Optimizing the diagnosis and treatment in patients with oral floor phlegmon: Summary of Ph.D Thesis in Medical Sciences: 323.01 – Dentistry

Abstract

The relevance and importance of the researched issue. Phlegmon of the oral floor is defined as a bilateral and rapidly progressive inflammatory condition affecting the sublingual, submandibular, and submental spaces. This condition represents a medical emergency typically characterized by firm induration and swelling of the floor of the mouth, accompanied by a high risk of airway compromise and spread of infection along fascial planes into adjacent compartments and towards the mediastinum [8, 16]. Due to the increased incidence of comorbid conditions (such as immunosuppression and diabetes mellitus), which are also major risk factors for the oral floor phlegmon, the incidence of this condition is on the rise. Although the condition is rare, it remains an important disease that can be life-threatening, primarily due to airway obstruction [1, 2]. In approximately 90% of cases, the oral floor phlegmon is of odontogenic origin, with teeth 7 and 8 in the mandible accounting for 70-80% [2, 7]. Respiratory tract protection and early use of anti-inflammatory and antibacterial drug therapy show favorable outcomes. However, surgical intervention involving proper drainage of purulent collections, debridement of necrotic tissue to the limit of clinically healthy tissues, and lavage with antiseptic solutions is essential. Despite its benefits, the traditional surgical treatment approach also comes with some disadvantages: a high level of surgical aggression; rapid wound sealing with fibrin, obstructing the drainage of purulent discharge; challenging tissue regeneration with bulky and cosmetically unappealing postoperative scars [4, 9]. Thus, the findings of the specialized literature analysis and our clinical experience advocate for the opportunity to develop a new concept/protocol for minimally invasive surgical intervention of buccal floor phlegmon, which would contribute to early, effective, and less traumatic rehabilitation. In this regard, it is important to select the appropriate interventional strategy, taking into account the individual characteristics of the patient [12, 13] [....].