employee from 01.01.2015 until now
Stavropol State Medical University (kafedra hirurgicheskoy stomatologii i chelyustno-licevoy hirurgii, assistent)
employee from 01.01.2023 until now
Stavropol, Stavropol, Russian Federation
employee
City Clinical Emergency Hospital
employee
Stavropol, Stavropol, Russian Federation
employee
Stavropol, Stavropol, Russian Federation
employee
Stavropol, Stavropol, Russian Federation
employee
Stavropol, Stavropol, Russian Federation
UDK 616 Патология. Клиническая медицина
GRNTI 76.29 Клиническая медицина
Subject. The stages of medication-related osteonecrosis of the jaws (MRONJ) are an important criterion for choosing treatment tactics, while laboratory diagnosis of the stages of MRONJ has not been developed. The aim of the study is to analyze the dependence of the levels of bone metabolic markers (BMM) on the stage of the disease in patients with MRONJ. Methodology. The study included 48 cancer patients with osteonecrosis of the jaws while taking osteomodifying agents (OMA) with stabilization of the underlying disease. The activity of osteosynthesis was assessed by the level of osteocalcin (OC), osteoresorption – C-terminal telopeptide (CTX) – in the blood serum before treatment. The stage of MRONJ was established according to the classification developed at the Department of Surgical Dentistry and Maxillofacial Surgery of Stavropol State Medical University (2017). The levels of BMM indicators were compared for clinically significant stages (1, 2, 3) using the Kruskal–Wallis test for p < 0.05. Results. Stage 1 MRONJ was established in 17 (35.42%) patients, stage 2 – in 25 (52.08%) patients, stage 3 – in 6 (12.5%) patients. The average values of BMM indicators were: in patients with stage 1 – OK – 14.65 (10.5;17.5) ng/ml, CTX – 0.289 (0.172;0.351); with stage 2 OK – 10 (8.74;11) ng/ml, CTX – 0.137 (0.09;0.18); with stage 3 – OK – 15.5 (14;21) ng/ml, CTX – 0.476 (0.353;0.633). The average OC values were statistically significantly different in groups of patients with different stages of MRONJ (H = 14.13; p = 0.00085; p < 0.05), as were the STX values (H = 22.3; p = 0.00001; p < 0.05). At the same time, the average levels of both BMM in patients with stage 2 were lower than in patients with stage 1, and their highest level was recorded in stage 3 of the process. Conclusions. A significant (p < 0.05) relationship was established between the levels of OC and CTX and the stage of MRONJ: the maximum values were recorded at the third stage, the minimum at the second and intermediate at the first.
osteomodifying agents, medication-related osteonecrosis of the jaws, osteocalcin, C-terminal telopeptide, laboratory diagnosis
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