ANALYSIS OF THE CLINICAL EFFECTIVENESS OF LOCAL ANESTHESIA IN THE TREATMENT OF ACUTE FORMS OF CARIES AND PULPITIS IN ADOLESCENTS
Local anesthesia in dentistry, as a way to block the pain syndrome, is one of the most common procedures at a dental appointment, and local anesthetics are among the most frequently used drugs in the daily practice of a dentist. In many cases, treatment is impossible without following most modern protocols. Painful sensations limit the volume of therapeutic measures and reduce the quality of treatment. In addition, the pain that a child may feel during a visit to the dentist leads to refusal of treatment and creates a fear of visiting doctors of any specialty. The child's behavior is controlled by emotions, which increase the physiological intolerance of pain in children. The doctor must help the patient get rid of the feeling of fear, create a situation of safety and painlessness during the examination and treatment. The peculiarities of the body in different age periods should be the basis of differentiated dental care for children.
The effectiveness of anesthesia in teenagers largely depends on the patient's level of basic anxiety, these factors are directly dependent.
The aim of the study. To determine the effectiveness of local anesthesia in the treatment of acute medium caries, acute deep caries and acute pulpitis in adolescents with different levels of basic anxiety.
Materials and methods. Patients aged 11 to 17 years were selected for analysis, in particular, 126 cases of acute medium caries (55 on the upper jaw and 71 on the lower), 128 cases of acute deep caries (63 on the upper jaw and 65 on the lower) and 98 cases of acute pulpitis (42 teeth on the upper jaw and 56 on the lower). All pathologies required treatment under local anesthesia. Dental pathologies were verified according to the main diagnostic criteria.
Drugs belonging to the group of substituted acetanilide amides were used as local anesthetics.
In all patients, the level of reactive and personal anxiety was assessed according to the method of Ch.D. Spielberger (adapted by Yu.L. Khanin).
Statistical analysis of the obtained data was carried out on a personal computer using licensed programs ˝MS Excel 7˝ for the operating system˝ Windows˝ and the standard program package "STATISTICA" v. 6.0.
All participants were informed about the goals, organization, methods of the study and signed an informed consent to participate in it, and all measures are taken to ensure patient anonymity.
Conclusions. In teenagers, pain during the treatment of dental diseases, such as acute caries or acute pulpitis, is directly proportional to the severity of the pathology and the level of basic anxiety of the individual.
In the treatment of acute forms of medium and deep caries and pulpitis, a significant decrease in the percentage of pain syndrome intensity was observed in all clinical groups, however, in the group with a low level of anxiety, 100% disappearance of pain syndrome was noted in all patients after 15 minutes.
In adolescents with a high level of anxiety, the reduction in the intensity of the pain syndrome was reliable in comparison with the indicators before the manipulation, the complete disappearance of the pain syndrome was noted 15 minutes after anesthesia in 43.8% (56 patients) in the treatment of acute deep caries, in 56.9% (45 patients) in the treatment of acute medium caries and in 45.2% (28 patients) in the treatment of acute pulpitis.
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