MINISTRY OF HEALTH OF UKRAINE

UKRAINIAN MEDICAL STOMATOLOGICAL ACADEMY

METHODICAL INSTRUCTIONS

for independent work of students

during the training for the practical studies

Educational discipline Therapeutic dentistry

Module number 3 Periodontal Disease.

Theme of class Physiotherapy in patients with periodontal diseases.

Course ІV

Faculty Foreign Students Training

Poltava 2019

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1. Actuality of theme. Physiotherapy - this is the only form of treatment,

which also increases the resistance of the body, strengthens the protective and

adaptive capabilities of the body and has a reflex, humoral and physical and

chemical effects on the body's tissues.

It has significant advantages over other methods of treatment: universality

(one factor used in various pathologies), physiology (does not cause excessive

stress in compensatory-adaptive reactions) is not toxic, without allergization, is

not invasive, well combined with other therapeutic agents, has lasting effects after

the procedure enhances the effect of drugs available, cheap, so widely used in

periodontology.

2. Specific objectives

1. Know contraindications for physiotherapy periodontal patients .

2. Know the etiological, pathogenetic and symptomatic indications for the use

of physiotherapy in periodontal patients.

3. Know the principles of physiotherapy appointment in periodontal patients.

3. Basic knowledge, skills necessary for studying the subject

(Interdisciplinary integration):

Name of previous subjects

Received skills

1.Biophysics Know physical factors

2. Normal anatomy Define term "periodontium"

3. Normal physiology

To know the physiology of the nervous

and vascular systems of the body

4. Pathological Anatomy Know pathological processes -

dystrophy, inflammation

5. Radiology Describe and analyze X-ray picture

6. Propaedeutics of Internal Medicine Know the rules of procedure and the

interview and examination of the

patient, to be able to interview the

patient to hold his inspection to

determine its constitution, the activity,

expression, etc.

7. Therapeutic dentistry, section

“periodontal pathology”

Know the clinic of periodontal diseases

4. Tasks for independent work during preparation for the classes.

4.1. The list of key terms, parameters, characteristics which the student

learn in preparation for the lesson:

Term Definition

Physiotherapy of periodontal patients

The use of physical (natural and

artificial) in the treatment of periodontal

patients.

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Advantages of physiotherapy Physiology, atraumatic, versatility after

effect phenomenon, accessibility,

affordability

Types of Physiotherapy:

1. Natural climatotherapy, balneotherapy,

peloidoterapy

2.Preformed Electromagnetic factors (currents,

fields)

Factors mechanical nature (massage,

ultrasound, vibrotherapy)

Factors airspace

Factors thermal nature (hydrotherapy,

cryotherapy, thermotherapy)

Step reactions to physiotherapy Physical

Physico-chemical

Biological

Mechanisms of formation reaction of

the body:

1. Nonspecific - Local

- Reflex-segmental

-General

2.Specific Specific for this physical factor

General contraindication for

physiotherapy

Subject to the general state of the body

Some contraindications for

physiotherapy

Determining each type of physical

therapy alone

The recipe of physiotherapy List of physiotherapy

The etiological indication about of

physiotherapy of periodontal patients

Causes comorbidities

Pathogenic evidence about of

physiotherapy periodontal patients

Normalization of immune processes

Normalization of blood circulation

Normalization of mineral metabolism

Normalization of nonspecific resistance

Symptomatic indications for

physiotherapy

Removal inflammation, bleeding,

purulent exudate, discomfort,

hyperesthesia.

The complexity of physiotherapy Simultaneous with the appointment

multiple physical treatments

Combined physiotherapy Appointments several courses of

physiotherapy series

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4.2. Theoretical questions for the class:

1. Define the concept "Physiotherapy of periodontal patients"

2. Tell the advantages of physical therapy

3. Tell the types of therapeutic physical factors

4. What determines the reaction of the body to effect physical factor?

5. What stage of this reaction?

6. Tell the mechanisms of formation reactions of the body to effect of physical

factor?

