<<
>>

PREVENTIVE MAINTENANCE OF DEVELOPMENT BISFOSFONATNOGO OF THE OSTEONECROSIS OF JAWS

VTSS and CHLH MGMSU of A.I.Evdokimova 15 patients (5 men and 10 women), requiring carrying out of surgical sanation of the oral cavity, having in the anamnesis intravenous therapy bisfosfonatami on a basis zolendronovoj acids in connection with malignant neoplasms of various localisation and, accordingly, being in group of risk of development bisfosfonatnogo an osteonecrosis of a jaw after surgical intervention carrying out (3 group of patients) have addressed.

Distribution of patients on a floor and a basic disease is presented in table 21.

Table 21

Distribution of the patients requiring surgical sanation of an oral cavity, on groups depending on a floor and a basic disease

Basic disease M
RMZH 0 7 (46,7 %)
RPZH 5 (33,3 %) 0
MM 2 (13,3 %) 1 (6,7 %)
IN TOTAL 15

Patients required carrying out of surgical sanation of an oral cavity in connection with presence of a chronic periodontitis of a teeth. In total 17 teeth, from which 10 - on the top jaw, 7 - on a mandible is removed.

Exodontia spent under local anaesthesia, used anaesthetics artikainovogo a number with the lowered maintenance of adrenaline («Ultracain D-S 1:200000) or on a basis mepivakaina without adrenaline («Scandonest»). Excisions spent as much as possible noninvasively, with
Use periotomov. After an odontectomy into the small cavity entered the plasma received as a result of a centrifugation of blood of the patient. Then on ostiums of the small cavities imposed referring seams («Vicryl 5-0»). 2 hours prior to an intervention and in the postoperative period prescribed a course of antibacterial therapy, of 10 days. Considering presence of an infectious link in an osteonecrosis pathogenesis, for preventive maintenance of development of complications, prescribed antibiotics of a penicillinic number - Amoksiklav 625 mg on 1 tab. 3 times day, and also antihistamine preparations - Klaritin on 1 tab. Once a day.

In the postoperative period followed a policy of local ozonotherapy in the field of the small cavities, consisting of 10 daily procedures, in for 2 minutes.

Control survey spent for 3, 5, 7, 10, 14 days. Defined presence (and character) or absence of a pain in postoperative area, presence of a hyperemia and a mucosa edema, a cuticularization of the small cavities. A removal of sutures spent on 14е days. Dynamics of a current of a wound process is presented in a drawing 51.

Fig. 51. The chart. Dynamics of healing of the small cavities of a remote teeth.


At survey for 1 days after operation noted moderately expressed edema and a mucosa hyperemia in postoperative area. Seams at all patients were well-founded. For 1 days to patients began carrying out of a course of ozonotherapy.

For 3 days the augmentation of expression of an edema of a mucosa, hyperemia reduction became perceptible. In the field of the small cavities fibrin scurf became perceptible.

For 5 days expression of an edema and a hyperemia mucous considerably decreased, inflammation signs it did not become perceptible.

The cuticularization of the small cavities occurred for 14 days when spent a removal of sutures.

Control radiological inspection spent in 6 months after excision. In one of cases it has not been taped clinical and radiological signs of an osteonecrosis in postoperative areas.

<< | >>
Scientific source ZASLAVSKAYA NATALIA ALEKSANDROVNA. OPTIMIZATION of PREVENTIVE MAINTENANCE And TREATMENT BISFOSFONATNYH of OSTEONECROSES of JAWS At PATIENTS WITH MALIGNANT NEOPLASMS. The dissertation on competition of a scientific degree of the candidate of medical sciences. Moscow - 2014. 2014

Other medical related information PREVENTIVE MAINTENANCE OF DEVELOPMENT BISFOSFONATNOGO OF THE OSTEONECROSIS OF JAWS:

  1. THE TABLE OF CONTENTS
  2. INTRODUCTION
  3. a pathogenesis, diagnostics, treatment bisfosfonatnogo an osteonecrosis of jaws
  4. PREVENTIVE MAINTENANCE OF DEVELOPMENT BISFOSFONATNOGO OF THE OSTEONECROSIS OF JAWS
  5. THE CLINICAL EXAMPLE 2
  6. CHAPTER 4. DISCUSSION OF RESULTS OF OWN RESEARCHES
  7. PRACTICAL REFERENCES