The importance of procalcitonin for assessing the severity of odontogenic purulent – inflammatory diseases of the soft tissues of the maxillofacial region and as a biomarker of treatment effectiveness

  • U. D. Matolych Danylo Halytskyi Lviv National Medical University
  • O. Ja. Mokryk Danylo Halytskyi Lviv National Medical University
  • S. V. Ushtan Danylo Halytskyi Lviv National Medical University
  • V. V. Vynarchuk-Paterega Danylo Halytskyi Lviv National Medical University
Keywords: inflammatory diseases of the maxillofacial area, serum procalcitonin, complications, monitoring, treatment

Abstract

Summary. Odontogenic inflammatory diseases of the maxillofacial area occupy the first place among the diseases in the clinic of maxillofacial surgery. The number of complications arising from inflammatory processes is 6–40 %. The success of treatment of patients with this pathology depends on early diagnosis, an objective assessment of the severity of the condition, the conduct of personified antibiotic therapy. The biomarker procalcitonin (PCT) is consistent with the SMART concept: S – specific and sensitive, M – measurable, A – available and affordable, R – responsive and reproducible, T – timely. At present, the diagnostic role of the PCT test in the comprehensive assessment of the odontogenic inflammatory process remains inadequate.

The aim of the study – to learn the features of changes in the level of serum procalcitonin in case of odontogenic inflammatory diseases of the maxillofacial region of varying severity and its effectiveness in monitoring the treatment.

Materials and Methods. The study included 89 patients with odontogenic infections of the maxillofacial area: 34 patients with odontogenic infection of one cellular space (group I), 35 – two cellular spaces (group II); 20 – three or more cellular spaces (group III). Determination of the level of PCT in serum was performed 1 day before treatment, at 5 and 9 days with immunoassay.

Results and Discussion. In the group I, a low PCT concentration was detected throughout the observation period (0.06±0.02) ng/ml. In group II, for 1 day, the level of PCT was elevated (1.15±0.5) ng/ml. In 26% of patients, the level of PCT for the 9th day was (1.02±0.05) ng/ml, which is 17 times higher than that of group I, p<0.05. The revealed value correlated with the severity of the pathological process. In the group III, for the first day, the level of PCT was 43 times higher than the level of group I, group II – 2.36 times. Maximum PCT levels were observed in 35 % of patients in group III during the entire observation: at day 1 – (3.23±0.19) ng/ml; 5 days – (3.14±0.05) ng/ml; 9 days – (2.82±0.04) ng/ml. These patients did not notice a significant decrease in PCT. The condition of patients was assessed as moderate, severe.

Conclusions. The level of PCT blood serum of 1.5 ng/ml is evidence of further development of purulent-inflammatory process, high risk of complications and requires an assessment of the effectiveness of antibiotic therapy and causes additional intervention – an audit of the inflammatory cell.

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Published
2019-09-05
How to Cite
D., U., Ja., O., V., S., & V., V. (2019). The importance of procalcitonin for assessing the severity of odontogenic purulent – inflammatory diseases of the soft tissues of the maxillofacial region and as a biomarker of treatment effectiveness. Clinical Dentistry, (2), 36-41. https://doi.org/10.11603/2311-9624.2019.2.10397
Section
Surgical stomatology