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The results of 20 patients (with odontogenic phlegmon of maxillofacial region) treatment by glycosaminosulphate were compared with the results of patients received traditional treatment. Significant speeding-up of the blood indices normalization terms, humoral immunity factors and postoperative wound regeneration after odontogenic phlegmon of maxillofacial region lancing was determined.

Time course of some laboratory values and clinical manifestations of inflammatory process is studied in 52 patients with exacerbations of chronic periodontitis and 284 patients with odontogenic perimaxillary abscesses. Routine laboratory studies (clinical and biochemical analyses of the blood and urine) were carried out. Acute odontogenic inflammations are characterized by an intermittent course with periodicity of about a week. The end of the first week from the disease onset coincided with recovery in exacerbation of chronic periodontitis and with the beginning of stabilization of inflammatory process in abscess. Recovery after abscess was observed 2 weeks after disease onset. These regularities may be useful for specifying the pathogenesis, terms of check-ups, and duration of treatment.

The effects of dioxycol and low-frequency ultrasound alone and in combinations on the microflora of suppurative wounds formed after opening of maxillofacial phlegmons are assessed in 142 patients. Clinical and laboratory findings indicate a higher efficacy of combined use of these treatment modalities, which are recommended for optimal local treatment of purulent maxillofacial wounds.

Time course of laboratory parameters is assessed in 31 patients with severe maxillofacial inflammations, hospitalized in intensive care wards. The patients were followed up for 4 to 42 days. Routine blood and urine analyses were monitored. Wave-like fluctuations in all laboratory parameters with periodicity of about a week (biorhythms) were detected. In lethal outcomes, the rhythms were disordered (desynchronized) and counterphases were detected. A grave course of inflammation is for the first time graphically represented critical periods of the diseases are determined; this will help planning the rational terms for monitoring the homeostasis, predict the disease outcome, and improve the treatment of such patients.

A total of 283 patients with odontogenic sepsis, in 66 of these complicated with septic shock, were observed in 1983-1995. A program for rapid assessment of the main clinical laboratory parameters is proposed for differentiating the phases of shock development. Combined use of hemoperfusion and extracorporeal perfusion oxygenation of the blood with preliminary or simultaneous intraarterial infusion of plasma substitutes possessing hemodynamic effects is pathogenetically justified in septic shock.

Contact odontogenic mediastinitis is a complication of advanced phlegmons of the face and neck. 22-year experience in the treatment of 107 patients with odontogenic mediastinitis, clinical and laboratory criteria of its diagnosis and differential diagnosis with advanced phlegmons are presented. The programs of intensive therapy adjusted for the disease phase and surgical treatment contributed to lowering of lethality from 50 to 15.3%.

A total of 470 patients with inflammatory diseases of the maxillofacial area and neck were examined and treated. Acute inflammatory process was complicated with sepsis in 87 of them. Clinical and laboratory studies revealed that the intensity of endogenous intoxication depended on the phase of inflammatory process. This helped accurately differentiate between the intoxication degrees and develop detoxication strategy for each of them. Such a differentiated approach helped appreciably decrease the mortality in the group of patients with odontogenic and stomatogenic sepsis.

The authors analyze the results of diagnosis and treatment in 1062 patients with diffuse inflammatory diseases of the maxillofacial area and of complications of these diseases, such as mediastinitis, thrombosis of the cavernous sinus of the dura mater, meningoencephalitis. Improvement of the program of diagnosis and treatment helped improve the results: mortality from sepsis reduced from 50 to 26%. Approaches to prevention of progressive purulent infection are outlined.

Autoresonance frequency vibromassage sessions were administered to patients with pyoinflammatory processes in maxillofacial soft tissues. Comprehensive examinations of these patients were carried out to assess the efficacy of this treatment modality; the examinations included rheographic and ultrasonic examinations of blood flow intensity, analysis of neutrophilic activity by chemiluminescence amplitude, measurements of trypsin inhibitor levels and cholinesterase activity, assessment of wound exudate pH values and of resorption capacity of purulent wound tissues. Microbiologic, histologic, cytologic, clinical and biochemical studies were carried out. The findings permit a conclusion that autoresonance vibromassage enhanced biologic purification of the wound from pyonecrotic mass and accelerated reparative regeneration.

