Kazinina E.N., Bobkova S.A., Makarenko V.N.

Crimea state medical university named after S. I. Georgievsky, Simferopol.

 

Etiopathogenic approaches to treatment the traumatic osteomyelitis of mandible

 

Last years the implantology precipitously progresses. The achievement of expected results leaded to new issues emergence about used materials.

Although the orthopedic treatment is very important, should take into account that during the treatment foreign bodies entered into the oral cavity and located there for long time, these foreign bodies from the materials that do not suited to the human body.

The article assessed the efficiency of treatment of patients with traumatic osteomyelitis of mandible. Therapeutic complex include antioxidant (erbisol) and osteoplastic material doped with silver (biomin GTLS)

Key words: traumatic osteomyelitis of the mandible , disorders of redox processes, antioxidant, antimicrobial and osteoplastic local therapy.

The preparation Erbisol is immunomodulator, reparant, and adaptogen. He has effect of activation of recovery processes, increase the functional activity of tissues and organs. The complex treatment of destructive complicantions after fractures of mandible should contribute the optimization the processes of reparation and complete eliminating of defect, developing after sequestration. For this used osteoplastic materials , having stability to inflammation and the ability to arrest the local inflammatory reactions.

The purpose of our investagation is to show the etiopathogenic approaches to treatment of osteomyelitis of mandible by including in complex of treatment the preparaions with antihipoxant , antibacterial and local osteoplastic effects.

Materials and methods

Were examined 58 patients with osteomyelitis. In additional were 27 people as control group. All examinated were divided into 2 groups: 1 group(27 patients) healthy people in age 18-25 with no diseases. 2 group (the main) included 2 subgroups. In first (subgroup A) patients with traumatic osteomyelitis of mandible, received traditional complex treatment(with preparation tocopherol ) with local use the hydroxyapatite. In second group( subgroup B) 26 patients with traumatic osteomyelitis of mandible also used Erbisol.

The patients with traumatic osteomyelitis of mandible carried out immobilization of mandible. In remission phase carried out surgical treatment phase(sequestrectomy). During the operation the formed defect of bone filled partly (2/3) by sintetic osteoplastic material. After impregnation of the material with blood he cover all volume of defect.

Results and discussion

During the first month after prosthetics the changes had statistically insignificant character in both groups of observation.

The analysis of received data has showed that agains the bahground of use the preparation Erbisoland osteop material the inflammatory reactions occurred expressively and poetry at an earlier date.

The dynamics of recovery indexes had main value for us because it allow to estimate the level of efficiency of carried out operation(sequestration) and the quanity of developing secondary immunodeficiency which had the patients with traumatic osteomyelitis of mandible.

In this way the indexes of complex investagation and treatment in

patients with traumatic osteomyelitis has showed , that the disease ocurs against the background of local hypoxia. The learning of efficiency of tocopherol and erbisol has showed the advantage of erbisol.

Conclusions

1. The use preparation Erbisol significantly decrease the terms of adaptation of orghanism after proshetics in all group of observation.

2.     The immediate and long-term results of treatment of patients with traumatic osteomyelitis of mandible testified, that the most effective is to close osseous defect by bioresorbable osteoplastic material , doped with silver with next administration immunomodulator and antioxidant Erbisol in postoperative perioud.

3.     The use the immunomodulator Erbisol allow to reduce drug load on patients body at the expense of it unique features.