Report of doctors of the Awatage medical center on the use of shock wave therapy in dentistry

Report of doctors of the Awatage medical center on the use of shock wave therapy in dentistry

In recent years, dentists have made some progress in improving the quality of medical care for patients with periodontal diseases, including periodontitis. Today, doctors have overcome the disbelief in the possibility of treating periodontal diseases. Although, the unsuccessful use of traditional means and methods, as well as the high social significance of the problem of treating periodontal diseases determine the need to search for new ways to solve it.

The report of the doctors of the Awatage medical center on the use of shock wave therapy in dentistry. Shockwave Kiev 2016 conference.

Paradontosis is a lesion of the gum tissue with atrophy of the alveolar processes; with paradontosis, the supporting part of the tooth is affected.

Periodontal disease symptoms:

• loosening of the tooth, sagging of the gums, increased sensitivity to cold and hot, thinning of the gums
• atrophy of the alveolar processes (the site of bone that forms the dental bed)
• pale coloration of the gums (depletion of periodontal vessels)
• possibly the addition of inflammatory processes against the background of a decrease in blood supply and reproduction of microbes in the oral cavity.

What leads to atrophic processes in the tissues of the body?

Of course, a decrease in the number of blood vessels. This can also be caused by systemic diseases that affect the vessels, for example, diabetes mellitus, vascular atherosclerosis, and thyroid disease.

Treatment of periodontal disease with shock wave therapy at the Awatage medical center

Modern approaches to the treatment of periodontal diseases.

• Antibacterial therapy
• Oral hygiene, removal of dental plaque and foci of oral infection
• Orthodontic teeth stabilization
• Bone plastic surgery to strengthen teeth.

The listed methods of treatment do not affect the processes leading to the destruction of periodontal tissues, therefore, after such treatment, there is no recovery. Dentists note that for the treatment of periodontal disease, it is necessary to apply procedures that improve blood circulation in the gums and bone.

Radial shock wave therapy affects the links in the pathogenesis of periodontal disease

• stimulates tissue growth factors,
• stimulates the growth of blood vessels and the formation of a capillary network in bone tissue.
• Dramatically increases metabolism in paradental tissues
• Stimulates osteogenesis.
• Periodontal tissue restores its integrity

Dental indications for radial shock wave therapy

• periodontal disease
• periodontitis
• bleeding gums
• alveolitis
• arthrosis of the temporomandibular joint
• frequent subluxation of the temporomandibular joint.preparation of the jaw bone for the integration of dental implants (improving bone metabolism, stimulating bone growth factors, stimulating osteoblasts and osteoclasts and, as a result, a balance is formed between bone remodeling and bone resorption processes)

Dysfunction of the temporomandibular joint.

With TMJ dysfunction, a weakening of the ligamentous apparatus, a change and loosening of the intra-articular disc are often observed, which leads to pain syndromes and frequent subluxations of the temporomandibular joint. Reduction and surgical techniques are not a guarantee against recurrent dislocations. Conducting procedures of shock wave therapy in such patients prevented the recurrence of dislocations in the next half-year (the period of observation of patients).

Example.

Temporomandibular joint after treatment with shock wave therapy before treatment with shock wave therapy

Before treatment

• the articular head is rested against the articular cavity, the disc is displaced posteriorly,
• the disc is displaced anteriorly, the joint head is displaced posteriorly. depressions.

Височно-нижнечелюстной сустав после лечения ударно-волновой терапией.

After treatment -

• the gap between the articular head and the cavity is
• disc between the articular head and the cavity.
• disk between sust. head and socket
• sust. head in the middle of the depression.

Periodontitis is a chronic bacterial infection of the periodontal tissue (tissue surrounding the tooth, including the areas of bone adjacent to the tooth).

In the future, options for chronic infectious periodontitis will be taken for consideration.

The main methods of treating periodontitis:

• Antibacterial therapy
• Dead bone plasty.

Initial research gave impetus to the use of the regenerative force (properties) of shock wave therapy.

Shock waves were applied from the outside of the cheek or lip directly to the periodontal area that needed to be treated.

Case 1.

A 57-year-old woman on anticoagulant therapy (Mankumar). Such patients require a special approach, postoperative treatment, because they have an increased tendency to bleeding. In this case, periodontal damage was found in the area of ​​the molars. X-ray shows vertical interradicular bone loss in the first molar, which is bridged to the rest of the molars on its side.

The consequence of bone destruction was bacterial and suppurative local periodontitis, in which osteoclasts destroy bone by an autoimmune mechanism. Weighing the pros and cons of possible treatment methods, taking into account the general condition of the patient, the choice of the treatment method fell on tooth extraction as the least harmful for the client's repeated prosthetics. But they decided to postpone and conduct a course of shock wave therapy

The state of the bone near the tooth after 4 sessions of shock wave therapy.

Results. Clinically, a decrease in the gingival pocket is evident 3 months after the course of shock wave therapy. Previously, the mobility of teeth 46 and 48 was 2 after treatment 0 (became immobile). Local symptoms in the form of suppuration and swelling, increased bleeding no longer occurred. In addition, the image showed bone formation with leveling of the periodical pocket (indicated by arrows).

Case 2.

After tooth extraction in region 35, a 53-year-old female patient developed bone failure after pretreatment with collagen gel. Vertical bone destruction in the region is confirmed both clinically and radiographically. The height of the bone above the alveolar site was 6-7 mm. and the inhomogeneous cancellous bone tissue at this site was not suitable for implantation. The aim of the SWT was to stimulate bone growth for the planned implant.

Bone condition after tooth extraction before treatment with shock wave therapy.

Bone condition after a course of shock wave therapy. Bone thickening is visible.

3 months after the shock wave therapy, a clinical examination of the implantation site revealed gingival stabilization and a decrease in the saddle-shaped bone defect. The bone formation found on X-ray created the conditions for further successful implantation of the prosthesis. The bone structure became more homogeneous (uniform), the thickness was 11 mm. The implant was successfully placed 6 months after the shock wave therapy.

Successful dental prosthetics after shock wave therapy.

Findings.

• The use of shock wave therapy for periodontal disease and periodontitis leads to a decrease and disappearance of inflammatory symptoms, bleeding of the gums, a decrease in the gum pocket and teeth shakiness.
• With vertical bone loss, restoration and compaction of bone tissue was noted, which was important in preparing the bone for dental implantation.
• The use of shock wave therapy in dentistry was based on the successful application of shock waves in traumatology for bone fusion.
• The optimal treatment protocol is for further study.
• Further study of the effect of shock wave therapy on the described periodontal conditions is also required (Histological studies and CT, ultrasound)

The use of shock wave therapy in dentistry will make a breakthrough in the treatment of periodontal diseases and dental prosthetics.