[Drug monitoring of the antibacterial drug Vancomycin in patients with purulent-inflammatory diseases of the maxillofacial region]. / Lekarstvennyi monitoring antibakterial'nogo preparata vankomitsin u patsientov s gnoino-vospalitel'nymi zabolevaniyami chelyustno-litsevoi oblasti.

THE AIM OF THE STUDY: To evaluate the change in the level of concentration of the antibacterial drug Vancomycin registered in the purulent focus area (facial vein) and in the peripheral blood flow (cubital vein) in patients with phlegmon of the maxillofacial region (MFR). MATERIALS AND METHODS: The clinical material of the study was 12 patients with phlegmon of MFR who were being treated in the maxillofacial department of the N.I. Pirogov State Clinical Hospital No. 1 of the Moscow Medical Center. The drainage of phlegmons was performed on the day of admission of the patient 2-3 days after the onset of the disease. The phlegmons involved two or more spaces of the MFR. As an antimicrobial drug, 500 mg of Vancomycin in 400 ml of saline solution was used intravenously. Quantitative registration of Vancomycin was carried out 2 hours after intravenous infusion. Blood sampling was carried out from the cubital and facial veins in an amount of 7-8 ml intraoperatively at the opening of the phlegmon, under endotracheal anesthesia. The concentration of the antibiotic was determined by high-performance liquid crystal chromatography. RESULTS AND DISCUSSION: The study found that the concentration of Vancomycin in the facial vein exceeds similar indicators obtained from the cubital vein. The difference in the percentage ratio averaged 19.2±7.3%. In 10 patients with phlegmons of various localization, it was found that the penetration of the antibacterial drug into the tissues of the inflammatory focus is higher compared to the periphery. However, in a number of patients, the concentration of the drug did not exceed the minimum suppressive concentration recommended for obtaining a therapeutic effect (for Vancomycin, it is at least 2 mcg / ml). CONCLUSION: To achieve the therapeutic effect of phlegmon treatment, it is necessary to select an individual dose of the drug for each patient.

[COVID-induced facial bones necrosis]. / COVID-indutsirovannyi nekroz chelyustnykh kostei.

The article focuses on the clinical manifestation of inflammatory and destructive lesions of the bones of the midface, nose and paranasal sinuses as a long-term complication of COVID-19 with clinical examples provided.

[The development of posttraumatic maxillary sinusitis due to transconjunctival penetration of a foreign body with a fracture of the lower wall of the orbit]. / Razvitie posttravmaticheskogo verkhnechelyustnogo sinusita vsledstvie transkon"yunktival'nogo proniknoveniya inorodnogo tela s perelomom nizhnei stenki orbity.

The article presents a clinical example of the course of posttraumatic acute purulent sinusitis with reactive soft tissue phenomena due to the previous injury of the orbit by a foreign body, the introduction of the latter into orbit and the maxillary sinus result in a fracture of the lower wall of the orbit. A feature of the injury is the penetration of a foreign body through the conjunctiva of the lower eyelid and lower conjunctival fornix, without damaging the skin. This case is professionally interesting for both young doctors and experienced specialists in otolaryngology, ophthalmology, maxillofacial surgery and neurosurgery. Experts, analyzing this clinical example, will be able to correctly diagnose, effectively eliminate the inflammatory process in the maxillary sinus.

[Experience of the interdisciplinary approach to diagnostics and treatment of patients with bisphosphonate osteonecrosis of the upper jaw]. / Opyt mezhdistsiplinarnogo podkhoda k diagnostike i lecheniiu patsientov s bisfosfonatnym osteonekrozom verkhnei cheliusti.

The article discusses the issues of diagnosis, the clinical course of osteonecrosis of the upper jaw in patients with oncological diseases. The assessment of radiological indicators of bone pathology of the upper jaw, signs of the development of the inflammatory process of the maxillary sinus and other sinuses of the nose. The experience of conservative tactics and surgical treatment of patients in this group is analyzed with the participation of specialists from otorhinolaryngologists and maxillofacial surgeons.

[ROLE OF INNATE IMMUNITY FACTORS IN PERIODONTITIS PATHOGENESIS].

Chronic generalized periodontitis (CGP) is a disease of periodontium tissues supporting tooth induced by bacteria, that is characterized by the presence of processes of inflammation with destruction of bone tissue. The knowledge of molecular mechanisms of CGP pathogenesis facilitates creation of the most effective methods of therapy of this disease. Bacterial infection is a primary factor in periodontitis etiology, however is not sufficient for its start and subsequent development. It is known, that bacterial factors induce alocal inflammationreaction and.activate the system of innate immunity through activation of Toll-like receptors (TLR), located on the surface of resident cells and leukocytes. Activation of these cells results in production of pro-inflammatory cytokines and recruitment of phagocytes and lymphocytes into the inflammation zone. In review we examined the known data regarding factors of immune protection of periodontium including cell populations and cytokines, as well as mechanisms of tissue destruction, that support the tooth. Perspectives of therapy are also discussed

[The modern strategy for the treatment of the patients presenting with odontogenic maxillary sinusitis and the oroantral fistula].

The objective of the present study was the comparative analysis of various methods for the plastic correction of the oroantral fistula with the use of the mucosal flap and the osteoplastic materials based on the data from the literature and on-line publkations. The characteristics of an ideal material for the plastic correction ot the oroantral fistula and the conditions for carrying out this surgery are discussed.