PREMORBIDITY IN ACUTE INFLAMMATION OF THE MAXILLOFACIAL AREA IN CHILDREN
Authors: Tkachenko P.І. , Bilokon S.О. , Popelo Yu.V. , Korotych N.M. , Lokhmatova N.M. , Dolenko О.B. 
Published: September 2020

Current state-of-the-art technologies facilitate studying the role of internal and external factors at a higher organ-specific level, and the broad and systematic provision of treatment and prevention care for child population of all age groups differs favorably from the routine visit to a doctor, if necessary. Apparently, the above methodological approach enables establishing different responses of the body to damaging factors in each case.

Methods and Material. 537 case histories of children with acute purulent odontogenic and neodontogenic inflammation of the maxillofacial area have been thoroughly studied. Only medical histories of in-patients have been selected.

Results and Discussion. The analysis of premorbid state of 240 patients with acute purulent lymphadenitis has shown that the onset of the diseases was triggered by the experienced ARVI in 89 patients (37%) and in 37 cases (15%) inflammation of the lymph nodes coincided with manifestations of acute pathology of the ENT organs; in 34 (14%) cases it was combined with acute inflammation of the bronchopulmonary system, in 23 (10%) cases with disorder of the gastrointestinal tract (GIT), in 13 (6%) cases it was provoked by acute periodontitis and exacerbation of chronic periodontitis in temporary and permanent molars of the mandible.

Concomitant chronic somatic diseases were detected in 122 patients (51%). They most often occurred in toddlers, preschoolers and school-aged children and related, in most cases, to the respiratory tract and ENT organs.

Precursors of adenophlegmon in 150 patients were ARVI (45 children (30%)); acute inflammation and exacerbation of chronic ENT processes (21 children (14%)); pathological changes in the bronchopulmonary system (19 children (13%)); gastrointestinal disorders (15 children (10%)); acute periodontitis and exacerbation of chronic periodontitis in temporary molars (20 children (13%)), permanent molars (6 (4%)); acute inflammation of the oral mucosa (5 children (3%)); pyoderma (4 children (3%)). In 15 children (10%) the provoking factor for the development of adenophlegmon failed to be established.

Concomitant chronic somatic pathology was diagnosed in 100 children out of 150 (66.7%), and combination of two chronic diseases was found in 6 children (6%). Most often, the chronic course of somatic pathology was established in preschoolers, less frequently in toddlers and school-aged children, and infrequently during breastfeeding.

In acute odontogenic osteomyelitis, the source of infection was temporary molars in all toddlers and preschoolers, as well as in 12 school-aged children (18%). In total, the onset of osteomyelitis was triggered by temporary teeth in 67 cases (46%). Notably, 35 cases (52%) were related to the first molar and 32 (48%) cases to the second molar. Complicated dental caries in permanent second premolars caused osteomyelitis in 2 (14%) adult children only. Permanent molars caused the development of purulent process in 78 cases (53%).

The analysis of the premorbid state has revealed that the onset of osteomyelitis was preceded by: ARVI (42 children (29%)); general hypothermia (37 (25%)), inflammation of the ENT organs (21 children (14%)) and bronchopulmonary system (15 (10 %)); exacerbation of chronic gastrointestinal diseases (8 children (5%)) and in 24 children (16%) a provoking factor failed to be established.

Concomitant chronic diseases of organs and systems were found in 90 children (61.2%) out of 147 with acute odontogenic osteomyelitis of the mandible. The combination of their two nosological forms was noted in 3 children (3%).

In conclusion, the establishment of certain adverse factors, or the presence of somatic diseases in children necessitates the formation of a risk group, especially when it comes to the existence of odontogenic foci of inflammation. Timely establishment of factors that can be influenced enables control over them through preventive measures, including routine dental check-ups.