employee
Nizhniy Novgorod, Nizhny Novgorod, Russian Federation
graduate student
Nizhniy Novgorod, Nizhny Novgorod, Russian Federation
employee
Nizhniy Novgorod, Nizhny Novgorod, Russian Federation
graduate student
Nizhniy Novgorod, Nizhny Novgorod, Russian Federation
graduate student
Nizhniy Novgorod, Nizhny Novgorod, Russian Federation
Subject. The article presents the results of a comprehensive method for the treatment of acute perforated maxillary sinusitis using the developed surgical method for eliminating perforation with a subepithelial vascular palatal flap with simultaneous use of PRF. The effectiveness of the proposed method of treatment was confirmed by x-ray data characterizing the intensity of the inflammatory reaction caused by surgery, morphological parameters of soft tissues in the alveolar process of the upper jaw in the area of intervention and the state of the maxillary sinus before and 3 months after surgery. The aim of the study was to evaluate the effectiveness of the use of subepithelial vascular palatal flap and PRF in the complex treatment of acute odontogenic perforated maxillary sinusitis. Methodology. An assessment and comparative analysis of the activity of the inflammatory process caused by surgery, as well as the study and comparison of the morphological parameters of the alveolar ridge (the depth of the vestibule of the oral cavity, the width of the keratinized gums, and the thickness of the mucous membrane), the X-ray data evaluating the state of the maxillary sinus, before and after 3 months were carried out. after surgical procedures. The study involved 50 patients with acute perforated maxillary sinusitis (J01.0), who were divided into two groups: the main and comparisons. In the main group (25 people), a new developed method of surgical treatment was used (a method of subepithelial vascularized palatal flap with simultaneous use of PRF), in the comparison group (25 people), the traditional method of complex treatment, including a mobilized mucoperiosteal cheek flap to eliminate perforation of the maxillary sinus . Results. Based on the analysis of the data, pronounced manifestations of the inflammatory process of the postoperative period and negative treatment results using the traditional technique, which were absent in the treatment of patients with the developed surgical method, were revealed. Findings. An analysis of the results obtained during the study revealed the high efficiency of the developed method in comparison with the traditional one.
maxillofacial surgery, dental surgery, maxillary sinus perforation, oroantral communication, odontogenic maxillary sinusitis, subepithelial palatine flap, PRF, elimination of oroantral communication, mobilized muco-periosteal buccal flap, maxillary sinus perforation closure
1. Timofeev, A. A. (2007). Osnovy chelyustno-litsevoy khirurgii : uchebnoye posobiye [Basics of maxillofacial surgery: textbook]. Moscow : Medical information Agency LLC, 315. (In Russ.)
2. Eremenko, A. I., Matina, V. N., Suslov, D. N., Lysenko, A. V. (2015). Khronicheskiy odontogennyy verkhnechelyustnoy sinusit: sovremennoye sostoyaniye problemy (obzor literatury) [Chronic odontogenic maxillary sinusitis: current state of the problem (literature review)]. Mezhdunarodnyy zhurnal prikladnykh i fundamental'nykh issledovaniy [International journal of applied and fundamental research], 10-5, 834-837. (In Russ.)
3. Durnovo, E. A., Eremenko, A. I., Panin, A. M., ed. Kulakov, A. A. et al. (2019). Vospalitel'nyye zabolevaniya chelyustno-litsevoy oblasti [Inflammatory diseases of the maxillofacial region]. Chelyustno-litsevaya khirurgiya : natsional'noye rukovodstvo [Maxillofacial surgery: national guide], Moscow: GEOTAR-Media, 109-232. (In Russ.)
4. Gulyuk, A. G., Varzhapetyan, S. D. (2015). Differentsial'naya diagnostika i lecheniye yatrogennykh gaymoritov stomatogennogo proiskhozhdeniya: monografiya [Differential diagnosis and treatment of iatrogenic sinusitis of stomatogenic origin: monograph]. 2, Zaporozhye : Krugozor, 254. (In Russ.)
