Background/objectives: mandibular fractures and their purulent-inflammatory complications represent significant challenges in maxillofacial surgery.

This study aims to evaluate the effectiveness of a comprehensive pathogenetic therapy in optimizing treatment outcomes for such conditions. Special attention is given to microbial contamination, oral and systemic dysbiosis, and their impact on the development of post-traumatic complications.

Methods: A total of 231 patients with mandibular fractures were analyzed. The patients were divided into two groups: one received traditional therapy (Furacilin, Chlorhexidine, Bifidumbacterin, and standard surgical fixation), while the other underwent a specialized treatment regimen, including Serrata, Sextophag, Azithromycin, and Florbiolact. Microbiological studies were conducted to determine microbial sensitivity to therapeutic agents. Radiological diagnostic methods, including computed tomography (CT) and magnetic resonance imaging (MRI), were used to assess fracture characteristics and treatment dynamics.

Results: the specialized treatment group demonstrated a significant reduction in purulent-inflammatory complications, such as osteomyelitis and phlegmons, compared to the traditional therapy group. By day 21, dysbiosis in the oral cavity was nearly eliminated, and indicators of local immunity (e.g., lysozyme levels and secretory immunoglobulin A) showed substantial improvement. In addition, patients receiving specialized therapy experienced faster resolution of pain and inflammation, with a decrease in temporary disability duration.

Conclusions: the findings confirm that the use of advanced pathogenetic therapy, which combines antimicrobial, probiotic, and enzymatic agents, enhances the treatment of mandibular fractures and reduces the risk of complications. This integrated approach emphasizes the importance of targeted and multidisciplinary strategies in maxillofacial surgery for achieving optimal clinical outcomes. 

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