Dynamics of Inflammatory Parameters in Hospitalized and Surgically Treated Patients with Odontogenic Abscesses

Background and objectives: Odontogenic abscess represents a serious infection in the head and neck region with the necessity of immediate treatment. Due to the fast pacing and progression, as well possibly severe consequences of this condition, it is important to have a fast and reliable biomarker to adequately monitor these patients. Since serum procalcitonin and C-reactive protein (CRP) are the most commonly used clinical biomarkers to monitor serious infections, the aim of this study was to investigate their temporal profiles in hospitalized patients undergoing surgical management of odontogenic abscesses. Materials and methods: This longitudinal, multicentric study was conducted on 65 patients with odontogenic abscesses at the University Hospital of Split and Dubrava University Hospital. Biomarker levels were assessed at admission and at four time points during the early and middle postoperative periods to evaluate initial elevations, treatment-associated changes, and differences in kinetic behavior. Results: After converting real procalcitonin and CRP values to proportions, a Δ between the time points was calculated. There was a statistically significant difference in the Δ proportion between procalcitonin and CRP in the 0-6 h time frame (19.3 (10.6-27.8)% vs. 7.2 (-3.0-20.4)%, p < 0.001) and the 24-48 h time frame (30.8 (24.5-35.0)% vs. 51.7 (30.5-57.7)%, p < 0.001). Furthermore, multiple linear regression analysis showed that procalcitonin at time point 0 (p = 0.037), 6 h (p = 0.009) and 24 h (p = 0.038) significantly predicted hospitalization duration after model adjustment for age, gender, BMI and pre-admission antibiotic treatment. Conclusions: The findings of this study show that procalcitonin exhibits a faster and more pronounced decrease in the early postoperative period compared with the CRP values. Following the middle postoperative period both biomarkers decreased in association with clinical improvement; however, procalcitonin demonstrated an earlier and more consistent decline. The observed pattern indicates a rapid dynamic of procalcitonin values during the early postoperative phase and supports its potential value for early monitoring of surgical treatment response in odontogenic abscesses.