THE CONTENT OF NK CELLS AND THEIR SUBTYPES IN THE CASE OF DRUG-INDUCED JAW OSTEONECROSIS.

The goal of the study is assessing the population structure of lymphocytes and the subpopulation composition of NK cells in the peripheral blood of humans in the case of drug-induced osteonecrosis of the jaw for improving the quality of diagnosis, treatment, and prevention of osteonecrosis of the jaw. Thirty patients were examined, including 15 patients with drug-induced osteonecrosis of the jaw (ONJ), 10 healthy individuals, and five patients with pyoinflammatory diseases of the maxillofacial region, aged 49 to 77. Every four weeks, the patients had been receiving 4 mg intravenous injections of bisphosphonates (the Zometa preparation (zoledronic acid)) for 1.5 - 3 years. The study was performed on a FACS Canto II flow cytometer manufactured by Becton Dickinson (BD), USA. In the patients with ONJ, an imbalance of the NK cell subtypes was observed. As to the common NK cells, the level of subtypes of cytolytic NK cells (CD3-CD16+(or hight)56dim) was elevated, and the level of cytokine-producing cells (СD3-CD16-(or low) 56bright) was reduced, compared to the healthy individuals (p<0.05). In the patients with ONJ, after the surgical treatment, the relative and absolute levels of lymphocytes and the total level of NK cells (CD3-CD16+/56+) normalized on the seventh day. The level of NK cells subtypes did not change after the treatment. This pathology is characterized by a low level of innate protection factors, as evidenced by the reduction of the total population of NK cells, and the imbalance of NK cells subtypes. The imbalance of NK cells (the natural killer cells) was an indicator of unfavorable prognosis for osteonecrosis treatment.

[Individual combined endoprosthesis for reconstruction of mandibular defects]. / Sposob zameshcheniia defekta nizhnei cheliusti s primeneniem individual'nogo kombinirovannogo éndoproteza.

Substitution of mandibular defects resulting from injuries and inflammatory bone diseases as well as surgical interventions for tumors is an important medical and scientific problem. The article presents the results of surgical treatment of 8 patients with the use of combined endoprosthesis of the mandible consisting of individual titanium metal structure and titanium silk. This solution provides the possibility for reliable fixation of the soft tissue structures of the lower face region by suturing, including facial and masticatory muscles, improving the biological integration of the endoprosthesis. The combined design shows high efficiency of restoration of both aesthetic and functional characteristics of the mandible, as well as good long term survival rate.

[The use of Foley catheter in reconstructive procedures involving the middle third of the facial skeleton].

The aim of this study was to improve the efficiency of surgical treatment of patients with fractures involving zygomatico-orbital complex and maxillary sinus through the use of Foley catheter. 352 patients with fractures of the middle third of the facial skeleton were treated at the Departments of Oral & Maxillofacial Surgery in Novokuznetsk Institute and I.M. Sechenov First MSMU. All patients underwent open reduction and osteosynthesis using extramedullary titanium mini-plates and NiTi mini-clamps. In the cases with large bone defects additional reconstructive techniques were used such as replantation of bone fragments and endoprosthesis with NiTi implants. For the purpose of drainage and retention Foley catheter was placed in the cavity of the maxillary sinus after the surgical procedure. We obtained good and satisfactory results in the majority of clinical cases. The use of Foley catheter was found to be very effective for the post-operative drainage and hemostasis of the maxillary sinus and in cases involving the use of fixation implant in the reconstructive surgeries in the middle third of the face.

[Nickelid titanium mesh for orbital floor reconstruction].

The treatment plan for patients with mid-face fractures was presented in this article. In maxillofacial department of the I.M. Sechenov First Moscow State Medical University we used nickelid titanium mesh for reconstruction of the orbital floor. The clinical case with good result of treatment was presented here.