Modern Approaches to Surgical Treatment of Patients with Generalized Periodontitis and Osteopenia

Iryna Yarmoshuk; Mykola Rozhko; Lubomir Pelekhan

doi:10.21802/gmj.2016.4.13

Changes in Densitometric Values in the Comprehensive Treatment of Generalized Periodontitis in Patients with Osteopenia

Archive of Clinical Medicine ◽

10.21802/acm.2016.2.3 ◽

2016 ◽

Vol 22 (2) ◽

pp. 201623

Author(s):

Iryna Yarmoshuk ◽

Mykola Rozhko ◽

Lubomir Pelekhan

Keyword(s):

Surgical Treatment ◽

Stable Process ◽

Repair Process ◽

Comprehensive Treatment ◽

Periodontal Tissues ◽

Conventional Procedure ◽

Group I ◽

Combined Use ◽

Antiresorptive Drug ◽

Osteoplastic Material

The issue of surgical treatment of patients with generalized periodontitis and osteopenia is particularly topical. Numerous studies have confirmed the benefits of surgical treatment procedures using osteoplastic material to stimulate repair process of periodontal tissues. The objective of the research was to improve the effectiveness of surgical treatment of patients with generalized periodontitis and osteopenia through the combined use of osteoplastic material and antiresorptive drugs in the preoperative and postoperative periods.93 patients underwent treatment and clinical observation. The patients were divided into three groups. Group I included 20 patients who underwent surgical treatment according to conventional procedure. Group II included 25 patients who underwent surgical treatment with local application of osteoplastic material “Easy Graft”. Surgical treatment in Group III (26 patients) was conducted using osteoplastic material “Easy Graft” and antiresorptive drug “Bonviva”. Experimental group consisted of 22 apparently healthy individuals. The obtained results indicated that surgical treatment using osteoplastic material and antiresorptive drug contributes to the most significant positive effect determined according to the dynamics of densitometric values. Combined use of osteoplastic material “Easy Graft” and antiresorptive drug “Bonviva” leads to stable process stabilization being confirmed by densitometric study indices both in early and in remote postoperative period.

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Biochemical Changes under the Influence of Comprehensive Treatment of Patients with Generalized Periodontitis and Osteopenia

Galician Medical Journal ◽

10.21802/gmj.2018.3.13 ◽

2018 ◽

Vol 25 (3) ◽

Author(s):

Iryna Yarmoshuk

Keyword(s):

Surgical Treatment ◽

Repair Process ◽

Control Group ◽

Comprehensive Treatment ◽

Conventional Procedure ◽

Group I ◽

Combined Use ◽

Antiresorptive Drug ◽

Antiresorptive Drugs ◽

Osteoplastic Material

The issue of surgical treatment of patients with generalized periodontitis and osteopenia is particularly topical. Numerous studies have confirmed the benefits of surgical treatment procedures using osteoplastic material to stimulate repair process of periodontal tissues.The objective of the research was to improve the effectiveness of surgical treatment of patients with generalized periodontitis and osteopenia through the combined use of osteoplastic material and antiresorptive drugs. Materials and methods. Ninety-three patients underwent treatment and clinical observation. The patients were divided into 3 groups. Group I included 20 patients who underwent surgical treatment according to conventional procedure. Group II included 25 patients who underwent surgical treatment with topical application of osteoplastic material “Easy Graft”. Surgical treatment in Group III (26 patients) was conducted using osteoplastic material “Easy Graft” and antiresorptive drug “Bonviva”. The control group consisted of 22 apparently healthy individuals.Conclusions. The obtained results indicated that surgical treatment with the combined use of osteoplastic material “Easy Graft” and antiresorptive drug “Bonviva” leads to process stabilization being confirmed by clinical study indices both in early and in remote postoperative period.

