Fluctuating currents in dentistry: indications, features and method of carrying out fluctuating

Fluctuorization - one of the types physiotherapy, based on the use of alternating and direct low voltage electric current with chaotically varying frequency and amplitude.

Fluctuating currents (lat. fluctuor means to fluctuate) are used in the treatment of various diseases. Fluctuorization is most widespread in dentistry for the treatment of a number of dental diseases - pulpitis, periodontitis, gingivitis, periostitis, alveolitis, periodontitis.

Mechanism of action

The electric current spreads through the tissues of the human body through the intercellular fluid, mainly along the lymph and blood flow. When its strength reaches the threshold values, fibrillation of muscle tissue occurs. A further increase in the intensity of the electrical signal causes chaotic twitching in the muscle fibers.

At the same time, the lymphatic and blood vessels in the affected area expand, and the circulation of blood and lymph increases. The temperature rises slightly (by 0.4 ° C in the oral mucosa), which can persist for half an hour or an hour after the procedure.

The chaotic nature of the frequency and amplitude parameters of the fluctuating current increases its irritating effect and reduces the adaptability of body tissues to the effect of an electric signal.

Fluctuorization has the following effects:

• analgesic (pain reliever);
• anti-inflammatory;
• local myostimulating (the functional state of muscle tissue increases);
• trophic-regenerative (the provision of tissues with nutrients is enhanced, which contributes to their accelerated recovery).

The use of fluctuorization in dentistry is based mainly on anti-inflammatory, analgesic and resorption (decongestant) action.

The anti-inflammatory effect occurs due to the activation of lymph and blood flow in the inflamed focus, increasing the activity of phagocytes, enhancing reparative regeneration and cellular immunogenesis, normalizing trophism of tissues. Decreases edema, the infiltrate is absorbed, regenerative processes are activated, leading to accelerated wound healing.

Purulent foci with a small area stop the spread and begin to shrink. Large inflammations are encased and form fistulous passages through which pus is drained, which ultimately leads to resolution of the inflammation.

The analgesic effect of fluctuating is due to a decrease in the excitability of the nerves with prolonged exposure to current. Asynchronous impulses that occur in the nerve tissues when an electric current passes through them causes the "suppression" of pain impulses.

The therapeutic effect of fluctuating usually increases with an increase in the number of procedures and an increase in the intensity of the current.

Fluctuating current forms

When fluctuating, 3 forms of electric current are used:

1. Bipolar AC symmetrical current in which the positive and negative values ​​are equal. Only the amplitude and frequency of the pulses changes. Form No. 1 provides the softest effect on the tissues, since the pulses of different polarity smooth out each other.
2. Bipolar unbalanced current biased towards minus polarity. Due to the alternation of the latter, the irritating effect of the 2nd form is more pronounced than the 1st.
3. Rectified current with negative polarity. It is used mainly for injecting drugs into tissues.

Voltage varies in the range of 0-100 V, frequency - 100-2000 Hz, density - 0-3 mA / cm².

Depending on the current density, expressed in mA / cm², fluctuating electrical signals are divided into small (0.1-1.0), medium (1.0-2.0) and high (2.0-3.0).

The most pronounced anti-inflammatory effect is achieved at an average current density.

Benefits of the procedure

If we compare fluctuating currents with others used in dentistry (dynamic modulated and sinusoidal), then they have a number of advantages:

• the probability of tissue habituation due to the randomness of the parameters is very small;
• the analgesic effect is manifested during the procedure itself;
• there is a pronounced anti-inflammatory and anti-edema effect.

Indications and contraindications

In dentistry, factorization is indicated for the following diseases:

• exacerbation of chronic dental diseases - periodontitis, pulpitis, periodontitis, alveolitis;
• arthritis / arthrosis of the temporomandibular joint;
• post-filling pain;
• neuralgia of the trigeminal or occipital nerves.

