ANATOMICAL VARIABILITY OF THE SENSITIVE INNERVATION OF THE MAXILLOFACIAL REGION, ITS INFLUENCE ON THE EFFECTIVENESS OF LOCAL ANESTHESIA IN DENTAL PATIENTS (LITERATURE REVIEW AND RESULTS OF OWN RESEARCH)
DOI:
https://doi.org/10.35220/2523-420X/2023.2.10Keywords:
maxillofacial area, anatomical variability, sensitive innervation, trigeminal nerve, great auricular nerve, transverse neck nerve, local anesthesia.Abstract
For successful surgical interventions in the maxillofacial area, full anesthetic support is necessary. Most invasive dental manipulations are performed under local anesthesia. Among the methods of local anesthesia, conductor anesthesia has a number of advantages. It provides a temporary loss of sensitivity of a large part of the upper or lower jaws when treatment or removal of a large number of teeth is necessary, as well as during operations on the jaws or face. However, performing conductor anesthesia requires knowledge of the topographical anatomy of the maxillo-facial area, the peculiarities of its innervation. In order to successfully conduct conduction anesthesia of the trigeminal nerve, peripheral branches of the great auricular and transverse nerves of the neck, which are involved in the innervation of the maxillofacial region, it is necessary to master the technique of their implementation and take into account anatomical factors that affect their effectiveness. The purpose of this study was to analyze the data of modern domestic and foreign medical literature, which are devoted to the study of the features of the sensitive innervation of the maxillofacial area and its influence on the effectiveness of local anesthesia, to highlight the results of our own craniometric studies, which we used for the development of methods of local conductor anesthesia. Analytical and bibliosemantic methods were used in the research. The search for scientific information was carried out in electronic databases. 71 sources of modern domestic and foreign professional publications related to this topic were identified and analyzed. The literature sources indicate the existence of anatomical variability in the branching of the trigeminal nerve, great auricular nerve and transverse neck nerve, therefore, when using standard methods of conduction anesthesia, it is not always possible to achieve the required effect of local anesthesia. It is necessary to take into account the anatomical variability of the innervation of the face of people depending on the shape and type of structure of the facial part of their skull, which dictates the need to develop new methods of conductive anesthesia of the peripheral branches of the trigeminal and great auricular nerves. We have developed safe methods of conductive anesthesia of these nerves.
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