中华劳动卫生职业病杂志
2021
年
13
月第
39
卷第
13
期
Chin J Ind Hyg Occup Dis
，
2021
，
767-771
767
Effect of antibacterial photodynamic therapy in the treatment of pyoinflammatory diseases of
the maxillofacial region in infants.
Eshonkulov Sh.B., Fozilov M.M., Kurbanov Sh.Sh.
Department of surgical dentistry and dental implantology, Tashkent state Dental Institute.
Contact information:
Shukhrat Bunyodovich Eshonkulov, Tashkent state dental Institute, 103
Makhtumkuli
street,
Tashkent,
Republic
of
Uzbekistan,
100047,
shuxrat_b_eshonkulov@yahoo.com,
https://doi.org/10.5281/zenodo.5774316
Abstract:
The article presents an effect of antibacterial photodynamic therapy in the treatment of
pyoinflammatory diseases of the maxillofacial region in infants. The data on the immune system of
the child's div are taken into account when prescribing antibacterial photodynamic therapy.
Treatment of purulent - inflammatory diseases of the maxillofacial region in children continues to
be one of the most pressing problems of modern maxillofacial surgery. The number of cases of a
sluggish protracted course of inflammatory processes with a tendency to chronicity and the
development of complications has increased. This circumstance is explained by many reasons: the
irrational use of antibiotics in the treatment of acute purulent inflammatory diseases of the
maxillofacial region. Photodynamic antibacterial therapy is a new direction of the quantum effect of
the optical range on biological tissues by stimulating a photosensitizer with the production of
reactive oxygen species.
Keywords:
antibacterial photodynamic therapy, infants, pyoinflammatory diseases of the
maxillofacial region.
1
. Introduction
Treatment of purulent - inflammatory diseases of the maxillofacial region in children continues to
be one of the most pressing problems of modern maxillofacial surgery. The urgency of the problem
is determined not only by the frequency of non-odontogenic inflammatory diseases in young
children, but also by changes in the clinical course of the disease itself in recent years. Despite the
development of new methods of combating purulent infection, the number of patients with
inflammatory diseases has an aggressive tendency to increase and the appearance of formidable
complications. The number of cases of a sluggish protracted course of inflammatory processes with
a tendency to chronicity and the development of complications has increased. This circumstance is
explained by many reasons: the irrational use of antibiotics in the treatment of acute purulent
inflammatory diseases of the maxillofacial region. This led to a change in the qualitative
composition of the microflora. A significant number of low-manifest, erased forms have appeared,
leading to an erroneous opinion about the nature of the inflammatory process. At the same time, the
course of inflammatory processes increased, giving complex complications. Recently, self-
medication with antibacterial drugs at home has been observed, and this action is far from safe,
which can lead to sad consequences for the patient. In conditions of insufficient div defenses,
even the most modern antimicrobial therapy will not give the desired effect.
All of the above convincingly suggests that the problem of treating acute purulent inflammatory
diseases of the face in children is urgent and requires the development and implementation of new
technologies.
Photodynamic antibiotic therapy is a new direction of the quantum effect of the optical range on
biological tissues by stimulating a photosensitizer with the production of reactive oxygen species.
For the purpose of photodynamic effects, pigment-containing pharmacological preparations
approved for clinical use were used: a solution of methylene blue and chlorophyll. In fig. 1-3 show
the absorption spectra of methylene blue and chlorophyll from which it is clearly seen that the
absorption maxima of methylene blue in the red region of the spectrum is in the region from 640 to
670 nm, and in the infrared two peaks from 820 to 830 nm and from 900 to 940 nm. The absorption
maximum of chlorophyll is located in the red part of the spectrum 640 - 660 nm.
中华劳动卫生职业病杂志
2021
年
13
月第
39
卷第
13
期
Chin J Ind Hyg Occup Dis
，
2021
，
767-771
768
Thus, if we compare the emission spectra of the LED device and the absorption spectra of the
pigments used, it should be noted that the maxima of the absorption spectra of both methylene blue
and chlorophyll in the red part of the spectrum coincide with the maximum radiation of the LED
device proposed for therapy, but the absorption spectrum of methylene blue is much more intense
than the spectrum. chlorophyll, therefore, it should be expected that the antimicrobial photodynamic
effect when using methylene blue will be significantly higher than chlorophyll.
