Clinical case of surgical treatment of patient with toxic phosporus osteonecrosis of maxilla

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Abstract

During the last few years on the territory of the Russian Federation, the number of cases of toxic phosphoric osteonecrosis of the jaws illicit use of drugs of “artisanal” production (pervitin, desomorphin). The aim of our study was to increase the effectiveness of surgical treatment of a patient diagnosed of toxic phosphorus necrosis of the maxilla. We performed a comprehensive treatment of a patient with a history of drug addiction and the above diagnosis. We performed complete resection of pathologically altered tissues and reconstructive techniques using local tissues and a replaced flap. This achieves good esthetic and functional results in the early and late postoperative period. Thus, we can use our proposed method of surgical treatment in similar clinical situations.

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About the authors

Yu. A. Medvedev

A.I. Evdokimov Moscow State University of Medicine and Dentistry of the Ministry of Health of the Russian Federation

Email: dispiryan@gmail.com
Russian Federation, Moscow

Davit Kh. Ispiryan

I.M. Sechenov First Moscow State Medical University of the Ministry of Health of the Russian Federation (Sechenov University)

Author for correspondence.
Email: dispiryan@gmail.com

post graduate student of Department of Maxillofacial Surgery of I.M. Sechenov First Moscow State Medical University of the Ministry of Health of the Russian Federation (Sechenov University)

Russian Federation, Moscow

I. V. Zakharova

Ryazan State Medical University

Email: dispiryan@gmail.com
Russian Federation, Ryazan

P. S. Petruk

I.M. Sechenov First Moscow State Medical University of the Ministry of Health of the Russian Federation (Sechenov University)

Email: dispiryan@gmail.com
Russian Federation, Moscow

References

  1. Adornato MC, Morcos I, Rozanski J. The treatment of bisphosphonate-associated osteonecrosis of the jaws with bone resection and autologous platelet-derived growth factors. J Am Dent Assoc. 2007;138(7):971–7. doi: 10.14219/jada.archive.2007.0294.
  2. Basin EM, Medvedev YuA. Toxic phosphorus osteonecrosis of facial bones among drug addicts to desomorphine and pervitin. Part I. Stoma-tologiya. 2015;94(2):53–7. (in Russian) doi: 10.17116/stomat201594253–57.
  3. Marx RE, Sawatari Y, Fortin, M, Broumand V. Bisphosphonate induced exposed bone (osteonecrosis/osteopetrosis) of the jaws: risk factors, recog-nition, prevention, and treatment. J Oral Maxillofac Surg. 2005;63(11):1567–75. doi: 10.1016/j.joms.2005.07.010.
  4. Coleman RE. Risks and benefits of bisphosphonates. Br J Cancer. 2008;98(11):1736–40. doi: 10.1038/sj.bjc.6604382.
  5. Dimopoulos M, Kastritis E, Moulopoulos LA, Melakopoulos I, Anagnostopoulos A, Gika D. et al. The incidence of osteonecrosis of the jaw in pa-tients with multiple myeloma who receive bisphosphonates depends on the type of bisphosphonate. Blood. 2005;106(11):637. doi: 10.1182/blood.v106.11.637.637.
  6. Eisele DW, Smith RV. Complications in head and neck surgery. 2nd ed. Philadelphia: Mosby, Elseiver; 2009.
  7. Medvedev YuA, Basin EM, Serova NS, Korshunova AV, Babkova AA, Kureshova DN. Total jaw osteonecrosis among drug addicts. Rossiyskiy stoma-tologicheskiy zhurnal. 2016;20(4):183–9. (in Russian) doi: 10.18821/1728–28022016;20(4)183–189.
  8. Malanchuk VA, Brodetskiy IS. Complex treatment of patients with osteomyelitis of the jaws on the background of drug addiction. Vestnik Vi-tebskogo gosudarstvennogo meditsinskogo universiteta. 2014;13(2):115–23. (in Russian)

Supplementary files

Supplementary Files
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1. JATS XML
2. Fig. 1. The patient on admission to the clinic.

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3. Fig. 2. Defect and bare area of the upper jaw bone in the projection of teeth 14–18 of a light sandy color, defect of the hard palate up to 4 × 3.5 cm in the area of teeth 22–23.

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4. Fig. 3. Scheme of elimination of a defect of the upper jaw, hard palate with flaps on the feeding pedicle from the cheek, transitional fold, nasolabial region.

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5. Fig. 4. Stage of the operation.

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6. Fig. 5. Macro-specimen of the resected upper jaw.

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7. Fig. 6. Control examination: no signs of recurrence of the disease.

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СМИ зарегистрировано Федеральной службой по надзору в сфере связи, информационных технологий и массовых коммуникаций (Роскомнадзор).
Регистрационный номер и дата принятия решения о регистрации СМИ: серия ЭЛ № ФС 77 - 80635 от 15.03.2021 г
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