DOI:

10.37988/1811-153X_2023_3_70

The use of vitamin D in the rehabilitation of patients after orthognathic surgery

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Authors

  • I.V. Ivanova 1, postgraduate at the Maxillofacial surgery Department, assistant of the Maxillofacial surgery Department
    ORCID ID: 0000-0002-8244-4136
  • S.Yu. Ivanov 1, 2, Russian Academy of Science corresponding member, PhD in Medical Sciences, full professor of the Maxillofacial surgery Department; full professor of the Maxillofacial surgery and surgical dentistry Department
    ORCID ID: 0000-0001-5458-0192
  • A.M. Gusarov 1, PhD in Medical Sciences, associate professor of the Maxillofacial surgery Department
    ORCID ID: 0000-0002-6583-4685
  • K.E. Ampilova 1, clinical resident at the Maxillofacial surgery Department
    ORCID ID: 0000-0001-9215-7846
  • K.S. Demidova 2, postgraduate at the Maxillofacial surgery and surgical dentistry Department
    ORCID ID: 0000-0002-6244-7145
  • 1 Sechenov University, 119991, Moscow, Russia
  • 2 RUDN University, 117198, Moscow, Russia

Abstract

Anomalies in the development of the jaws are inevitably accompanied by changes in the bite and are one of the most common pathologies in the maxillofacial region. These anomalies can cause both cosmetic and functional disorders. The purpose of this study is to develop a scheme for the use of vitamin D for patients with malformations of the jaws after orthognathic surgery.
Materials and methods.
The study of vitamin D content in the blood of 50 patients who were divided into 2 groups. Group I included patients with vitamin D deficiency (less than 30 ng/ml) who were prescribed 8000 IU per day for 8 weeks. Group II patients with normal vitamin D levels were divided into 3 subgroups, each of which was prescribed from 600 to 2000 IU for 4 weeks. To evaluate the developed scheme of use and the effect of vitamin D on bone regeneration, 40 more patients were examined, who were divided into 4 groups. Group III included 10 patients with normal vitamin D levels and who took it according to the developed scheme; group IV included 10 patients with vitamin D deficiency and taking it according to the developed scheme; group V included 10 patients with initially normal vitamin D levels did not receive it additionally; 10 patients of group VI with vitamin D deficiency did not receive it additionally. After orthognathic surgery, the patients’ subjective sensations (pain and numbness) were evaluated in the hospital for 10 days. Bone density was measured according to MSCT data 7 days and 6 months after the operation.
Results.
After 8 weeks, vitamin D levels reached normal in 95% of group I patients. In group II, the vitamin D level exceeded the baseline and approached the optimal level after 4 weeks. Ten days after the operation, numbness persisted in 1 patient of group III and in 7 patients of group VI. In group III, the average bone density exceeded 1000 Hounsfield units, in IV and V it was at the level of 800—900 HU, and in group VI it was 655±9 HU.
Conclusions.
Based on the work done, the effectiveness of the proposed scheme for the use of vitamin D after surgery was confirmed: 8000 IU per day with vitamin D deficiency for 8 weeks, and 2000 IU per day for 4 weeks at its normal level. We recommend a revision of the standard therapy, including vitamin D in it based on its initial concentration in the blood serum.

Key words:

orthognathic surgery, osteosynthesis, research, vitamin D, bone tissue, fracture, regeneration, treatment, rehabilitation, bone density, densitometry

For Citation

[1]
Ivanova I.V., Ivanov S.Yu., Gusarov A.M., Ampilova K.E., Demidova K.S. The use of vitamin D in the rehabilitation of patients after orthognathic surgery. Clinical Dentistry (Russia).  2023; 26 (3): 70—76. DOI: 10.37988/1811-153X_2023_3_70

