Galvanic phenomena occurring in the mouth strips in the treatment of dental patients. Their influence on the functional state of organs and tissues of the oral cavity

Dentistry has made a huge leap, but even the use of innovative materials does not protect against some unpleasant phenomena. One of them is galvanization.

This is when discharges of galvanic currents occur in the oral cavity of a person with dentures or crowns as a result of potential mismatch. Galvanosis in the ICD has code 10 - "Other diseases of the lips, mucous membranes."

How does this happen?

First, it is worth considering this concept from the point of view of its occurrence. It is a constant electric current, which is characterized by low power and voltage. It occurs between metals different kind or their oxides, but subject to the presence of a conductor. This phenomenon was discovered by Luigi Galvani, a scientist, anatomist from Italy. In the process of operating a frog, he conducted an experiment, as a result of which he called this phenomenon “animal electricity”. The name was given on behalf of the scientist this species current.

In medicine, various metal alloys are used, which, once in the mouth, are subject to corrosion. Suffice it to recall school chemistry lessons. What reaction of the metal will occur if it is in an electrolyte solution? A potential will arise, which differs depending on the type of compound, as well as the substance. Thus, in the patient's mouth, the circuit is closed and a galvanic battery is created.

An alloy with great potential negative type, lends itself to corrosion, that is, destruction occurs. Saliva is an excellent electrolyte, so it remains only to imagine what processes take place in the human oral cavity. Microcurrents reach 50 or even 150mV, when 10mV is the standard.

Among all metals on special place gold is worth due to its high biological and chemical inertness in the oral cavity. AT Soviet years gold prostheses were very popular, although they were expensive. As an imitation of this metal, a coating of titanium nitride was used. It looks like gilding, but is stronger than gold and does not corrode. However, titanium nitride wears off and the base metal on which it has been deposited is exposed.

Causes of galvanosis

The main reason is associated with the installation of fixtures made of metals of several alloys. This includes dentures, crowns, braces. For their production, metal alloys of various types are used. Up to 20 types of metals are used. The structure installed in the mouth is susceptible to corrosion and leads to allergic reactions.

Another reason is intolerance to one of the substances in the composition of prostheses. Most often, the patient suffers from allergies to palladium, chromium, acrylic, gold, stainless steel.

Symptoms of the disease

Electromagnetic allergy or galvanosis of the oral cavity is caused by the following symptoms:

• Taste of metal in the mouth.
• A sour taste that constantly haunts the patient.
• Itching, burning.
• Violation taste sensations. Eating sweet food, the patient perceives it as bitter, etc.
• Diseases of the salivary glands, sensation of dryness.
• Slight hyperemia on the tongue and mucosa.
• Headaches, irritability, loss of energy.

Similar symptoms occur a month or two after prosthetics. Oxide deposits are noted at the site of the alloy.

Classification of galvanosis in dentistry

Allocate atypical and typical types of pathology.

1. Atypical type of galvanization

With this form, the potentiometric parameters are increased three times compared to normal indicators but the person does not notice any symptoms. There are only single deviations. This type of disease lasts several months or even years after the prosthesis is placed. After that, there is a possibility of transition of galvanization to a typical state.

The danger of this form is associated with the complexity of diagnosis and the lack of timely treatment. Therefore, a person acquires dangerous pathology- malignant neoplasms that affect the tissues of the face and jaw.

2. Typical type

With this type there are bright severe symptoms. Making a diagnosis is not difficult. It is important to eliminate the cause of the disease in time, otherwise, as in the first case, the disease lasts for several months or even years, after which dangerous complications(crayfish).

Any pathology is expressed next to related problems. If a we are talking about galvanosis, then there are constant bronchitis, SARS, herpes, etc.

What are the complications?

With a long course of the anomaly, certain complications occur. Chronic form this disease leads to the appearance of ulcers, erosions of the enamel, which are characterized severe pain and a long recovery period. The reason is work related. galvanic current, which remodulates processes at the biochemical level throughout the mucosa.

In places of maximum traumatization under the influence of current, areas of hyperkeratosis appear. They look like hard spots. white color are painless. Their prolonged existence contributes to the occurrence of parakeratosis, as well as the appearance of leukoplakia, which, if left untreated, becomes malignant.

Red is often added to galvanization. lichen planus oral cavity, which is quite successfully treated by itself, but difficult to eliminate in tandem with galvanic current.

Another unpleasant feature of this disease is associated with pain. Their prolonged manifestation in combination with paresthesia of the oral cavity leads to the appearance of a focus pain in the CNS. As a result, she attracts nerve impulses and recognizes them as painful, even if they are not.

The following processes are formed:

Prelaxia after surgical procedures (for example, improper tooth extraction or prosthetics).

Irrational installation of orthopedic devices.

Galvanic syndrome, paresthesia and discomfort associated with pain entering the nerve plexuses and its further transition to the central nervous system. Programming is formed for the constant suffering of the patient.

Diagnosis of an anomaly

Define this disease of the oral cavity and it is timely eliminated by measuring equipment. But even in serious specialized clinics, such a unit is often absent. What is good about this device? Such an installation measures the bioelectromagnetic reactivity at the site of contact of the prosthesis with the oral mucosa. If the results deviate by 30%, a diagnosis is made.

