[Improving the effectiveness of local anesthesia in patients with arterial hypertension in the provision of emergency dental care]. / Povyshenie effektivnosti mestnogo obezbolivaniya u patsientov s arterial'noi gipertenziei pri okazanii neotlozhnoi stomatologicheskoi pomoshchi.

THE AIM OF THE STUDY: Was to evaluate the use of Ketorol Express as a preventive analgesia to increase the effectiveness of local anesthesia in providing emergency dental care to patients with arterial hypertension. MATERIALS AND METHODS: The study was conducted on the basis of the state autonomous healthcare institution of the Moscow region «Royal Dental Clinic¼ with the participation of 83 people. The patients were divided into two groups. In group 1, Ketorol Express was prescribed as a preventive analgesia in a dosage of 20 mg before local anesthesia. Patients of group 2 underwent dental interventions without the use of preventive analgesia. A 3% solution of mepivacaine was used as a local analgesic solution. For a subjective assessment of the effectiveness of anesthesia, use a visual analog scale. All patients had their blood pressure and heart rate measured before and after the interventions and hemodynamic parameters were continuously monitored during emergency dental care. RESULTS: In group 1, the effectiveness of combined anesthesia with the infiltration method of local anesthetic administration was 93±1.17%, according to the patient, 94±1.47%, according to the doctor, with the conductive method of anesthesia at the mandibular orifice - according to the patient it was 91±1.01%, according to the doctor 92± 1.36%. In group 2, when providing emergency dental care with the infiltration method of administration of 3% mepivacaine the anesthesia was effective in 80±1.97% of cases according to the patient and in 80±1.17% of cases according to the doctor, with the conductive method of anesthesia at the mandibular orifice, the effectiveness of anesthesia according to the patient was 82±1.11%, according to the doctor 85±1.23%. CONCLUSION: The results of the study demonstrated a statistically significant increase in the effectiveness of local anesthesia performed with a 3% solution of mepivacaine in patients with arterial hypertension due to the use of preventive analgesia with Ketorol Express at a dosage of 20 mg (2 tablets of 10 mg) in emergency dental care with registration and analysis of changes in hemodynamic parameters.

[Pain syndrome correction after teeth whitening]. / Korrektsiya bolevogo sindroma pri otbelivanii zubov.

THE AIM OF THE STUDY: Was to develop an algorithm for the correction of pain syndrome using the drug Ketorol Express depending on the level of situational and personal anxiety of patients during office teeth whitening. MATERIALS AND METHODS: The study involved 60 people (mean age 25±0.85 years), who were divided into three groups depending on the level of personal and situational anxiety according to the Spielberger scale modified by Yu. L. Khanin. In the first group of patients with a high level of anxiety Ketorol Express was prescribed as a preventive analgesia before the whitening procedure, then the drug was used in case of pain. In the second group, patients with an average level of anxiety the drug was prescribed immediately after the whitening procedure, and then used in the event of a pain syndrome. The third group of patients with a low level of anxiety took the drug only in case of pain. To assess the severity of pain, the general well-being by the patient and the general well-being by the doctor, visual analogue scales were used. RESULTS: The study showed that the occurrence and correction of pain syndrome during teeth whitening depends on the patient's psycho-emotional state (both personal and situational anxiety). CONCLUSION: The developed regimen for prescribing Ketorol Express can significantly reduce pain in patients with different levels of anxiety.

[Comparative analysis of 2% and 4% articaine solution efficacy and safety for the local anesthesia]. / Sravnitel'nyi analiz primeneniya 2% i 4% rastvora artikaina pri in"ektsionnoi mestnoi anestezii.

