[Evaluation of the effectiveness of the compression method for infiltration anesthesia of the mandibular molars]. / Otsenka effektivnosti primeneniya kompressionnogo metoda pri infil'tratsionnoi anestezii dlya obezbolivaniya zhevatel'nykh zubov na nizhnei chelyusti.

AIM: To study the depth of analgesia and the electrical excitability dynamics of the pulp of the tooth under local anesthesia without and with compression on the depot of local anesthetics. MATERIALS AND METHODS: 87 men and 93 women took part in the study, the average age of men was 36.8±5.02 and the average age of women was 30.43±2.14. According to the indications, local anesthesia of infiltration type with and without compression at the depot of local anesthetics was performed. The injection was carried out with a solution of 4% articaine with epinephrine1:100000 or 1:200000. Patients were divided into 2 groups depending on the used concentration of the vasoconstrictor with 4% articaine. The target area thermometry and electroodontometry (EOD) of the first mandibular molar were performed. The criterion for the onset of pulp analgesia was the value from 92 to 100 mA. RESULTS: Dynamics of change in pulp electrical excitability of the first molar with the use of 4% articaine with epinephrine 1:200000 without a compress showed that in the latter case the reduction of pulp electrical excitability to 96.6 µA, which is optimal for painless treatment, was developed by the 5th minute of the study and remained at the limit of 92.2-92.1 µA for 20 minutes. When using 4% articaine 1:100 000 it was noted that also the compression technique allowed to reach the necessary reduction of EOD indices to 93.5 µA by the 5th minute of the study, and to 97.2 µA by the 10th minute. Increased hypothermia in the injection depot area was noted thermographically, especially when high concentrations of epinephrine were used. CONCLUSION: Our own studies reflect the dynamics of change in the electrical excitability of the pulp of the first molar with the use of 4% articaine by compression method more intensively reduces the electrical reacrivity of the dental pulp depending on the concentration of the epinephrine: with the use of 1:100000, the advantage of the pressure technique is 19.3% and 1:200000 - 21.8%.

[Evaluation of dentists regulatory systems stress during the provision of dental care according to pulse oximetry data]. / Otsenka napryazheniya regulyatornykh sistem vrachei-stomatologov v period okazaniya stomatologicheskoi pomoshchi naseleniyu po dannym pul'soksimetrii i saturatsii krovi.

OBJECTIVE: To evaluate the status of individual hemodynamic parameters (HR) and respiratory indicators of dentists performing local anesthesia. Material and methods. In the period from April 2019 to December 2019 the determination of heart rate (Heart rate) and blood saturation at 120 doctors aged 25-55 years was performed. The value of blood saturation by non-invasive pulse oximeter technique: SpO2 measurement range 0-99%; heart rate range 18-300 beats per minute. The limit of 95-98% was considered normal. However, we consider it correct to note the introduction of an error of 0.1% due to the constant wearing of a dentist's tight polymer mask. All subjects were preliminarily determined by Robergs-Landvere formula: maximum heart rate (MF)=205.8-(0.685·age). RESULTS: Maximum HR limits for the groups of subjects were 185.6±3.1 beats per minute in the first group; 178.7±3.1 beats per minute in the second group; 171.5±3.4 beats per minute in the third group. In all groups the tendency to decrease blood saturation in case of pain appearance in patients during treatment against the background of block anesthesia, as well as during anesthesia on the mandible was determined. The definition of SpO2 showed a slight downward trend in blood saturation when pain occurs within normal parameters. Thus, the limit of changes in the index against the background of performed local anesthesia on the mandible was 95.2-96.1% and 96.3-96.6% on the maxilla. CONCLUSION: Measurement of arterial oxygen saturation in dentists showed a tendency for a slight decrease in this indicator within the normal range when the patient developed pain. Thus, the limit of changes in the indicator against the background of local anesthesia on the lower jaw was 95.2-96.1%, on the upper jaw - 96.3-96.6%.