In the absence of this device, the doctor focuses on clinical picture, complaints, as well as their own dental experience. If galvanosis is suspected, a saliva test is performed. Such an analysis is able to confirm the disease by determining the pH level. In the case of galvanization, it is acid environment. Blood test and skin tests will not show results.

The main thing that needs to be done to eliminate the disease is to get rid of the root cause. Therefore, at the doctor's appointment after the diagnosis, the dentist will offer to remove the denture. best way out the situation will be the installation of a structure from another alloy. The effect after this procedure, the patient will feel in the first days, but not always. Sometimes it takes months to get rid of the symptoms.

In addition to this simple manipulation, it is worth fixing the effect with the help of immunostimulating and herbal medicine. In the first case, pyrogenal is prescribed, etc. Nice results showed treatment of consequences folk remedies. Pharmacies sell tincture of lemongrass or eleutherococcus. You do not need to cook it, since the medicine is available in finished form. If the disease is accompanied nervous disorders, shows the use of sedatives: motherwort or valerian.

Often, the disease appears already against the background of the emerging periodontium. Then inflammatory processes take place, which lead to various complications: periostitis, candidiasis, etc. Therefore, if present purulent abscess, shown surgical intervention with opening and wound treatment.

Medical therapy is also important. writes out medications doctor. The appointment of one or the other medicinal product depends on what disease accompanies galvanosis.

If there is an excessive reproduction of fungi, then antifungal therapy is indicated.

Fluconazole is prescribed at a dosage of 50-400 mg per day. The amount of the drug is determined by the doctor, taking into account the characteristics of the disease. Take once a day. It is forbidden to accept people with individual intolerance.

Together with Fluconazole, Terfenadian is prescribed. It prevents allergies. Maximum daily rate Terfenadian is 480mg. The agent is absorbed by the gastrointestinal mucosa quite well. Prescribe this drug even to persons connected by work with an increased load of the brain. Contraindications include liver disease.

If the patient asked for help in time, the prognosis for recovery is favorable. With a protracted pathology, the consequences are extremely unpleasant, up to soft tissue cancer. Therefore, after installing prostheses or crowns, it is important to listen to your feelings and visit a doctor at the first sign of discomfort.

Treatment of galvanosis of a typical form

First, the doctor determines the cause of the disease. Then he prescribes medications, treats inflammation and other complications. If required, surgical manipulation is performed. For example, if the underlying cause is streptococcus or staphylococcus aureus, Norsulfazol is prescribed. The drug is well absorbed by the gastrointestinal tract and is quickly excreted. single dose equals 2 g, but more than 7 grams should not be consumed per day. It is better to drink the drug with a solution of soda or mineral water"Borjomi".

If the course of the disease is accompanied by ulcerative stomatitis, the doctor will prescribe Ingalipt. This drug in the form of an aerosol, has a good antiseptic effect, successfully fights inflammation. As part of Ingalipt - norsulfazol, including thymol, streptocid, eucalyptus, mint oils. The oral cavity is irrigated 3-4 times a day for about 1-2 seconds. Contraindications include intolerance to the oils that make up the composition.

Any methods of treatment are carried out under the supervision of a physician. If you have problems taking the drug, the doctor will prescribe its analogue or change the dose.

Disease prevention

It is possible to prevent the appearance of an anomaly if all the rules for sterilizing instruments, as well as other devices for prosthetics, are followed in the doctor's office. The doctor should also refuse to manufacture stainless steel structures (even if it is coated with titanium nitride), prosthetic devices with large bridges.

If the patient has weakened the immune system, it is important to reduce to zero the use of several types of metals in one design. To prevent galvanosis, it is shown to introduce modern technologies and materials: clasp prostheses, metal-ceramic crowns etc.

Individual work with patients at risk: older people, people suffering from diseases of the central nervous system, patients who have had surgeries in the past to remove tumors of the maxillofacial area - adenophlegmon.

The patient requires meticulous oral hygiene and prosthesis.

recovery prognosis

When visiting a dentist for early stages the occurrence of pathology can be carried out quality treatment and get rid of the disease. Only the patient himself can prevent the disease. It is necessary to take oral hygiene and the installed prosthetic construction seriously, and at the slightest discomfort, immediately visit a doctor.

- an atypical disease, if left untreated, it leads to dangerous consequences for health and life. Careful attitude to his body will not allow the occurrence of unpleasant anomalies.

The owners of the patent RU 2325844:

The invention relates to medicine and is intended to detect a metal inclusion, causative in the occurrence of galvanic currents in the oral cavity. Measure the potential difference between all metal inclusions and biological tissues using a millivoltmeter. The measurement is carried out three times. Before the second measurement, the patient rinses oral cavity distilled or deionized water. Before the third measurement, the patient rinses the mouth with a 0.2-2% solution of acetic acid, or citric acid, or 0.5-5% sodium bicarbonate solution. The cause of the occurrence of galvanic currents is considered to be that metal inclusion, for which at least two pairs in three measurements revealed a potential difference above 120 mV. The proposed method improves the accuracy of detecting a metal inclusion, causative in the occurrence of galvanic currents in the oral cavity. 4 tab.