5. Piskunov, G. Z., Piskunov, S. Z. (2017). Klinicheskaya rinologiya [Clinical rhinology]. 3, Moscow : Medical information Agency, 750. (In Russ.)
6. Afanasiev, V. V. et al. (2010). Khirurgicheskaya stomatologiya : uchebnik [Surgical dentistry: textbook]. Moscow : GEOTAR-Media, 880. (In Russ.)
7. Durnovo, E. A., Fedorichev, A. O., Homutinnikova, N. Ye. (2019). Sovremennyy vzglyad na problemu ustraneniya oroantral'nykh soobshcheniy: obzor literatury [Modern view on the problem of eliminating oroantral messages: literature review]. Stomatologiya [Dentistry], 2, 76-80. doi:https://doi.org/10.17116/stomat20199802176. (In Russ.)
8. Hirata, Y., Kino, K., Nagaoka, S. et al. (2001). A clinical investigation of oro-maxillary sinus-perforation due to tooth extraction. Kokubyo Gakkai Zasshi, 68, 3, 249-253. doi:https://doi.org/10.5357/koubyou.68.249.
9. Arias-Irimia, O., Barona-Dorado, C., Santos-Marino, J. A. et al. (2010). Meta-analysis of the etiology of odontogenic maxillary sinusitis. Medicina oral, patologia oral y cirugia bucal, 15, 1, 70-73. doi:https://doi.org/10.4317/medoral.15.e70
10. Lazutikov, D. O., Morozov, A. N., Chirkova, N. V. et al. (2018). Obzor metodov plastiki odontogennykh perforatsiy verkhnechelyustnogo sinusa (obzor literatury) [Elektronnyy resurs] [Review of methods of odontogenic perforations of the maxillary sinus closure (literature review) [Electronic resource]]. Vestnik novykh meditsinskikh tekhnologiy : elektronnyy zhurnal [Bulletin of new medical technologies: electronic journal], 3. URL : https://cyberleninka.ru/article/n/obzor-metodov-plastiki-odontogennyh-perforatsiy-verhnechelyustnogo-sinusa-obzor-literatury. (In Russ.)
11. Sysolyatin, S. P. (2010). Odontogennyy verkhnechelyustnoy sinusit: voprosy etiologii [Odontogenic maxillary sinusitis: questions of etiology]. Voprosy chelyustno-litsevoy, plasticheskoy khirurgii, implantologii i klinicheskoy stomatologii [Questions of maxillofacial, plastic surgery, implantology and clinical dentistry], 2-3, 3-6. (In Russ.)
12. Shulakov, V. V., Luzina, V. V., Tsarev, V. N. et al. (2011). Odontogennyye perforatsii verkhnechelyustnykh pazukh: prichiny razvitiya oslozhneniy i printsipy ikh preduprezhdeniya [Odontogenic perforations of the maxillary sinus: causes of complications and principles of their prevention]. Klinicheskaya stomatologiya [Clinical stomatology], 1, 22-27. doi:https://doi.org/10.17116/otorino201580275-80. (In Russ.)
13. Solovykh, A. G., Angutaev, I. B., Avdeev, K. S. (2014). Yatrogennyy odontogennyy gaymorit [Iatrogenic odontogenic sinusitis]. Rossiyskaya rinologiya [Russian rhinology], 4, 51-56. (In Russ.)
14. Bykanova, T. G. (2003). Konservativnoye i khirurgicheskoye lecheniye odontogennykh verkhnechelyustnykh sinusitov : dis. ... kand. med. nauk : 14.00.04 [Conservative and surgical treatment of odontogenic maxillary sinusitis: dis. cand. doc. med. Sciense : 14.00.04]. Saint Petersburg,143. (In Russ.)
15. Sipkin, A. M. (2013). Diagnostika, lecheniye i reabilitatsiya bol'nykh oslozhnennymi formami verkhnechelyustnogo sinusita s primeneniyem maloinvazivnykh khirurgicheskikh metodov : dis. ... d-ra med. nauk : 14.01.14 [Diagnostics, treatment and rehabilitation of patients with complicated forms of maxillary sinusitis using minimally invasive surgical methods : dis. Doctor of Medical Sciences: 14.01.14]. Moscow, 207. (In Russ.)