[Comparative evaluation of P.M. Egorov and modified G. Gow-Gates mandibular block efficacy]. / Sravnitel'naia otsenka éffektivnosti in''ektsionnoi anestezii po P.M. Egorovu i po modifitsirovannoi metodike Dzh. Gou-Geitsa.

AIM: To assess the efficacy and safety of mandibular block performed by two different techniques. MATERIAL AND METHODS: The study involved 92 patients divided in two groups according to mandibular block technique: method of P.M. Egorov (45 patients) and G. Gow-Gates modified by S.A. Rabinovich and O.N. Moskovets in 1999 (47 patients). RESULTS: The number of local complications was reduced to 1/9% when modified Gow-Gates mandibular block technique was used with anesthesia efficacy of 98%. CONCLUSION: Modified Gow-Gates mandibular block technique shows better efficacy and is associated with lower complications rate for oral surgical procedures and inflammatory oral diseases treatment in mandible.

[Objective assessment of mental nerve local anesthesia]. / Ob''ektivnaia otsenka urovnia mestnogo obezbolivaniia podborodochnogo nerva.

AIM: To study the reaction of the mental nerve to selective stimulation of thin nerve fibers by thermal stimuli during conduction anesthesia. MATERIAL AND METHOD: The pilot study involved 24 healthy volunteers: 13 subjects were injected with a 4% solution of articaine-containing anesthetic with a vasoconstrictor in a ratio of 1:200 000 (pH 4.8-5.4) and 11 subjects - a 3% solution of mepivacaine-containing local anesthetic without a vasoconstrictor (pH value 5.8-6.4). The registration of evoked potentials was performed twice: before local anesthesia and 5 minutes after anesthesia. With the help of disposable carpal dental injectors, local anesthesia was performed near the mental foramen in order to anesthetize the innervation region of the mental nerve through a conductive type. The evoked potentials (VP) were recorded on a Nicolet instrument (USA) with Bravo evoked potentials software. The study of thermal EPs was performed using a Contact heat evoked potential stimulator (CHEPS) device ('Medoc Ltd, Ramat Yishai', Israel). The base and peak temperature were set at 33 and 54 °C, correspondingly. RESULTS: The evoked potentials for thermal stimulation demonstrated a significant decrease in the amplitude of all components and the elongation of the LP of the main negative-positive N2-P2 complex after anesthesia compared with the initial thermal EP. The complete disappearance of thermal responses was observed in 14 (58%) of 24 study participants, minor changes were seen in 3 (12.5%) cases only. The total response disappearance was observed in 10 (77%) of 13 participants after articaine and in 3 (27%) of 11 - after mepivacaine (p<0.05), weak changes were registered in 2 (15%) cases in the articaine group and in 1 (9%) case in the mepivacaine group. CONCLUSION: A 4% solution of articaine is somewhat more effective for pain relief of teeth and bone since it often causes deeper anesthesia, and a 3% solution of mepivacaine without a vasoconstrictor is physiologically more suitable for working with soft tissues.

[Possibilities of thermographic rating the level of microcirculation with local anesthesia in dentistry]. / Vozmozhnosti termografii dlia otsenki urovnia mikrotsirkuliatsii pri mestnom obezbolivanii v stomatologii.

It is known that the reduction of blood vessels by epinephrine that are part of the local anesthetic leads to a decrease in oxygen intake and the development of hypoxia, which has a significant effect on the excitability of nerve fibers. This is due to the fact that epinephrine is present in the local anesthetic cartridge, which helps to reduce, until termination, microcirculation in the depot area, which leads to local hypothermia. With the introduction of local anesthetics, the temperature of which is significantly lower than the depot temperature, the patient experiences severe discomfort, which is associated with unsuccessful local anesthesia. The goal of the study was the need to analyze the feasibility of using the thermography method in assessing the degree of ischemia of the soft tissues of the maxillofacial region against the background of local anesthesia with a different concentration of epinephrine in dentistry. MATERIAL AND METHODS: In the pilot study, 22 healthy volunteers aged between 29-35 years of both sexes participated. To assess the degree of external vasoconstriction, a buccal region was chosen near the maxilla. Infiltration anesthesia was used with a 4% solution of articaine with epinephrine 1: 100 000 and 1: 200 000 at a dosage of 0.5-0.7 ml. The temperature distribution in the study area was estimated using a thermal imager Nec InfReC Thermo Gear G30. RESULTS: The study showed that the use of epinephrine in local anesthetics naturally has a moderate effect on hemodynamics in areas adjacent to the anesthesia depot. When using a low concentration of epinephrine (1:200 000), the projection hyperthermia of the skin is determined. Perhaps this is due to the activation of microcirculation due to an increase in capillary blood flow in the region above the zone of action of the epinephrine. From the point of view of physiological arterial hyperemia, this mechanism carries positive properties, since leads to an increase in tissue oxygenation. When using a high concentration of epinephrine (1:100 000), the zone of hypothermia of the skin is determined, which corresponds to the phenomenon of angiospastic ischemia.

