Sequestrectomy in osteonecrosis of the jaws caused by using of the desomorphin

Cover Page

Cite item

Full Text

Abstract

The purpose of our study was to investigate the characteristics of sequestration, to determine the indications for sequestrectomy and the specificity of this surgical intervention in patients with osteonecrosis of the jaw bones, the results of surgical treatment were also evaluated. A retrospective study of 45 patients with osteonecrosis of the jaws aged from 20 to 47 years, observed in the dental clinic of PSMU from 2012 to 2019, including 29 men and 16 women, was conducted. Of these, 19 patients had osteonecrosis of the lower jaw and 8 suffered from osteonecrosis of the upper jaw. They were operated on and sparing sequestrectomy was performed. The early postoperative period was characterized by satisfactory healing: there was no purulent exudation, wound healing was accompanied by the formation of pink granulations in the area of the defect. After the surgery patients almost did not complain of pain and discomfort. Subsequently (averagely 10 days later), marginal epithelialization of the defect was noted. Functional disorders (restriction of mouth opening, dysfunction of swallowing, speech and eating) were not identified. The state of postoperative defects was assessed 3 and 6 months later. Relapse of the disease is not marked. The subjects were sent to an orthopedic dentist to manufacture complex dental-maxillary prosthesis in order to replace the resulting jaw defect and subsequent rehabilitation. The obtained favourable results after sparing sequestrectomy allow to introduce this technique into the list of standard treatment modalities for this group of patients and recommend it as the method of choice for the surgical treatment of osteonecrosis upon condition of complete sequestration.

About the authors

Gleb I. Antakov

Academician E.A. Wagner Perm State Medical University

Author for correspondence.
Email: glebreanimator@inbox.ru

MD, Head of Maxillofacial Purulent Surgery Department, Dentistry Hospital, Clinical Multiprofile Medical Center

Russian Federation, Perm

Galina I. Shtraube

Academician E.A. Wagner Perm State Medical University

Email: gstraube@mail.ru

MD, PhD, Associate Professor, Head of Surgical Dentistry and Maxillofacial Surgery Department