The invention relates to the field of medicine, namely dentistry.

A known method for detecting galvanic currents in the oral cavity by measuring the potential difference between metal inclusions in the oral cavity (prosthetic and other metal constructions, fillings) / Freidin L.I., Freidin B.L., Stompel I.Ya., Sedov E.S. Potential difference in the tissues of the oral cavity. // Dentistry. - 1983. - No. 1. - S.50-52/. In this method, using a millivoltmeter with a high input resistance (at least 10 MΩ), the potential difference between metal inclusions and the oral mucosa is measured, and with an increase in the potential difference compared to people who do not have metal inclusions in the oral cavity, the presence of galvanic currents is diagnosed in the oral cavity. This method has insufficient accuracy, since galvanic currents in the presence of a metallic inclusion can be detected in different places oral cavity, including in those pairs that do not include metal inclusions, their intensity depends on pH in local areas of the oral cavity and other reasons and varies over time. Therefore, this method cannot be used to detect a metal inclusion that is the cause of galvanism.

A known method for detecting galvanic currents in the oral cavity (prototype) /Sagan N.N., Lebedev K.A., Ponyakina I.D., Sagan L.G., Mitronin A.V., Zhuruli G.N., Goncharov AND .YU. Detection of galvanic currents in the oral cavity. // Dentist - 2006. - No. 1. - C.35-43/, in which, using a millivoltmeter with an input resistance of at least 10 MΩ, a series of measurements of the potential difference between all metallic inclusions, other (non-metallic) inclusions and biological tissues in the oral cavity is performed twice, and the second series of measurements is made after rinsing mouth with deionized or distilled water, reveal the maximum values ​​of the potential difference in each of the series and determine their average value. This method allows more accurate detection of galvanic currents in the oral cavity in comparison with the analogue, but it does not make it possible to detect inclusions that are causal in the occurrence of galvanic currents with sufficient accuracy.

The objective of the invention is to improve the efficiency of the method for detecting galvanic currents in the oral cavity.

The technical result consists in the fact that a metallic inclusion is detected, which is causal in the occurrence of galvanic currents.

This is achieved due to the fact that after rinsing the oral cavity with a 0.5-5% sodium bicarbonate solution, the potential difference is again measured, and the metal inclusion, for which at least two pairs in three measurements revealed a potential difference above 120 mV, considered causal in the occurrence of galvanic currents. Instead of a sodium bicarbonate solution, you can use a 0.2-2% solution of acetic or citric acid.

The present invention makes it possible to more accurately identify pairs with constant levels of galvanic currents, which makes it possible to determine the inclusion that causes galvanic currents in the oral cavity, since it involves measuring the potential difference in three different modes: in the presence of saliva, after the removal of saliva by rinsing the mouth with distilled or deionized water and after changing the pH in the oral cavity by at least 0.7 as a result of rinsing the mouth with an alkaline or acidic solution. Carrying out measurements in three different modes makes it possible to identify pairs in which the increase in the potential difference is constant, and if the same inclusion is present in at least two such pairs, it is considered causal in the occurrence of galvanic currents in the oral cavity.

The range of used sodium bicarbonate concentrations of 0.5-5% is due to the fact that when using a concentration of less than 0.5%, not in all the examined people, saliva pH changed by 0.7 or more, and a significant pH shift is necessary to identify the maximum potential difference scatter. The upper limit - 5% concentration - is determined based on the fact that such a concentration is close to a saturated solution.

The range of used concentrations of lemon or acetic acid 0.2-2% is determined based on the fact that at a concentration below 0.2% it was not always possible to obtain a pH shift of 0.7 or more, which is important for identifying the maximum range of potential difference fluctuations in the oral cavity. The upper limit of concentration - 2% - is determined on the basis that when using such a concentration, the patient does not experience discomfort.

The diagnostic limit of 120 mV is determined based on the fact that in the presence of such a potential difference, some people may experience clinical manifestations of galvanism.

The method is carried out as follows: in a patient between all biological tissues (mucosa of the oral cavity, tongue, healthy teeth), non-metallic inclusions (teeth with non-metallic inclusions) and metal inclusions (teeth with metal inclusions) measure the potential difference using a millivoltmeter with an input resistance of at least 10 MΩ. Then the patient rinses his mouth with distilled or deionized water for 1-2 minutes (4-5 servings of water) to wash off saliva, and the potential difference between the same inclusions and biological tissues is re-measured. Then the patient rinses his mouth with 0.5-5% sodium bicarbonate solution for 1-2 minutes (4-5 portions of the solution), which leads to a change in pH in the oral cavity, and the potential difference between the same objects is measured again. Those pairs are analyzed in which, in all three measurements, a potential difference of at least 120 mV is detected. That metal inclusion, which is present in at least two such pairs, is considered causal in the occurrence of galvanic currents in the oral cavity.

Instead of a sodium bicarbonate solution, you can use a 0.2-2% solution of acetic or citric acid.

Clinical example No. 1.

Patient M.N., 57 years old. Complaints of sour taste in the mouth and burning sensation after the last prosthesis using ceramic-metal (2 months ago). In the mouth there were prosthetic constructions made of metal coated 5 years ago, and metal pins (2 pcs.) Made of different metals in different time. The presence of galvanic currents in the oral cavity was assumed. The data obtained as a result of measuring the potential difference between various inclusions in the oral cavity are shown in Table 1.

