EVALUATION OF BIOCHEMICAL INDICES OF BONE TISSUE METABOLISM IN WOMEN OF POSTMENOPASAL AGE AFTER SURGICAL TREATMENT OF ALVEOLAR PROCESS ATROPHY OF THE UPPER JAW AND PART OF THE LOWER JAW
Atrophy of the alveolar process of the upper jaw and part of the lower jaw is often observed after the tooth extraction. The loss of bone tissue of the alveolar process of the upper jaw and part of the lower jaw in the postmenopausal period is associated with changes in the hormonal status of the female body, in particular with estrogen deficiency. It is known that bone remodeling occurs on the average at 5% in the cortical and at about 20% in the spongy layers of bone tissue annually. A characteristic peculiarity of bone remodeling is that this process is heterogeneous and different for each bone, as well as it is different between the spongy and cortical layers.
Objective of the study. To assess the condition of bone tissue metabolism in postmenopausal women before and after surgical treatment of atrophy of the alveolar process of the upper jaw and lower jaw using osteoplastic material, resorbable barrier membrane and ossein-hydroxyapatite compound.
Materials and methods of research. There were observed 102 postmenopausal women, aged 51 to 58 years, with atrophy of the alveolar process of the upper jaw and part of the lower jaw, who underwent surgical treatment for atrophy of the jaw bone tissue.
Results of the study and their discussion. One of the methods of assessing the condition of bone tissue metabolism is biochemical, in particular using markers of bone formation (osteocalcin) and resorption (deoxypyridinoline). It is known that the assessment of osteocalcin levels is measured in the blood and deoxypyridinoline in the urine. When performing biochemical studies, we’ve made a comparative analysis of indices in patients of groups I, II and III. Assessing markers of bone formation and resorption helps the doctor to more accurately diagnose the condition of bone tissue and then choose the correct approach in treatment. The use of these markers allows us to assess the condition of bone tissue, the rate of metabolic processes in bone tissue and predict the risks of pathological fractures, as they are associated with the degree of activity of osteoblasts and osteoclasts. During the analysis before surgical intervention, the indices of deoxypyridinoline in the urine of patients in groups I and II increased compared with patients in group III, where these values were within norm. After re-analysis of indices after 12 months in patients of group I there was a decrease in deoxypyridinoline in the urine, which may be caused by taking an ossein-hydroxyapatite compound by patients of this group. At the same time, in patients of groups II and III there were observed no significant changes in these indices at repeated examination.
Conclusions. The use of bone markers to assess the processes of bone metabolism can significantly complement the diagnosis before surgical treatment of jaw bone atrophy, especially in postmenopausal women. However, this method of bone metabolism assessment cannot completely replace methods of bone tissue density or densitometry assessment and be an independent reliable method for diagnosing bone metabolism. Important advantages of biochemical studies are the ability to assess the level and prognosis of bone tissue loss, the effectiveness of therapeutic methods for osteopenia or osteoporosis treatment and the assessment of bone metabolism after treatment.
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