Introduction. According to different authors, 4 to 40% of the child and adult population suffer from chronic tonsillitis (СT), with many authors noting an increase in the number of cases and no tendency to decrease the frequency of this pathology.Objective. To optimize diagnostics and treatment tactic of taking patients with chronic tonsillitis (CT) using our own clinical and laboratory data and morphological data as well as literature data.Materials and methods. Аt the first stage of work, 166 patients were examined. They were divided into 4 categories (experimental groups) depending on clinical CT classification according to B.S. Preobrazhensky and V.T. Palchun. We also formed a group of patients who did not have CT symptoms. All patients underwent tonsillectomy or tonsillotomy. All tissue samples of palatine tonsils we got were investigated using immunohistochemical markers and default histological colorings. At the second stage, the dynamics of complaints, clinical symptoms and laboratory parameters were assessed in 247 patients diagnosed with CT Toxic-Allergic Form I (CT TAF I) before conservative treatment and 3 months after conservative treatment. Patients were divided into 3 groups depending on the conservative treatment regimen: a course of flushing the lacunae of the tonsils; antibiotic therapy with a retard form of clarithromycin; complex treatment combining the first two options.Results. Тhe chronic inflammatory process in the palatine tonsils changes their cytoarchitectonics. At the same time, there is a direct correlation between the presence and severity of changes with the clinical classification of chemotherapy according to B.S. Preobrazhensky and V.T. Palchun.Conclusion. With CT TAF II, the palatine tonsil not only loses its importance as an organ of the immune system, but also becomes a hotbed of infection in the body, which can cause severe complications. Only tonsillectomy can effectively protect the patient from these complications. At the stage of CT TAF I, the formation of metatansillar complications occurs. Patients with this form of CT require special attention, and correctly conducted conservative therapy can protect patients from local and general complications of CT. A variant of such conservative therapy that gives a lasting effect is complex therapy with washing the lacunae of the palatine tonsils with an antiseptic solution and simultaneous antibiotic therapy with 14-membered macrolides that can accumulate in the lymphadenoid tissue.

Backgroud: The aim of this study was to create an accessible, simple and reliable method for assessing the relative density of bone tissue in dentistry based on the analysis of digital panoramic radiographs. Methods: Measurement of average gray values on orthopantomograms was carried out using ImageJ Version 1.54i software. To estimate the relative bone density, functions for selecting regions of interest (ROI), calculating the area of selection, and statistics of the selected area were used. Statistical characteristics of samples and testing of hypotheses using statistical criteria were performed using Microsoft Excel. Results: we found that when manually selecting the reference and comparison areas for areas without signs of pathological changes in bone tissue, the average standard deviation was 0.058, and the coefficient of variation was 0.055 ± 0.011%, which makes the choice of the jaw angle as a reference more preferable. The average relative bone density of the assessed defective areas to the jaw angle was 0.64 ± 0.11, and the average relative bone density of the areas without pathology to the jaw angle was 1.052 ± 0.058. Conclusions: a research protocol was developed and justified using the ImageJ software package, which establishes a strict procedure for quantitative assessment of relative bone density based on the results of digital panoramic radiography. The proposed protocol can be used to monitor the condition of bone tissue after all types of dental treatment over time.

The article is devoted to the problem of chronic tonsillitis. The aim of the study was to assess changes in the morphofunctional state of the palatine tonsils in chronic inflammation. The study presents comparative data of immunohistochemical examination of the tonsils in normal and chronic tonsillar pathology. The authors used the clinical classification of chronic tonsillitis developed by B.S. Preobrazhensky and V.T. Pal’chun. Histological changes in the palatine tonsils of patients with toxic-allergic form 2 chronic tonsillitis were described in accordance with this classification. The control group represented palatine tonsils tissue taken from patients without chronic tonsillitis. The examination was carried out using markers of apoptosis, antiapoptosis, cell proliferation, as well as various types of lymphocytes. The authors describe a tonsil tissue handling technique, morphological and functional state in each study group, compared the studied parameters in two groups, reflected the dynamics of changes in the palatine tonsils with chronic tonsillitis. Increased apoptotic and anti-apoptotic activity combined with decreased cell proliferation, increased number of T-helpers and B-lymphocytes gives evidence of significantly decreased functional activity of the palatine tonsils in chronic inflammation. These changes are correlated with the clinical picture to develop the most optimal management of the disease.