Measurement 3 - after rinsing the mouth with 5% aqueous solution sodium bicarbonate

As can be seen from Table 1, the potential difference above 120 mV in all three measurements was detected in pairs 8 and 12. Both pairs included pin No. 1. Therefore, the metal from which pin No. 1 is made is the cause of the occurrence of galvanic currents in the oral cavity in this patient.

After removal of this pin, the patient's clinical symptoms of galvanism disappeared: sour taste in the mouth and burning sensation. The results of measuring the potential difference are shown in Table 2.

As can be seen from Table 2, none of the remaining pairs showed an increased potential difference in any of the three measurements.

Clinical example No. 2.

Patient K.A., 65 years old. Complaints about increased salivation, the taste of metal, the tingling of the tip of the tongue, and the feeling of a "battery" in the mouth after setting two metal-ceramic prostheses(prosthesis No. 1 and prosthesis No. 2) six months ago. All these signs developed gradually, within 2 months after the installation of prostheses. In addition to these prostheses, there are two metal crowns in the mouth, set 1 year ago (crowns No. 1), 1 metal crown, set 3 years ago (crown No. 2), and a clasp, set simultaneously with metal-ceramic prostheses. The data obtained as a result of measuring the potential difference between various inclusions in the oral cavity of this patient are shown in Table 3.

Measurement 1 - initial measurement

Measurement 2 - after rinsing the mouth with distilled water

Measurement 3 - after rinsing the mouth with a 0.2% aqueous solution of citric acid.

Table 3 shows that the values ​​of the potential difference over 120 mV for all three measurements were detected in pairs 5, 9, 12, 16, 17. At the same time, pairs 5 and 9 included prosthesis No. 1, pairs 12, 16, 17 - prosthesis number 2. Prostheses No. 1 and 2 were made at the same time from the same materials. This made it possible to consider the metal used in their manufacture to be causal in the occurrence of galvanic currents in the oral cavity.

After the removal of these prostheses, the patient's clinical manifestations of galvanism disappeared within 2 weeks. Measurement data of the potential difference in the oral cavity are given in table.4.

From table 4 it can be seen that in none of the presented pairs of an increase in the potential difference was detected.

A method for detecting a metal inclusion that causes galvanic currents in the oral cavity by measuring the potential difference between all metal inclusions and biological tissues using a millivoltmeter, characterized in that the measurement is carried out three times, before the second measurement, the patient rinses the oral cavity with distilled or deionized water, before the third measurement with a 0.2-2% solution of acetic or citric acid, or a 0.5-5% solution of sodium bicarbonate, that metal inclusion is considered to be the cause of the occurrence of galvanic currents, for which at least two pairs of three measurements revealed a potential difference above 120 mV.

- a disease that occurs when there is in the oral cavity metal prostheses, changing electrochemical processes and leading to the development of such symptoms as a metallic taste in the mouth, taste perversion, burning tongue, decreased salivation, impaired general condition body (headaches, irritability, weakness, fatigue, anxiety). Diagnosis includes the study clinical symptoms and dental examination data, measurement of potentiometric indicators. Treatment of galvanosis is complex: removal of the causative factor (prosthesis, inlays), immunocorrection, treatment of local inflammatory and general somatic diseases.

General information

Galvanosis is a pathological process that occurs in the oral cavity due to intolerance to dentures made of various metals. At the same time, excessive galvanic currents appear, the electrical conductivity of saliva increases, and clinical signs of irritation of the oral mucosa appear, and then general symptoms of the body's troubles.

According to statistics, intolerance to metal inclusions (crowns, bridges, inlays, implants) occurs in 15-35% of patients who visit a dentist. As a result, the importance of right choice materials for prosthetics and implantation, as well as the timely elimination of defects and the replacement of old dentures.

Causes of galvanosis

In the oral cavity and normal conditions certain electrochemical processes occur, but their intensity increases significantly in the presence of various metal inclusions - amalgam fillings and metal inlays, bridges and individual crowns, orthodontic appliances and implants. The picture deteriorates with simultaneous presence in the mouth of alloys of various metals, as well as as a result of damage and signs of corrosion of previously installed dentures.

The appearance of metal oxides in the oral fluid leads to an increase in galvanic currents (current strength and electrical potential difference). Galvanism occurs - a condition in which a healthy person has an excess of potentiometric indicators above the norm in comparison with people who do not have any metal inclusions in their mouths. At the same time, the person does not present any health complaints, and during a dental examination, no signs of pathology of the oral cavity are detected.

We can say that galvanism is not a disease, but a predisposing factor that increases the risk of developing diseases. But in the presence of galvanism and the appearance of symptoms of irritation of the oral mucosa and common symptoms malaise, the diagnosis of galvanosis is established.

Predisposing risk factors for the development of the disease are the initial defects of metal inclusions installed in the oral cavity, mechanical damage prostheses during their operation and changes in the pH of saliva to the acid side in case of periodontitis, stomatitis, diseases gastrointestinal tract.

