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Clinical methods of inspection

All patients have been surveyed with application of the basic and additional methods of research to an intervention, in the course of treatment and control terms of observation of 14 days and later 9 months.

Inspection included: interrogation, survey, definition of index KPU, an estimation of seals on G.Rjuge. All patients were healthy and had no somatic diseases. Health questionnaires were filled, data of clinical survey were brought in an out-patient card on sootvetsvujushchie forms (the Appendix 1 see). In all terms of observation the threshold of electroexcitability of a pulp of a tooth from sensitive points by L.R.rub's (1955) technique was defined, in 18 months the roentgenography was spent aim dentalnaja. All data were brought in an out-patient card of the patient. All groups of the surveyed patients were sopostavimi on a floor and age.

the Diagnosis «dentine caries» was established on the basis of complaints of the patients, the given anamnesis, survey, sounding, a palpation, thermal assays, a percussion and additional methods of inspection. According to I.G.Lukomsky's (1949) classification, allocated; initial caries (caries in maculae stage), superficial caries, average, deep caries (caries nadpulparnogo a dentine). According to classification ÌÊÁ-10 defined enamel caries, dentine caries, cement caries. Initial caries or enamel caries diagnosed at revealing asymmetrical melopodobnyh maculae. Average caries (dentine caries) diagnosed at diffusion of carious defect for limits emalevo-dentinnoj borders, thus sounding of a bottom and walls of a carious cavity was painless, EOM within norm. Deep caries, according to classification ÌÊÁ-10, surveyed as the polymorphic pathological process characterised by a focal demineralization of firm tissues of teeth with formation of a carious cavity, capable throughout a life to become aggravated, be stabilised, get various activity and to be in different degree of indemnification. Sounding of a bottom and walls of a carious cavity and holodovaja
assay during inspection, caused a pain reaction which is quickly passing after elimination of a stimulus.

Prior to the beginning of treatment and in control terms in 18 months the X-ray inspection of a teeth was spent. Aim dentalnye pictures of a surveyed teeth were carried out by means of high-pitched ­ radiological equipment X-Genus-Ds de Goetser (Germany). On x-ray images degree of a lesion of tissues of a tooth, affinity of a locating pulparnoj chambers, a condition of periapical tissues was defined.

Visually intensity of a lesion caries estimated on classification Nikiforuk (1985) - Table 2.5.

Table 2.5 - caries Classification on Nikiforuk (1985)

Gravity of a lesion the Amazed teeth the Amazed surfaces
the Class I. Very weak caries Occlusal fossas and fissures
67
the Class II. Weak caries (usual caries) 67

67

Occlusal fossas and fissures, contact surfaces
the Class III. Average caries 567 Occlusal, contact surfaces
567
the Class IV.
Serious caries (extensive caries)
1234567

4567

Contact and occlusal, and-or casual prisheechnye 1234567
567
the Class V. Very serious caries (the extremely widespread caries) 1234567

1234567

Contact 123 and-or prisheechnye 1234567
1234567

the Clinical condition of seals defined by clinical criteria of

Rjuge (1998) - Table 2.6, 2.7.

Table 2.6 - Criteria for an estimation of regional adaptation of seals on G.Rjuge

Are opened
the Estimation Regional adaptation Points
it is satisfactory
AND #923; lfa the Cleft on section border is absent 1
Bravo visually defined cleft on section border has so essential size, that the acute probe can take root into it 2
it is unacceptable
d AND # 953; arlie the dentine or a seal basis 3
Delta the Seal is mobile or broken, or otsutsvuet partially or completely 4

Table 2.7. Criteria of a discoloration of edges of a seal on G.Rjuge

the Estimation Change of edges of a cavity Points
it is satisfactory
AND ^ the Discoloration somewhere on edge between a seal and prilezhashchimi tooth structures is absent 1
Bravo There is a discoloration somewhere on edge between a seal and prilezhashchimi tooth structures 2
it is unacceptable
Oiarlie the Discoloration extends along edge plombirovochnogo a material in a pulp direction 3

regional adaptation of seals, a discoloration of edges of a cavity and presence of secondary caries Was estimated. Regional adaptation defined by means of a probe and a mirror. Visually with the help svetopolimerizatsionnoj lamps defined change of edges of a cavity. «Secondary caries» diagnosed at

detection krioznogo lesions of tissues of a tooth near to a seal. The discoloration of firm tissues immediately on border a seal-tooth, assumed presence of relapsing caries. For the purpose of statistical data processing "descriptive" criteria on Rjuge translated in the digital. «Alfa» - 1 point, «Bravo» - 2, «Ñharlie» - 3, «Delta» - 4 points, accordingly.

Estimated presence, and character posleplombirovochnyh pains in the early and remote control terms after treatment and estimated them on 10 ball scale at different groups of patients.

a pulp Excitation threshold defined by elektroodontometrii from sensitive points on L.R.rub's method (1955) by means of apparatus Diagnostik System (SybronEndo) (the Drawing 2). The definition regimen vitalnosti pulps (VS) Vitality Scanner allows to define without serious consequences for the patient viability of a pulp by means of technology pulsatsionnoj stimulations. Force of stimulation automatically increases from the bottom level that allows to avoid a pain. Electron stabilisation allows to receive consecutive results. Upon termination of testing of a tooth of the indication remain on the display that facilitates record of results. Automatic dump on a zero allows to check up some teeth quickly.

Indicators of an excitation threshold of a pulp for the given apparatus fluctuate in borders; for incisors, canines, premolar tooths and molar tooths. Indications of the digital indicator. Indications of viability of a pulp fluctuate in a range from 1 to 80 mka. Results of the published researches show, that reaction of the central teeth with a vital pulp is in a range 10-26 mka, canines - 18-31 mka, premolar tooths - 25-28 mka, molar tooths 35-40 mka.

the Technique of definition of an excitation threshold of a pulp consisted in the following: the surveyed tooth and as nearby a standing teeth cleared
besftoristoj Pasta c crushed zircon Detartrin Z (Septodont), carefully isolated from a stomatic liquid sterile paper rollers, dried up a current of air. A passive electrode fixed by means of "biteboard" in an angle of a mouth of the patient. The active electrode greased with Pasta Detartrin Z (Septodont), placed on a sensitive point of a tooth. At the first sensations in a tooth (the pricking, squeezing, sensation "murashek"), the patient asked to lift an arm upwards. At this time an active electrode deleted from a tooth surface, and on an electron board of the device the certain digits corresponding to units of measure of electroexcitability of the given device were fixed. For "cleanliness" of inspection, measurement started to spend with a number of a standing intact teeth. Measurements repeated three times for each tooth. Data elektroodontometrii fixed in an out-patient card of the patient.

the Drawing 2 - the Apparatus for definition of an excitation threshold of pulp Diagnostik System (SybronEndo).

the Received quantitative results of research statistically, estimated in parametrical and nonparametric parametres ­ of variation rows with use of computer program Statistica12. Data are presented in a kind deskriptsii M±SD by criterion Stjudenta with amendment Bonferroni.

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Scientific source KOVALEVA MARIA SERGEEVNA. Clinico-morphological research of a condition of tissues of a tooth at treatment of caries of a dentine with application of deep fluorination and nizkointensivnogo laser radiation. The dissertation on competition of a scientific degree of the candidate of medical sciences. Great Novgorod - & 2014. 2014

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