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Ультраструктурний стан пародонта при удосконаленні клаптевої операції у лікуванні хворих на генералізований пародонтит

CLINICAL DENTISTRY ◽

10.11603/2311-9624.2017.4.8057 ◽

2017 ◽

Author(s):

S. A. Ohiienko ◽

V. P. Piuryk ◽

O. H. Popadynets

Keyword(s):

Surgical Treatment ◽

Average Rate ◽

Economic Losses ◽

Negative Consequences ◽

Periodontal Tissues ◽

Group I ◽

Technological Chain ◽

Frequent Relapses ◽

Group Ii ◽

Morphological Transformations

Among all surgical dental diseases periodontal disease occupies one of the leading places, taking into account the prevalence of this pathology among the population and its negative consequences (loss of teeth and impaired functions of the tooth-jaw system). The severity of GP, frequent relapses and complications leads to a decrease in the quality of life of patients, signifi cant socio-economic losses, impaired chewing and speech.The aim of the study – to increase the effectiveness of surgical treatment of patients with GP III degree of severity by improving certain technological steps in the operations of Tseshynskyi-Widman-Neimann.Materials and Methods. We operated 46 patients with chronic generalized paradontitis (GP) of the III degree, divided into two groups: group I (20 people), which was the traditional modifi ed operation of Tseshynskyi-Vidman-Neimann; Patients of the group II (26 persons) – modifi ed operation of Teshynskyi-Vidman-Neimann, improved by the method of periost penetration with medical correction (using oral trays with miramistin and applications of methyluracil ointment with miramistin on periodontal tissues and postoperative sutures with application in the postoperative periods of the preparation “Glutargin “(First in injections No. 5 intravenous 5 ml (2 g) per 200 ml of 0.9 % sodium chloride solution 2 times a day and then in tablets – 4 tablets of 0.75 mg 3 times a day for a month).Results and Discussion. After the treatment, it was found that the average rate of the Schiller-Pysariev sample was higher in patients of group I (2.5 ± 0.05%) compared with the corresponding index of group II (0.95±0.04 %). After treatment, the average index of bleeding index was (0.77±0.04) points in the group I and (0.32±0.04) points in the group II. The ultrastructural state of periodontal undergoes positive transformations in shorter terms in patients of the group II. Thus, the use of peristaltic penetration with medical correction in the surgical treatment of patients with a GP of the III degree has advantages over traditional treatment.Conclusions. As a result of the research, the technological chain of the modifi ed Tseshynskyi-Vidman-Neimann operation was improved for the treatment of GP patients with a chronic course of the third degree through periosteal penetration. Ultrastructurally up to the twelfth month after operative intervention in the periodontitis of patients of the fi rst and second groups, a positive dynamics is observed; however, better morphological transformations occur in the periodontitis of patients who underwent periosteal penetration in combination with drug correction.

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CLINICAL PECULIARITIES OF WOUND HEALING IN THE POSTOPERATIVE PERIOD OF SURGICAL TREATMENT OF ALVEOLAR PROCESS ATROPHY OF THE UPPER JAW AND PART OF THE LOWER JAW IN POSTMENOPAUSAL WOMEN

Art of Medicine ◽

10.21802/artm.2021.2.18.129. ◽

2021 ◽

pp. 129-134

Author(s):

Yu. І. Solodzhuk ◽

М. М. Rozhko ◽

О. H. Denysenko

Keyword(s):