7. What are the contraindications for physiotherapy?

8. What are caused some contraindications for physiotherapy?

9. What is the recipe of physiotherapy?

10. Tell about etiological, pathogenetic and symptomatic indications for

physiotherapy of periodontal patients.

11. What is complex and combined physical treatment?

12. How to evaluate the effectiveness of physiotherapy particular patient?

4.3. Practical work (tasks) that are performed in class:

1. To be able to conduct a survey of patients with periodontal disease and identify

contraindications to physical treatment.

2. To be able to identify the etiologic, pathogenetic and symptomatic indications

for physiotherapy patients with periodontal disease.

3. To be able to assign physical therapy in the treatment of periodontal disease in

specific patient.

4. To be able to identify the receptions for physiotherapy patients with

periodontal disease, and assign complex and combined physiotherapy , referral

to a physical write office.

5. To be able to determine the effectiveness of physical therapy.

5. Content of topic

The modern definition of physiotherapy - is the branch of medicine that

studies the effects on the body natural and artificial physical factors that are used to

treat patients, disease prevention and medical rehabilitation.

The advantages and benefits of physiotherapy:

I. Universality of action (the same factor can be applied in diferent diseases).

II. Physiological and has a normalizing nature (physical factor as usual body

stimulus, causing soft-adapted compensatory reactions).

III. The absence of toxicity, allergic effects, side effects.

IV. Non-invasive action.

V. Good compatibility with other therapeutic agents.

VI. The long aftereffect (therapeutic effect long shelf life and increases after the

end of treatment).

VII. Potentiating effect of most drugs.

VIII. Availability and relative cheapness.

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Types of therapeutic physical factors:

Natural (no preformed):

1. Climatotherapy, aerotherapy, speleotherapy, heliotherapy, thalassotherapy.

2. Balneotherapy.

3. Peloidoterapiya.

Artificial (preformed):

1. Factors electromagnetic nature (6 types):

a) constant electric current (galvanization, medicinal electrophoresis,

elektrosonterapiya, electroanalgesia, electrostimulation, diadynamic).

b) alternating electric current (amplimpulse, interferential fluctuarization,

ultratonotherapy, local and general darsonvalization).

c) electric field (franklinization, infitoterapiya, electrostatic massage therapy

UHF).

d) magnetic field (continuous, pulsed, low-frequency, high-frequency

physiotherapy).

e) electromagnetic radiation frequency range (microwave therapy, Deci-,

Centimeter wave therapy, short-wave therapy)

f) electromagnetic radiation in the optical range (infrared radiation,

chromotherapy, ultraviolet irradiation, laser therapy, photodynamic

therapy).

2. Factors mechanical nature:

– mechanical stress (therapeutic massage, chiropractic, acupuncture).

– mechanical vibrations (vibrotherapy, ultrasound therapy, phonophoresis).

– factors airspace (barotherapy, normooxygenation, oxygenobaro-therapy,

oxygenohelio- therapy, carbogenes, aeroion-therapy, aerosol-therapy, hala-

therapy.

3. Factors thermal nature (hydrotherapy (pouring, sponging, wet wrapping,

showers, baths, washing), baths, saunas, cryotherapy, paraffin, ozokerit-terapy,

thermotherapy, batch cryotherapy).

The response of the body to determine the effect of physiotherapy:

1. The physical nature and dosage factor.

2. The initial functional status and quality of the individual organism.

3. The electoral body's sensitivity to a particular factor.

4. The nature of the disease process.

Stages of reaction in response to the action of physical factors:

I. PHYSICAL - physical energy performance physical factor on the biological

system as a whole, tissues, cells, intercellular substance.

II. PHYSICO-CHEMICAL - Primary effects (shift):

– Heat generation.

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– Changing the concentration and ratio of ions in cells and tissues.