References

  1. Tanashyan M.M., Maksimova M.Y., Ivanov S.Yu., Musaeva E.M., Fedin P.A. Ttigeminal neuropathy following orthognathic surgery. Neurology, Neuropsychiatry, Psychosomatics. 2020; 4: 37—42 (In Russian). eLIBRARY ID: 43944314
  2. Andreishchev A.R., Gerasimov S.N., Mishustina Yu.L., Nuritdinov R.M., Bulycheva D.S. Planning and correction of asymmetrical face in patients with dentofacial anomalies. The Dental Institute. 2020; 2 (87): 82—85 (In Russian). eLIBRARY ID: 44051479
  3. Musaeva E., Ivanov S.Yu., Murayev A.A., Gusarov A.M. Prevention of the trigeminal nerve’s third branch injuries during the sagittal osteotomy of the mandible. Head and Neck. 2018; 1: 18—22 (In Russian). eLIBRARY ID: 41304584
  4. Fedotov R.N., Topol‘nickij O.Z., Shuba M.I., Yakovlev S.V., Zangieva O.T., Epifanov S.A. Orthognathic surgery, distraction osteogenesis and digital planning in patients with bilateral cleft lip and palate. Bulletin of Pirogov National Medical and Surgical Center. 2021; 4: 88—92 (In Russian). eLIBRARY ID: 47251760
  5. Bykovskaya T., Ivanov S.Yu., Korotkova N.L., Muraev A.A., Bekreev V.V., Safyanova E.V., Gusarov A.M. Assessment of the temporomandibular joint state during orthognathic surgery for congenital anomalies of jaw development without the use of a surgical template. Head and Neck. 2018; 1: 23—28 (In Russian). eLIBRARY ID: 41304585
  6. Slabkovsky R.I., Drobysheva N.S., Slabkovskaya A.B., Drobyshev A.Yu., Medvedev V.E., Uspenskaya M.O. Possibilities of psychological and psychiatric rehabilitation of adult patients after orthognatic surgery. Clinical Dentistry (Russia). 2021; 2: 65—71 (In Russian). eLIBRARY ID: 46322603
  7. Ivanov S.Yu., Muraev A.A., Korotkova N.L., Sidorova E.V., Do M.F. New method of correction of inherent and acquired abnormalities of jaws. Medical Almanac. 2015; 3 (38): 168—171 (In Russian). eLIBRARY ID: 24361069
  8. Lee S.J., Yoo J.Y., Woo S.Y., Yang H.J., Kim J.E., Huh K.H., Lee S.S., Heo M.S., Hwang S.J., Yi W.J. A complete digital workflow for planning, simulation, and evaluation in orthognathic surgery. J Clin Med. 2021; 10 (17): 4000. PMID: 34501449
  9. Ramanathan M., Kiruba G.A., Christabel A., Parameswaran A., Kapoor S., Sailer H.F. Distraction osteogenesis versus orthognathic surgery: Demystifying differences in concepts, techniques and outcomes. J Maxillofac Oral Surg. 2020; 19 (4): 477—489. PMID: 33071493
  10. Paul N.R., Baker S.R., Gibson B.J. Decision making from the experience of orthognathic surgery patients: A grounded theory approach. JDR Clin Trans Res. 2022; 7 (3): 256—266. PMID: 34027746
  11. Zura R., Xiong Z., Einhorn T., Watson J.T., Ostrum R.F., Prayson M.J., Della Rocca G.J., Mehta S., McKinley T., Wang Z., Steen R.G. Epidemiology of fracture nonunion in 18 human bones. JAMA Surg. 2016; 151 (11): e162775. PMID: 27603155
  12. Fedchishin O.V., Fedchishin N.O. Modern diagnostic methods in dentistry. Siberian medical journal (Irkutsk). 2013; 6: 177—179 (In Russian). eLIBRARY ID: 20607551
  13. Ivashenko S.V., Ostapovich A.A., Martinovich A.A. Assessment of bone after exposure of pulsed and modulated low frequency ultrasound by facts of computer densitometer. Sovremennaya stomatologiya (Belarus). 2012; 2 (55): 88—90 (In Russian). eLIBRARY ID: 18928523