Wound Healing ◽

Surgical Treatment ◽

Postmenopausal Women ◽

Bone Tissue ◽

Alveolar Process ◽

Jaw Bone ◽

Lower Jaw ◽

Group I ◽

Upper Jaw ◽

Osteoplastic Material

Introduction. Atrophy of the alveolar process of the upper jaw and part of the lower jaw is often observed after the tooth extraction. It is known that the atrophy of bone tissue is most likely observed in the first 12 months after the tooth extraction. According to the Koln classification, atrophy of the bone tissue of the jaws can be vertical, horizontal and combined. The aim of surgical treatment of jaw bone tissue atrophy is to increase the size in the area of alveolar process of the upper jaw and part of the lower jaw to further restoration of masticatory function, in particular with the use of dental implants. The aim of the study: to study the dynamics of wound healing in postmenopausal women with osteopenia after surgical treatment of jaw bone tissue atrophy using osteoplastic material and ossein-hydroxyapatite compound. Materials and methods of the study. There were observed 63 postmenopausal women with osteopenia, aged from 50 to 59 years, with atrophy of the maxillary and mandibular alveolar process, who were performed surgical treatment. During surgery, patients were divided into 3 groups: Group I – 23 patients with atrophy of the alveolar process of the upper jaw and part of the lower jaw with osteopenia, with the reduced bone tissue density, who were treated surgically for bone tissue atrophy using the method worked out by us. Group II – 23 patients with atrophy of the alveolar process of the upper jaw and part of the lower jaw with osteopenia, with the reduced bone density who were performed surgical treatment of atrophy of the jaw bone tissue using osteoplastic material of animal origin. Group III – 23 patients with atrophy of the alveolar process of the upper jaw and part of the lower jaw with the indices of bone tissue density within normal limits, who were performed surgical treatment of atrophy of the jaw bone tissue using osteoplastic material of animal origin. The results of the study. A total of 69 edentulous areas on the upper and lower jaws were examined after surgery for the treatment of jaw bone tissue atrophy. Examination of the postoperative wound was performed during the 3rd, 9th, and 14th day in the absence of complaints from patients during this period, as well as in the presence of signs of complications. Discussion of the results. According to the offered by us method of decortication of the bone tissue of the jaws, which was used to treat patients of group I, the blood supply to the postoperative area and infiltration of bone material with blood due to provoked by decortication of bone tissue bleeding, are improved. Impregnation of bone material with blood promotes angiogenesis in the postoperative area, increasing cellular activity during wound healing. It is known that due to the absence of sufficient blood supply, tissue necrosis occurs [8,9]. In patients of groups II and III the complete healing of the postoperative wound with primary tension took longer than in patients of group I. Also, in 3 patients of group II and in 1 patient of group III the wound dehiscence in the postoperative area was observed. Conclusions. As a result of the performed observations of wound healing after surgical treatment of jaw bone tissue atrophy in patients of groups I, II and III, the least complications were observed in patients of group I in the early postoperative period.

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Manual therapy and visual color-impulse therapy in the rehabilitation of patients with piriformis syndrome

Russian Osteopathic Journal ◽

10.32885/2220-0975-2020-3-95-101 ◽

2020 ◽

pp. 95-101

Author(s):

V. A. Frolov ◽

M. S. Akopyan

Keyword(s):

Manual Therapy ◽

Muscle Tone ◽

Randomized Study ◽

Integrated Approach ◽

Medical Rehabilitation ◽

Piriformis Syndrome ◽

Piriformis Muscle ◽

Group I ◽

Combined Use ◽

Visual Color

Introduction. Piriformis syndrome (PS) is a condition accompanied by tension of the piriformis muscle and followed then by compression of the sciatic nerve passing through the piriformis muscle. According to statistics, PS occurs in 6–35 % of patients with lower back pain. Practitioners still face difficulties in treating patients with PS, and it necessitates the searching of new therapy methods and assessment of their compatibility.The goal of research — to study the clinical efficacy of the combined use of manual therapy and visual colorimpulse therapy in patients with piriformis syndrome.Materials and methods. A prospective, controlled, randomized study was conducted in 2019 at the Department of Sports Medicine and Medical Rehabilitation of I. M. Sechenov First Moscow Medical State University. In accordance with the inclusion criteria, 40 patients participated in the study. All participants, depending on the used treatment methodology, were divided by the method of simple randomization using envelopes into two equal groups. In the main group (group I), an integrated approach to treatment was tested: manual therapy in combination with visual color-impulse therapy (CIT); and in the other group (group II) only manual therapy was used.Results. The combined use of manual therapy and CIT in patients with piriformis syndrome leads to a significantly more pronounced decrease in the pain degree and normalization of impaired muscle tone. Also, an integrated approach helps to eliminate existing angiospastic disorders of the lower extremities.Conclusion. The study shows a clear positive dynamics in the integrated use of manual therapy methods in combination with visual color-impulse therapy in the treatment of patients with piriformis syndrome. It is planned to continue the study and assess the possibilities of using the combined technique in different groups of patients (athletes, pregnant women) with this syndrome.

