tongue, upper lip, vestibuloplasty, removal of individual teeth, etc.), irradiation tissue sections with laser light with a wavelength of 0.85 - 0.95 μm, a power of 3 - 4 W, a frequency of 80 - 100 Hz with an exposure of 2 minutes on the field, 3 - 6 procedures daily;
after stopping the inflammatory process (or, if anti-inflammatory treatment was not carried out, immediately before the start of the hardware treatment), laser irradiation with a wavelength of 0.85 - 0.95 μm, a power of 0.5 - 1.0 W, a frequency of 2 - 3 kHz at area of orthodontic exposure with an exposure of 1 - 2 minutes on the field, every other day, 8 - 12 procedures;
during active orthodontic treatment, on the days of the patient’s visits to the doctor, or within 24 to 72 hours after activation of the orthodontic apparatus, laser irradiation is performed with a wavelength of 0.85 - 0.95 μm, a power of 3 - 4 W, a frequency of 80 - 100 Hz with an exposure of 1 - 2 minutes on the field once;
in case of complications (inflammatory phenomena on the mucous membrane), laser therapy is prescribed with a wavelength of 0.85 - 0.95 μm, a power of 3 - 4 W, a frequency of 80 - 100 Hz with an exposure of 2 minutes on the field, 3 - 8 daily procedures;
after active orthodontic treatment is completed, to ensure retention of the achieved results, laser irradiation is carried out with a wavelength of 0.85 - 0.95 μm, a power of 0.5 - 1.0 W, a frequency of 2 - 3 kHz with an exposure of 1 - 2 minutes in the field, 8 to 12 treatments daily.

 We carry out specific examples of clinical applications of the proposed method for orthodontic treatment of anomalies in the position of individual teeth.

 Example 1. B-th B-I, 13 years old. Diagnosis: neutral bite, individual macrodontia, close position of the front teeth of the upper jaw, vestibuloposition 3 /, lack of space for it in the dentition for 2/3 of the crown. Treatment: according to orthodontic indications removed 4 /; after removal, 3 laser therapy procedures were carried out with a wavelength of 0.85 - 0.95 μm, a power of 3 - 4 W, a frequency of 80 - 100 Hz with an exposure of 2 minutes to the area of the extracted tooth, then 8 procedures for laser irradiation with a wavelength of 0.85 - 0.95 μm, power 0.5 - 1.0 W, frequency 2 - 3 kHz in the same field with an exposure of 1 minute every other day. A removable plate for the upper jaw was made with Adams clasps on the first molars and a double thrust spring at 3 /. On days of visits to the orthodontist, after activating the double traction spring, laser light was used to irradiate the Optodan physiotherapeutic apparatus with a wavelength of 0.85 - 0.95 μm, a power of 3 - 4 W, a frequency of 80 - 100 Hz with an exposure of 2 minutes to an area of 432 / once. No complications were observed during treatment. Active orthodontic treatment was continued for 4.5 months. After its completion, 3 / is installed in the dentition, three in place of the removed 4 / no, the close position of the teeth is eliminated, the dentition of the upper jaw is of the correct shape. After the end of the apparatus treatment, in order to ensure retention of the achieved results, 10 daily laser irradiation procedures were performed with a wavelength of 0.85 - 0.95 μm, a power of 0.5 - 1.0 W, a frequency of 2 - 3 kHz with an exposure of 2 minutes to an area of 432 /. At the follow-up examination after 9 months, the results of orthodontic treatment are stable.

 Example 2. B-th N-va, 21 years old. Diagnosis: neutral bite, endocclusion / 35, cake position / 5, vestibular position / 4, lack of space in the dentition for / 345. According to orthodontic indications, it was removed / 4, compactosteotomy was performed in the / 345 area, 3 daily laser therapy procedures were performed with a wavelength of 0.85 - 0.95 μm, a power of 3 - 4 W, a frequency of 80 - 100 Hz in the / 345 area with an exposure of 2 minutes, and then 8 laser irradiation procedures with a wavelength of 0.85 - 0.95 μm, a power of 0.5 - 1.0 W, a frequency of 2 - 3 kHz with an exposure of 1 minute in the same field every other day. The treatment was carried out using the fixed orotodontic technique of the Roth system. On the days of visits to the orthodontist, the Optodan semiconductor laser apparatus was irradiated with light in the / 345 region with a wavelength of 0.85 - 0.95 μm, a power of 3 - 4 W, a frequency of 80 - 100 Hz with an exposure time of 2 minutes once. No complications were observed during orthodontic treatment. Active orthodontic treatment was completed 8 months after its start: the dentition of the upper jaw of the correct form, / 35 installed in the dentition. For retention of the achieved results, 10 daily laser therapy procedures were carried out with a wavelength of 0.85 - 0.95 μm, a power of 0.5 - 1.0 W, a frequency of 2 - 3 kHz with an exposure of 2 minutes per area / 345. At follow-up after 6 months, the results of orthodontic treatment are stable.

