Microbiological substantiation of the effectiveness of quercitin and its combination with ethylmethylhydroxypyridine succinate in the complex treatment of odontogenic phlegmon and maxillofacial abscesses.

Odontogenic infections can become life-threatening. The aim of the study was to determine the effectiveness of quercitin and its combination with ethylmethylhydroxypyridine succinate in the complex treatment of odontogenic infections by assessing the microbial population of the infection site. Materials and methods: The cross-sectional study included 75 patients. Purulent exudate was collected from the infection site. The number of colony-forming units was counted using the standard plate method. Results: The microbiological examination of purulent exudate obtained from the patients revealed the general prevalence of Gram-positive cocci. On the seventh day of treatment, the total number of microorganisms in the purulent exudate of patients in group I, whose treatment included a combination of the standard protocol with quercitin, significantly decreased compared to the first day of the same group. The results of treatment of patients in group II, which included the standard protocol in combination with quercitin and 2-ethyl-6-methyl-3-hydroxypyridine succinate, demonstrate a significant decrease in the total number of bacteria in the infection focus on the fifth day of treatment compared to this indicator of the group at the beginning of the study. Conclusions: When quercitin was used as part of complex treatment, the total treatment period was reduced by 1.4 days. However, the combined use of quercitin and ethylmethylhydroxypyridine succinate against the background of standard treatment of patients with odontogenic infection contributed to a reduction in hospital stay by 2 days.

DIFFERENTIAL-DIAGNOSTIC INFORMATIVENESS OF THE MORPHOLOGICAL AND IMMUNOHISTOCHEMICAL STUDY OF PAROTID SALIVARY GLAND CYSTS.

OBJECTIVE: The aim: To conduct a general analysis of the results of the study of the morphological and immunohistochemical structure of cysts of the parotid salivary glands. PATIENTS AND METHODS: Materials and methods: Our study is based on the application of generally accepted, additional and special methods of examination, which concerns 21 patients who underwent surgical intervention to remove cystic formations of the parotid salivary gland. RESULTS: Results: It was established that there are 2-3 HLA-DR+ cells per 100 epithelial cells located in the basal and subbasal layers in the form of their continuous ribbon and their moderate infiltration of tissues within the acinar epithelium. In the epithelium, CD3+ cells were also detected in the number of 1 to 7 per 100 epitheliocytes and they were the most numerous, along with HLA-DR+ cells. Instead, the presence of CD4+ and CD20+ cells was not detected in the epithelium, unlike the subepithelial layer, where they occupied significant areas. In turn, the infiltration of CD8+ cells of the epithelial layer was established in the amount from 1 to 7 per 100 epitheliocytes. A moderate number of them was also determined subepithelially, and they were single directly in the cyst wall. CONCLUSION: Conclusions: Immunohistochemical study of the structural components of cystic formations is this is the direct way to establish the nature of the redistribution of immune cells in it, which is very important when conducting differential diagnosis in difficult and doubtful cases.

FREQUENCY, STRUCTURE AND CLINICAL MANIFESTATIONS OF THERMAL BURNS OF THE JAW-FACIAL AREA IN CHILDREN.

OBJECTIVE: The aim: To establish the frequency, structure and features of the clinical course of facial and neck burns in children. PATIENTS AND METHODS: Materials and methods: During 5 years, 78 patients aged from 6 months to 15 years with isolated burns of the face and neck and in combination with lesions of other anatomical areas were treated. In the dynamics of observation of patients were used classical methods of examination, and in their treatment we followed the protocol of medical care for this category of patients. RESULTS: Results: Thermal injuries of the face and neck accounted for 12.6% of the total number of patients with burns. Their isolated lesion was 26.9%, and in combination with other areas it was 73.1%. The most frequently affected were children of nursery, primary school and preschool age, with a predominance of rural residents (52.6%), mostly boys (78.0%). Anesthesia support had to be used in the treatment of 24 patients (30,8%). The features and nature of the burns depended on the relief of the face and the most damaged are its protruding parts.

EFFECTIVENESS OF CORRECTION OF PSYCHO-EMOTIONAL STRESS IN CHILDREN WITH TRAUMATIC INJURY TO SOFT TISSUES AND FACIAL BONES.