  14. Sirak S.V., Andreev A.A. Regeneration of bone tissue after fractures of the lower jaw complicated by traumatic osteomyelitis of nonspecific etiology. Dentist (Minsk). 2018; 4 (31): 83—87 (In Russian). eLIBRARY ID: 36654921
  15. Shkerskaya N.Y., Zykova T.A. New data on the effect of vitamin D on the human body. Siberian medical journal (Irkutsk). 2013; 7: 24—32 (In Russian). eLIBRARY ID: 21082480
  16. Diachkova E.Y., Trifonova D.O., Ibadulaeva M.O., Runova G.E., Fadeyev V.V., Tarasenko S.V. Vitamin D imbalance effects on dentoalveolar system: a review. Osteoporosis and Bone Diseases. 2021; 1: 19—25 (In Russian). eLIBRARY ID: 46452970
  17. Sarkisyan N.G., Gaisina E.F., Dobrinskaya M.N., Pototskaya A.D. Physiological mechanisms of action of vitamin D in oral tissues and organs and the possibility of its use in preventive dentistry (literature review). Humans and their health. 2022; 3: 42—52 (In Russian). eLIBRARY ID: 49593648
  18. Maylyan E.A., Rheznichenko N.A., Maylyan D.E. Vitamin D regulation of bone metabolism. Medical Herald of the South of Russia. 2017; 1: 12—20 (In Russian). eLIBRARY ID: 28840425
  19. Wójcik D., Krzewska A., Szalewski L., Pietryka-Michałowska E., Szalewska M., Krzewski S., Pels E., Beń-Skowronek I. Dental caries and vitamin D3 in children with growth hormone deficiency: A STROBE compliant study. Medicine (Baltimore). 2018; 97 (8): e9811. PMID: 29465564
  20. Kim I.J., Lee H.S., Ju H.J., Na J.Y., Oh H.W. A cross-sectional study on the association between vitamin D levels and caries in the permanent dentition of Korean children. BMC Oral Health. 2018; 18 (1): 43. PMID: 29534753
  21. Fischer V., Haffner-Luntzer M., Prystaz K., Vom Scheidt A., Busse B., Schinke T., Amling M., Ignatius A. Calcium and vitamin-D deficiency marginally impairs fracture healing but aggravates posttraumatic bone loss in osteoporotic mice. Sci Rep. 2017; 7 (1): 7223. PMID: 28775273
  22. Antonova I.N., Grigoriants A.P., Nikitin V.S., Grigoriants A.A. Influence of vitamin D deficiency on progression of inflammation and reparative healing in patients with orofacial region diseases. Medical Council. 2019; 12: 166—170 (In Russian). eLIBRARY ID: 39251555
  23. Luneva S.N., Matveeva E.L., Gasanova A.G., Boichuk S.P., Sazonova N.V. The role of calcium and vitamin D3 in the repair of fractured bones. Doctor.Ru. 2019; 2 (157): 55—60 (In Russian). eLIBRARY ID: 37303325
  24. Botelho J., Machado V., Proença L., Delgado A.S., Mendes J.J. Vitamin D deficiency and oral health: A comprehensive review. Nutrients. 2020; 12 (5): 1471. PMID: 32438644
  25. Soe H.H., Abas A.B., Than N.N., Ni H., Singh J., Said A.R., Osunkwo I. Vitamin D supplementation for sickle cell disease. Cochrane Database Syst Rev. 2017; 1 (1): CD010858. PMID: 28105733
  26. Fretwurst T., Grunert S., Woelber J.P., Nelson K., Semper-Hogg W. Vitamin D deficiency in early implant failure: two case reports. Int J Implant Dent. 2016; 2 (1): 24. PMID: 27888492
  27. Pigarova E.A., Rozhinskaya L.Ya., Belaya J.E., Dzeranova L.K., Karonova T.L., Ilyin A.V., Melnichenko G.A., Dedov I.I. Russian Association of Endocrinologists recommendations for diagnosis, treatment and prevention of vitamin D deficiency in adults. Problems of Endocrinology. 2016; 4: 60—84 (In Russian). eLIBRARY ID: 26731885

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Received

May 30, 2023

Accepted

September 7, 2023

Published on

September 24, 2023