In order to develop and justify the proposed method of orthodontic treatment, comparative clinical studies were conducted on two groups of patients:
1) 48 patients treated by a known method (1);
2) 64 patients treated by the proposed method.

 Both groups of patients are comparable in forms of pathology, age, gender and other characteristics.

When comparing the obtained data, the proposed method of orthodontic treatment showed significant advantages compared with the known method (1):
light from a semiconductor pulsed laser with a wavelength of 0.85 - 0.95 μm suppresses inflammation more efficiently (compared with a helium-neon laser), 4 procedures were used mainly daily;
the period of tissue regeneration in the area of teeth removed according to orthodontic indications under the influence of laser light of a semiconductor laser with a wavelength of 0.85 - 0.95 μm proceeded in a noticeably short time, basically no more than 3 procedures were required;
the light of a semiconductor pulsed laser with a wavelength of 0.85 - 0.95 μm penetrates into tissues to a depth of 60 mm (the light of a helium-neon laser with a wavelength of 0.63 μm penetrates only a few mm) and not only eliminates inflammation, but also stimulates the normalization of tissue after it, including the regeneration processes, which clinically determines the strengthening of the moved teeth;
the pulsed mode of light generation by semiconductor lasers with a wavelength of 0.85 - 0.95 μm leads to a higher therapeutic effect (compared to continuous light from a helium-neon laser with a wavelength of 0.63 μm) due to its adequacy to the energy parameters of tissue tunics, their resonance and other physiological properties, as well as the exclusion of the thermal effect at relatively high power values (up to 4 W);
the total duration of orthodontic treatment by the proposed method was reduced on average by 35% compared with the known method (1);
due to a reduction in the cost of laser equipment and operating costs, reduction of treatment time, increased therapeutic efficiency, and labor productivity of the personnel, the overall economic effect was 35 - 40% higher compared to the known method (1).

 Used Books.

 1. Zufarov S.A., Ospanova G.B., Popova D.N. et al. / Application of helium-neon laser light in orthodontics. // Application of lasers in surgery and medicine. -M., 1988. - Part 2 - S.284 - 285.

 2. Prokhonchukov A.A., Zhizhina N.A., Balashov A.N. and other Laser physiotherapy of dental diseases. // Dentistry, 1995, N 6, p.23 - 31.

 3. Prokhonchukov A.A., Metelnikov M.A. Laser physiotherapy apparatus of the new generation "Optodan". // Dentistry, 1997, N 1, p. 56 - 59.

Claims (1)

 A method of orthodontic treatment of anomalies of the position of individual teeth, including the action of laser light, characterized in that the treatment is carried out in 5 stages: in the first stage, before irradiation treatment, tissue sections are irradiated with laser light with a wavelength of 0.85-0.95 μm, power 3 -4 W, frequency 80-100 Hz with an exposure of 2 min on the field, 3-6 procedures daily, in the second stage after stopping the inflammatory process, laser irradiation with a wavelength of 0.85-0.95 microns, a power of 0.5-1 , 0 W, with a frequency of 2-3 kHz per orthodontic area exposure with exposure 1-2 minutes on the field every other day, 8-12 procedures, in the third stage during active orthodontic treatment on the days of the patient visiting the doctor, or within 24-72 hours after activation of the orthodontic apparatus, laser light is irradiated with a wavelength of 0 , 85-0.95 μm, 3-4 W power, 80-100 Hz frequency with an exposure of 1-2 minutes on the field once, in the fourth stage, when complications in the form of inflammatory phenomena on the mucous membrane appear, laser therapy with a wavelength of 0.85- 0.95 microns, power 3-4 W, frequency 80-100 Hz with exposure d 2 min on the field, 3-8 daily procedures, at the fifth stage after the end of active orthodontic treatment, to ensure retention of the achieved results, laser irradiation with a wavelength of 0.85-0.95 microns, a power of 0.5-1.0 W , with a frequency of 2-3 kHz with an exposure of 1-2 minutes on the field of 8-12 procedures daily.