AIM: To determine the functional diagnostics criteria for predicting the effectiveness of using 2% and 4% solutions articaine without vasoconstrictor and with epinephrine content of 1:200.000. MATERIAL AND METHODS: The study involved 357 patients (193 women and 164 men) aged 20 to 35 years. with the presence of intact single-rooted and multi-rooted teeth without periodontal pathology without pronounced general somatic pathology, and with a low level of situational anxiety according to the Spielberger-Khanin scale. All the patients received injection anesthesia by the infiltration method of 2% and 4% articaine solution without vasoconstrictor or with epinephrine concentration of 1:200.000. The effectiveness of local anesthesia was assessed by recording functional parameters (electrosensitivity threshold test and hemomicrocirculation) of the pulp of intact single-root and multi-root teeth before anesthesia, 5, 10, 15, 30, and 60 minutes after local anesthesia. The safety of the anesthesia was determined by continuous monitoring of the patient's hemodynamic parameters: blood pressure, heart rate, blood oxygen saturation before anesthesia and within 60 minutes after. RESULTS: Articaine solution 2% with epinephrine concentration of 1:200.000 used for infiltration or modified periodontal anesthesia resulted in pulp electrosensitivity threshold growth by 95.93% and 93.58%, respectively. There were no statistically significant differences in hemodynamic values between both study groups. CONCLUSION: Analysis of the data obtained showed the effectiveness and safe anesthesia with drugs based on 2% articaine with an epinephrine concentration of 1:200.000.

[Preventive analgesia for the improvement of local anesthesia efficacy in treatment of acute pulpitis in molars]. / Ispol'zovanie preventivnoi anal'gezii dlya povysheniya effektivnosti mestnogo obezbolivaniya pri lechenii ostrykh pul'pitov molyarov.

THE AIM OF THE STUDY: Was the assessment of the efficacy of using non-steroidal anti-inflammatory drug Ketorol Express as a preventive analgesia in the treatment of acute pulpitis in molars. MATERIALS AND METHODS: The study comprised 128 individuals, 76 (59.4%) women and 52 (40.6%) men. The mean age was 37.4 years. Two different visual-analog scales were used to evaluate the effectiveness of pain relief and the general well-being of the patient and the doctor. THE RESULTS: Of the study proved that the preventive analgesia with Ketorol Express at a dosage of 20 mg 15 minutes before local anesthesia with 4% articaine with epinephrine 1:200 000 in patients diagnosed with acute pulpitis of molars was effective since local anesthesia high effectiveness, absence of necessity for alternate anesthesia were registered by patients, which coincided with the dentist's opinion. CONCLUSION: Preventive analgesia with Ketorol Express improves the efficacy of local anesthesia in the treatment of acute pulpitis in molars.

[Comparative effectiveness of periodontal methods of anesthesia in the treatment of dental caries]. / Kliniko-funktsional'noe issledovanie effektivnosti i bezopasnosti primeneniya parodontal'nykh sposobov obezbolivaniya pri lechenii kariesa zubov.

AIM: The analysis of the criteria for predicting the effectiveness and safety of the use of periodontal anesthesia methods in the treatment of dental caries was carried out. MATERIALS AND METHODS: The study involved 78 patients: 41 women and 37 men aged from 25 to 56 years without severe somatic pathology, who needed treatment for dental caries. Intraligamental and modified periodontal anesthesia using a 4% articaine solution with different concentrations of vasoconstrictor were used as methods of anesthesia. The «method of the local injection anesthesia of the tooth pulp evaluating¼ was used during the modified periodontal and intraligmental anesthesia which determines the criteria for predicting the effectiveness and safety of the planned anesthesia and which is based on determining the functional parameters of the tooth pulp such as electrical excitability and microcirculation. RESULTS: The obtained results demonstrated the high efficiency and safety of the modified periodontal anesthesia with 4% articaine with epinephrine 1:200 000, which is easier to use and does not require specialized equipment. CONCLUSION: Modified periodontal anesthesia is safe and effective for the treatment of dental caries.

[Pain relief by Ketorol Express after oral surgery procedures]. / Kupirovanie bolevogo sindroma preparatom Ketorol Ekspress posle stomatologicheskikh vmeshatel'stv, soprovozhdayushchikhsya travmoi tkanei.

