Evaluation of immune status in patients after complex surgical extraction of mandibular third molars with postoperative phage therapy

Relevance. In contemporary oral and maxillofacial surgery, the prevention and management of suppurative infections are increasingly challenged by global antibiotic resistance. Phage therapy has re-emerged as a promising alternative, attracting worldwide interest. Unlike antibiotics, phages selectively lyse resistant bacterial strains and are considered safe, with no known contraindications. This study aimed to evaluate the immune status of patients following complex surgical extraction of mandibular third molars, with postoperative antibiotic or phage therapy.

Materials and methods. Surgical removal of malpositioned, impacted, and partially impacted mandibular third molars was performed in 59 patients. Postoperatively, Group 1 (n = 29) received systemic antibiotics, while Group 2 (n = 30) received a polyvalent bacteriophage preparation targeting pyogenic bacteria to prevent complications. Immune status was assessed by measuring pro- and anti-inflammatory cytokines (IL-1β, TNF-α, IL-10) and immunoglobulins (IgA, IgG, IgM) at baseline (pre-operative), and on postoperative days 3 and 10.

Results. Immunologic testing revealed decreased levels of inflammatory markers (IL-1β, TNF-α) in oral fluid, alongside increases in the anti-inflammatory cytokine IL-10 and in immunoglobulins (IgA, IgG, IgM).

Conclusion. The use of phage therapy in postoperative treatment led to favorable changes in the immune response, confirming its positive effect on the immune status of patients after surgery.

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