Classification

Distinguish between atypical and typical shape galvanose. Atypical form galvanosis is characterized by an excess of potentiometric indicators (potential difference, galvanic current strength, electrical conductivity of saliva) in the oral cavity by three or more times compared to physiological norm and the presence of single clinical signs diseases - periodic complaints of "burning tongue", dry mouth, fatigue (usually only one of the listed symptoms bothers).

A typical form of galvanosis manifests itself along with an increase in potentiometric indicators by more than 3 times by constant clinical manifestations diseases - both local (metallic taste in the mouth, burning, dryness, identification during a dental examination of signs of mucosal hyperemia, stomatitis, gingivitis, leukoplakia, etc.), and general (weakness, irritability, headache, decreased performance).

Symptoms of galvanosis

The first signs of the disease appear, as a rule, 1-2 months after the installation of a metal denture, implant or orthodontic appliance (in some cases, this period is reduced to 1-3 weeks). This gives rise to unpleasant feeling metal taste in the mouth (“sour taste”, “acid in the mouth”, as the patients themselves say), aggravated by the use of spicy and sour foods. The taste is often distorted ("sweet seems bitter"), there is a burning sensation of the tongue, dry mouth.

With the preservation of galvanism in the mouth for a long time, it begins to break down general well-being galvanic patient. Periodic headaches appear, the quality and duration of sleep are disturbed, worries general weakness, fast fatiguability, decreased performance, increased irritability, anxiety, mood swings. Such non-specific symptoms indicate violations of the neuro-reflex connections between organs and systems, a decrease in the body's resistance to the effects of adverse factors.

If the metal inclusions that caused the appearance of galvanism are not removed in a timely manner, they begin to develop in the oral cavity. inflammatory changes in the form of gingivitis, papillitis, stomatitis, and also allergic reactions associated with the release of metal corrosion products into saliva. Galvanosis, which persists for several years, often leads to the appearance of leukoplakia and other precancerous diseases of the oral mucosa, which significantly increases the risk of developing malignant neoplasms in this region.

Diagnosis of galvanosis

The diagnosis is established on the basis of complaints, dental examination data of patients with metal fillings, crowns, bridges and other inclusions, and the results of measurements of potentiometric indicators (if appropriate equipment is available).

Normally, the potential difference in the oral cavity in a healthy person does not exceed 60 mV, the strength of the galvanic current is not more than 5-6 μA, the conductivity of saliva is less than 5-6 μS. Measurements are made using special equipment– potentiometers, microammeters, millivoltmeters.

For differential diagnosis with others pathological processes oral cavity and general somatic diseases, if necessary, consultations of a gastroenterologist, allergist, oncologist, psychotherapist are prescribed, additional laboratory and instrumental studies are carried out - saliva analysis, biochemical analysis blood, immunogram, skin allergy tests, computed tomography facial skull and etc.

Treatment of galvanosis

When identifying signs of galvanosis, it is first necessary to eliminate causal factor which led to the development of the disease. To do this, a thorough examination is carried out with the identification of all metal inclusions in the oral cavity and the removal of problematic products (dissimilar metals, signs of corrosion). If the elimination of individual problematic crowns does not lead to an improvement in the patient's condition, it is necessary to remove all existing metal inclusions, after which a full-fledged prosthesis is performed from homogeneous materials that do not cause signs of galvanism.

The next step is the sanitation of the oral cavity, medical and surgical treatment identified inflammatory and precancerous diseases. An increase in nonspecific resistance of the organism is performed (local and general immunocorrection is carried out). Treatment of identified vegetative-vascular, neurotic disorders carried out with the involvement of specialists of the relevant profile (therapist, neurologist, psychotherapist).

Prevention of galvanosis includes a thorough sanitation of the oral cavity with regular visits to the dentist (2 times a year), installation metal crowns, prostheses made of homogeneous metals, the use of modern technologies for the manufacture of dental products (solid structures, full coverage of metal crowns with ceramics, the rejection of soldered prostheses, etc.).

From Galvani's first experience, it is known that dissimilar metals are a source of the so-called galvanic current, which can irritate living tissues. This should be taken into account by a dentist when prosthetics and filling teeth with dissimilar metals (gold, stainless steel, amalgams), which act as electrodes; while saliva is an electrolyte. The release of metal ions into saliva creates a condition for the occurrence of microcurrents of various sizes in the oral cavity. The strength of the resulting current depends on the pH of the saliva, the state of the metal surface, the quality of the metal prostheses and their distance from each other.

In a number of cases, a potential difference arises between metals of the same name, for example, between amalgam alloys different composition or between crowns made of identical metals, if there is a metal seal. Microcurrents arising in the mouth can cause a phenomenon that is called galvanism in dentistry. Galvanic currents arising in the mouth, in the presence of different metals, cause increased irritability of taste reception and some perversion of taste sensations.

Most common symptoms galvanism: constant burning of the oral mucosa of various localization (80%); - metallic and sour taste, which usually appears 3-5 months after prosthetics (70%); salivation disorder (58%); headache (47%); insomnia (19%); pain in the abdomen (8%); vomiting (3%)% feeling of sparks in the eyes (1%). As a rule, several symptoms appear at once, often patients cannot identify them specifically, but experience only a feeling of discomfort. Chronic inflammation of the oral mucosa may develop: it becomes hyperemic, the papillae of the tongue swell, erosions and ulcers occur.

