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Combined local and general ozone therapy was used in 30 patients with local sluggish pyoinflammatory diseases of the maxillofacial soft tissues. The results were compared to those in 33 patients administered no ozone therapy. Ozone therapy decreased the duration of treatment more than 2-fold due to antibacterial effect and stimulation of nonspecific and immunological reactivity. Lack of obvious contraindications and selective activity and universal immunocorrective effect recommend ozone therapy for wide use in this patient population irrespective of the type of inflammatory reaction.

Studies of immunotropic effects of ampicillin, gentamicin sulfate, lincomycin, and rifampicin SV used in endolymphatic therapy of patients with maxillofacial phlegmons demonstrated a pronounced immunomodulating effect of rifampicin SV in polygluquine. The immunomodulating effect of lincomycin was lower, and that of ampicillin virtually null. Gentamicin sulfate suppressed some parameters of the immune status.

Prevention of infectious inflammatory complications of intraosseous implantation is a pressing problem. Chlorohexidine dosage forms Corsodyl and Eludril were used for this purpose. In the control group, furacillin was used. Microbiological studies showed that instillations of Corsodyl and Eludril solutions during the postoperative period did not modify normal oral microflora and led to disappearance of the most aggressive anaerobic bacteria in 1-3 days. These drugs are more effective that Listerine, and they are recommended for prevention of infectious inflammatory complications after intraosseous implantation.

Colonization of materials used for making dentures with oral microflora was studied in 12 patients with chronic generalized medium severe periodontitis during remission. Time course of dentures colonization with representatives of oral microflora (S. sanguis, Peptostreptococcus sp., Prevotella oralis) and with bacteria pathogenic for the periodontium (Prevotella melaninogenica, A. naeslundii, Fusobacterium sp.) depends on the material from which the dentures are made. Minimal colonization of bacteria pathogenic for the periodontium was observed on cermet dentures.

Effects of antiorthostatic hypokinesia (AOH, -6 degrees) during 60 and 120 days on the parodontium in 10 human subjects aged 24-33 yr. have been studied. Clinical, functional, immunologic, and microbiological analyses were performed 30 days prior to, on days 7 and 30, and on day 7 since the experiment. The parodontium was assessed by relevant indices, immunoglobulines in the oral fluid, and bacteriological parameters determined with the anaerobic cultivation technique. AOH was found to reduce the colonisation resistance of the parodontium due to obviously, the immunologic inertia and consequent changes in the qualitative composition of microflora. It is concluded that the parodontium responds to extreme conditions by replacement of the commensal microflora by opportunistic and obligate parodontosis pathogens.

Sensitivities of peptostreptococci, streptococci, Actinomyces, bacteroid, and fusobacterial strains pathogenic for the periodontium to wide-spectrum penicillines, cephalosporines, lincomycin, macrolides, metronidasole, and nitasole are compared. New macrolide antibiotics rulide. Macropene, gramicidin C, levomycetin, and rifampicin are highly effective. Some narrow-spectrum drugs, e.g. augmentin, cephalexin, and vancomycin (towards actinomycetes) were highly effective, too.

The effects of dioxycol and low-frequency ultrasound alone and in combinations on the microflora of suppurative wounds formed after opening of maxillofacial phlegmons are assessed in 142 patients. Clinical and laboratory findings indicate a higher efficacy of combined use of these treatment modalities, which are recommended for optimal local treatment of purulent maxillofacial wounds.

Antibiotic sensitivities of peptostreptococci, streptococci, Actinomyces, bacteroid, and fusobacterial strains pathogenic for the periodontium are analyzed. The sensitivities of these bacteria to broad-spectrum penicillins, cephalosporines, lincomycin, and macrolides, and to metronidasole and nitasole are assessed. New macrolide drugs macropen and rulide and gramicidine C, levomycetine, and rifampicin are highly active towards the above microflora. Microbiological indications for oral and local use of these antibiotics are validated. Some narrow-spectrum antibiotics, such as augmentine, cephalexin, and vancomicin are highly active, too; the latter drug is specifically active towards Actinomyces.