The results evidence the efficacy of intracorporeal exposure of the blood to He-Ne laser as part of multiple-modality treatment of patients with maxillofacial phlegmons. The method is simple and involves no complications or side effects, this recommending it for wide use.

The examination has involved a total of 216 patients (111 in the study group and 105 in the reference one) with maxillofacial phlegmons. Patients of the main group were administered multiple-modality treatment with surgical treatment of the purulent focus, involving a primary suture on the wound and intraarterial local drug therapy. Partial necrectomy was found possible in the majority of cases with the surgical treatment of the purulent focus; therefore to prevent dissemination of the inflammatory process and liquidate it as soon as possible surgery had to be performed against the background of the maximal permissible antibiotic concentration in the adjacent tissues. Primary suturing of the purulent wound had to be combined with draining and continuous dialysis of the postoperative wound. The postoperative wound healed by primary tension in 91.89% of patients in the main group; the incidence of complications was lower in them than in the reference group; the length of hospital stay and invalidity periods were reduced almost twofold.

All the patients were administered preoperative antimalarial therapy, antibiotics and sulfanilamides, and agents maintaining the defense factors, as well as detoxifying and desensitizing therapy. Rational nutrition was prescribed. All these measures helped liquidate the inflammation foci not only in the bones, but in the soft tissues of the paramaxillary area as well.

Analysis of case histories of patients with odontogenic sinusitis helped single out the typical errors often made by the practitioners when diagnosing and treating this disease. These errors are: untimely diagnosis of the perforation, inadequate examination, erroneous interpretation of the diagnosis. When the maxillary sinus bottom is perforated during removal of a tooth, the physician often erroneously closes this opening. Treatment of sinusitis is often carried out regardless of the disease form and stage.

Application of regencur, a local draining sorbent, to phlegmons of the face and neck in 48 patients resulted in shortening of the first phase of the wound process, this permitting earlier suturing of the wounds with primary delayed and secondary sutures. Active sorption and local detoxication were conducive to reduction of lipid peroxidation processes in tissues and blood plasma and to enhancement of leukocytic bactericidal activity.

The efficacy of treatment of 98 patients suffering from maxillofacial odontogenic phlegmons was assessed from the results of clinical, laboratory, immunologic, biophotometric, and morphologic investigations, and compared to the results of traditional treatment of 132 patients with the same conditions. Multiple-modality treatment has proved to be much more effective; its advantages consisted in a shorter inpatient treatment and in better cosmetic results.

The efficacy of multiple-modality treatment including interstitial He-Ne laser exposure and agents normalizing redox processes due to their antioxidant effect, 5 percent ascorbic acid and 1 percent methylene blue aqueous solution, was assessed in the treatment of 188 patients with maxillofacial phlegmons. The treatment accelerated injured tissue regeneration, this permitting early secondary suturing and shortening the invalidity periods.

Changes in the blood serum protein and mineral composition, trypsin inhibitor content, alanine amino-transferase, aspartate aminotransferase, alpha-glutamyl transpeptidase, creatine kinase, choline esterase activities, blood plasma trace element levels were examined in 112 patients with pyoinflammatory involvement of the soft tissues of the face and neck. The study was revealed reduced blood serum albumin concentration, elevated trypsin inhibitor levels and alpha-glutamyl transpeptidase and creatine kinase activities, decreased content of Mg and Zn and, in some patients, of choline esterase activity. Biochemical parameters gradually normalize, as the patients recover, their normalization depending on the therapeutic methods and detoxication treatment.

Experience gained in the treatment of 63 children has demonstrated the validity of bone perforation and intraosteal drug lavage in a complex of therapeutic measures for acute mandibular odontogenic osteomyelitis running an unfavorable course. Incorporation of immunostimulant thymalin in the solutions used for intraosteal lavage of the inflammation focus in this condition is conducive to normalization of the cellular and humoral immunity and liquidation of the pathologic process without destruction of the bone tissue.