The aim of the study was providing rationale for using a new form of Ketorol Express for pain relief in outpatient dental practice. The study comprised 85 patients with an average age of 43.2 years, who were prescribed a three-day course of Ketorol Express therapy after a complex traumatic tooth extraction. Three different visual-analog scales were used to assess the severity of pain, the patient's General well-being, and the doctor's General well-being. After treatment with dispersed Ketorol Express tablets, the severity of the pain syndrome decreased from 4 to 1.8 points within three days. Anesthesia occurred on average in 10 minutes. This therapy was safe and well tolerated. There were no one serious adverse events, and no one patient stopped therapy due to side effects.

Influence of needle bevel design on injection pain and needle deformation in dental local infiltration anaesthesia - randomized clinical trial.

The aims of this in vivo study were to evaluate the impact of needle bevel design on patients' pain perception and the mechanical deformation of the needle tip after the injection. In a prospective single-blinded trial, 150 patients received conventional infiltration anaesthesia for dental treatment by one examiner. Patients were randomized for one out of three different needle bevel types (scalpel-designed bevel needle (SB), n=50; triple bevel needle (TB), n=50; regular bevel needle (RB), n=50). Subjects' self-reported injection pain perception was evaluated using a numeric rating scale (NRS). For each needle tip, deformations after single use were measured using SEM. A significant lower injection pain level was found in SB (mean 2.1±1.2) than in TB (mean 3.5±1.6;) and RB (mean 3.4±1.0; all P<0.001). A needle deformation was detected in about 97.3% of all needles (SB 50/50, TB 50/50, and RB: 46/50). A higher number of barbs were found in SB (29/50) versus TB (17/50) and RB (19/50). For dental local infiltration anaesthesia, injection needles with a scalpel-designed bevel demonstrated significantly less injection pain. Needle tip deflections after anaesthetic agent infiltration, especially barbed hooks on the non-cutting edge may result in greater soft tissue trauma.

[Safe local anesthesia in patients with bronchial asthma]. / Osobennosti bezopasnogo mestnogo obezbolivaniia u patsientov s bronkhial'noi astmoi.

The paper presents the analysis of studies of local anesthesia in patients with bronchial asthma. It was found that the diagnosis of hypersensitivity to sodium metabisulfite in patients with bronchial asthma must be optimized for development of local anesthesia selection algorithm in outpatient dentistry.

[Out-patient dental care in patients with arterial hypertension]. / Osobennosti okazaniia ambulatornoi stomatologicheskoi pomoshchi patsientam s arterial'noi gipertenziei.

The aim of the study was to improve dental treatment quality in patients with arterial hypertension. The study included 256 patients with arterial hypertension (153 females, 103 males) aged 35 to 60 years. Anesthesia efficacy was assessed by visual analog scale after treatment. Oral adverse effects caused by regular intake of antihypertensive drugs and interrelation with articaine and mepivacaine were described. The study proved high efficacy of 4% articaine 1:200 000. The efficacy of 3% mepivacaine with no vasoconstriction agents was 86.4±2.3% but may be enhanced to 93.3±2.3% by preventive non-steroid anti-inflammatory agents taken 25-30 minutes before treatment in maximal daily dosage.

[Local anesthesia selection algorithm in patients with concomitant disease. Part 2.] / Algoritm okazaniya stomatologicheskoi pomoshchi patsientam s soputstvuyushchei patologiei. Chast' 2.

A group of authors presents the rationale for local anesthesia selection in patients with concomitant disease based on case history; interaction analysis of drugs with local anesthetic and sedation agents; estimation of patient functional status; patient anxiety correction; dental care with hemodynamics monitoring. It was found that adhering to this algorithm promotes the prevention of urgent conditions in outpatient settings.

Local anesthesia selection algorithm in patients with concomitant somatic diseases. / Algoritm okazaniya stomatologicheskoi pomoshchi patsientam s soputstvuyushchei patologiei. Chast' 1.