Antibacterial activities of modern antiseptics listerine, myramistine, cidipol, octenisept, tantum verde, matecide, and rautine drugs chlorhexidine and dioxidine are compared. The prospects of their use in dentistry for the treatment of inflammations associated with anaerobes are discussed. Metacide, listerine, chlorhexidine, and dioxidine are characterized by the widest spectrum of activity towards obligate anaerobic bacteria; moreover, these drugs inhibit bacterial growth when used in lower concentrations than other drugs.

In vitro study of the antibacterial activity of macrolide antibiotics azitromycin (sumamed), midicamycin (macropen), roxitromycin (rulide), and erythromycin demonstrated their high activity towards clinical strains of bacteroids, fusobacteria, peptostreptococci, streptococci, and corynebacteria. These antibiotics were effective in the treatment of 62 adult patients with severe and moderate generalized periodontitis. Rulide and sumamed were the most effective, macropen and erythromycin were inferior to them.

The microflora of purulent maxillofacial wounds formed after dissection of odontogenic phlegmons consists of major types of the residual oral microorganisms. In 100% of cases, a purulent exudate displays obligate nonspore-forming anaerobic bacteria which are present both in the monoculture and in the culture in combination with facultative anaerobes and aerobes. The results of topical treatment first used for purulent wounds in surgical dentistry by using ultrasonic aerosol treatment. This procedure shows a more profound antimicrobial effect mainly against obligate anaerobes than that of the conventional treatment. This promotes the most prompt elimination of inflammation and the reduction of treatment duration.

The sensitivities of clinical strains of obligate anaerobic bacteria, isolated from the periodontal pouches of patients with generalized periodontitis, to antibiotics, quinolone drugs, and metronidasole were studied. The minimal suppressing concentration (MSC90) of ciprofloxacin, norfloxacin, and antibiotics gramicidin C, eritromicin, lincomycin, levomicetin, and trichopol for sensitive strains of Porphyromonas, peptostreptococci, and fusobacteria ranged from 5 to 10 mg/ml. Among the bacteria and actinomyces studied the highest percentage of resistant strains was noted for abactal and tarivid, and the minimal for gramicidin C and eritromicin. Actinomyces were little sensitive to quinolone derivatives.

The authors analyze the results of diagnosis and treatment in 1062 patients with diffuse inflammatory diseases of the maxillofacial area and of complications of these diseases, such as mediastinitis, thrombosis of the cavernous sinus of the dura mater, meningoencephalitis. Improvement of the program of diagnosis and treatment helped improve the results: mortality from sepsis reduced from 50 to 26%. Approaches to prevention of progressive purulent infection are outlined.

Clinical and laboratory examinations of 86 patients with relapsing aphthous stomatitis making use of a complex of clinical, immunological, cytochemical, and microbiological methods, helped specify the clinico-anamnestic features in the course of this disease. An immunobacterial concept of the pathogenesis of relapsing aphthous stomatitis has been formulated; according to this concept, the disease is initiated by disorders of T and B immunity system and nonspecific defense factors, leading to increase of the content and virulence of oral microflora, and thus stimulating the bacterial sensitization of the organism of patients with relapsing aphthous stomatitis.

The present research was aimed at assessment of the quantitative and qualitative composition of oral microflora in cases with different filling material used. Forty-four patients were fitted with 6 types of filling, both traditional and rarely used cliofil (Japan). Soft dental deposit was collected from the surface of fillings for microbiologic investigation. The results permit a conclusion that composites are preferable in comparison with amalgams and cements, the contamination being 8-9 times lower when they are used. Moreover, macrocomposite fillings were associated with streptococcal contamination, in contrast to other materials, when actinomycetes were mainly isolated.

