Kopchak A. V., Ivanytska O. S., Pronina O. M., Polishchuk S. S., Yaroshenko I. R., Bukhanchenko O. P., Lychman V. O.

FEATURES OF CLINICAL COURSE OF ODONTOGENIC PHLEGMONS OF THE FLOOR OF THE MOUTH

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About the author:

Kopchak A. V., Ivanytska O. S., Pronina O. M., Polishchuk S. S., Yaroshenko I. R., Bukhanchenko O. P., Lychman V. O.

Heading:

DENTISTRY

Type of article:

Scientific article

Annotation:

This research is devoted to the study of the features of the course, clinical characteristics and treatment of patients with odontogenic phlegmons of the floor of the mouth, especially on the background of concomitant somatic pathology, as well as to identify factors predisposing to complications leading to death. A retrospective analysis of the medical histories of 80 patients with odontogenic phlegmons of the floor of the mouth, whose treatment was carried out in the departments of maxillofacial surgery, which are the bases of the Bogomolets National Medical University, Poltava State Medical University and National Pirogov Memorial Medical University, Vinnytsya. During the first examination it was recorded that the most common patient’s complaints were severe pain (100%), painful mouth opening (75 patients – 93.75%), swelling of facial tissues and neck edema (69 persons– 86.3%), dysphagia (54 patients – 67.5%), and fever (70 patients – 87.5%). In 85% (68 persons) of the cases the pathology was related to the infection process associated with the second and third lower molars, in 6.25% (5 patients) – with premolars and in 8.75% (7 cases) – with incisors or canines. Bilateral swelling was found in 26.25%, unilaterally right and left sides were affected almost equally (respectively 36.25% and 37.5% of cases). Thirty-five patients (43.8%) had associated systemic diseases. Diabetes mellitus was the most common, and was observed in 26 patients (32.5%). In 2nd place was ischemic heart disease, which was diagnosed in 21 patients (26.3%). Microbiological diagnostics were performed in all cases. The most frequently cultured were: coagulase-negative staphylococci, Klebsiella pneumoniae, Staphylococcus aureus, Fusobacterium nucleatum, Streptococcus viridans, Bacteroides spp., Peptostreptococcus spp. The following risk factors for complications were identified. Anterior visceral space lesions and diabetes mellitus were the most important prognostic factors. Anterior visceral space lesions were detected in 16 patients (20%). Patients with diabetes mellitus and coronary heart disease, as a rule, have a higher prevalence of anterior visceral space lesions. Despite the aggressive treatment of odontogenic phlegmons of the floor of the mouth, especially anaerobic, serious complications still are possible. Clinical evaluation of patients with comorbidities, especially diabetes and coronary heart disease, requires a high level of attention to the occurrence of potential complications that can threaten life.

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Bibliography:

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Publication of the article:

«Bulletin of problems biology and medicine», 2025 Issue 1, 176, 506-513 pages, index UDC 616.31-002.36-06-07

DOI:

10.29254/2077-4214-2025-1-176-506-513