Osteomyelitis of the jaws and facial bones caused by drug use (amphetamine, αpyrrolidinovalerophenone).

Abstract

Abstract. Introduction. An attempt was made to detect the pathogenetic factors involved in the occurrence of the disease by studying the clinical and laboratory data of 160 patients diagnosed with chronic osteomyelitis of the jaws treated in the clinic of oro-maxillo-facial surgery between 2005 and 2022. The patients studied were or are still drug users who use illicitly produced (amphetamine-type drugs) or other drugs (abbreviated α-PVP). We obtained positive results in the treatment of toxic osteomyelitis of the jaws following the implementation of a conservative and surgical treatment scheme. Materials and methods. Detailed anamnesis of disease development, clinical examination, pictures, an orthopantomogram, general blood analysis and biochemical profile, urine analysis, blood markers, and AIDS analysis. Results. The study of the composition of used substances is an important factor in the definition and development of the given disease’s cause and mechanism. According to the patient’s statement, this disease developed following the use of the amphetamine drug. This drug contained the main substance – ephedrine, and also red phosphorus and iodine, which accumulate and cause trophic changes. Almost all organisms’ systems are affected by amphetamine intoxication. Given that only surgical treatment has a small effect on any of the patients in this group, we devised a conservative presurgical treatment plan. We prescribe medication for these patients: detoxification of the body from drugs that cause spasm of small blood vessels and accumulate in bone tissue, causing necrosis. Lavages of the mouth cavity are performed daily, and necrectomy is eventually performed. Conclusions. Assistance to drug addicts with jaw necrosis is a demanding subject given that the majority of their population is unemployed and without insurance. According to unofficial data, there are only 5000 such patients in Chisinau.