– The formation of free forms biologically active substances.

– The generation of free radicals.

– Changes in the spatial structure (conformation) of proteins .

– Changing the electric potentials of organs, tissues, cells.

III. BIOLOGICAL - There are direct and reflex changes in organs and tissues.

Mechanisms of formation reaction of the organism

the effect of physical factors are:

UNIVERSAL:

Nonspecific aimed at increasing the general resistance, improved adaptation:

- Local reactions of the body

- Reflex-segmental

- General

SPECIFIC:

Activated specific factors are inherent only this factor effect.

General contraindications to physiotherapy:

1. Tumors.

2. Systemic diseases of blood and bleeding tendency.

3. Severe cardiovascular and respiratory failure.

4. Individual intolerance of physical factor.

5. The total depletion of the patient.

6. Severe cerebral atherosclerosis.

7. Acute infectious process.

8. Epilepsy, hysteria, convulsive seizures, psychosis with psychomotor

agitation.

9. Pregnancy (except hydro-, balneotherapy, electro, ultraviolet irradiation,

laser therapy).

Some contraindications for physiotherapy:

Galvanization, electrophoresis:

- Acute skin disease.

- Acute inflammation, especially pus.

- Toxic conditions.

- Pharmacological contraindications to the drug.

- Violation of the integrity sheets in places imposition electrodes.

Electrosleep:

- Eyelid skin diseases.

Diadynamic, amplipulse:

- purulent processes.

- fractures of the bones.

Fluctuarization:

- Mynera syndrome.

UHF and microwave therapy:

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- Hypotension.

- Active tuberculosis.

- Limited (encysted) purulent processes.

- Metallic foreign bodies within range.

Darsonvalization:

- Active tuberculosis, children under 7 years.

UV irradiation:

- Systemic lupus erythematosus.

- Active tuberculosis.

- Endocrinopathy.

Aeroiono-, aerosoltherapy:

- Pulmonary tuberculosis.

- Asthma.

Ultrasound therapy:

- Diseases of the central nervous system and the endocrine system, scleroderma.

- Vascular dystonia.

- Metallic osteosynthesis.

- Dermatomyositis, pemphigus.

Thermotherapy:

- Acute inflammation.

- Renal disease.

Hydrotherapy:

- Purulent inflammation.

Vacuum therapy:

- Vitamin deficiency.

Massage:

- Acute inflammation, especially pus.

- Violation of renal excretory function

No contraindications to local cryotherapy.

Physical methods shown in periodontology at all stages of treatment in any

form and severity of periodontal pathology.

Physiotherapy in practice of periodontologist is contraindicated in:

- Idiopathic periodontal disease,

- Parodontomy,

- The presence of general contraindications,

- If presence personal contraindications.

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The terms to appointment of physiotherapy in periodontology:

- Previous removal of local traumatic factors in the mouth;

- Simultaneous combination of orthopedic, surgery, medical treatment of

periodontal disease.

Recipes physiotherapy in periodontal disease is determined by:

- Features of a pathological process in the periodontium;

- Course, phase of development, severity of disease;

- The general condition of the patient;

- Universal and specific mechanisms of action of physical factor.

Etiologic indications for physiotherapy periodontal disease:

I. Elimination of microflora in the mouth:

1. Local UV irradiation, short UV radiation;

2. Electrophoresis of antibiotics, antiseptics.

II. The presence of somatic illness:

Neurosis, asthenic conditions:

1. Electrosleep,

2. General UV irradiation.

3. Aeroionization.

4. Galvanizing zone extracted tooth.

5. The effect on the nasal mucosa diadinamy and SMT-currents.

Vascular dystonia:

1. Galvanizing zone extracted tooth.

2. The general UV irradiation.

3. Electrophoresis on zone of extracted tooth by bromine, vitamins, novocaine

5%, 2% trymekayine, 5% magnesium sulfate.