As a result of electrochemical processes in the oral cavity, a large amount of trace elements and metal ions will enter saliva from metals (especially from solder). As a result of their toxic effect on the receptor apparatus of the oral mucosa, local inflammation processes develop. The taste sensitivity to sweet, sour and salty is reduced and perverted. This can lead to a violation of the mechanical and chemical processing of food in the oral cavity and speech production. In addition, when such saliva enters the digestive tract and the action of trace elements of saliva on the mucous membrane of the stomach and intestines, exacerbations of chronic gastrointestinal diseases can occur.

The strength of the current that occurs between dissimilar metals correlates with the degree of subjective complaints. At a current of 80 μA, the phenomena of galvanism are strongly pronounced, at 25-80 μA there are weak sensations, and at 5 μA there are practically no complaints. After the replacement of dissimilar metals by homogeneous, the phenomena of galvanism disappear.

In dentistry electricity applies with medicinal purposes. The use of continuous low voltage direct current (30-80 V) and small power (up to 50 mA) for medicinal purposes is called galvanization. Under the action of direct current in the oral mucosa, vasodilation occurs, blood flow accelerates, and the permeability of the vascular wall increases, which is accompanied by hyperemia and fever. Such reactions contribute to the activation of local metabolism, regeneration of the epithelium and connective tissue. Irritation of receptors in the affected area leads to a change in their excitability. At the same time, afferent impulses in the central nervous system cause reflex reactions of a local, segmental and generalized type, which leads to a change in functions internal organs(blood pressure, heart rate, etc.).

With the help of electric current, you can enter medicinal substances in tooth tissue medicinal electrophoresis). Finally, direct electric current is used to prevent pain during various dental interventions. The analgesic effect of direct current is associated with the development of electric tone phenomena in tissues, causing a change in their excitability during the passage of current. At the same time, excitability increases under the cathode (kathelektroton), under the anode it decreases (anelectroton). With prolonged current transmission, excitability also decreases under the cathode (Verigo's cathodic depression phenomenon).

Question #4

Electromyography is a method for studying the motor apparatus, based on the registration of skeletal muscle biopotentials.

EMG founded on registration of action potentials of muscle fibers functioning as part of motor (motor, or neuromotor) units.

motor unit(ME) consists of motor neuron and group of muscle fibers innervated by this motor neuron. AT chewing Muscles have about 100 muscle fibers per motor neuron. temporal- up to 200.

The action potential of a single ME when registered with a needle electrode usually has the form of a 2-3 phase oscillation with an amplitude of 100-3000 μV and a duration of 2-10 ms.

EMG reflects the degree of motor innervation, indirectly indicates the intensity of contraction of an individual muscle.

Vibrations are recorded with a special device - electromyograph.

AT therapeutic dentistry MG is carried out with periodontium and periodontal disease

In surgical dentistry, surface EMG is used for jaw fractures, inflammatory processes maxillofacial region (phlegmon, abscesses, periostitis, osteomyelitis) - in inflammatory processes maxillofacial region significant decrease in bioelectrical activity on the side of the lesion.