Solid-phase EIA was used to titer antibodies to polysaccharide and ultrasonic disintegrate antigens of the most incident agents of anaerobic infections of the maxillofacial area. Comparison of the results of EIA with polysaccharide antigens of B.melaninogenicus, B.asaccharolyticus, F.nucleatum, P.intermedius, and Str.sanguis and the results of bacteriological detection of these bacteria in a closed pyoinflammatory focus in 283 patients with maxillofacial abscesses and phlegmons brought the authors to a conclusion that the suggested EIA technique may be used to prove the contribution of these bacteria to the development of an inflammatory process in a patient. Data are presented on the frequency of detection of a diagnostically significant level of antibodies in patients with positive results of bacteriological investigation.

Antibacterial activity of sumamed, a macrolide antibiotic, in respect of anaerobic microflora of the oral cavity, such as Bacteroides, Prevotella, Porphyromonas, Fusobacterium, Peptostreptococcus, Str. sanguis and Staph. aureus, was assessed. The drug was found to be highly effective in respect of bacteroids (MPC90: 1,4 to 30 mg/mlMg/ml, this permitting the use of sumamed in the treatment of 9 patients with chronic generalized periodontitis in the exacerbation stage. Bacteriological and clinical control of the results of therapy demonstrated the drug efficacy in respect of periodontopathogenous flora, particularly as regards bacteroids and fusobacteria which maintain the inflammatory process in periodontitis.

In 186 patients with odontogenic infection the level of antibodies to B.melaninogenicus polysaccharide antigen, teichoic acid and S.aureus polysaccharide was determined in the enzyme-linked immunosorbent assay (ELISA). The positive values of ELISA indices were found to coincide with the data of bacteriological study in more than 90% of cases. The role of B.melaninogenicus and S.aureus associations in the development of purulent infections was confirmed with the use of ELISA in 34.2% of the patients for S.aureus and in 50% of the patients for B.melaninogenicus and bacteriologically in 31.4% and 46.9% of the patients respectively.

A test system for enzyme immunoassay of antibodies to Bacteroides melaninogenicus has been developed. The authors describe a method for the preparation of the protein and polysaccharide antigens with the use of ultrasonic, lysozyme, and beta-naphthol treatment. A total of 105 blood serum samples, 46 samples of gingival blood and gingival fluid from patients with maxillofacial phlegmons and periodontitis were examined, making use of the 1 +/- 3 omega index (from the values in healthy donors). The results evidence statistically significant difference in antibody levels of patients from whom B. melaninogenicus were isolated and of those with the negative results of bacteriologic analysis. The titers of antibodies to B. melaninogenicus in the blood and gingival fluid of patients with periodontitis were in good correlation.

Antibacterial activities of 40 routinely used antibacterial drugs in respect of 288 strains of anaerobic and opportunistic anaerobic bacteria, isolated from purulent foci of 110 patients with odontogenic and nonodontogenic inflammations were examined. The results permitted a more accurate specification of the drug groups for local therapy of purulent wounds, drugs of choice, those for grave cases, and a reserve group; these groups were distinguished with due consideration for the bacterial sensitivity, side effects and mode of administration of the drugs. Data on the microflora composition, its sensitivity to antiseptics and antibiotics are presented.

The results of identification of 710 clinical strains of anaerobic microorganisms isolated from the pathological foci of patients with maxillofacial diseases are presented. The species composition of the microflora associations in the cases with abscesses, phlegmon, lymphadenitis, osteomyelitis and parodontitis is described. Along with a high frequency of nonsporulating anaerobes, staphylococci, microaerophilic streptococci and in the cases with parodontitis actinomycetes, Bacillus licheniformis and Bacillus coagulans strains (1.6-15% of the isolated strains) were first detected in cases with various forms of the disease. Two groups of the drugs effective against the anaerobes were identified by the data on the antibiotic sensitivity. The lowest MICs along with the activity broad spectrum were defined for gramicidin, levomycetin and nitazol.