OBJECTIVE: The aim: To study the effectiveness of correction of psycho-emotional stress in children with traumatic injuries of the tissues of the maxillofacial area. PATIENTS AND METHODS: Materials and methods: A comprehensive examination and treatment of 58 children aged 3 to 15 years with traumatic injuries of the maxillofacial area were conducted during the period of 5 years. This applied to soft tissue injuries in 51.7% of cases and in 48.3% - to facial bone injuries. To test the severity of the psycho-emotional state, two homogeneous groups were formed in a total of 41 persons of primary and secondary school age. RESULTS: Results: A comparison of the results of our previous studies, which concerned only the fact of psychological testing and changes in vegetative balance in children with traumatic injuries with a group of patients who underwent comprehensive treatment with additional involvement of targeted psychoneuropharmacological correction allowed to establish, that this approach made it possible to eliminate vegetative disorders and reduce the degree of stress in them for 9-10 days from the time of hospitalization. CONCLUSION: Conclusions: In children with traumatic injuries of soft tissues and bones of the face, dysregulation of vegetative function and intensity of compensatory-adaptive mechanisms of the body with the predominance of the central mechanism of regulation. With the additional involvement of the drug "Noofen®" in the complex of therapeutic measures, it allows to stabilize their psychological state, which indicates its effectiveness.

Bitten wounds of the maxillofacial area in children.

OBJECTIVE: The aim of the work is to determine the frequency, structure, features of clinical manifestations and treatment of bitten wounds of the face and neck in children of Poltava region. PATIENTS AND METHODS: Materials and methods: It has been analyzed 91 histories of disease of thematic patients undergone treatment at the Surgical Department of Pediatric town clinical hospital of Poltava. RESULTS: Results: In the structure of traumatic injuries of maxillofacial area in children 5.3% were patients with bitten wounds of the face and neck. Among the injured were children of the age 7-12 years old (30.2%). In 74.7% of cases, the bites were complicated by acute inflammatory processes. Urban residents accounted for 71.8% of the total number of cases, while rural residents accounted for 28.2%. Boys were injured by 53.6% and girls by 46.4%. Sharps (74.5%), punctures (19.3%) and lacerations (6.2%) differed in form. The comprehensive treatment of patients with bitten maxillofacial area wounds was carried out according to the protocol of care. CONCLUSION: Conclusions: The clinical picture and severity of bitten wounds of maxillofacial area in children have individual features, which are largely due to topographic and anatomical localization of injuries. The choice of the optimal variant of primary surgical treatment of wounds and the amount of surgery should be determined individually depending on the severity of the injury, the time of injury. Special attention should be paid to normalization of psycho-emotional state of patients and prevention of scar formation.

Adverse factors that can affect on the course of chronic parenchimatic parotitis in children.

OBJECTIVE: The aim: The study of the presence of disorders in the ante- and postnatal periods of development of children from 2 months to 15 years with chronic parenchimatic parotitis, which may affect its course. PATIENTS AND METHODS: Materials and methods: It has been examined and treated 88 children, aged from 2 months to 15 years with chronic parenchimatic parotitis, and their mothers were interviewed, who indicated the pathological course of pregnancy, childbirth and indicated the type of breastfeeding babbies. The scope of the survey included general, additional methods, consultations by related specialists and statistical processing of results. RESULTS: Results: 88 children with the exacerbation of chronic parenchimatic parotitis were examined (42 - (47%) with active course and 46 - (53%) with inactive). The exacerbation occurred on the background of acute infectious processes or coincided with the exacerbation of one of the chronic diseases. The first manifestations occurred in spring (55%) and autumn (36%) periods, 44% of children were hospitalized with other diagnoses. The presence of pathological conditions during pregnancy and birth defects in their mothers were recorded more often 3,5 and 3,3 times, respectively, compared with control. 70% of children received mixed and artificial feeding and were more likely to become ill. CONCLUSION: Conclusions: The severity of clinical manifestations of inflammation and disorders of the general condition depended on the activity of the course of chronic parenchimatic parotitis and were more pronounced when active. During the remission period, no apparent clinical manifestations were detected in 72% of observations, however, in 28%, the identified signs indicated a latent course, which required additional treatment and rehabilitation measures.

Clinical-morphological characteristics and peculiarities of treatment of paraururicular fistulas in children.

OBJECTIVE: The aim: Determining the frequency of occurrence of paraauricular fistula in children and comparing the results of their own experience regarding their clinical manifestations, treatment principles and morphological features with existing scientific data. PATIENTS AND METHODS: Materials and methods: The results of a comprehensive examination and surgical treatment of 25 children with paraauricular fistulas. RESULTS: Results: Most often, para-auricular fistula was observed in infants 22 - (88%). In 18 persons (72%), they were unilateral, in 10 - (40%) hereditary. In 8 - (32%), fistula was diagnosed immediately after birth. In 17 - (68%) the pathology was not clinically manifested, but was an accidental finding during the next medical examination. Morphological research has shown that congenital paraauricular fistula is a formed canal intimately associated with the epithelium and cartilage, and the presence of epithelial lining on the fistula wall with constant support of the inflammatory process makes it impossible to heal even against the background of multicomponent treatment. CONCLUSION: Conclusions: Due to the topographic-anatomical localization, features of the clinic of the born fistula, surgical treatment does not always allow to achieve the desired results, and requires repeated interventions during recurrence. It is possible to prevent recurrence by the extensive use of additional diagnostic manipulations before surgery and careful wound control during surgical procedures.

