РАСПРОСТРАНЕННОСТЬ И КЛИНИЧЕСКИЕ ОСОБЕННОСТИ МЕДИКАМЕНТОЗНО АССОЦИИРОВАННЫХ ОСТЕОНЕКРОЗОВ ЧЕЛЮСТЕЙ

Abstract

Subject of study. Bisphosphonate - related osteonecrosis of the jaw (BRONJ) is a severe complication, which may arise in patients, receiving BP therapy and also in patients taking designer drugs (desomorphine, methamphetamine). Urgency of the study is caused by broad bisphosphonate administration in patients with the proved bone metastasises, myelomatosis, Paget disease. Use of red phosphorus at clandestine production of desomorphine and methamphetamine in patients with drug abuse. Atypical forms of osteomyelitis develop at these two categories of people. Purpose - to study the prevalence and features of clinical and X-ray picture of the drug-related osteonecrosis. Methodology. The study is based on retrospective survey of records and X-ray examination of patients being on treatment in maxillofacial surgery’s unit in MAU “CGKB” (Central Clinical City Hospital) #23 in 2013-2017. Results. Drug - related osteonecrosis was diagnosed in 31.2% hospitalization cases with jaw osteomyelitis. In 50% designer drugs taking (desomorphine, methamphetamine) was the reason. In 50% was the administration of bisphosphonates therapy at bone metastasises in patients with malignant neoplasms and myelomatosis. The clinical picture is characterized by protracted disease course with frequent relapses. At X-ray examination the lack of sequesters with an accurate demarcation zone is characteristic. Conclusions. Prevalence of drug-related osteonecrosis is increasing due to widespread use of drugs called Zoledronic acid in patients with cancer. Detailed history taking on the outpatient reception hours plays the leading role at osteonecrosis diagnostics. Chemotherapy as well as continuing of designer drugs taking promotes progressing of osteonecrosis of a jaw and its relapses in spite of the treatment. Relapses nascency is the reason for rehospitalizations.