The paper presents basic principles of local anesthesia selection in patients with concomitant somatic diseases. These principles are history taking; analysis of drugs interaction with local anesthetic and sedation agents; determination of the functional status of the patient; patient anxiety correction; dental care with monitoring of hemodynamics parameters. It was found that adhering to this algorithm promotes prevention of urgent conditions in patients in outpatient dentistry.

[Specific features of emergency dental care in pregnant women].

The aim of the study was to evaluate the algorithm of safe emergency dental care in pregnant patients. Eighty-five pregnant women aged 20-35 were included in the study. The paper presents elaborated state-of-the-art guidelines for emergency dental care in pregnant patients. Articaine 4% with epinephrine 1:200,000 is recommended as a choice agent for local anesthesia in these patients.

[The choice of local anesthesia for patients with hypertension in dental practice].

The study involved 153 patients (92 females, 61 males aged 30-75 years) with arterial pressure from 120/80 to 180/100 mm Hg. The role of dentist in primary diagnosis of hypertension was identified. The study highlights the need for functional status assessment before dental treatment and the importance of safe and effective local anesthesia for the patients with arterial hypertension. The paper presents rationale for the choice of local anesthetic agent for these patients.

[Five star dentistry - IV Congress of European Federation for the Advancement of Anesthesia in Dentistry].

The Russian delegation of the European Federation for the Advancement of Anesthesia in Dentistry (EFAAD) participated in IV Congress of EFAAD where were considered such problems of dental and anxiolysis in patients with severe concomitant diseases and training dentists improvements on such problems as anesthesia, sedation, prophylaxis and emergency management inpatients with accompanying diseases.

[Efficiency and safety of local anesthesia in teeth with mild and moderate periodontal disease].

The rationale for the choice of local anesthesia in teeth with mild to moderate periodontal disease was formulated based on a comparative analysis of the effectiveness and safety of different local anesthesia methods with 4% articaine. Effectiveness of anesthesia was assessed using objective values of electric study of pulp sensitivity and registration of microcirculation in dental pulp. Safety analysis was based on changes in periodontal tissues microcirculation assessed by laser Doppler flowmetry, as well as of central hemodynamics rates.

[Clinical-physiological substantiation of brown algae preparation use for gingivitis treatment].

1% water solution extract Fucus reduced inflammation emerged in cases of chronic parodontal disease. This was confirmed by positive dynamics of subjective and objective clinical symptoms, reduction of parodontal and hygienic indexes, improvement of parodontal microcirculation.

[The action of Carpule-delivered local anesthetics and their combinations with vasoconstrictors]. / Deistvie karpulirovannykh mestnykh anestetikov i ikh sochetanii s vazokonstriktorami.

Analysis of published data on the effects of drugs used in dentistry for local analgesia and of the authors' findings will help the dentists properly select adequate analgesia with due consideration for the extent of intervention and patient's condition. Study of carpulated local amide anesthetics lidocaine, mepivacaine, and articaine revealed the relationship between the efficacy of anesthesia and its effects on cardiovascular system, on the one hand, and the anesthetic proper, presence of a vasoconstrictor, and type of anesthesia, on the other.

[The characteristics of the action of Carpule-delivered local anesthetics and their combinations with vasoconstrictors (a preliminary report)]. / Osobennosti deistviia karpulirovannykh mestnykh anestetikov i ikh sochetanii s vazokonstriktorami (predvaritel'noe soobshchenie).

Analysis of the authors' findings and published reports on the effects of local anesthetics will help a dentist properly choose adequate anesthesia for each patient with due consideration for the type of intervention and anesthesia. Study of the carpulated local amide anesthetics lidocaine, mepivacaine, and articaine helped detect the relationship between the efficacy of analgesia and its effect on the cardiovascular system, on the one hand, and the drug used, presence of a vasoconstrictor, and type of anesthesia, on the other.