The use of modern immunomodulators in the complex treatment of odontogenic phlegmons of the maxillofacial area

Abstract

The aim of this study was to increase the effectiveness of treatment of patients with acute purulent odontogenic inflammatory processes of the maxillofacial area by improving treatment algorithms with the inclusion in the treatment of immunomodulators (synthetic adaptogen based on oxyethylammonium methylphenoxyacetate).
Materials and methods. The study involved 114 patients with infectious-inflammatory processes of the maxillofacial area, 60 patients were treated according to our developed treatment – prevention complex (main group); in 54-treatment was performed according to the standard protocol of surgical administration of patients (control group).
Results. When studying the humoral part of innate immunity in patients of both groups of the study for 1–3 days of the postoperative period, negative changes in almost all humoral factors relative to the average norm were found. At 5–7 days of the postoperative period, as a result of treatment, the indicators of the humoral link of nonspecific immunity had a positive trend, most pronounced in patients where we used our proposed treatment regimen. In the later postoperative period (8–12 days) of observation in patients from the main group in the blood increased the content of protein, albumin, lysocyme titer and the background of reduced concentrations of γ-globulin and C-reactive protein relative to data for 1–3 days postoperative period. The remaining analyzed indicators were equal to the reference value. In patients of the control group on day 8–14 of the postoperative period, the concentration of CRP in the blood was higher, and the titer of lysocyme and albumin remained lower relative to the data on days 1–3 of the postoperative period. It was noted that the concentration of CRP in the blood exceeded, and the lysocyme titer was lower than the normative values.
Conclusion. As a result of studies of the main components of immunity in the treatment of acute purulent odontogenic inflammatory processes of the maxillofacial area, a significant violation of humoral and cellular factors was found, which manifested itself in both a decrease and a dangerous increase in most of the studied indicators. Comprehensive standard treatment, which was carried out according to traditional schemes, does not allow to achieve a significant and stable improvement of immune factors. Inclusion in the complex treatment of acute purulent odontogenic inflammatory processes of the maxillofacial area of immunocorrective and adaptogenic therapy allows not only to obtain the most pronounced and stable positive result, but also to achieve significant improvement and normalization of basic humoral and cellular factors of innate immunity.