EXPERIENCE IN THE TREATMENT OF CHRONIC ODONTOGENIC OSTEOMYELITIS OF THE LOWER JAW IN A SURGICAL HOSPITAL
Abstract and keywords
Abstract (English):
Subject. More than 70% of patients with chronic odontogenic osteomyelitis are of working age. Chronic odontogenic osteomyelitis is detected in 10% of the total number of patients admitted to the maxillofacial hospital. In more than 20% of cases, relapses of diseases after osteonecrsequestrectomy are noted. Objective. To analyze the results of treatment of patients with chronic odontogenic osteomyelitis of the lower jaw to identify predisposing factors to the development of relapses after osteonecrosequestrectomy. Methodology. The analysis of medical records of 30 patients with chronic odontogenic osteomyelitis of the lower jaw, whose complex treatment included radical osteonecrosequestrectomy, was carried out. Re-sults. The average duration of inpatient treatment was 8.2±1.97 days, and patients with a bur-dened somatic history were treated 1.7 times longer. The most common cause of the disease (70%) was an inflammatory process localized in the area of the 3rd molar. Microbiological monitoring of the wound discharge after radical osteonecrsequestrectomy showed that the most common causative agent (70%) of cases was Staphylococcus aureus. At the same time, 60% of patients have a mixed microflora. This group of patients had the highest duration of inpatient treatment up to 16 days. The presence of a focus of chronic infection has not only a local (soreness, hyperemia, edema), but also a systemic effect on the body, which is reflected in the change in blood parameters. Conclusion. The residual microflora is a phlogogenic factor of local inflammation, acting as a trigger for primary alteration, stimulating the release of inflammatory mediators.

Keywords:
osteomyelitis of the lower jaw, osteonecrosis, osteonecrsequestrectomy, microbiological landscape, bacteriological study inflammatory changes, lower jaw, odontogenic diseases
References

1. Balaji S.M., Balaji P. Maxillary rehabilitation after complete destruction by fungal osteomyelitis // Indian journal of dental research. – 2019;30(5):807-809. https://doi.org/10.4103/ijdr.IJDR_711_19.

2. Liu D. et al. Chronic osteomyelitis with proliferative periostitis of the mandibular body: report of a case and review of the literature // Annals of the Royal College of Surgeons of England. – 2019;101(5):328-332. https://doi.org/ 10.1308/rcsann.2019.0021.

3. Dunphy L., Warfield A., Williams R. Osteomyelitis of the mandible secondary to malignant infantile osteopetrosis in an adult // BMJ Case Reports. – 2019;12(3):25-29. https://doi.org/ 10.1136/bcr-2018-224452.

4. Gill G.S., Pulcini M. Maxillary osteomyelitis in a patient with pansinusitis and recently diagnosed focal segmental glomerulosclerosis // Cureus. – 2019;11(8):534-537. https://doi.org/ 10.7759/cureus.5347.

5. Asif S. et al. Maxillary osteomyelitis with an incidental diagnosis of maxillary diffuse large b-cell lymphoma: a case report // Cureus. – 2019;11(7):523-528.

6. Artemova A.V., Dikusar A.A., Schekina L.A. Ispol'zovanie lazera v lechenii bol'nyh osteomielitami nizhney chelyusti. Byulleten' medicinskih internet-konferenciy. 2015;5(10):1188. [A.V. Artyomova, A.A. Dikusar, L.A. Shchekina. The use of a laser in the treatment of patients with osteomyelitis of the lower jaw. Bulletin of medical Internet conferences. 2015;5(10):1188. (In Russ.)].

7. Barannik N.G., Varzhapetyan S.D. Sostoyanie citokinovogo statusa bol'nyh vyalotekuschim ostrym odontogennym osteomielitom chelyustey. Science Rise. 2015;1;3(6):25-28. [N.G. Barannik, S.D. Varzhapetyan. The state of the cytokine status of patients with sluggish acute odontogenic osteomyelitis of the jaws. Science Rise. 2015;1;3(6):25-28. (In Russ.)].

