TREATMENT OF PATIENTS WITH THE CYCLE OF THE SUPERMONTAL ARM OF THE ONTOGENIC GENESIS

Abstract

The maxillary sinus cysts are a fairly common pathology of the paranasal sinus system, which has a multifactorial etiology that continues to be actively investigated. In recent years, particular attention of researchers has focused on the role of chronic inflammation of the root of the teeth, which are directly adjacent to the lower wall of the maxillary sinus, and accordingly involve the surrounding structures in the pathological process. One of the objective indicators of the severity of inflammation is the level of matrix metalloproteinases, in particular matrix metalloproteinase 9 (MMP-9). Аs follows, the purpose of the study is to study of efficiency of treatment of patients with cystic sinus cysts of odontogenic origin in the long term. Materials and methods. The study included 150 patients. Group 1 - 125 people (age 20-69 years, men - 58, women - 67), group 2 - 25 patients (age 21-59 years, 11 men and 14 women). All patients from the examined groups underwent surgical treatment - removal of the cyst of the maxillary sinus through the lower nasal passage, with subsequent conservative treatment; patients of the first group in the postoperative period were audited channels of the teeth of the upper jaw with replacement of the filling material, and patients of the second group this intervention was not carried out. The inclusion criterion is an increase in the level of ММП-9 in saliva. The exclusion criteria were the presence of acute disease 3 months before surgery, treatment with the dentist 3 months before surgery, normal level of MMP-9 in saliva. In the course of preoperative preparation, all patients underwent CT scan of the paranasal sinuses, endoscopic examination of the nasal cavity and nasopharynx, rhinopneumometry, determination of the index of mucociliary clearance, activity of MMP-9 in saliva. The study of MMP-9 activity in saliva was performed using ELISA kit. Statistical data processing was performed using IBM SPSS Statistics 22. 

Conclusion. The level of ММР-9 in the saliva of patients of the first group was 1347 (± 328) ng / ml, the second - 1410 (± 220) ng / ml. The number of recurrences of sinus cyst in group 1 was 8, accounting for 6.4% of the total. Other complications include sinus mycetoma - 4 oroantral fistula - 1, hoonal polyp - 2.. The number of relapses of the sinus cyst in group 2 was 9 cases (36%), mycetoma of the sinus cyst - 3 cases, oroantral fistula - 1, hoonal polyp - 1. Conclusion. The results obtained indicate a higher likelihood of recurrence of the maxillary sinus cyst in the absence of a subsequent revision of the root of the teeth and around the root areas immediately adjacent to the lower sinus wall.