4. Utrasound on the upper cervical spine.

5. Franklinization.

6. Hydrotherapy.

7. Massage.

Functional disorders of the circulatory system:

1. Galvanization by nasal procedure.

2. Electrosleep.

3. Electrophoresis method for nasal by dimedrol, vitamin B1, 5% novocaine,

aeroionotherapy.

4. Franklinization.

5. General hydrotherapy.

6. Walks on fresh air.

Hypertension:

1. Massage the area of wells.

2. Reflexotherapy.

3. Aeroionotherapy,

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Pathogenetic indications for physiotherapy periodontal disease.

I. Normalization of immune processes:

1. Aeroionotherapy.

2. Reflexotherapy.

3. Franklinization.

4. UV irradiation.

II. Normalization of blood circulation:

1. Ultrasound.

2. Electrophoresis of heparin.

3. Automassage, vibration, vacuum massage.

4. Hydrotherapy.

5. Paraffin, ozokeryt-, mud therapy.

6. UV therapy.

III. Normalization of mineral metabolism:

1. Electrophoresis F while general admission Ca.

2. Phonophoresis vitamins E, B, D.

IV. Normalization of nonspecific resistance:

1. Electrophoresis aloe for segmental method.

2. Vakuum therapy, vakuumforesis.

3. Hidrotherapy.

Symptomatic indications for physiotherapy:

I. Elimination of gingival inflammation:

1. Local hypothermia.

2. Laser radiation.

3. Microwave therapy.

4. UHF.

5. Ultrasound therapy

6. Electrophoresis for transverse methods of vitamins C, D, drugs Ca, Zn,

trasilol, contrical.

7. Electrophoresis for longitudinal methods of KJ, galaskorbin, maraslavin,

romazulan, ATF, honsuryd.

8. Darsonvalization.

9. Diadynamic and SMT-therapy for segmental method.

10. Paraffin and ozokeryt-, mud therapy.

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II. The elimination of gingival bleeding:

1. Electrophoresis method for transverse vitamins C, D, drugs Ca, trasilol,

contrical.

2. Fonoforesis of heparin ointment.

3. Darsonvalization.

4. Magnetotherapy.

5. Vacuum therapy.

III. Eliminate of itching, discomfort of the gingiva:

1. Darsonvalization.

2. Electrophoresis of tannin, sulphate 3% Zn, Cu for transverse method.

IV. The elimination of purulent exudate of periodontal pockets:

1. Elektroforesis of 2% trypsin.

2. UV irradiation.

3. Vacuum curettage

4. Flyuktuorization

5. Hidrotherapy

6. Aerosol of Ingalipt.

V. Elimination of hyperesthesia of teeth:

1. Electrophoresis of cathode silver, 1% NaF for longitudinal methodology.

2. Electrophoresis of vitamin B1, calcium glycerophosphate 2,.5%, 1%

trymekayin for segmental method .

3. Ultrasound in the cervical spine.

4. Diadynamic.

5. UV.

6. Laser.

Errors of physiotherapy appointment with periodontal disease:

– Appointment of thermal treatments for acute inflammation;

– Appointment of UV irradiation without biodoses schemes and their admission;

– Application for electrophoresis lead electrodes;

– The drug is administered during electrophoresis excluding polarity;

– Do not select the optimal method of electrophoresis;

– Do not take into account the principles of physiotherapy appointment,

especially complexity.

Principles of physiotherapy appointment:

Unity of etiological, pathogenetic and symptomatic physiotherapy, and the

prescribed factors that cause both local, segmental and general reactions used

individualization physiotherapy and mix it with psychotherapy - conducted

according to age, sex, constitution, concomitant diseases, reactivity and biological

rhythms of the body, individual contraindications.

Course duration is determined by the dynamics of subjective and objective

indicators of the disease.

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Optimum treatment is that the parameters of therapeutic factors, methods of

application must conform to the nature and phase of the disease process.

