Clinical and laboratory characteristics of the postoperative period in patients with maxillofacial phlegmon

Abstract

The problem of treatment of purulent-inflammatory diseases of the maxillofacial area remains one of the most pressing problems of modern dentistry. The aim of the work is to conduct a clinical and laboratory analysis of the postoperative period in patients operated on for odontogenic phlegmon of the maxillofacial area. 39 patients with odontogenic phlegmons of the maxillofacial area were examined. All patients before surgery, in the postoperative period for 3, 5, 7, 10 days and before discharge, conducted laboratory tests with the definition of a general analysis of blood and urine, the total amount of protein, sugar, urea and creatinine. Serum C-reactive protein (CRP), interleukin-6 (IL-6) and tumor necrosis factor-alpha (TNF-a) were determined by ELISA with the definition of IMMUNOTECH kits (France) and IMTEK kits (Russia). Endogenous intoxication was determined by the level of molecules of average weight in the blood, leukocyte index and hematological index of intoxication. The obtained data were processed statistically and compared at different periods of observation. During hospitalization in all patients, inflammatory process, severe endogenous intoxication, and systemic inflammatory response syndrome were expressed. In the postoperative period, patients significantly (p<0.05) reduced the total amount of blood protein, erythrocytes, hemoglobin, which a day before discharge were significantly lower (p<0.05) compared with the time of hospitalization. The number of leukocytes, the level of urea and creatinine also decreased before discharge, their indicator was at the level of the upper limit of normal. Up to 5 days after surgery, an elevated level of average weight molecules was established with a gradual reliable (p<0.05) decrease of this indicator to the upper limit of normal before discharge. Up to 5 days after surgery, an elevated level of average weight molecules has been established with a gradual reliable (p<0.05) decrease of this indicator to the upper limit of normal before discharge. In the first 5 days after the start of treatment, there was a significant (p<0.05) increase in the level of CRP¸ TNF-α and IL-6, whose level was normalized before discharge. Clinical and laboratory characteristics of the postoperative period in patients operated on for phlegmon of the maxillofacial region indicates that the severity of the course is due to the development of the systemic inflammatory response syndrome and endogenous intoxication.