Idashkina N. G.

CONTENTS

Scentific article

According to current statistics from the delayed consolidation of mandibular fractures in 50 days after trauma observed in 2. 4 to 14% of clinical cases. Structural base of consolidation’s complications by the patients with mandibular fractures are different pathogenic factors: lipoperoxidation processes disorders, immune response, bone metabolism and others. Unfortunately incomplete of data on the status of lipid peroxidation – antioxidant protection in the patients with delayed consolidation of the mandible fractures, absence of investigations of the role of free radical oxidation and antioxidant potential of phagocytic cells of the blood in disorders of reparative osteogenesis. Studying the impact of oxidative stress and antiradical defense emergence and consolidation of development disorders in patients with mandibular fractures is an urgent theoretical and practical need. Objective. To establish the role of lipid peroxidation – antioxidant protection in the development of delayed consolidation by the patients with mandible fractures. Materials and methods. Conducted general clinical, biochemical and radiological study of 32 patients with fractures of the mandible: 26 men and 6 woman in age from 22 to 57 years. Patients were divided into two groups: the first main group (16 patients) included patients with mandibular fractures with concomitant diseases that worsened overall health, the second (comparison group – 16 patients), patients with mandibular fractures without comorbidity. Results. It was established the increased activity of lipid peroxidation and decreased levels of antioxidant defense in the patients with mandibular fractures. Severity of disturbances in the system lipid peroxidation – antioxidant protection depends on the background of comorbidity, which affects overall health. Among patients with mandibular fractures with concomitant diseases that worsened overall health were widespread enough alcohol and drag abuse, smoking, disease of gastrointestinal tract and liver, hormonal disorders. Initial imbalance in the functioning of lipid peroxidation – antioxidant protection system causes the development of delayed consolidation in the patients with mandibular fractures. It is remarkable, that the healing of fracture was taking without a fibro-chondroid phase in 87. 5 % cases for the group of comparison (patients with the mandibular fractures without concomitant pathology), on the contrary the patients of basic group with high values of activity of lipid peroxidation – antioxidant protection and low coefficient of AOP/LPO had not only bone callosity (68. 8 %) but also non-union of mandible (25. 0 % cases), among patients with low indexes LPO and the mildly mionectic coefficient of АОА/LPO such complications were observed only in 2 cases (12,5 %). It should be noted, that reposition of bone fragments was good in all 32 cases and lengthening of terms of consolidation in bone tissues did not depend on local factors. The high degree of activation of lipid peroxidation is one of the pathogenetic links that shapes the development of disorders of reparative osteogenesis. Index anti- and prooxydant activities can more accurately assess the condition of free-radical oxidation of lipids and their role in causing the delayed consolidation of fractures of the mandible and is usable as criteria of prediction of delayed bone union for the screening of risk groups among the patients with traumatic injuries of the bones of the facial skull. Obviously, that the initially raise of activating of free-radical oxidation can be a cause of disorders of reparative osteogenesis. Therefore, application of antioxidants in the complex therapy of delayed consolidation of mandible must consider as an important link of nosotropic therapy.

fractures of the mandible, consolidation, reparative osteogenesis, free radical oxidation, lipid peroxidation

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«Bulletin of problems biology and medicine» Issue 2 part 1 (107), 2014 year, 150-154 pages, index UDK 616.314.22-001.5-06-084:615.32