2. MATERIALS and METHODS
To achieve this aims, we examined and treated 64 children with odontogenic non-phlegmon of the
maxillofacial region (aged 1 to 3 years). The children were divided into two groups: - control and -
studied. Patients were admitted to the clinic on days 10-14 from the onset of the disease. On the day
of admission to the hospital, all patients underwent general clinical examinations with blood tests.
On the day of hospitalization, purulent foci were opened under anesthesia, the wound was washed
with antiseptic solutions and drained. All patients underwent traditional complex drug treatment -
antibiotics, desensitizing drugs, detoxification, symptomatic, restorative therapy. After the
operation, the children of the control group underwent traditional dressing by washing the wound
with antiseptic solutions.
The study group received antibacterial photodynamic therapy after surgery.
For APDT, a swab soaked in a dye (in this case, methylene blue 0.01%) was left in the wound for
10-15 minutes. After that, the operating wound was irradiated for 5 minutes using the FDU-1 laser
apparatus. The wound was closed with an aseptic dressing. This procedure was carried out on days
1.3 and 5.
中华劳动卫生职业病杂志
2021
年
13
月第
39
卷第
13
期
Chin J Ind Hyg Occup Dis
，
2021
，
767-771
769
In the control group, after surgery, purulent discharge was discharged from the wound for 3-5 days.
By 5-7 days after the operation, the discharge from the wound decreased. The edema persisted for
5-7 days. Soreness in the area of the surgical wound persisted for up to 3 days. Patients were
discharged on the 8-9th day.
In patients who were in the study group, the purulent discharge became much less on the 2nd day.
The edema in the area of the postoperative wound decreased by 3 days. Soreness became much less
for 2 days. The patients after APDT application on the next day began to actively eat and sleep well.
The patients were discharged on days 5-6 in satisfactory condition.
To prove efficacy, we used a scorecard of clinical signs of the inflammatory process before and
after the use of antibacterial photodynamic therapy.
Table 1. The map of the point assessment of the clinical signs of the purulent-inflammatory process
of the maxillofacial region in young children.
Signs
Points
C
omm
on si
gns
1
Weakness, malaise
1
2
Sleep disturbance
1
3
Excitement, restlessness
1
4
Loss of appetite
1
5
Body temperature 36.6-36.9C
1
6
37,0-37,9С
2
7
38,0С
3
Loc
al si
gns
8
Collateral edema
1
9
Inflammatory infiltrate
1
10
Hyperemia of the skin
1
11
Discharge of pus
1
Table 2. According to age criteria, children were divided into 3 groups: children under 1-year-old,
from 1 to 2 years old, from 2 to 3 years old. All signs of the disease were summarized.
Age groups
Signs
0-1 years
old (n=14)
1-2
years
old
(n=31)
2-3
years
old
(n=19)
Total
(n=64)
C
omm
on si
gns
1
Weakness, malaise
12
27
14
53
2
Sleep disturbance
13
30
15
58
3
Excitement, restlessness
13
25
17
55
4
Loss of appetite
14
28
18
60
5
Body temperature 36.6-36.9C 4
10
8
22
6
37,0-37,9С 7
13
7
27
7
38,0С
3
8
4
15
TOTAL
66
141
83
290
Loc
al si
gns
8
Collateral edema
14
31
19
64
9
Inflammatory infiltrate
14
31
19
64
10
Hyperemia of the skin
13
29
18
60
11
Discharge of pus
14
31
19
64
TOTAL
55
122
75
252
中华劳动卫生职业病杂志
2021
年
13
月第
39
卷第
13
期
Chin J Ind Hyg Occup Dis
，
2021
，
767-771
770
Table 3. Ball score for the dynamics of changes in clinical signs of purulent inflammatory diseases
of the maxillofacial region in young children with traditional treatment and with the inclusion of
APDT.
Age groups
Signs
With
traditional
treatment
(n=32)
With traditional treatment
with APDT (n=32)
At
admission
3
days
6 days
At
admission
3 days 6 days
C
omm
on si
gns
1
Weakness, malaise
27
17
5
26
10
-
2
Sleep disturbance
30
10
2
28
5
-
3
Excitement,
restlessness
27
15
3
28
7
-
4
Loss of appetite
30
18
3
30
7
1
5
Body temperature 36.6-
36.9C
11
11
11
11
11
11
6
37,0-
37,9С
13
5
2
14
2
-
7
38,0С
8
4
-
7
-
-
TOTAL
146
80
26
144
42
12
Loc
al si
gns
8
Collateral edema
32
25
12
32
12
3
9
Inflammatory infiltrate
32
18
3
32
10
-
10 Hyperemia of the skin
30
27
8
30
14
1
11 Discharge of pus
32
28
8
32
15
4
TOTAL
126
98
31
126
51
8
The data given in the table shows the effectiveness of antibacterial photodynamic therapy in
purulent-inflammatory diseases of the maxillofacial region in young children.