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Results of modern tuboperitoneal infertility treatment

Vojnosanitetski pregled ◽

10.2298/vsp0901057t ◽

2009 ◽

Vol 66 (1) ◽

pp. 57-62 ◽

Cited By ~ 1

Author(s):

Drenka Turjacanin-Pantelic ◽

Dragana Bojovic-Jovic ◽

Biljana Arsic ◽

Eliana Garalejic

Keyword(s):

Statistical Analysis ◽

Surgical Treatment ◽

Infertility Treatment ◽

P Value ◽

Modern Approach ◽

Vitro Fertilization ◽

Group I ◽

Significant Difference ◽

Group Ii

Background/Aim. A modern approach to surgical treatment of tuboperitoneal infertility is based on laporascopic techniques. The aim of this study was to compare results of tuboperitoneal infertility treatment by the use of laparoscopy and classical laparotomy. Methods. A retrospectiveprospective study on 66 women treated operatively form tuboperitoneal infertility was performed. Data from patient's anamnesis and those related to the surgical treatment results, obtained by the use of an inquiry, were used in retrospective and prospective analysis, respectively. Chi-square test was used in statistical analysis. P value < 0.05 was considered significant. Results. Classical laparotomy was used on 34 women in a period from 1996 to 1997, while 32 women were operated laparoscopically in a period from 1999 to 2000. The results were as follows: a total number of conceived women was 16 (24%), seven in the group I (20.6%) and nine in the group II (28.1%); 13 women were with one pregnancy, six in the group I (17.6%) and seven in the group II (22%). Twice pregnant were three women, one in the group I (2.9%) and two in the group II (6.2%). The resulting pregnancies were: five women with abortion spontaneous, two in the group I (5.9%) and three in the group II (9.4%); two women with extrauterine pregnancy in the group I (5.9%); three with pretemporal birth, one in the group I (2.9%) and two in the group II (6.2%), while six women were with the temporal birth, two in the group I (5.9%) and four in the group II (12.5%). Statistical analysis showed that there was no significant difference in the results between these two groups. Conclusion. Surgical treatment of tubeperitoneal infertility, regardless of the used methods (classical laparotomy or laparoscopy) was successful in a great number of women. These methods have a great advantage over in vitro fertilization, and they should not be ignored.

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Outcomes of ophtalmologic surgical procedures of esotropia in children and adolescents

Vojnosanitetski pregled ◽

10.2298/vsp0808627k ◽

2008 ◽

Vol 65 (8) ◽

pp. 627-631

Author(s):

Tamara Kljakovic-Avramovic ◽

Miroslav Vukosavljevic ◽

Sinisa Avramovic

Keyword(s):