8. Bozhkova S.A., Polyakova E.M., Krasnova M.V. Preodolenie ustoychivosti k gen-tamicinu u meticillinorezistentnyh shtammov stafilokokka. Mezhdunarodnyy zhur-nal prikladnyh i fundamental'nyh issledovaniy. 2017;8-1:97-103. [S.A. Bozhkova, E.M. Polyakova, M.V. Krasnova. Overcoming gentamicin resistance in methicillin-resistant strains of staphylococcus. International Journal of Applied and Basic Research. 2017;8-1:97-103. (In Russ.)]. https://www.elibrary.ru/item.asp?id=29810153

9. Bozhkova S.A., Novokshonova A.A., Konev V.A. Sovremennye vozmozhnosti lo-kal'noy antibiotikoterapii periproteznoy infekcii i osteomielita (obzor litera-tury). Travmatologiya i ortopediya Rossii. 2015;3(77):92-107. [S.A. Bozhkova, A.A. Novokshonova, V.A. Konev. Modern possibilities of local antibiotic therapy of periprosthetic infection and osteomyelitis (literature review). Traumatology and Orthopedics of Russia. 2015;3(77):92-107. (In Russ.)].

10. Carev V.N. i dr. Vzaimosvyaz' klinicheskogo techeniya hronicheskogo osteomielita nizhney chelyusti i ekspressii receptornyh molekul kletochnoy aktivacii. Endodontiya Today. 2017;2:41-47. [V.N. Tsarev et al. The relationship between the clinical course of chronic osteomyelitis of the lower jaw and the expression of receptor molecules of cellular activation. Endodontics Today. 2017;2:41-47. (In Russ.)]. https://www.elibrary.ru/item.asp?id=29969383

11. Terehova R.P. i dr. Vozbuditeli osteomielita dlinnyh kostey i ih rezistent-nost'. Rany i ranevye infekcii. 2016;3;2:24-30. [R.P. Terekhova et al. Causative agents of osteomyelitis of long bones and their resistance. Wounds and wound infections. 2016;3;2:24-30. (In Russ.)].

12. Gubin M.A., Eliseev V.V., Kudinov Yu.A. Hronicheskiy odontogennyy osteomielit chelyustey. Sovremennye metody diagnostiki i lecheniya. Metodicheskie rekomendacii. Voronezh : OKSP. 2004:24. [M.A. Gubin, V.V. Eliseev, Yu.A. Kudinov. Chronic odontogenic osteomyelitis of the jaws. Modern methods of diagnosis and treatment. Guidelines. Voronezh: OKSP. 2004:24. (In Russ.)].

13. Guseynova M.G., Bisaev U.I. Farmakoterapiya flegmony i odontogennogo osteo-mielita chelyustnyh kostey. Byulleten' medicinskih internet-konferenciy. 2017;7;6:1279. [M.G. Guseinova, U.I. Bisaev. Pharmacotherapy of phlegmon and odontogenic osteomyelitis of the jaw bones. Bulletin of medical Internet conferences. 2017;7;6:1279. (In Russ.)].

14. Dzhumaev Sh.M., Tairov U.T. Endoprotezirovanie kostnyh defektov i deforma-cii pri osteomielitah nizhney chelyusti. Izvestiya VUZov Kyrgyzstana. 2016;9:57-60. [Sh.M. Dzhumaev, U.T. Tairov. Endoprosthetics of bone defects and deformities in osteomy-elitis of the lower jaw. News of the universities of Kyrgyzstan. 2016;9:57-60. (In Russ.)].

15. Sletov A.A. i dr. Diagnostika i prognozirovanie hirurgicheskogo lecheniya pa-cientov s osteonekrozami i asepticheskimi osteomielitami chelyustnyh kostey. Krym-skiy terapevticheskiy zhurnal. 2018;1(36):73-77. [A.A. Sletov et al. Diagnostics and pre-diction of surgical treatment of patients with osteonecrosis and aseptic osteomyelitis of the jaw bones. Crimean therapeutic journal. 2018;1(36):73-77. (In Russ.)]. https://www.elibrary.ru/item.asp?id=32522216

16. Balmasova I.P. i dr. Kliniko-immunologicheskiy podhod k differencial'noy diagnostike i hirurgicheskomu lecheniyu pervichno hronicheskogo osteomielita nizhney chelyusti. Klinicheskaya stomatologiya. 2018;4(88):38-43. [I.P. Balmasova et al. Clinical and immunological approach to differential diagnosis and surgical treatment of primary chronic osteomyelitis of the mandible. Clinical dentistry. 2018;4(88):38-43. (In Russ.)].https://www.elibrary.ru/item.asp?id=36517614