16. Davydov, D. V., Gvozdovich, V. A., Stebunov, V. E., Manakina, A. Yu. (2014). Odontogennyy verkhnechelyustnoy sinusit: osobennosti diagnostiki i lecheniya [Odontogenic maxillary sinusitis: features of diagnosis and treatment]. Vestnik otorinolaringologii [Bulletin of otorhinolaryngology], 1, 4-7. (In Russ.)
17. Vishnyakov, V. V., Makarova, N. V. (2013). Otsenka rezul'tatov khirurgicheskogo lecheniya patsiyentov s odontogennym verkhnechelyustnym sinusitom [Evaluation of the results of surgical treatment of patients with odontogenic maxillary sinusitis]. Rossiyskaya rinologiya [Russian rhinology], 3, 20-22. (In Russ.)
18. Shchipsky, A. B., Mukhin, P. N., Filatkina, I. V. (2009). Sposob plastiki perforatsii verkhnechelyustnogo sinusa : pat. № 2370220 Rossiyskaya Federatsiya, MPK A61V17/00 [Method of the maxillary sinus perforation closure: Pat. no. 2370220 Russian Federation, IPC A61B17 / 00]. Applicant and patent holder of the Moscow state medical and dental University of the Federal Agency for health and social development of the Russian Federation, 2008111623/14 ; 27.03.2008 ; 20.10.2009, 29. (In Russ.)
19. Ed. Palchun, V. T. (2016). Otorinolaringologiya : natsional'noye rukovodstvo [Otorhinolaryngology : national guide]. Moscow : GEOTAR-Media, 1024. (In Russ.)
20. Sakakibara, A., Furudoi, S., Sakakibara, S. et al. (2015). Tunnel technique for the closure of an oroantral fistula with a pedicled palatal mucoperiosteal flap. Journal of maxillofacial and oral surgery, 14, 3, 868-874. doi:https://doi.org/10.1007/s12663-014-0703-z
21. de Souza Lopes, P. H., de Oliveira Sampaio, D., de Souza Menezes, B. L. et al. (2015). Combined palatal flap and titanium mesh for oroantral fistula closure. Annals of maxillofacial surgery, 5, 1, 89-92. doi:https://doi.org/10.4103/2231-0746.161090
22. Manuel, S., Kumar, S., Nair, P. R. (2015). The versatility in the use of buccal fat pad in the closure of oro-antral fistulas. Journal of maxillofacial and oral surgery, 14, 2, 374-377. doi:https://doi.org/10.1007/s12663-014-0669-x
23. Batra, J., Attresh, G., Garg, B., Porwal, S. (2015). Double-layered closure of chronic oroantral fistulas using a palatal rotational flap and suturing of the sinus membrane perforation: is it a successful technique? Journal of Maxillofacial and Oral Surgery, 73, 9, 1668-1669. doi:https://doi.org/10.1016/j.joms.2015.04.043
24. Kapustecki, M., Niedzielska, I., Borgiel-Marek, H., Różanowski, B. (2016). Alternative method to treat oroantral communication and fistula with autogenous bone graft and platelet rich firbin. Medicina oral, patologia oral y cirugia bucal, 21, 5, 608-613. doi:https://doi.org/10.4317/medoral.21037
25. Pandikanda, R., Singh, R., Patil, V. et al. (2019). Flapless closure of oro-antral communication with PRF membrane and composite of PRF and collagen - a technical note. Journal of stomatology, oral and maxillofacial surgery, 120, 5, 471-473. doi:https://doi.org/10.1016/j.jormas.2018.12.012.
26. Choukroun, J. (2014). Advanced PRF and i-PRF: platelet concentrate or blood concentrate? Journal Periodontal. Med. Clin. Pract, 1, 1-3.
27. Marrelli, M., Tatullo, M. (2013). Influence of PRF in the healing of bone and gingival tissues. Clinical and histological evaluations. European review for medical and pharmacological sciences, 17, 14, 1958-1962.
