Roganov G.G., Nepreluk O.A., Bobkova S.A.
Crimea state medical university named after S. I.
Georgievsky, Simferopol.
Modern
approaches to prophylaxis of traumatic osteomyelitis of mandible
The estimation of the
effectivenes of treatment of patients with fractures of lower jaw by inclusion
of antioxidant erbisol into therapeutic complex for local and common
application is given in article.
Key words :mandibular fracture, prevention of complications, disorders in
oxidizing-restorative processes, antioxidant therapeutics
Last years because of increasing the level
of traumatism the number of patients with damages in maxillofacial field
significantlly became high in both :our and foreign countries. The problem of
prophylaxis and treatment of traumatic osteomyelitis despite of big number of
studies stays one of the most actual and complicated in surgical stomatology.
The main morphological
contain of inflammatory process is damage of cell membrane. Established, that
the mechanism of cell structers damage and
bracking of regeneration processes during the severe course of wound
processes justified by activation the system of proteolysis and lipid
peroxidation of membranes against background of functional opportunities of
antioxidant protect and also the change of cytochemical activity of
dehydrogenases in peripheric blood neutrophils. But the issue of influence the
formed imbalance on aerobic oxidation processes and anaerobic glycolysis, and
also local and general disturbances of redox enzymatic systems on development
of posttraumatic destructive reactions in mandible till nowadays wasn't studied
deep.
The purpose of investigation
to increase the efficiency of treatment of the patients with fracture of
mandible by including in complex of treatment preparations with pathogenetic
therapeutic effect.
Materials
and methods
Carried out the investigation and treatment
of 97 patients with fracture of law jaw in age 18 to 50. Additionaly to this 27
healthy people in age 18 to 25 were in control group.
All examined were divided
into 3 groups :1 group (27 people) – healthy people in age 18-25 with no
diseases, 2 group(control) – 30
patients with traumatic osteomyelitis , received traditional therapy; 3
group(main) consisted off 2 subgroups.The first subgroup received traditional
complex therapy with including preparation Tocopherol and second group received preparation Erbisol.
In complex traditional
treatment included antibacterial, antiinflammatory, antihistamine, analgetics,
microelements,
The results and
discussion
For prognosis used the method of
chemiluminescence : the intesity of lipid peroxidation in the blood of the
patients with traumatic osteomyelitis was higher than the rate.
The analysis of data ,
registrated in 2 control allowed to notice the decrease of local pain component
of inflammatory processes in big part of the patients. During the treatment of
the patients with use Tocopherol (group 3, subgroup A) noticed the improvement of general condition, normalization
of temperature , decrease of pain and expressive of edema in 34 patients.
In subgroup B (3 group) with
using Erbisol the improvement
noticed 32 patients .
In this way, the results of
investigation testified about intensification of lipid peroxidation processes.
Conclusions
1.
Clinical
course of fractures of low jaw characterized
by the more prolonged local inflammatory reactions, frequent development
of early complications of infection and inflammatory processes.
2.
The dynamics
of changes the indexes of lipid
peroxidation , dehydrogenases and proteolysis correlate with the features
of clinical course of fractures of law jaw.
3.
Including in complex of treatment antioxidant Erbisol
in 10,1 % decrease the risk of development of traumatic osteomyelitis,
relatively with traditional therapy . By influence on indicators of intensity
the lipid peroxidation and cytochemical indicators of peripheric
blood in patients with fracture of law jaw
erbisol demonstrated more exspressive therapeutic effect than
tocopherol.