The operation of a galvanic cell is based on redox reactions. The activity of the galvanic element of the oral cavity, i.e., the ability to dissolve its electrodes (dentures), is determined and evaluated by the magnitude of the potential difference between them, the resulting current strength and the chemical activity of the electrolyte (saliva). The pH shift to the acidic side occurs with periodontitis (locally, in the gingival pocket), in the foci of inflammation in diseases of the mucous membranes of the mouth, diseases of the gastrointestinal tract. Galvanosis is a disease caused by the action of galvanic currents that appear as a result of the occurrence of electrochemical processes in the oral cavity between metal prostheses. It is characterized by a pathological symptom complex: a metallic taste in the mouth, a feeling of acid, a taste perversion, a burning tongue, a change in salivation (dryness). There are changes in the neurological status: irritability, headaches, cancerophobia, general weakness, etc. The most common symptoms of galvanism: constant burning of the oral mucosa of various localization (80%); - metallic and sour taste, which usually appears 3-5 months after prosthetics (70%); salivation disorder (58%); headache (47%); insomnia (19%); pain in the abdomen (8%); vomiting (3%)% feeling of sparks in the eyes (1%). As a rule, several symptoms appear at once, often patients cannot identify them specifically, but experience only a feeling of discomfort. Can develop chronic inflammation the mucous membrane of the oral cavity: it becomes hyperemic, the papillae of the tongue swell, erosion and ulcers occur. Typical complaints are a metallic taste in the mouth, a feeling of acidity. This unpleasant sensation is constant, aggravated by the intake of sour food. The position that the elements of the periodic system determine the taste is also confirmed by the trace element composition of saliva. According to spectral analysis, in the saliva of persons with galvanization on stainless steel prostheses, the quantitative content of copper, chromium, manganese and other microimpurities increases. Burning of the tongue, more often the tip or lateral surfaces, is due to the fact that the tongue is a powerful reflexogenic zone. Galvanic currents, different in strength (up to 50 mV), irritate nerve endings receptor apparatus of the tongue, while the summation of excitation is possible. Patients also note dry mouth. This makes them constantly rinse, moisten their mouth. Dryness in galvanosis is due to a violation of the function of the central and vegetative nervous system. When examining the organs of the oral cavity, changes in the mucous membranes are often not detected, with the exception of the tongue. Side surfaces and the tip of the tongue are hyperemic, the tongue is somewhat swollen. Large oxide films are visible in the places of adhesions. From Galvani's first experience, it is known that dissimilar metals are a source of the so-called galvanic current, which can irritate living tissues. This should be taken into account by a dentist when prosthetics and filling teeth with dissimilar metals (gold, stainless steel, amalgams), which act as electrodes; while saliva is an electrolyte. The release of metal ions into saliva creates a condition for the occurrence of microcurrents of various sizes in the oral cavity. The strength of the resulting current depends on the pH of the saliva, the state of the metal surface, the quality of the metal prostheses and their distance from each other. In some cases, a potential difference also arises between metals of the same name, for example, between amalgam alloys of different composition or between crowns made of identical metals if there is a metal filling under them. Microcurrents arising in the mouth can cause a phenomenon that is called galvanism in dentistry. Galvanic currents arising in the mouth, in the presence of different metals, cause increased irritability of taste reception and some perversion of taste sensations. As a result of electrochemical processes in the oral cavity, saliva from metals (especially from solder) will get a large number of trace elements and metal ions. As a consequence of their toxic action local processes of inflammation develop on the receptor apparatus of the mucous membrane in the mouth. The taste sensitivity to sweet, sour and salty is reduced and perverted. This can lead to a violation of the mechanical and chemical processing of food in the oral cavity and speech production. In addition, when such saliva enters the digestive tract and the action of saliva microelements on the mucous membrane of the stomach and intestines, exacerbations of chronic gastrointestinal diseases can occur. The strength of the current that occurs between dissimilar metals correlates with the degree of subjective complaints. At a current of 80 μA, the phenomena of galvanism are strongly pronounced, at 25-80 μA there are weak sensations, and at 5 μA there are practically no complaints. After the replacement of heterogeneous metals by homogeneous galvanism phenomena disappear. In dentistry, electric current is also used for therapeutic purposes. The use of continuous low voltage direct current (30-80 V) and small power (up to 50 mA) for medicinal purposes is called galvanization. Under the action of direct current in the oral mucosa, vasodilation occurs, blood flow is accelerated, and permeability is increased. vascular wall accompanied by hyperemia and fever. Such reactions contribute to the activation of local metabolism, regeneration of the epithelium and connective tissue. Irritation of receptors in the affected area leads to a change in their excitability. At the same time, afferent impulses in the central nervous system cause reflex reactions of local, segmental and generalized type, which leads to a change in the functions of internal organs ( blood pressure, heart rate, etc.). With the help of an electric current, medicinal substances can be injected into the tissues of the tooth (drug electrophoresis). Finally, direct electric current is used to prevent pain during various dental interventions. The analgesic effect of direct current is associated with the development of electric tone phenomena in tissues, causing change their excitability during the passage of current. At the same time, excitability increases under the cathode (kathelektroton), under the anode it decreases (anelectroton). With prolonged current transmission, excitability also decreases under the cathode (Verigo's cathodic depression phenomenon).

16. masticatory muscles. purpose. Chewing muscles. Functional purpose of individual chewing muscles. The masticatory muscles include: 1) the masticatory muscle itself, which lifts the lower jaw, pushing it forward and shifting it to its side; 2) the temporal muscle, which provides lifting of the lowered lower jaw and the return of the jaw pushed forward; 3) lateral pterygoid muscle, pushing the lower jaw forward with a bilateral contraction, and with a unilateral displacement of the jaw to the side opposite to the perverted muscle; 4) the medial pterygoid muscle, which, with a unilateral contraction, displaces the lower jaw into opposite side, with bilateral - raises it. The listed muscles belong to the main chewing muscles. In addition to them, there are auxiliary muscles - the geniohyoid, maxillohyoid, anterior belly of the digastric muscle. They lower the lower jaw. Chewing is an important physiological act during which food substances are crushed in the oral cavity, wetting them with saliva and forming a food bolus before swallowing. The act of chewing involves the upper and lower jaws with dentition, chewing and facial muscles, oral mucosa, tongue, soft palate and salivary glands. Chewing muscles, setting the lower jaw in motion, provide mechanical processing of food. The amount of chewing pressure necessary for biting and grinding food to the desired consistency depends on the force of contraction of these muscles. These muscles are also involved in performing other functions of the oral cavity - speech, swallowing. The chewing process is a complex coordination of conditioned and unconditioned food motor reflexes that determine the mutually combined contractions of the masticatory muscles, muscles of the tongue, cheeks and lips. Coordination of contractions of the main and auxiliary masticatory muscles is regulated reflexively. The degree of chewing pressure on the teeth is controlled by the proprioceptive sensitivity of the periodontium. The strength of the muscles is directed dorsally, therefore, the masticatory muscles are able to develop the greatest efforts in the most distal sections of the dentition. The loss of lateral teeth sharply reduces the efficiency of chewing food, and lower jaw tends to move distally. Such a change leads to an overload of the temporomandibular joint and the destruction of the synchrony of contraction of the masticatory muscles.

