Dynamic of activity of neuron-specific enolase and titres of protein S100 in blood serum of patients with iatrogenic-compression-toxic lesions of the lower alveolar nerve for different therapeutic tactics
Optimization of the tactics for the patients with iatrogenic-compression-toxic lesions of the lower alveolar nerve (ICT LAN) - is an urgent task of modern medicine and dental service in particular. The solution of the above problem can be achieved by involving neuroprotective agents with a blocking effect on the excessive activity of NMDA receptors in the therapeutic tactics. This can prevent further nerve damage and trigeminal neurons site and restore the activity of the cells due to ischemic-hypoxic process in a state of hibernation. Objective — to conduct a comparative, dynamic (within 30 days) evaluation of the activity and level of neuromarkers (neuron-specific enolase and protein S100) in blood serum of patients with iatrogenic-compression-toxic lesions of the lower alveolar nerve for different therapeutic tactics, including with the addition of amantadine hydrochloride to therapy. The study involved male patients, aged 20 to 60 years, without concomitant dental pathology ICT LAN, which came with overfilling into the mandibular canal fillings material Foredent or AH-Plus. On the 7th, 14th and 30th days of the pathology in the blood serum of such patients, the isozyme determination of the enolase activity and the titration of the S100 protein were performed on the background of different therapeutic tactics, including when combining standard therapy with neuroprotector Neomidantan. Comparing neuromarker dynamics in groups without neuroprotective support (II and III) and in the conditions of appointment of Neomidantan, one can conclude that the last drug causes the most powerful de-escalation and activity of NSE and titers of the S100 protein. Therefore, Neomidantan shows neuroprotective effect on system inferior alveolar nerve/trigeminal neurons site and its function in patients with ICT LAN helps preserve morphological and functional integrity of this system, which is particularly manifested in the 30th day of therapy. Summing up the neuromarkers changes in the ICT LAN on the 30th day of observation, depending on the therapeutic tactic, the following variation series can be constructed: ICT LAN+ protocol therapy (II group) > ICT LAN+ protocol surgical and therapeutic treatment (ІІІ group) > ICT LAN + protocol therapy + Neomidantan (IV) > ICT LAN + protocol surgical and therapeutic treatment + Neomidantan (V group).
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