[Before arrival of emergency ambulance ]. / Do pribytiia skoroi meditsinskoi pomoshchi...

Safety is one of fundamental requirements of modern dentistry. The emergency situation when immediate treatment is required for stabilization of the general condition of the patient, can occur to the dentist of any specialty. For rendering the urgent, emergency or resuscitation help it is necessary to know modern treatment protocols, to be able to demonstrate a workplace steady skills of saving actions in the conditions of effective team interaction, and also to have for this purpose all necessary equipment and medicines.

[Anatomic rationale for clinical efficacy of intraosseous mental nerve anesthesia]. / Anatomicheskoe obosnovanie klinicheskoi éffektivnosti provodnikovoi anestezii vnutrikostnoi chasti podborodochnogo nerva.

The aim of the study was to prove the anatomical and clinical effectiveness of the modified anesthesia of mental nerve. The effectiveness of conductive anesthesia near the mental foramen was objectively evaluated using the electric pulp test (EPT) in 100 volunteers of both sexes, aged 35-43 years. Wet anterior mandible preparations obtained from 350 cadavers aged 18-74 years were also studied. EPT value after local mental anesthesia conducted according to Malamed C. using 4% articain solution of local anesthetic with vasoconstrictor concentration of 1:200.000 after 2 minutes was 93±0.82 mA, after 4 minutes - 188±1.26 mA. Yield variability indicators of intraosseous mental nerve anesthesia was slightly higher varying from 94.11 mA to 96.61 mA after 2 minutes and from 197.4 to 199.92 mA after 4 minutes survey. The study showed the efficiency and predictability of intraosseous anesthesia of the mental nerve.

[Effect of dexmedetomidine on perfusion of free flaps transferred to head and neck]. / Vliianie deksmedetomidina na perfuziiu revaskuliarizirovannykh autotransplantatov, perenesennykh v oblast' golovy i shei.

The paper presents the impact of perioperative care on feasibility of free fibula flap transfer for facial reconstruction. Flaps vitality was measured by means of somatic oximetry in 85 patients aged 20-74 years receiving reconstruction procedures in midfacial and lower facial areas. The patients were divided in three groups according to sedation agent used postoperatively. It has been demonstrated that dexmedetomidine postoperative sedation significantly improved free fibula flaps perfusion compared to propofol sedation.

[Systemic toxicity of local anesthetics]. / Sistemnaia toksichnost' mestnykh anestetikov.

The paper presents characteristics of local anesthetics used in dentistry and maxillofacial surgery taking into account their effectiveness and toxicity. We described the main clinical symptoms of manifestation of systemic toxicity and measures for prevention of local anesthesia complications, as well as the detailed protocol of 'lipid rescue' and resuscitation at manifestation of systemic toxic reaction of local anesthetics with the mechanism of the fatty emulsion action.

[Functional cardiovascular assessment in dentists performing local anesthesia in out-patient settings]. / Otsenka funktsional'nogo sostoyaniya serdechno-sosudistoi sistemy vrachei-stomatologov pri provedenii mestnogo obezbolivaniya v ambulatornykh usloviyakh.

