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: 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: 0000-0001-5458-0192
  • A.M. Gusarov 1, PhD in Medical Sciences, associate professor of the Maxillofacial surgery Department
    ORCID: 0000-0002-6583-4685
  • K.E. Ampilova 1, clinical resident at the Maxillofacial surgery Department
    ORCID: 0000-0001-9215-7846
  • K.S. Demidova 2, postgraduate at the Maxillofacial surgery and surgical dentistry Department
    ORCID: 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

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Received

May 30, 2023

Accepted

September 7, 2023

Published on

September 24, 2023