Contraindications:

• temperature above 38 ° C;
• acute infections;
• malignant tumors;
• the presence of metal in tissues;
• the presence of a pacemaker;
• decompensated cardiovascular diseases;
• low blood clotting, hemorrhagic syndrome;
• thrombobliterating pathologies;
• hypertensive crisis;
• vibration disease;
• individual electric current intolerance;
• obsessive-compulsive disorder (mental disorder, expressed in anxiety, fear, anxiety);
• Meniere's syndrome (pathology of the inner ear associated with an increase in the amount of labyrinth fluid (endolymph);
• aortic aneurysm;
• stroke;
• myocardial infarction.

With regard to stroke and heart attack, contraindications are valid only for the first year after the illness.

Fluctuorization in children

Due to the anatomical and physiological characteristics of children, the result of exposure to electric currents is manifested in them faster and at a lower intensity. A stricter dosage of all current parameters is required. Ignoring this requirement can cause a specific reaction in the child - excitement or, on the contrary, lethargy, whims, drowsiness, and impaired appetite.

The basic rules that must be followed when fluctuating in children:

1. Strict control of the child's reaction during treatment. Refusal of the procedure in the event of anxiety manifestations.
2. Decrease in the strength and duration of electric shock compared to standard values ​​for adults. You need to start the procedure with a reduced intensity with a gradual, careful increase.
3. With acute inflammations daily sessions are carried out only for the first 3-5 days, and then they switch to every other day procedures.
4. Fluctuorization is not recommended for children with reduced immunity and increased reactivity of the body.

Methodology for various diseases of the oral cavity

Fluctuorization devices are equipped with special electrodes that allow electric current to pass through any part of the oral cavity. Exposure to fluctuating currents is carried out by installing them longitudinally or transversely to the treated area. Together with external plate electrodes, special cavity electrodes are also used. Sometimes bifurcated electrodes are used, which are connected to one terminal of the device.

The general rules for treatment are as follows:

1. The position of the patient during fluctuation should be comfortable.
2. Treatment is recommended half an hour to an hour after eating.
3. The time of one session and their number is determined by the doctor, taking into account the nature of the pathology and the reactivity of the body.

Post-filling pain

Plate electrodes 3 × 4 cm are used, which are placed transversely on the desired area of ​​the jaw. The cathode electrode is placed over the affected tooth. All this is securely fixed with a bandage.

Use the 2nd or 3rd form of the average current density. The duration of the session is 6-8 minutes. The duration of treatment is every day for a week.

Periodontitis, periodontal disease, periodontitis

Between the lip and the gum, a gauze swab (turunda) is placed soaked in a solution of the drug - nicotinic acid, no-shpa, vitamin B, etc. A plate electrode 5 × 10 cm is placed on the skin of the jaws so that the current flows through the injected drug. A 10 × 10 cm electrode is attached to the upper cervical spine.

Use the 2nd or 3rd form of medium density current. Session time - 10-12 minutes. The total number of daily or daily repetitions is 8-10.

Trigeminal neuralgia

A 10 × 10 cm electrode with positive polarity is attached to the right forearm. Another 1.5 × 1.5 cm electrode with negative polarity is attached alternately to three zones:

• the brow ridges - where the 1st branch of the nerve comes out;
• the lower edge of the orbit - where the 2nd branch leaves;
• chin - at the point of exit of the 3rd branch.

Each branch is exposed to the 2nd or 3rd form of medium density current for 3 minutes. In total, 6-8 procedures are required.

Arthritis / arthrosis of the temporomandibular joint

On the temporomandibular joint, 2 electrodes 3 × 4 cm are placed transversely.

Use the 1st form of electric current at medium or low intensity.

The exposure time is 10-12 minutes. The number of sessions is 8-10.

Conclusion

Fluctuorization was developed by the staff of the Moscow Dental Institute in 1964-1969, but it is still an effective treatment in some clinical cases.

It can be used both as an independent therapy and in combination with other methods of prevention, treatment and rehabilitation.

The universality of the effect of electric current, its ability to relieve pain, activate local microcirculation, increase tissue trophism, stimulate metabolism makes it in certain clinical situations very effective.