X-RAY CLASSIFICATION OF OSTEONECROSIS OF THE MIDFACE IN PATIENTS WITH DRUG-ADDICTION FROM DESOMORPHINE AND PERVITIN
Aim: was to develop a classification of osteonecrosis of the midface, based on clinical and radiological examinations. Such classification can allow to make detailed planning of surgical intervention tactics and develop criteria for surgical intervention basing on the bone division of the facial skeleton, as well as to assess dynamics of changes in bones of the facial skull. Materials and methods: the study included 87 drug-addicted patients with a diagnosis of «toxic phosphate osteonecrosis». All patients underwent clinical and radiological examination. Basing on MSCT data, tactics of surgical treatment was determined. Results: basing on results of clinical and radiological methods of examination in 29 cases (33%) we observed toxic phosphate osteonecrosis of the upper and lower jaw. In 18 patients (21%) the disease occurred only in the upper jaw. Lesion of the upper jaw within the I and II parts below the infraorbital foramen was observed in 39 cases (45%). Lesion of the maxilla above the infraorbital foramen was determined in 8 cases (9%). In case of diffuse lesions of the maxilla in 23 cases (26%), different patterns of midface were involved in pathologic process. Conclusion: creation and application in clinical practice of this classification of osteonecrosis of the midface bone in patients with drug-addiction on desomorphine and pervitin, based on the data of MSCT, allowed to pinpoint boundaries and the nature of the defeat of facial bones and choose the best tactics of surgical treatment in all patients.