28. Dohan, D. M., Choukroun, J., Diss, A. et al. (2006). Platelet-rich fibrin (PRF): a second-generation platelet concentrate. Part II: Platelet-related biologic features. Oral surgery, oral medicine, oral pathology, oral radiology, and endodontics, 101, 3, e45-e50. doi:https://doi.org/10.1016/j.tripleo.2005.07.009
29. Lang, T. A., Sesik, M., ed. Leonov, V. P. (2011). Kak opisyvat' statistiku v meditsine. Annotirovannoye rukovodstvo dlya avtorov, redaktorov i retsenzentov [How to report statistics in medicine. Annotated guide for authors, editors and reviewers]. Moscow : Practical medicine, 480. (In Russ.)
30. Mastitsky, S. E., Shitikov, V. K. (2015). Statisticheskiy analiz i vizualizatsiya dannykh s pomoshch'yu R [Statistical analysis and visualization of data using R]. Moscow : DMK Press, 496. (In Russ.)
31. Durnovo, E. A., Tishkova, S. K., Kuzmin, A. V., Fedorichev, A. O. (2018). Sposob plastiki perforatsii verkhnechelyustnogo sinusa : pat. 2649514 Rossiyskaya Federatsiya, MPK A61B 17/00 [Method of plastic perforation of the maxillary sinus: Pat. 2649514 Russian Federation, IPC A61B 17/00]. Applicant and patent holder of the Volga research medical University OF the Ministry of health of the Russian Federation, 2016149700 ; 16.12.2016 ; 03.04.2018, 10. (In Russ.)
32. Troshkova, G. B. (1987). Kliniko-eksperimental'noye obosnovaniye metodov operativnogo lecheniya bol'nykh odontogennym verkhnechelyustnym sinusitom, oslozhnennym oro-antral'nym soobshcheniyem : avtoref. … dis. kand. med. nauk [Clinical and experimental substantiation of methods of surgical treatment of patients with odontogenic maxillary sinusitis complicated by Oro-antral communication : author of the thesis of the candidate of medical Sciences]. Leningrad, 24. (In Russ.)
33. Kozlov, V. A. (2014). Vospalitel'nyye zabolevaniya i povrezhdeniya tkaney chelyustno-litsevoy oblasti : rukovodstvo dlya vrachey [Inflammatory diseases and tissue damage of the maxillofacial region: a guide for doctors]. Saint Petersburg : SpetsLit, 415. (In Russ.)
34. Kozlov, V. A., Troshkova, G. B., Kochubey, N. M., Nekachalov, V. V. (1982). Dinamika morfologicheskikh izmeneniy tkaney verkhnechelyustnoy pazukhi pri eksperimental'nom perforativnom verkhnechelyustnom sinusite [Dynamics of morphological changes in maxillary sinus tissues in experimental perforative maxillary sinusitis]. Stomatologiya [Dentistry], 1, 49-51. (In Russ.)
35. Uspenskaya, O. A., Fadeeva, I. I. (2019). Osobennosti stomatologicheskogo statusa u patsiyentov s onkologicheskimi zabolevaniyami [Features of the dental status in patients with oncological diseases]. Problemy stomatologii [Actual problems in dentistry], 63-67. (In Russ.)
36. Uspenskaya, O. A. (2019). Issledovaniye biokhimicheskikh pokazateley kostnogo metabolizma rotovoy zhidkosti pri lechenii agressivnykh form parodontita [Study of biochemical parameters of bone metabolism of oral fluid in the treatment of aggressive forms of periodontitis]. Problemy stomatologii [Actual problems in dentistry], 1 (15), 68-73. (In Russ.)
37. Uspenskaya, O. A., Kachesova, E. S. (2017). Izmeneniya biokhimicheskikh pokazateley krovi pri lechenii bystroprogressiruyushchego parodontita [Changes in the biochemical parameters of blood in the treatment of rapid-progressing periodontitis]. Problemy stomatologii [Actual problems in dentistry], 13, 2, 33-38. (In Russ.)
