MEDICAL GENESIS OSTEONECROSIS OF THE JAWS IN CANCER PATIENTS

Аннотация

 The article is about the actual problem of osteonecrosis of the jaws due to medical genesis. The disease occurs in oncological patients undergoing anti-desorption chemotherapy with bisphosphonate drugs. The relevance of the problem is indicated on one hand by the recent sharp increase in clinical cases and on the other hand by the severe course of the disease. 7 clinical cases identified during the last year (6 women and 1 man) were studied. In 5 cases, osteonecrosis developed in the lower jaw bone, in 2 cases in the upper jaw bone. Due to the urgency of the problem, one clinical case of bisphosphonate necrosis is described. The case concerns a 47-year-old woman, who underwent Surgery in 2016 for invasive ductal carcinoma of the right breast. After the operation, the patient underwent scheduled chemotherapy courses with bisphosphonate (Zometa) and denosumab (Ixgeva) group drugs. 2022 The patient was diagnosed with the third stage of drug-induced osteonecrosis of the lower jaw, which is why she was admitted to the clinic. An area of diffuse destruction of the lower jaw bone with hyperostosis was revealed by MRI. The patient underwent complex treatment. The mandibular bone was surgically resected - both the hyperostosis area and the necrotic bone mass within the healthy tissue were resected. It should be noted that in terms of the treatment and outcome of this category of patients, it is important to establish the diagnosis at the early stage of the disease, in which the planned MRI study of the jaws is of crucial importance.