Features of oral immunity indicators in patients with phlegmons of the maxillofacial region against the background of insulin-independent diabetes mellitus

Objective: studying the interrelations of the local oral immunity indicators which allow to predict the severity of phlegmons course in patients with maxillofacial region phlegmons against the background of insulin-independent diabetes mellitus.

Materials and methods. 44 patients were included in this prospective study. The main group: 19 patients with the maxillofacial region phlegmons and the type 2 diabetes mellitus as a concomitant pathology (PH+DM). The comparison group: 20 patients with the maxillofacial region phlegmons with no diabetes mellitus among the concomitant pathologies (PH). The control group: 5 patients were undergoing routine surgical treatment in the maxillofacial surgery department. The groups were comparable in age, gender, and phlegmon treatment (p > 0.05). Levels of the proinflammatory and anti-inflammatory cytokines, the humoral immunity factors and the microbial adsorption reaction (MAR) index to the oral epithelial cells were determined in the saliva of patients on the 1^st and 5^th days. The obtained data were statistically processed.

Results. On the 1^st day of hospital treatment the PH+DM group revealed an increase in interleukin-6, a decrease in interleukin-10 and lactoferrin as compared to the PH and control groups (p < 0.05). On the 5^th day of the treatment the interleukin-6 and tumor necrosis factor-α levels did not differ between PH+DM and the control groups (p < 0.05). The interleukin-4 and interleukin-10 levels were lower in the PH+DM and PH groups than in the control group on the 5^th day (p < 0.05). The lactoferrin level in the PH+DM group was lower than in the PH and control groups (p < 0.05). The significant negative correlation was found between the MAR index values and SOFA (Sequential organ failure assessment score) points in patients with sepsis, R = -0.9 (p < 0.05).

Conclusion. The delayed regression of the saliva inflammation indicators was specific for the PH+DM group patients in comparison with the PH group patients. The MAR index below 10% may be a predictor of unfavorable course of the phlegmon development.

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