Abstract

Treatment of odontogenic phlegmon of the maxillofacial region remains an urgent problem of surgical dentistry due to the steady increase in their frequency, tendency to generalize the process and adverse effects. In this regard, there is a constant search for ways to improve the effectiveness of treatment of patients with odontogenic phlegmons of maxillofacial region. New technologies of drug treatment of this pathology are developed and put into practice.
 In recent years the attention of researchers in various conditions accompanied by the development of oxidative stress began to attract drugs that have antioxidant action, as it became known that the excess of reactive oxygen species in the regenerating wounds in the hearth of purulent inflammation affects the course of the course, wound healing. Interest in the treatment of various pathological conditions of the body is caused by the domestic antioxidant multifunctional enzyme "Bioceruline" which is composed of copper.
 In this regard, the purpose of our study was to evaluate the effectiveness of the use of "Biocerulin" in the complex treatment of patients with odontogenic phlegmon of maxillofacial region.
 The object of the clinical study was 45 patients with odontogenic phlegmons of the maxillofacial region from 18 to 55 years old, who were treated in the maxillofacial department of PU "Poltava M.V. Sklifosovskyi regional clinical hospital PRC». All patients were without somatic pathology in compensated clinical condition. Immediately after hospitalization, patients underwent an emergency opening of purulent lesion, revision and adequate drainage of the affected cellular spaces, removal of the "causal" tooth. The extent of surgery and the choice of optimal access depended on the location and prevalence of phlegmon. Depending on the treatment, patients were divided into comparison groups (22 patients) and the main group (23 patients). The traditional therapy was used in the comparison group. "Biocerulin"was prescribed for the patients of the main group in addition to the traditional therapy.
 Analysis of obtained data in the treatment of patients with phlegmon revealed that both groups of patients had clear differences in the clinical course of purulent-inflammatory process. On the 2nd day after the opening of the phlegmon theweakness, headache, and sleep disorders were noted in the most of the patients of the comparison group who received traditional therapy. Pain with varying degrees of intensity was present in all patients. Improvement of the general condition of patients of this group was noted not earlier than 3-5 days after surgery. The improvement of the general condition and reduction of pain, normalization or decrease in body temperature, the beginning of restoration of function of the jaw apparatuswere notedin patients of the main group on the background of the introduction of "Bioceruline" already on the 2-3rd day after surgery.
 Thus, on the basis of the conducted researches it is possible to conclude that the basic (traditional) conservative therapeutic measures used for patients of the comparison group are not effective enough for the relief of the local and general inflammatory process, which caused the prolonged nature of organ-specific and functional rehabilitation of patients as a whole. The use of "Bioceruline" in complex therapy of patients with odontogenicphlegmons of the maxillofacial regionprovides rapid and intensive recovery of the general condition of patients and accelerates reparative processes in the wound and shortens the treatment time via 1.4 bed-days.

Highlights

  • On the basis of the conducted researches it is possible to conclude that the basic conservative therapeutic measures used for patients of the comparison group are not effective enough for the relief of the local and general inflammatory process, which caused the prolonged nature of organ-specific and functional rehabilitation of patients as a whole

  • Очищення рани від некротизованих тканин, зменшення виділень, перифокального набряку й інфільтрації, розвиток зрілої грануляційної тканини поряд зі зниженням температури тіла і поліпшенням стану хворих основної групи свідчили про перехід у II фазу ранового процесу, яка наставала на 3 доби раніше, ніж у групі порівняння

  • The extensive phlegmon of the neck leading to severe complicationsa case report

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Summary

Матеріали і методи дослідження

Об'єктом клінічного дослідження були 45 хворих віком 18-55 років з одонтогенними флегмонами ЩЛД, яких лікували в щелепно-лицевому відділенні КП«ПОКЛ ім. Залежно від проведеного лікування хворих було розподілено на групи порівняння (22 хворих) і основну групу (23 хворих). Хворим основної групи на додаток до традиційної терапії призначали «Біоцерулін» за схемою: перед уведенням внутрішньовенно крапельно вміст флакона розбавляли у 200 мл 0,9% розчину натрію хлориду. Разова доза становила 100 мг щодня, курс лікування – 5 ін'єкцій. У місцевому лікуванні післяопераційної гнійної рани в I фазі у хворих обох груп у ролі санірувального розчину використовували 0,3% розчин перекису водню. У II фазі з метою стимуляції репаративних процесів хворим на рану наносили мазь «Левоміколь». Після купірування ексудативних явищ і появи молодих грануляцій краї рани зближували і накладали вторинні шви у хворих обох груп. При надходженні хворих і в динаміці вивчали клінічні загальні й місцеві прояви захворювання

Результати дослідження та їх обговорення
Терміни гноєтечі Терміни появи грануляцій
Список літератури
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