EFFECTIVENESS OF PERFORMING CENTRAL CONDUCTIVE ANESTHESIA OF THE MAXILLARY NERVE THROUGH THE PALATINE ROUTE IN DENTAL PATIENTS WITH DIFFERENT INDIVIDUALLY TYPOLOGICAL FEATURES
DOI:
https://doi.org/10.35220/2523-420X/2025.4.13Keywords:
central conduction anesthesia, maxillary nerve, type of facial skeleton, palatine canal, craniometry, anesthetic efficacyAbstract
This article highlights the individually typological features of the facial skeleton of dental patients, which must be taken into account during performing central conduction anesthesia of the maxillary nerve. The purpose of the study: to study the morphometric parameters of the greater palatine canal depending on the individually typological features of the facial skeleton and to establish their influence on the effectiveness of central conduction anesthesia of the maxillary nerve via the palatine route in dental patients. Materials and methods of research. To study the anatomical features of the greater palatine canal, craniometric studies were conducted on 92 X-ray images of the facial skeleton obtained during computed tomography of the skulls of dental patients. The facial index was determined using the Garson formula, the angle of inclination of the greater palatine canal relative to a stable anatomical landmark in the oral cavity was measured, the trajectory of injection needle insertion, its angle of inclination were determined, and the possible depth of its advancement in the greater palatine canal to the pterygopalatine fossa was established. In clinical conditions, 30 dental patients underwent central conduction anesthesia of the maxillary nerve via the palatine route during planned surgical interventions (10 radical maxillotomies, 8 oronasal cystectomies, 7 open sinus lifts, 5 implants in the area of the maxillary tubercle using the pterygoid technique), and a clinical assessment of its effectiveness was given using our modified scoring method. Research results. During craniometric studies, anatomical variability in the structure of the facial skeleton was revealed. It has established for the first time that patients with different types of facial skeleton structure have individual anatomical variability of the greater palatine canal (length and diameter, configuration, angle of inclination relative to the hard palate), which affects the technique of performing central conduction anesthesia of the maxillary nerve through the greater palatine canal and its clinical effectiveness. Based on these clinical observations, it can be stated that the most favorable conditions for performing central conduction anesthesia of the maxillary nerve through the greater palatine canal are in patients with mesoprosopic and euriprosopic types of facial skeleton. Conclusions. In dental patients with different types of facial skeleton structure, individual anatomical variability of the greater palatine canal was found, which affects the technique of performing central conduction anesthesia of the maxillary nerve via the palatine route and its clinical effectiveness. The most favorable conditions for performing this anesthesia are for patients with mesoprosopic and euriprosopic facial skeleton types. In leptoprozops, after blockade of the maxillary nerve in the pterygopalatine fossa with access through the greater palatine canal, statistically significant (χ2 - 4.0229, p = 0.0449) cases of insufficient anesthesia of the ipsilateral soft tissues of the midface and the frontal group of teeth of the upper jaw are detected. Key words: central conduction anesthesia
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