Dynamic treatment is physical therapy that must meet the patient, consider

clinical dynamics, turning to use of physical factors periodically repeated

treatments.

The complexity of the treatment is combined use of physical factors:

– Combined treatment - simultaneous administration of multiple physical factors

.

– Combined treatment – use of physical factors consistent with a time interval of

1-2 days or change the course of one another.

Rules of the complex of physiotherapy are:

1. Absolutely no conflicting procedures.

2. In one visit is not desirable:

- More than 2 procedures;

- 2 procedures that cause the overall reaction;

- 2 procedures for one reflexogenic area;

- 2 factors close to nat. nature;

- Of countervailing procedures;

- 2 treatments that damage the skin;

- 2 electroprocedure.

3. On the day of complex surveys do not prescribe physical therapy.

4. Acupuncture is not combined with other physical factors.

5. Incompatible one day physical procedures if necessary, appoint in different

days.

6. Essential guide - table combination of physical procedures.

Combination of physical factors in periodontology:

- Hydrotherapy combined with all kinds of electricity, light, heat,

- Heat factors combined with light factors;

- High-frequency electromagnetic fields - with direct current;

- Ultrasound with heathydrotherapy;

- Music and therapy of laugh and all physical factors.

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Physiotherapy of catarrhal gingivitis:

1. Hydrotherapy

2. Ultraviolet irradiation

3. Laser

4. Darsonvalization

5. Aeroionotherapy

6. Franklinization

Acute:

7. Hydrotherapy

8. Local hypothermia

9. Elektoroforesis on collar region

10.Auto-, vibromassage

11.Vakuum therapy, vakuumforesis

12. Magnetotherapy

13.Ultrafonoforesis

14.Peloid-therapy

15.Paraffin-, ozokerit-therapy

Chronic:

7. Electrophoresis

8. Fluctuorisation

9. Diadynamic, SMT-therapy

Physiotherapy of hypertrophic gingivitis:

1. Electrophoresis

2. Darsonvalization

3. Hydrotherapy

4. Diadynamotherapy

Swollen form:

5. Vakuum -therapy, vakuumforesis

6. UV

7. All kinds of massage

8. Fhonophoresis

Fibrous form

5. Laser

6. Paraffin

7. Diathermocoagulation

8. Cryodestruction

Physiotherapy of ulcerative gingivitis:

1. Hypothermia

2. UV

3. Aerosol therapy

4. Hidroterapy

5. Athermanous doses of UV

6. Microwave therapy

7. Laser therapy

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Physiotherapy of periodontitis:

1. Hydrotherapy

2. Laser- therapy

3. Flyuktuorization

4. Phonophoresis

Exacerbation:

5. Aerosol therapy

6. UV

7. The electric field of UV

8. Hypothermia

9. Microwave therapy

Chronic:

5. All types of massage

6. Electrophoresis

7. Pelloid-therapy

8. Darsonvalization

9. Vakuum -therapy

10. Magnetic

11. Paraffin, ozokerit-herapy

12.Diadynamic, amplimpus-therapy-

phoresis

Physiotherapy of periodontosis:

1. All types of massage

2. Darsonvalization

3. Magnetic

4. Electrophoresis

5. Phonophoresis

6. Diadynamic -therapy

7. SMT-therapy

8. UV

9. Laser

10. Hyperbaric oxygenation

11. Local hypo-, hyperthermia

12. Paraffin, ozokerit-therapy

To eliminate periodontal pockets last years used vacuum curettage, cryo-

curettage as less traumatic.

For vacuum curettage have special currets through which vacuum suction

device pocket contents. When using cryo- curettage granulation frozen with liquid

nitrogen and rejected. Blood clot becomes the basis for the formation of connective

tissue, which can partially fill the pocket. After curettage imposed periodontal

healing bandages, which include antiseptic, anti-inflammatory and keratoplastyc

means.