17. Physical properties chewing muscles. Strength and work of chewing muscles. Gnatodynamometry.

Chewing muscles, setting the LF in motion, provide mechanical processing of food. The amount of chewing pressure necessary for biting and grinding food to the desired consistency depends on the force of contraction of these muscles. The strength of the muscles is directed dorsally, so the masticatory muscles are able to develop the greatest efforts in the most distal sections of the dentition. By contracting, chewing muscles develop a certain strength. The absolute strength of the masticatory muscles is understood as the tension that they develop during maximum contraction. Its value is calculated by multiplying the physiological cross-sectional area of ​​the muscle by its specific force. The cross section of the temporal muscle is 8 cm2, the main chewing muscle is 7.5 cm2, the total cross section of all other chewing muscles is about 19 cm2. 195 kg, for all muscles is 390 kg. The chewing muscle itself develops the greatest effort (due to the more vertical location of its resultant). Muscles, having great absolute strength, develop it extremely rarely to its possible limits, only in a moment of danger or extreme mental stress. Therefore, the value of the absolute strength of the chewing muscles lies in the ability to perform significant muscle work when chewing food without fatigue. If the effort required For the implementation of the act of chewing, on average = 9-15 kg, then practically only 10% of absolute strength is used, the rest is a reserve. and chewing pressure (JD). This is the force developed by the muscles for chewing food and acting on a certain surface. ZhD with the same muscle effort will be different on the molars and front teeth (explained by the fact that the LF is a second-row lever with a center of rotation in the joint. The chewing force is measured using gnatodynamometers. Used electronic devices with sensors. When the gnatodynamometer is compressed with teeth, a sensation of pain appears, this moment is recorded as an indicator of gnathodynamometry. Gnatodynamometry is a method for determining the strength of the chewing muscles and the endurance of the supporting tissues of the teeth to the perception of pressure when the jaws are compressed using a gnathodynamometer, measuring chewing pressure. ZhD on incisors: 7-12 kg, on premolars: 11-18 kg, on molars: 14-22 kg (According to Denis). According to Eckerlean, in women, ZhD on incisors is 20-30 kg, on the teeth of a teenager 4-6 kg. In men, on the incisors 10-23 kg, on the wisdom teeth 50-60 kg. ZhD on molars is not an indicator of the entire muscle strength, but is limited by the endurance limit of the periodontium. (for incisors it is 5-10 kg, for canines 15 kg, for premolars 13-18 kg, for molars 20-30 kg). For processing different products chewing apparatus expends various efforts. For crushing chocolate in bars and caramel 27-30 kg, nuts of various sizes 23-102 kg, boiled meat 39-47 kg, fried pork 24-32 kg, stewed veal 15-27 kg. When studying the force of contraction of the zhev. Muscles using dynamometry examines the vertical pressure. For chewing food, crushing and rubbing it, along with vertical loads, horizontal loads are also necessary.

18. Participation of the muscles of the maxillofacial region. The function of swallowing, speech production and breathing.

The muscles of the maxillofacial area are represented by facial and chewing muscles, muscles of the tongue, soft palate and pharynx. They play their part in various functions ETC. For example, the main function of the facial muscles is participation in facial expressions, breathing, speech, less in chewing. Chewing muscles - participation in chewing, speech, less - in breathing. Mimic muscles start from the pov-ti bone or underlying fascia and end near the face. With the reduction, the expression changes, changes in the state of the person. Participate in articulate speech and chewing. Facial expression changes with paralysis facial nerve or loss of teeth. Participation of mimic muscles in the act of chewing: capture of food, retention of food in the PR during chewing. When eating, a special role belongs to the mimic muscles, the most important is the muscle, the surroundings. mouth opening. In children: influence on the growth of teeth, bite. Chewing muscles: 1) actually chewing - provides raising the LF, pushing forward, shifting in its direction. 2) temporal - provides lifting of the lowered LF and returns the LF, advanced forward. displacement of the jaw in the direction opposite to the contracted muscle. 4) medial pterygoid - with unilateral contraction, it shifts the LF in the opposite direction, with bilateral contraction, it raises the LF. Chewing muscles, setting the LF in motion, provide mechanical processing of food. The magnitude of chewing pressure depends on the force of contraction, and biting off, breaking food to the required consistency depends on it. They are also involved in speech and in the act of swallowing. Auxiliary muscles-maxillary-hyoid, geniohyoid, anterior belly digastric. They lower the bass. The muscles of the tongue are involved in the function of chewing and speech formation. Distinguish muscles that start on the bones, and muscles that start in soft tissues - the own muscles of the tongue. The geniolingual, hyoid-lingual and stylolingual change the position of the tongue. Speech defects can be caused by a violation of the chewing muscles - muscle contracture and motor nerve paralysis. During swallowing, the jaws close, the soft palate rises, the contracting palatopharyngeal muscles form a partition between the mouth nasal cavity. The entrance to the larynx is closed by the epiglottis, and the vocal cords close the glottis. That's why food bolus when the muscles of the pharynx contract, it can only get into the opening of the esophagus. Normally, 22 muscles of the maxillofacial region take part in the act of swallowing.