The article presents the results of the cardiovascular changes assessment using electrocardiography (ECG) monitoring during local anesthesia in GP dentists. Selective ECG monitoring was carried out in 60 dentists aged 25-55 years (1 group - 25-34 y.o.; 2 group - 35-44 y.o.; 3 group - 45-55 y.o.) by means of portable «Valens¼ system. The study of stress index or the index of regulatory systems tension (IT) was conducted for 6 hours in the first day half within 1 working day. IT from 50 to 150 relative units was considered normal. In the first group IT peak was observed at the time of expectation of clinically relevant anesthesia in upper and lower jaw, while in the second and third groups it was associated with pain reaction in the course of treatment despite of clinical signs of anesthesia in the maxilla (IT=20±5.3 and 231±1.4, correspondingly) and mandible (IT=213±2.7 and 223±2.6, correspondingly). In all groups greater IT correlated more with mandible anesthesia events.

[Choice of local anesthetic volume at the infiltration anesthesia on the upper jaw].

The aim of this study was to investigate the effect of volume and pressure, at which the solution of local anesthetic is injected into the tissue, on the effectiveness of infiltration anesthesia of the periosteum on the upper jaw. We used the technique of tooth pain sensitivity thresholds. According to the rate of development and the duration of the maximum analgesia effect, the optimum volume for different levels of pressure was determined. The influence of the tissue density at the injection site on the effect criteria of analgesia was demonstrated.

[The estimation of the effectiveness of the anesthetic techniques applied for the combined treatment of the patients presenting with chronic generalized periodontitis].

UNLABELLED: The treatment of patients presenting with periodontitis is one of the most difficult tasks facing modern dentistry. Most periodontal manipulations are associated with pain sensation; therefore, pain relief is one of the most topical problems in dentistry. The objective of the present study was to enhance both the safety and the effectiveness of anesthetization procedures applied for the treat-ment of patients suffering from moderately severe chronic generalized periodontitis. MATERIAL AND METHODS: The effectiveness of local anesthesia was estimated using the methods of functional diagnostics, such as the assessment of the threshold pain sensitivity and bioimpedance spectrometry of the periodontal tissues. RESULTS: The data on dynamics of the threshold pain sensitivity were used to estimate the effectiveness of local anesthesia during periodontal interventions. CONCLUSION: The results obtained by means of bio-impedance spectrometry made it possible to estimate the influence of anesthesia on extracellular hydration of thee periodontal tissues.

[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.

[Anesthesia and sedation by admixture of xenon-oxygen in dentistry. Part I].

The modern out-patient dental treatment which is performed under combined anesthesia with of xenon-oxygen inhalations provides comfortable conditions for the doctor and the patient, effective anesthesia and safe level of the sedation controlled by dentist.

[Methodological features of DNA isolation for nested PCR for the differential diagnosis of malaria].

Current PCR assays for the differential diagnosis of malaria need to be further developed and certified in the Russian Federation. PCR may serve as a control diagnostic method. These investigations have demonstrated that an erythrocytic clot may be used as an adjunct to microscopy and the described procedure can be employed to isolate DNA for PRC in an inpatient setting.

[Effectiveness of 0.5% ipidacrine fluctophoresis in lower alveolar nerve dysfunction treatment].

The aim of the study was to evaluate effectiveness of 0.5% ipidacrine solution fluctuophoresis. The study included complex examination and treatment of 12 patients with dysfunction of inferior alveolar nerve. The efficiency criteria included resolution of pain and sensitive disturbances, characteristics of electric pulp test of lower jaw teeth, sensitivity thresholds of lower lip skin, hydration level of periodontal tissues of innervated area, peripheral hemodynamics in the area of mental foramen. The study results showed that complex therapy of inferior alveolar nerve dysfunction using fluctuophoresis of anticholinesterase drug ipidacrine effectively relieves pain syndrome and recovers sensitivity in the affected area.

[Hydraulic pressing in complex treatment of recurrent TMJ disc dislocation].

The aim of the study was to estimate the complex treatment efficiency in patients with TMJ internal disorder. TMJ structures repositions and its functional rehabilitation was achieved in 87.2% of cases by using minimally invasive treatment modes (TMJ splint and hydraulic pressing).