Gingival pockets eliminated using diathermocoagulation and cryosurgery -

necrotizing with high and low temperatures, then also impose periodontal healing

bandages that promote epithelialization of the damaged surface of the gums.

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6. Materials for self-control:

Tests for self-control:

1. The Gerontology Center in connection with the opening of the physiotherapy

department in patients with periodontal disease provides for the use of

physiotherapy. Of these diseases indicate those that are not contraindications to it`s

purpose:

A. Myocardial infarction

B. Stroke

C. Tuberculosis

D. Gastritis

E. Non-malignant and malignant tumors

2. Patient B., 44 years old, finished treatment of acute ulcerative gingivitis and

was sent for electrophoresis in Physiotherapy office. On examination, physical

therapist showed areas of necrosis with little purulent discharge in the lower right

molars. Electrophoresis is not appointed, if after local treatment is not stopped:

A. Pain

B. Puffiness

C. Pus

D. Periodontal pockets

E. The mobility of teeth

3. Patient C., 23 years, treating of periodontosis 1 degree. Complains of increased

tooth sensitivity to thermal stimuli. OBJECTIVE: clear pale, atrophied, teeth bared

neck, teeth stable, is wedge-shaped defects. Periodontal pockets are absent. To

reduce of severity hyperesthesia 1 degree physiotherapist appointed electrophoresis

2.5% calcium glycerophosphate number 10, the duration of 15 minutes. For

electrophoresis using:

A. Constant current

B. Curent alternating

C. The electromagnetic current

D. Darsonvalization

E. Ultrasound

4. Patient A., 54 years old, is treating by a doctor periodontologist about chronic

generalized periodontitis 1 severity. Now no complaints. OBJECTIVE:gingiva

dense, pale pink, teeth stable, periodontal pockets to 3.5 mm, with serous release.

Doctor- appointed electrophoresis 2.5% calcium gluconate number 10, the duration

of 15 minutes. Amperage electrophoresis Gum:

A. 1-5 mcA

B. 10-15 mcA

C. 20-30 mcA

D. 1-5 mA

E. 30-50 mA

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5. Patient G., 37 years old, were complaints of pain in the gingiva, bleeding of

gingiva and increased tooth mobility, submandibular lymph nodes inflamed. An

objective study observed redness of the gingiva, swelling, purulent exudate of

periodontal pockets, tooth mobility 1-2 degrees, periodontal pockets to 5 mm.

Exposed roots half length. To relieve inflammation early in treatment included

UHF. How many sessions UHF an exacerbation of periodontitis:

A. One

B. 3-5

C. 10-15

D. 6-8

E. Always

6. Patient C., 16 years old, complains cosmetic defect. Now the patient is treating

of hypertrophic gingivitis 1 severity, granulating form. On examination revealed,

that inflamed gums, hypertrophied 1/3 crowns, teeth stable, no periodontal

pockets. In the complex treatment doctor included phonophoresis of heparine

ointment. Phonophoresis it is:

A. Introduction medicine ultrasound

B. Introduction drugs shock

C. Rubbing a massage

D. Introduction drugs applique

E. Injection drug

7. Patient B., 34 years old, is undergoing rehabilitation at department of neurosis of

psychiatric clinic. On examination, the dentist: pale gums, teeth bared neck, teeth

stable, there are multiple wedge-shaped defects. He was diagnosed with an initial

degree of periodontosis. This department used alternative therapies. Music therapy

and therapy of laugh in the treatment of periodontosis combined with:

A. Electrophoresis

B. Hyperbaric oxygenation

C. All the physiotherapeutic procedures

D. Darsonvalization

E. Massage

8. Patient T., 48 years old, complaining of bleeding gums during brushing.

OBJECTIVE: clear hyperemic with a bluish tint, stable teeth, no periodontal

pockets. He was diagnosed - chronic catarrhal gingivitis and treated, followed by

treatment for physiotherapeutic cabinet. The patient does not tolerate the electrical

and asks her to appoint phototherapy - is:

A. Ultrasound

B. UHF therapy

C. Galvanization

D. Laser, Bioptron

E. Massage

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9. Patient K., 48 years old, with abscessed periodontitis to reduce inflammation in

the periodontal tissues after opening the abscess is intended method of physical

therapy. Which method is most appropriate?

