Microbiological aspects concerning the etiology of acute odontogenic inflammatory diseases in the soft tissues of the head and neck region

Abstract

Odontogenic purulent inflammatory diseases (OPIDs) make up about 20% of cases in the structure of general surgical pathology and are among the frequent diseases of the head and neck region with a high (10−40%) mortality rate. Insufficient information about the source state of acute odontogenic inflammation of the perimandibular soft tissues significantly reduces the effectiveness of diagnostic measures of OPID in head and neck region, as evidenced by almost 50% of the diagnostic error rate. Statistically, OPID in soft tissue of head and neck region most often occurs due to dissemination of pathogens of the necrotized pulp, periodontal pockets in periodontitis, or pericoronitis during the difficult eruption of retained teeth. Previously, the quantitative dominance (about 70%) of Staphylococcus spp. among the microorganisms isolated from the odontogenic foci of inflammation was determined. However, in recent years, with the expansion of microbiological diagnostic capabilities, the presence of non-fermenting Gramnegative bacteria and anaerobes with a significant proportional proportion of the total microbiota of OPID in soft tissue of head and neck region has been increasingly indicated. Recently, there has been a rapid acquisition of resistance of pathogens of odontogenic purulent inflammatory diseases of the maxillofacial region to various groups of antibiotics, which leads to ineffectiveness of their treatment and prompts the revision of existing protocols and treatment regimens in surgical dentistry.