New approach in complex treatment of purulent odontogenic diseases and inflammatory complications of mandibular fractures

Aim. To evaluate antioxidant and therapeutic effects of multivitamins on the area of inflammation in the complex treatment of purulent odontogenic diseases and inflammatory complications of mandibular fractures.

Methods. The study included 120 patients with acute odontogenic suppurative inflammatory diseases and infectious inflammatory complications of mandibular fractures. Control group included 23 healthy subjects aged of 20 to 27 years. Levels of phosphorus (P), calcium (Ca), silicon (Si), strontium (Sr), and zinc (Zn) in the oral fluid were measured by atomic absorption and atomic emission spectroscopy with inductively coupled plasma. Therapeutic effect of «Vinibis» adaptogen containing a complex of vitamins, macro- and micronutrients, amino acids of natural origin was analyzed.

Results. All patients receiving «Vinibis» adaptogen had the following changes in the oral fluid. In acute purulent odontogenic periostitis because of the increased concentration of strontium up to 0.1374±0.0334 mg/l (p <0.05), ratio of Ca/Sr decreased from 2532±446 at the admission down to 792±373 (p <0.05) at discharge. A reduction in the calcium concentration to control values in 5-7 days of hospitalization was established: in acute odontogenic osteomyelitis down to 60.43±4.24 mg/l, and in odontogenic osteophlegmon - down to 54.36±1.95 mg/l. Strontium levels in odontogenic phlegmonous adenitis significantly decreased from 0.3172±0.0868 mg/l at admission to 0.0501±0.0073 mg/l at discharge. In cases of traumatic mandibular fractures, complicated with wound festering, Ca/Si ratio approached the control values at the early stages (5-7 days of admission) and were 134.81±10.27 (p >0,05). The reduction of Ca/Si ratio compared to control values on day 7 was discovered at traumatic mandibular fractures, complicated by wound festering and phlegmon, down to 138.54±12.23 (p >0.05), as well as in chronic traumatic osteomyelitis complicated by phlegmon down to 137.95±11.01 (p >0.05).

Conclusion. Differentiated use of «Vinibis» adaptogen, considering its potential antioxidant action due to the value of vitamins synergy coefficient of 1.14, might improve the efficiency of complex treatment of purulent odontogenic inflammatory diseases and complications of mandibular fractures.