Воспалительные заболевания глотки занимают одно из ведущих мест в структуре оториноларингологической патологии. С острыми и хроническими воспалительными процессами в глотке, а также с обострениями последних сталкиваются врачи широкого круга специальностей. Для определения конкретного патогена необходимо лабораторное исследование мазка из ротоглотки, которое требует времени. В связи с этим особый интерес представляют местные лекарственные препараты, обладающие необходимым спектром действия, применение которых возможно в качестве монотерапии или в сочетании с системной терапией. Комбинация тиротрицина (tyrothricin), бензалкония хлорида (benzalkonium chloride) и бензокаина (benzocaine) (доритрицин) обладает высокой эффективностью в лечении бактериальных, вирусных и грибковых поражений глотки, а микроорганизмы стабильно демонстрируют высокую чувствительность к компонентам препарата.

Introduction. The high incidence of chronic tonsillitis (CT), as well as the high risk of complications, make research in this area very relevant. The ambiguity of approaches to conservative therapy determines the need to search for new, reasonably effective, chemotherapy regimens.Objective. To carry out a comparative characteristic of various options for conservative therapy of chronic tonsillitis of toxicallergic form (TAF) I degree (CT TAF I).Materials and methods. The study included patients with CT TAF I according to the classification of B.S. Preobrazhensky and V.T. Palchun. The patients were divided into three clinical groups, depending on the therapy. Patients of the first group underwent a course of washing the lacunae of the tonsils with 1% dioxidine solution. Patients of the second group were prescribed antibiotic therapy with a retard form of clarithromycin. Patients of the third group underwent complex treatment – washing the lacunae of the palatine tonsils and simultaneously taking antibiotic therapy. The effectiveness of treatment was assessed by comparing the dynamics of changes in complaints, pharyngoscopic symptoms of CT, regional lymph nodes, and laboratory parameters.Results. Complex conservative therapy of CT TAF I provides early relief of patients’ complaints (in 93.2% of patients on the 7th day from the start of treatment), the maximum decrease in the severity of local CT symptoms (up to 1 point on the VAS at the end of treatment, with the exception of the Zak sign — 1.4 points) and the greatest positive dynamics of laboratory parameters.Conclusions. The analysis showed that for patients with CT TAF I, complex therapy, including a course of washing the lacunae of the palatine tonsils with 1% dioxidine solution and simultaneous administration of antibacterial therapy with a retard form of clarithromycin, is the most optimal therapeutic tactic that allows to achieve an earlier and stable reduction in the severity of symptoms HT, patient complaints, as well as the normalization of laboratory parameters.

Lichen planus is a chronic autoimmune skin-mucosal disease that often affects the oral cavity and can affect the esophagus, the mucous membrane of the genitals, the skin and its appendages. Lichenoid reactions are considered as lesions clinically similar to lichen planus erythematosus, but differing in pathogenesis, etiology and, consequently, treatment approaches. The main provoking factors of lichenoid reactions are medicines and dental materials. The aim of the study was to identify histopathological differences between lichen planus erythematosus and lichenoid reactions of the oral cavity for a more accurate differential diagnosis of these conditions. Materials and methods. The study included 35 patients of both sexes, aged 35 to 70 years, who sought treatment between 2019 and 2024. All patients were clinically diagnosed with lichen planus of the oral mucosa (L43) or lichenoid reaction of the oral mucosa (L43.8 according to ICD-10). Among them were 10 patients with erosive and ulcerative form, 12 patients with hyperkeratotic form of Lichen planus, 8 patients with exudative-hyperemic form of Lichen planus and 5 patients with lichenoid reactions in the oral cavity. All patients underwent an incision biopsy of the affected areas of the oral mucosa, followed by histopathological analysis. Results. Despite the similarity of clinical and histopathological signs of lichen planus and lichenoid reactions, the study revealed signs that allow them to differentiate. The presence of Sivatt bodies, hydropic degeneration and banded lymphocytic infiltrate are key diagnostic signs of lichen planus. Conclusions. Histological analysis of biopsy material should be considered as the main research method for making a final diagnosis when detecting lesions of the oral mucosa.