Russian Federation, Perm

Iosif A. Boev

Academician E.A. Wagner Perm State Medical University

Email: iosifboev@gmail.com

Resident physician, Surgical Dentistry and Maxillofacial Surgery Department

Russian Federation, Perm

References

  1. Иващенко А.Л., Матрос-Таранец И.Н., Прилуцкий А.С. Современные аспекты этиопатогенеза, клинической картины и лечения остеомиелитов челюстей у пациентов с наркотической зависимостью и ВИЧ-инфекцией // Питання експериментальної та клінічної медицини. Збірник статей. – 2009. – №13(1) – С. 213–219. [Ivashchenko AL, Matros-Taranets IN, Prilutskii AS. Sovremennye aspekty ehtiopatogeneza, klinicheskoi kartiny i lecheniya osteomielitov chelyustei u patsientov s narkoticheskoi zavisimost’yu i VICH-infektsiei // Pitannya eksperimental’noї ta klіnіchnoї meditsini: Zbіrnik statei. 2009;13(1):213–219. (In Russ.)]
  2. Лесовая И.Г. Клинический опыт оказания специализированной помощи больным с нетипичным течением одонтогенного остеомиелита, страдающих наркоманией и синдромом приобретенного иммунодефицита / И.Г. Лесовая, В.М. Хименко, В.В. Хименко // Матер. Всеукраинской научно-практической конференции «Новые технологии в стоматологии и челюстно-лицевой хирургии». – Харьков, 2006. – С. 77–82. [Lesovaya IG. Klinicheskiy opyt okazaniya spetsializirovannoy pomoshchi bol’nym s netipichnym techeniem odontogennogo osteomielita, stradayushchikh narkomaniey i sindromom priobretennogo immunodefitsita / I.G. Lesovaya, V.M. Khimenko, V.V. Khimenko. In: Mater. Vseukrainskoy nauchno-prakticheskoy konferentsii “Novye tekhnologii v stomatologii i chelyustno-litsevoy khirurgii”. Kharkov, 2006. P. 77–82. (In Russ.)]
  3. Маланчук В.А., Бродецкий И.С. Комплексное лечение больных остеомиелитом челюстей на фоне наркотической зависимости // Вестник Витебского государственного медицинского университета. – 2014. – № 2. [Malanchuk VA, Brodetskii IS, Kompleksnoe lechenie bol’nykh osteomielitom chelyustei na fone narkoticheskoi zavisimosti. Vestnik of Vitebsk state medical university. 2014;(2). (In Russ.)]
  4. Маланчук В.А., Бродецкий И.С. Современные достижения и перспективы развития хирургической стоматологии и челюстно-лицевой хирургии : Республиканская научно-практическая конференция с международным участием : Мат. конф. – Харьков, 2010. – С. 51–53. [Malanchuk VA, Brodetskiy IS. Sovremennye dostizheniya i perspektivy razvitiya khirurgicheskoy stomatologii i chelyustno-litsevoy khirurgii : Respublikanskaya nauchno-prakticheskaya konferentsiya s mezhdunarodnym uchastiem. In: Mat. konf. Kharkov, 2010. P. 51–53. (In Russ.)]
  5. Медведев Ю.А., Басин Е.М. Остеонекрозы костей лицевого скелета у лиц с наркотической зависимостью: клиника, диагностика, принципы лечения // Врач. – 2012. – № 2. – С. 55–60. [Medvedev YuA, Basin EM. Facial osteonecroses in persons with drug addiction: clinical picture, diagnosis, principles of treatment. Vrach. 2012;(2):55–60. (In Russ.)]
  6. Уракова Е.В., Нестеров О.В. Выбор методов оперативного лечения больных с дезоморфиновым остеомиелитом // Практическая медицина. – 2014. – № 4–2(80). – С. 142–144. [Urakova EV, Nesterov OV. Choosing the methods of operative treatment of the patients with desomorphine osteomyelitis. Practical medicine. 2014;(4–2):142–144. (In Russ.)]
  7. Яременко А.И., Иванов Д.А. Дезоморфиновый остеонекроз. Социальная и медицинская проблема // Стоматологический научно-образовательный журнал. – 2012. – № 1/2. – С. 2–6. [Yaremenko AI, Ivanov DA. Dezomorfinovyi osteonekroz. Sotsial’naya i meditsinskaya problema. Journal of dental science and education. 2012;(1/2):2–6. (In Russ.)]

Supplementary files

Supplementary Files
Action
1. JATS XML
Download
2. Fig. 1. Osteonecrosis of the mandible on the left side. The appearance of the demarcation line

Download (148KB)
Indexing metadata
3. Fig. 2. The appearance of the line of ossification of the periosteum in the lesion area along the lower edge of the mandible, creating a “frame” of the newly formed bone

Download (155KB)
Indexing metadata
4. Fig. 3. A sparing sequestrectomy. The postoperative defect is plugged with iodoformturunda

Download (144KB)
Indexing metadata
5. Fig. 4. An early postoperative period. The granulation of defect walls

Download (125KB)
Indexing metadata
6. Fig. 5. A newly formed bone along the lower edge of the mandible prevented the displacement of fragments after sequestrectomy

Download (125KB)
Indexing metadata
7. Fig. 6. The epithelization of the walls of the postoperative defect

Download (127KB)
Indexing metadata
8. Fig. 7. The sequestration in the maxilla with involvement of the zygomatic bone

Download (182KB)
Indexing metadata
9. Fig. 8. The formation of bone “lintels” with extensive damage of the maxilla

Download (164KB)
Indexing metadata

Copyright (c) 2020 Antakov G.I., Shtraube G.I., Boev I.A.

Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 International License.

Согласие на обработку персональных данных

 

Используя сайт https://journals.rcsi.science, я (далее – «Пользователь» или «Субъект персональных данных») даю согласие на обработку персональных данных на этом сайте (текст Согласия) и на обработку персональных данных с помощью сервиса «Яндекс.Метрика» (текст Согласия).