Surgical Treatment ◽

Prospective Study ◽

Children And Adolescents ◽

Deviation Angle ◽

Group Iii ◽

Military Medical Academy ◽

Group I ◽

Medical Academy ◽

Group Ii ◽

Common Manifestation

Background/Aim. Esotropia is the most common manifestation form of strabism accompanied by refraction deviations and amblyopia. The aim of this prospective study was to present the outcomes of surgical treatment of esotropia in children and adolescents. Methods. Within the period from January 1st 2006 to February 1st 2007 at the Clinic for Ophtalmology, Military Medical Academy, Belgrade a total of 25 patients with esotropia (34 eyes) and previously corrected refraction anomaly and treated amblyopia were operated on. The patients were 4-19-year of age. All of the patients were submitted to a complete ophtalmologic and orthoptic examination prior to the surgery, and a month, three months and six months after the surgery. The surgery was performed under general anesthesia. Out of the total number of the patients nine were operated on both eyes, while 16 patients on one eye with amblyopia or frequent esodeviation. Nine patients were submitted to retroposition of the inner straight muscle, two to myectomy of the outer straight muscle, while in 14 of the patients a combination of retroposition and myectomy was performed. The patients were divided into three groups according to the preoperative angle at the distance and followed-up accordingly after the surgery. Deviation angle at the distance in the group I was 18-25 DP, in the group II 26-35 PD, while in the group III it was 36-60 PD. Results. The most numerous, group I (12 patients; 48%), a month following the surgery showed angle reduction by 55.58%, after three months 63.25%, and after six months 63.92%. The group II consisted of 8 patients (32%) showed angle reduction by 70.75% a month following the surgery, by 76% after three months, and by 79.12% after six months. The group III (5 patients; 20%) showed angle reduction by 72.20% a month following the surgery, 79.20 after three months, and 80.12% after six months following the surgery. Conclusion. The best postoperative outcomes after a month, three and six months were obtained in the group of patients with the highest esodeviation angle at the distance solved by the surgery on both eyes. Timely surgical treatment befell into major precondition for developing and maintaining the elements of binocular vision in the operated on patients. .

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Possibilities of minimally invasive treatments of hemorrhoidal disease

Ambulatory surgery hospital-replacing technologies ◽

10.21518/1995-1477-2018-3-4-77-82 ◽

2018 ◽

pp. 77-82 ◽

Cited By ~ 1

Author(s):

M. V. Abritsova

Keyword(s):

Surgical Treatment ◽

Minimally Invasive ◽

Postoperative Period ◽

Harmonic Scalpel ◽

Hemorrhoidal Disease ◽

Single Center ◽

Narcotic Analgesics ◽

Group I ◽

Minimally Invasive Treatments ◽

Observation Period

The article presents the results of surgical treatment of patients with stages III to IV hemorrhoids followed by an observation period of 45 days, which is designed to improve the results of surgical treatment of this category of patients. The surgical treatment methods included doppler-guided transanal hemorrhoiddearterialization with mucopexy (DDM) (Group I) and harmonic scalpel hemorrhoidectomy (HSH) (Group II). Operated patients underwent all necessary examinations according to the “per protocol” principle. Study Design: single-center controlled randomized prospective. The effectiveness of DDM was comparable to that of hemorrhoidectomy (HE), which made it possible to significantly reduce the duration of the operation (DDM 17.9 ± 6.1 min, GE 34.5 ± 10.1 min (p <0.01) ), reduce the level of pain in the postoperative period (DDM an average of 2.5 points, HE 4.8 points (p <0.01)), reduce the frequency of narcotic analgesics (DDM an average of 1.3 doses, HE an average of 6.1 doses (p <0.01)) and shorten the period of disability (DDM 14.4 ± 5.2 days, HE 30.3 ± 5.4 days (p <0.01)) patients with stages III to IV disease.

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Surgical treatment of patients with sagittal imbalance of degenerative etiology: a comparison of two methods

N.N. Priorov Journal of Traumatology and Orthopedics ◽

10.17816/vto202027316-26 ◽

2020 ◽

Vol 27 (3) ◽

pp. 16-26

Author(s):

Evgenii S. Baykov ◽

Alexey V. Peleganchuk ◽

Abdugafur J. Sanginov ◽

Olga N. Leonova ◽

Aleksandr V. Krutko

Keyword(s):

