МИКРОЦИРКУЛЯТОРНЫЕ НАРУШЕНИЯ СЛИЗИСТОЙ ОБОЛОЧКИ АЛЬВЕОЛЯРНЫХ ОТРОСТКОВ У ПАЦИЕНТОВ С МЕДИКАМЕНТОЗНОАССОЦИИРОВАННЫМ ОСТЕОНЕКРОЗОМ ЧЕЛЮСТИ

Abstract

The research is relevant due to the widespread use of osteomodifying agents among patients with bone metastases with malignant neoplasms of various localization. The healing process is sluggish due to the toxic effect of these medications, including their influence on soft tissues; it often occurs that relapse sets in after surgical treatment. The research aims to study possible variants and degree of mucosa microcirculation disorders of the alveolar processes among patients with drug-associated osteonecrosis of the jaw. Materials and methods of the research. Microcirculation was examined with the method of Laser Doppler flowmetry (LDF) with the LAKK-OP analyzer (modification 1) (SPE “LAZMA” Ltd, Moscow). The patients diagnosed with drug-associated osteonecrosis of the jaw were examined for microcirculation by Laser Doppler flowmetry method in the lesion and at the side with no visible clinical manifestations. The exclusion criterion was the patient’s general medical condition with the score no less than three on the EGOC scaling. The comparison group included practically healthy volunteers. The exclusion criteria were complete secondary adentia, heart defects, hypertension, vascular pathology, diabetes mellitus, cancer, bronchial asthma, chronic obstructive pulmonary disease, maxillofacial inflammatory diseases, HIV infection. 
 Results. The perfusion index among the patients with drug-associated osteonecrosis of the jaw was lower by 0.65 pf. units (17,53 ± 4,04 pf. units) in the lesion and by 2,14 pf. units (16,14 ± 3,23 pf. units) at the side with no visible clinical manifestation compared to the healthy group (18,18 ± 6,24 pf. units). The average amplitude of myogenic oscillations in the main group (3,24 ± 2,08 pf. units) was higher than the oscillation indices of different origin; on the contrary, in the comparison group, as well as in the healthy part of the main group, the amplitude of neurogenic oscillations prevailed (1,64 ± 0,91 pf. units and 3,41 ± 1,53 pf. units). Conclusion. The research reveals impaired microcirculation symptoms of the ischemic-stagnant type, both in the lesion and at the side with no visible clinical manifestations, which indicates a system failure of the mucous membrane of alveolar processes among these patients.