Qualitative and quantitative composition of associations of the agents of odontogenic infection were studied making use of present-day bacteriologic methods and of analysis of the microflora sensitivity to trichopol and nitazole, imidazole derivatives. The microflora was found to be represented by associations with the predominance of obligate and facultative anaerobes. The anaerobes were found highly sensitive to trichopol, both in vivo and in vitro, and even more so to nitazole, the drug manufactured in this country.

A micromethod based on the use of plates with wells and microquantities of microbial suspensions is described. It provides determination of MICs of antibacterial drugs and sensitivity of clinical strains of anaerobes of 2 or 3 species predominating in pathological materials as well as to preliminarily identify some anaerobic bacteria by their antibiotic sensitivity.

Twenty-three patients with generalized periodontitis were examined. Microbiologic examination of the periodontal pouch contents, making use of anaerobic cultivation, resulted in isolation and identification of 103 strains, 76 (72.8%) of which were referred to obligate anaerobes. Facultative anaerobes made up 27.2% of the total number of the isolates. Therapy with water-soluble nitasole resulted in reduction of the number of microorganisms, decrease or arrest of pus discharge from the pouch, resolution of the edema and gingival ridge hyperemia, etc. Diffusion of nitasole (water-soluble) and cliostom from various dressings used in periodontitis was studied and the efficacy of combining these dressings revealed.

The results of identification and sensitivity assay of 156 strains of pathogens causing odontogenic infections are presented. In the sensitivity assay antibacterial drugs were used. 42.3 percent of the strains were obligate anaerobes belonging to Bacteroides, Fusobacterium, Peptococcus, Peptostreptococcus, Veillonella and Actinomyces. Significant differences in the microbial sensitivity to the drugs used for general and local therapy were detected. There was observed high sensitivity of the obligate anaerobes to gramicidin (0.02 micrograms/ml), nitazol (10 micrograms/ml), levomycetin and tetracycline (60 micrograms/ml). Antiseptics such as dioxidine and chlorhexidine used locally showed satisfactory results. The above mentioned drugs and especially levomycetin were also rather active against facultative organisms in associations of pathogens causing odontogenic infections: Bacillus coagulans, B. licheniformis, Pseudomonas sp., Acinetobacter calcoaceticus, Staphylococcus sp. and Streptococcus sp.

A tampon made of the new spongy polyvinyl-formal AQUIPOR 3500/40 is suggested for quantitative studies of mixed anaerobic-aerobic microflora. Comparison of the adsorption characteristics, the preservation of the tested pathologic material during the collection and transportation of the material, and the potential antibacterial characteristics of the suggested tampon and the traditional cotton wool tampons has shown the advantages of the new tampon, that permits standardization of the investigation by the quantitative bacteriologic method and preserves both aerobic and anaerobic microorganisms viable. This tampon may be used in studies of purulent wound and periodontal pocket microflora.

An economic rapid 'cassette' micromethod for estimating the sensitivity of obligate anaerobes to antibiotics has been developed, applicable at clinical laboratories. The method permits simultaneous testing of a microorganism with a wide range of antibiotics and assessment of the minimal inhibiting concentration of the agent, making use of the minimized volume of the inoculum. The technique has been tried with 176 anaerobe strains isolated from maxillofacial purulent foci from 76 patients; sensitivities to 42 antibiotics and antiseptics have been tested. Parallel inoculations were carried out, as was a comparative study with the traditional serial dilutions in solid nutrient medium. The suggested method is available and rapid; the results are ready within 1-3 days.

An increase of lysozyme content in biological fluids observed during treatment of pulmonary diseases was shown to be followed by positive immunological and clinical effects. The parameters of immunological properties of lysozyme determined on the patient blood cells in vitro (before treatment) may be used for prediction of the drug efficacy during treatment.