A. UV

B. Laser therapy

C. Hydromassage

D. Vacuum therapy

E. X-ray therapy

10. After examination of the patient L., 23 years old, dentist was diagnosed with

generalized chronic catarrhal gingivitis. In treatment for topical application of

therapeutic mud. What is the main factor in the appointment of this procedure?

A. The chemical composition

B. Oscillatory effect

C. Compression

D. Cavitation

E. Polarization

B. Task to self-control:

1.During sanation of oral cavity patient L., 56 years old, dentist noticed changes in

periodontal tissues around abutment teeth prosthetic appliances - clear stagnant

hyperemic, swollen, bleeding on probing, periodontal pockets around the deep-set

bits to 5 mm. The doctor diagnosed localized periodontitis II severity, chronic

course. What is physiotherapy quickly eliminate gingivitis after removal of the

prosthesis?

A. Massage

B. Electrophoresis antibiotics

C. UV

D. UHF

E. Darsonvalization

2. In consultation with a dentist turned patient, 62 years old,. The patient is being

treated in the cardiology department after the transfer of myocardial infarction. On

examination: clear hyperemic, swollen, painful, bleeding on probing, in

periodontal pockets deeper than 5 mm, purulent exudate, mobile teeth 2-3 degrees.

The doctor diagnosed generalized periodontitis, III severity, exacerbation. What is

physiotherapy is symptomatic in this case?

A. Hydrotherapy (irrigation gums anti-inflammatory drugs), aerosol

B. Electrophoresis antibiotics

C. Massage

D. UV

E. UHF

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3. Patient B., 49 years old, treated of chronic generalized periodontitis 2 severity.

On examination: clear dense, resistant teeth, teeth bared roots to 1/2. What is

physiotherapy can be assigned to the patient at the final stage of treatment to

improve the trophic periodontal tissues?

A. Massage; darsonvalization

B. Electrophoresis calcium and fluoride

C. Ultrasound, phonophoresis

D. UHF, Bioptron

E. Laser, hydrotherapy

4. In consultation with a dentist turned patient B., 59 years old. Suffering from

chronic leukemia in remission, complaining of bleeding gums, tooth mobility, and

bad breath. In the history of the patient is allergic to novokain. On examination

revealed that the clear stagnant hyperemic, mobile teeth 1-2 degrees, periodontal

pockets to 5 mm. The doctor diagnosed generalized periodontitis II severity,

chronic course. Identify contraindications to physiotherapy:

A. Bleeding gums

B. Allergy

C. Reluctance treatment

D. Leukemia

E. The mobility of teeth

5. Man, 28 years old, is complaining of pain and bleeding gums, bad breath,

general weakness, fever up to 37.5 C., ill 3 days ago after hypothermia.

OBJECTIVE: clear dramatically swollen, hyperemic; gingival papillae and

marginal edge in the region of the upper and lower front teeth ulcers covered with

a dirty gray bloom; supragingival deposits, oral cavity without sanation. Which

shows physiotherapy patient in the acute phase of the disease?

A. Hydrotherapy (irrigation gums anti-inflammatory drugs, aerosol)

B. Diathermy

C. Darsonvalization

D. UHF therapy

E. Electrophoresis of himopsynum

6. Patient D., 45 years old, turned to the dentist complaining of bleeding gums

when brushing teeth. OBJECTIVE: clear the upper and lower jaws hyperemic,

swollen, bleeding in contact probe, periodontal pocket depth of 4-5 mm, mobile

teeth 1- II degree. On radiographs: irregular resorption of interdental membranes to

½ the length of the roots of teeth. What is physiotherapy techniques amplify the

effect of drugs used locally?

