METHOD OF TREATMENT AND MAINTENANCE THERAPY OF PROSTHETIC STOMATITIS IN PATIENT WITH DIABETES MELLITUS
Relevance. Adaptation to prostheses and their further wearing is often associated with traumatic injuries of the oral mucosa. Mechanical traumas of the oral mucosa with removable laminar dentures, toxic effects of plastic components, the allergic effects of the prosthesis on the oral mucosa and the prosthesis wearer's body as a whole, as well as a stress factor considerably contribute to the occurrence of prosthetic stomatitis. Most often, a removable laminar denture acts as a combined stimulus. The manifestations of diabetic microangiopathies in the oral mucosa enhance the severity of prosthetic stomatitis in individuals with diabetes mellitus. The clinical picture of prosthetic stomatitis also depends on the size and condition of denture supporting area, for instance, atrophy of the edentulous jaws, conditions for anatomical retention of dentures. Therefore, the treatment of stomatitis in patients who wear removable laminar dentures is still a challenging problem in orthopaedic and therapeutic dentistry.
Purpose and objective: to investigate available treatment approaches and maintenance therapy for managing prosthetic stomatitis in patients with diabetes mellitus who wear removable acrylic laminar dentures; to offer our newly developed treatment and maintenance therapy of prosthetic stomatitis in diabetic patients.
Material and methods. The existing approaches and methods of treatment and maintenance therapy for prosthetic stomatitis in patients with diabetes mellitus were thoroughly investigated with clear focus on their advantages and disadvantages. The available methods to manage the complications caused by laminar denture wearing in patients with diabetes mellitus include topical remedies and oral hygiene products. The treatment of prosthetic stomatitis in patients who wear dentures is often reported as ineffective. Therefore, at present, it is relevant to search for new methods of treating prosthetic stomatitis under diabetes mellitus with the use of agents that boost the body antioxidant protection, stimulate tissue regeneration and epithelialisation.
Results. The method we have developed for the treatment of prosthetic stomatitis in individuals with diabetes mellitus includes the application of 2% Thiotriazolin ointment for local treatment, and Thiotriazolin preparation for systemic therapy. Thiotriazoline is a domestic drug of polytropic action. It has membrane-stabilizing, antioxidant and reparative properties. Thiotriazoline stimulates tissue regeneration and epithelialisation processes, somewhat reduces the intensity of the inflammatory process. In dental practice, 2% Thiotriazolin ointment is recommended to treat ulcerative lesions of the oral mucosa and periodontal tissues. Our treatment method includes the following steps: after the denture adjustment and sanitation of the oral cavity done, patients are prescribed to apply 2% Thiotriazolin ointment onto the denture supporting areas, which are the most often traumatized, in particularly, onto the maxillary tubercles, along the transitional fold, in the sublingual, retromolar and retroalveolar spaces, daily for 7-10 days. The patients are also recommended to apply 2% Thiotriazolin ointment onto the inner surface of the prosthesis base. For systemic therapy, “Thiotriazolin” is prescribed to be taken by mouth in a dosage of 1 tablet of 100 mg per day for 30 day course.
Supportive therapy involves Quvertin, while Lizak tablets are used for local prophylaxis. Following the oral sanitation, patients are prescribed to Lizak tablets (should be held in the mouth until dissolved slowly) 3-4 times a day for 5-7 day course. As part of a comprehensive supportive therapy, patients are prescribed Quvertin tablets, 1 tablet twice a day 30 minutes before meals (chew the tablet) for 30 day course.
Conclusion. The proposed method of the therapy of prosthetic stomatitis in people with diabetes mellitus is quite easy to use, causes no side effects, produces a positive effect on the clinical course of the conditions, and enabled to achieve a stable remission after the disease, and, thus, can be recommended for implementing into dental practice. The described maintenance therapy for diabetic patients with prosthetic stomatitis is clinically effective, has no side effects, and can increase the periods of remission after the disease. This combination therapy can be recommended as an effective treatment option in therapeutic and orthopaedic dentistry.
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