USING MACRO- AND MICROELEMENT CONTENT OF THE AUTOLOGIC BONE MARROW AND ARTIFICIAL BONE SUBSTITUTES IN THE TREATMENT OF PATIENTS WITH POSTOPERATIVE BONE DEFECTS OF THE JAWS

Piuryk V., Prots H., Ohienko S., Piuryk Y., Mahlanetc N.

CONTENTS

Scentific article

The research is dedicated to the development of new operations – medical methods of postoperative filling bone defects that consist in developing and applying new materials based on osteoplastic autologous bone marrow of a human and synthetic bone substitutes. Numerous researches proved that the vital elements necessary to ensure the normal functioning of systems and organs are iron, calcium, zinc and manganese. Therefore, iron – is trace mineral that is part of the more than 70 enzyme systems involved in the transport of oxygen (myoglobin) and electrons (cytochromes) is a catalyst of lipid peroxidation, affects the immune system, the development of body cells and so on. Calcium – is macronutrients, which is part of the bone and cartilage tissue provides important cell functions (enzymatic, energy, secretory, phagocytic) affects the metabolism. Zinc and manganese – are micronutrients involved in the activation of enzyme systems and ensure the normal reproduction and development of cells. Basing on the clinical, radiographic, anthropometric, ehoosteometric researches is was proved that following the traditional methods of treating radicular cysts of the jaws formed bony cavity the healing which is accompanied, especially in medium and large size cavities, frequent complications, and formation of bone regenerate is long-lasting. The clinical and biochemical studies have found no local or general impact of newly created composite materials on the the patient. Depending on the nature of the material undergoing replacement postoperative bone cavity, patients were di-vided into 7 groups: Group 1 – 20 patients whose bone replacement was performed oral blood clot, Group 2 – 20 patients – according Bioactive glass, group 3 – 20 patients – Stimulus-Oss and 4 group – 20 patients – Kolapan, 5, 6, 7 groups of 20 patients each, postoperative bone defects based on them replaced with autologous bone marrow (CM) and one of the synthetic drugs (Bioactive glass, Stimulus-Oss, Kolapan). For the reliability study selected patients aged 18-60 years without expressed comorbidities, including connective tissue diseases that could influence the reparative processes in bone. Bone marrow obtained by abstraction iliac bone, in the amount of 5-7 ml, which was sufficient to create a com-bined graft using the stabilizer “Glyugitsyr”. Results. All 7th postoperative groups of patients ran with minor complications. Thus, in 4 patients of group 1 (20%) and 5-patients 2, 3, 4 groups (25%) in 1 patient at 5, 6, 7 groups (5%) were recorded signs of suppuration of the wound, accompanied by fever and discharge pus. Subsequently, these patients were wound under aseptic bandage. The smallest percent of inflammatory complications in patients with Group III, in our view may explain anti-inflammatory effect created composite material. Such clinical signs as spontaneous pain in the damage, pain on palpation, swelling, redness of the oral mucosa disappeared in patients of group 1 through 6,8±1,2 days in patients 2, 3, 4, groups listed symptoms lasted 6, 08±0,4 days in patients 4, 5, 6 groups – 4,9±0,7 days (p<0,05). In 4 (20%) patients in Group I and in 3 patients (15%) of the second group differences were observed in part the wound edges without suppuration. At control examination at 1 month after surgery in all groups of patients were observed inconspicuous scars on-site intervention, the mucous membrane was pale pink, smooth and shiny. After 4 weeks, the patient was marked had surgery fortifications teeth that had I-II degree of mobility. Number of teeth on the degree of mobility and de-creased in patients of group 1 with 35±6% and 15±4% of patients 2, 3, 4 groups with 32±2% to 14±2% (P> 0. 05), 4, 5, 6 – 34±3 to 8±2% (p<0,05). In all groups of patients after 6 months of follow all the teeth are stable. In the dynamic X-ray alveolar processes of patients after cystectomy with osteoplasty mixture of autologous bone marrow and synthetic bone substitutes after 1 month appears quite clear signs of active bone forming pro-cesses in place bone defects. They were shown the emergence blur and loss of definition television of contours bone cavity, change contrast of TKF and HA particles as a result of biodegradation and occurrence in multiple locations delicate mesh of bony trabeculae of the newly formed bone. With increasing time of observation of bone structure changed and differentiated into mature trabecular patterned with distinctive and differed from neighbor-ing areas of bone. Atrophy and deformation of the crest of the alveolar process of the jaws in place of surgery was not determined radiographically. There have been developed, proved and approbated the new methods for filling bone cavities by combining artificial substitutes and autologous bone marrow that would allow effective prevention of the development of complications of inflammatory and atrophic character.

cavity defects of the jaws,, artificial substitutes for bone, bone marow

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