Impact of polychemotherapy on the oral soft tissues in children with malignant abdominal tumors.

OBJECTIVE: Introduction: According to modern standards of treatment of malignant neoplasms conducting polychemotherapy requires up to 90% of cancer patients. However, in addition to the expected cytotoxic effects, it is accompanied by disorders in dental health in the vast majority of patients. The aim: To study the effect of cytostatics on soft tissues of the oral cavity in children with malignant tumors of the abdominal cavity. PATIENTS AND METHODS: Materials and methods: Material for writing this scientific work served as a synthesis of results for 25 people aged 7 to 15 years with malignant tumors of the abdominal cavity, in which a comprehensive oral examination was performed to determine the manifestations of dental toxicity cytostatics. RESULTS: Results: At the end of the first course of chemotherapy, all patients had dry redness of the lips, 20 - (80,0%) with eruptions, in 18 - (20,0%) erosion. The Green-Vermillion, PMA, and PBI indices grew by 1,8; 7 and 3,3 times respectively. In cytograms with buccal epithelium an increase in the number of cells of polymorphic sizes and forms with signs of gidropic dystrophy was found. The nuclear-cytoplasmic ratio decreased by 1,4 times compared with the primary examination. CONCLUSION: Conclusions: This situation creates the preconditions for the development of inflammatory process in the tissues of the oral cavity and requires the use in this category of patients of a substantiated pathogenetic correction of existing disorders.

Insect bites as the cause of infectious and allergic inflammatory processes of the maxillofacial area in children.

OBJECTIVE: Introduction: The part of purulent inflammatory processes (IP) of the maxillofacial area (MFA) as a result of insect bites are increased. The aim: To attract attention of the medical community to the problem of the complexity of the diagnosis and treatment of these dermatogenic forms of IP MFA. PATIENTS AND METHODS: Materials and methods: The work is based on the results of 5 year observations of 42 patients with acute IP MFA arising after insect bites, their comprehensive examination and treatment. CONCLUSION: Conclusions:1. IP of MFA, arising as a result of insect bites, is a very urgent problem of pediatric surgical dentistry and require an individual approach in the diagnosis and treatment of patients. 2. A large role in preventing the occurrence of these nosological forms is given to medical workers, a sufficient organization level of sanitary and educational work, and the treatment of such cases becomes a common task of doctors of different profiles. However, much depends on the parents, their level of responsibility and competency, ensuring of timely treatment and provision of qualified medical care to children, preventing the development of severe complications. 3. The issues related to the etiopathogenesis of this pathology require profound scientific research.

[Statistical information about the inflammatory processes of the jaw-facial part in children].

OBJECTIVE: Introduction: The acute and chronic inflammatory processes prevail in the structure of the dental surgical diseases in children. Notably, various forms of lymphadenitis, adenophlegmon and odontogenous osteomyelitis dominate in the specialized surgical units; however, it is not possible to resolve a number of organizational problems without clear understanding of the statistical situation. The aim: The paper is aimed at the analysis of the incidence rate of major nosological forms of the acute suppurative inflammations of the maxillofacial area in children for the prospective planning of arrangements to provide them with high-quality specialized care. PATIENTS AND METHODS: Materials and methods: The paper involves findings of comprehensive examination and treatment of 537children with acute purulent lymphadenitis, adenophlegmon and odontogenous osteomyelitis that was carried out within 6 years. RESULTS: Results: The resulting clinical data have shown that three abovementioned nosological forms of the disease accounted for 42% of the overall number of the inpatient dental patients and 11% of the total number of children with acute surgical pathology. Out of 537 patients, 240 patients (44.8%) with acute purulent lymphadenitis, 150 (27,9%) patients with adenophlegmon and 147 (27.3%) patients with acute odontogenous osteomyelitis have been observed (318 (59,2%) boys and 219 (40,8%) girls aged from 2 months to 15 years). The study of the past history of the disease has established that in the majority of patients burdened premorbid history and occurrence of concomitant chronic general somatic diseases was presented prior to the onset of acute inflammation. CONCLUSION: Conclusions: The factors, mentioned above, greatly contributed to increase in protective-adaptive properties of child body and create the prerequisites for the formation of pathological symptomocomplex in children, which can be implemented even in the minimal effect of antigen load on the tissues of maxillofacial area. Such situation requires a balanced multidisciplinary approach to the planning of preventive measures in this category of patients at all stages of the observation.