A. UHF therapy

B. UV

C. Hydrotherapy

D. Paraffin

E. Mud

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7. Patient K., 42 years old, complaining of itching, discomfort in the gums,

increased tooth sensitivity to different stimuli. After examination of newly

diagnosed with periodontosis 2 degree. Which physical therapy appropriate to

include in a complex treatment plan that pain?

A. Diadinamotherapy

B. Laser irradiation

C. Darsonvalization , contact method

D. UHF therapy

E. Fluctuorization

8. Patient D., 45 years old, turned to the dentist complaining of bleeding gums

when brushing teeth. OBJECTIVE: clear the upper and lower jaws hyperemic,

swollen, bleeding on touching of probe periodontal pockets depth of 4-5 mm,

mobile of teeth II degree. On X-ray: irregular resorption of interdental membranes

to 1/2 the length of the tooth roots. What is physiotherapy treatment must assign to

eliminate bleeding gums?

A. UHF therapy

B. Darsonvalisation

C. Electrophoresis 5% ascorbic acid

D. UV

E. Fluctuarization

9. An examination of the oral cavity of the patient ID, 43 years old, dentist

diagnosed chronic generalized periodontitis II severity. In the history of the life of

the patient - asthenic syndrome. What is physiotherapy is indicated for the

normalization of the nervous system?

A. Electrosleep

B. UHF therapy

C. Aeroionotherapy

D. Fluctuorisation

E. Electrophoresis 5% ascorbic acid

10. On examination of the oral cavity of the patient M., 25 years old, dentist found

cyanosist and swelling of the gums of the upper and lower jaws, proliferation of

gingival papillae to ½ the height of the crowns of the teeth, gingival pocket, a

small amount of dental plaque. In history – disturbance of menstrual cycle. What is

physical therapy treatment to be assigned after occupational health?

A. Phonophoresis heparin ointment

B. UHF therapy

C. Laser

D. Spark darsonvalisation

E. Hydromassage

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7. LITERATURE.

BASIC SOURCES

1. Nikolishin A.K., Ilenko N.N., Nikolishina E.V. Geranin S.I. Practical Guide:

methodical recommendations for doctors practice at IV course. – Poltava 2010.

– 91 р.

2. Ripetska O., Deneha I., Hrynovets V., Hrynovets V., Hysyk M. Diseases of the

periodontium. Pathogenesis. Diagnosis. Treatment. – Lviv: Liga-Press, 2004.

174 p.

ADDITIONAL SOURCES

1. Bartolucci E.G. Parodontologia. – Milano: Edisioni scientifiche, 1999.

2. Carranza F.A., Newman M.G. Clinical Peridontology. – 8-th ed. –

Philadelphia: Saunders, 1996.

3. Keiser J.B. Periodontics. – London: Wrigth, 1990.

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Information resources:

1. http://dental-ss.org.ua/load/kniga_stomatologia/terapevticheskaja/8

2. http://www.stomatkniga.ru/index.php?start=48

3. http://stomatbook.blogspot.com/p/blog-page_14.html

4. http://www.mosdental.ru/Pages/Page28.1.html

5. http://www.booksmed.com/stomatologiya/153-terapevticheskaya-

stomatologiya-borovskij.html

6. http://nashol.com/2011041354397/propedevtika-stomatologicheskih-

zabolevanii-- skorikova-l-a-volkov-v-a-bajenova-n-p.html

7. -http://www.booksmed.com/stomatologiya/2393-propedevtika-

stomatologiches-kih-zabolevaniy-skorikova.html

8. -http://mirknig.com/knigi/nauka_ucheba/1181309066-terapevticheskaya-

stomatologiya-uchebnik.h