Surgical Treatment ◽

Blood Loss ◽

Perioperative Complications ◽

Sagittal Imbalance ◽

Radiological Parameters ◽

Results Of Treatment ◽

Group I ◽

Surgical Methods ◽

Group Ii ◽

Clinical And Radiological Results

Purpose. Compare the clinical and radiological results of treatment of patients with spinal deformities operated on using the PSO method and corrective fusion in the lumbar spine. Materials and methods. Retrospective monocenter cohort study. The data of 42 patients were analyzed. PSO (group I) was performed in 12 patients; 30 patients had a combination of surgical methods (group II) with mandatory ventral corrective spinal fusion at levels L4-L5, L5-S1. Clinical and radiological parameters were evaluated during hospitalization and at least 1 year later. Results. Postoperative hospitalization in group I 32.5 7.4 days, 27.1 7.4 in group II (p = 0.558758). The duration of the operation in group I was 402.5 55.6 minutes, in group II 526.0 116.2 minutes (p = 0.001124); blood loss 1862.5 454.3 ml versus 1096.0 543.3 ml (p = 0.000171). In both groups, significantly improved clinical and radiological parameters after surgery and after 1 year (p 0.05). In group II, as compared with group I after surgery and more than 1 year: lower back pain according to VAS (p = 0.015424 and p = 0.015424); below ODI after 1 year was (p = 0.000001). In group I, compared with group II after surgery and after 1 year, SVA is less (p = 0.029879 and p = 0.000014), lumbar lordosis is higher (p = 0.045002 and p = 0.024120), LDI is restored more optimally (p = 0.000001 and p = 0.000002), the GAP is lower (p = 0.005845 and p = 0.002639). The ideal Russoly type is restored more often in patients of group II (p = 0,00032). Complications in group I were noted in 12 (100%) patients, in group II in 13 (43.3%) patients (p = 0.001). Conclusions. In multistep surgical treatment compared with PSO, the anterior corrective interbody fusion L4-L5, L5-S1 reliably better and more harmoniously restores the sagittal balance parameters, has significantly lower volume of intraoperative blood loss, fewer perioperative complications and significantly improves the quality of life of patients.

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Surgery of cholesteatoma: Surgical technique and cholesteatoma recurrences

Acta chirurgica iugoslavica ◽

10.2298/aci0401103a ◽

2004 ◽

Vol 51 (1) ◽

pp. 103-107

Author(s):

Nenad Arsovic ◽

Radomir Radulovic ◽

Snezana Jesic ◽

S. Krejovic-Trivic ◽

P. Stankovic ◽

...

Keyword(s):

Surgical Treatment ◽

Surgical Technique ◽

Complete Removal ◽

Initial Surgery ◽

Group I ◽

Number Of Patients ◽

Significant Difference ◽

Diffuse Form ◽

Surgical Failure

Past experience with open and closed techniques of tympanoplasty in surgery of cholesteatoma has shown that recurring illness is one of the major causes of surgical failure. The literature has reported varying trend of surgical treatment of cholesteatoma. The objective of the study was to analyze the significance of surgical technique in relation to the incidence and most frequent localization of recurrent cholesteatoma. Our study analyzed 120 patients operated on for cholesteatoma. The patients were divided into two groups, group I (45) with recurring disease and group II (75) without any recurring condition, which were followed up three years. Statistical analysis was carried out by modified t-test. The largest number of patients was re-operated in the first two years from the initial surgery (50%), In the majority of patients (50%), recurrent cholesteatoma was most commonly localized (stage I) in attic (20%) and much rarely in mesotympanum (11,9%). Stage III recurrent cholesteatoma was verified in 35% of patients, most frequently diffuse form (13,4%). The involvement of attic by all three stages of disease accounted for over 60%. The analysis of the used techniques of surgical treatment in both groups revealed significant difference. Open techniques of tympanoplasty were used in 60% of patients with no recurrence. Closed techniques were used more frequently in patients with recurring disease, i.e. in over 90% of cases. Recurrent cholesteatoma develops, in the majority of cases, during the first two years after the surgical intervention. Attic is the most common localization of cholesteatoma. More frequent utilization of open technique of tympanoplasty for surgery of cholesteatoma significantly reduces the incidence of recurring condition. The indications for CWD technique are the initial spread of cholesteatoma, possibility of complete removal of cholesteatoma and postoperative follow-up of patients.

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