17. Chergeshtov Yu.I. i dr. Kliniko-laboratornoe issledovanie antibakterial'noy effektivnosti ozonoterapii i svetodiodnogo izlucheniya pri lechenii al'veolita i osteomielita chelyusti. Klinicheskaya stomatologiya. 2015;4(76):36-41. [Yu.I. Chergeshtov et al. Clinical and laboratory study of the antibacterial effectiveness of ozone therapy and LED radiation in the treatment of alveolitis and osteomyelitis of the jaw. Clinical dentistry. 2015;4(76):36-41. (In Russ.)]. https://www.elibrary.ru/item.asp?id=25136362

18. Lepskiy V.V. Differencial'naya diagnostika al'veolita, ostrogo osteomielita lunki i ostrogo nevrita lunochkovogo nerva (klinicheskie nablyudeniya). Vestnik problem biologii i mediciny. 2015;1;4(124):287-289. [V.V. Lepskiy. Differential diagnosis of alveolitis, acute osteomyelitis of the socket and acute neuritis of the lunar nerve (clinical observations). Bulletin of problems of biology and medicine. 2015;1;4(124):287-289. (In Russ.)]. https://www.elibrary.ru/item.asp?id=36328463

19. Lepskiy V.V. Oshibki v diagnostike i lechenii hronicheskogo osteomielita al'veolyarnogo otrostka. Svit medicini ta biologii. 2015;11;4-2(54):37-39. [V.V. Lepskiy. Errors in the diagnosis and treatment of chronic osteomyelitis of the alveolar bone. Svit medi-cine and biology. 2015;11;4-2(54):37-39. (In Russ.)]. https://www.elibrary.ru/item.asp?id=25625536

20. Moskalev A.V., Galkina O.V. Osobennosti razvitiya odontogennogo osteomieli-ta chelyustey. Infekciya i immunitet. 2016;6;3:73. [A.V. Moskalev, O.V. Galkina. Fea-tures of the development of odontogenic osteomyelitis of the jaws. Infection and immunity. 2016;6;3:73. (In Russ.)].

21. Bahteeva G.R. i dr. Prognozirovanie razvitiya osteomielita nizhney chelyusti po dannym ul'trazvukovogo issledovaniya. Dental Forum. 2016;4:14. [G.R. Bakhteeva et al. Prediction of the development of osteomyelitis of the lower jaw according to ultrasound. Dental Forum. 2016;4:14. (In Russ.)]. https://www.elibrary.ru/item.asp?id=27300195

22. Sirak S.V., Andreev A.A. Regeneraciya kostnoy tkani pri perelomah nizhney chelyusti, oslozhnennyh travmaticheskim osteomielitom nespecificheskoy etiologii. Stomatologiya. Estetika. Innovacii. 2018;2;4:479-484. [S.V. Sirak, A.A. Andreev. Re-generation of bone tissue in fractures of the mandible complicated by traumatic osteomyelitis of nonspecific etiology. Dentistry. Aesthetics. Innovation. 2018;2;4:479-484. (In Russ.)].

23. Slepov A.V., Zaycev A.B. Ozonoterapiya v kompleksnom hirurgicheskom lechenii osteomielita. Bioradikaly i antioksidanty. 2018;5;3:215-217. [A.V. Slepov, A.B. Zaitsev. Ozone therapy in the complex surgical treatment of osteomyelitis. Bioradicals and antioxidants. 2018;5;3:215-217. (In Russ.)].

24. Novomlinskiy V.V. i dr. Sovremennye aspekty diagnostiki i lecheniya osteo-mielita. Obzor literatury. Sovremennye problemy nauki i obrazovaniya. 2016;5:122. [V.V. Novomlinsky et al. Modern aspects of diagnosis and treatment of osteomyelitis. Litera-ture review. Modern problems of science and education. 2016;5:122. (In Russ.)].

25. Sakovich N.V. i dr. Sovremennye aspekty etiologii, diagnostiki i lecheniya osteomielita. Vestnik eksperimental'noy i klinicheskoy hirurgii. 2018;11;1:70-79. [N.V. Sakovich et al. Modern aspects of the etiology, diagnosis and treatment of osteomyeli-tis. Bulletin of Experimental and Clinical Surgery. 2018;11;1:70-79. (In Russ.)]. https://doi.org/10.18499/2070-478X-2018-11-1-70-79


Login or Create
* Forgot password?