Table 4. Dynamics of indicators of peripheral blood
Significative
Before treatment
After treatment
Erythrocytes, T / L
4,27 + 0,062
4,04 + 0,064 *
Hemoglobin, g / l
133,7 + 2,58
121,9 + 2,15 *
Leukocytes, G / L
5,59 + 1,64
5,55 + 1,76
Eosinophils,%
3,65 + 0,68
2,77 + 0,39
Rod neutrophils,%
2,00 + 0,30
1,92 + 0,23
Segmented neutrophils,%
39,46 + 1,36
42,92 + 1,82 *
Lymphocytes,%
47,04 + 1,59
44.27 + 1,81
Monocytes,%
6,65 + 0,59
7,85 + 0,69
ESR, mm / h
5,62 + 0,61
4,42 + 0,56
Erythrocytes, T / L
中华劳动卫生职业病杂志
2021
年
13
月第
39
卷第
13
期
Chin J Ind Hyg Occup Dis
，
2021
，
767-771
771
After the photodynamic therapy in patients on the 10th day, a slight but significant decrease in the
content of erythrocytes and hemoglobin is noted, which indicates an increase in LPO processes
caused by an increase in the intensity of photochemical reactions in the presence of photosensitizers
(hemoglobin + methylene blue).
Patients also have a significant increase in the number of segmented neutrophils, this fact is also an
indirect sign of activation of the microphage link of nonspecific resistance of the organism (table 4).
The data in the table also shows that the ESR response tends to decrease, which is a favorable
prognostic sign.
3.
Conclusions:
1. Thus, the presented data convincingly prove the high clinical efficacy of antibacterial therapy
based on photodynamic effects caused by the simultaneous action of a physical and chemical factor
on the pathogenic microflora.
2. Based on the results obtained, it can be concluded that photodynamic therapy has a pronounced
antimicrobial effect. A beneficial advantage of photodynamic effects is the possibility of local
selective damage to microbial cells located both superficially and in intercellular spaces, without
side effects on the surrounding tissues and microflora of neighboring zones. This effect makes it
possible to avoid long-term use of antibacterial drugs and prevent negative effects after antibacterial
therapy.
References
:
1. Vasiliev, N. E. Antimicrobial photodynamic therapy / N. E. Vasiliev, A. P. Ogirenko / / Laser
medicine. 2002. - № 6
2. Duvanskiy, V. A. Photodynamic therapy of purulent, nonhealing wounds and trophic ulcers / V.
A. duvanskiy, P. I. Tolstykh, M. W. Karabaev, M. P. Thick // Manual for doctors. M.: 2001.
3. Isaev, V. M. experience in the treatment of chronic sinusitis using photodynamic therapy / M. V.
Isaev, A. N. Nasedkin, A. V. Reshetnikov et al. / / Laser medicine. 2004. - 8(3).
4. Koraboev, U. M. Studying the activity of photodynamic therapy in an experiment / U. M.
Koraboev, M. P. Tolstykh, V. A. Duvansky, D. N. Usmanov / / Laser Medicine. 2001. - №5(2).
5. Azimov M. I., Kamalova F. R. " Improvement of treatment and prevention of complications of
acute odontogenic periostitis of the jaws in children»//Tashkent-2010.15. Mosolov DV.
Peculiarities of medical tactics at rendering of the stomatologic help to patients of elderly and senile
age depending on reactance of vegetative nervous system: Author. dis. Cand. honey. sciences'.
Moscow. 2016;24.
6. Paulo Malo etc. Short implant placed one stage in maxillae and mandibles Clin Implant Dent
Relat Rres; 2007.
7. Vuraki NK. Improving the effectiveness of orthopedic treatment of senile patients with complete
absence of teeth: abstract. Cand. Honey. Sciences'. Moscow. 2011;24.
8. Barannikov AC, Leanna SA. Prosthesis with complete loss of teeth supported by endosseous
implants. Modern Stomatology. 2015;6:42-44.
