X-ray anatomical provement of the right trajectory choice during mandible regional anaesthesia
Background. Inferior alveolar nerve blockage (IANB) is the most popular dentist’s anaesthesia technique. But the inferior alveolar nerve blockage failure rate is about 20-25%. In this regard, the analysis of anatomical landmarks for blockade of the lower alveolar nerve according to computer tomography (CT) is relevant. Objective. To determine the right trajectory for mandible regional anaesthesia by X-ray scan analysis. Material and methods. The study involved 57 patients aged 53.37±1.83 years (35 male and 22 female). The mandible foramen position was measured at CT scan. According to this data the optimal trajectory was calculated. The effectiveness of the technique was evaluated using electro-dental diagnostics. Comparison and analysis of the results of the study were carried out in the Statistical Package for Social Science (IBM SPSS Statistics 23). The Student’s t criterion was used to access the statistical significance of the differences between the samples and the Pearson correlation coefficient as well as. The differences were considered statistically significant at p<0.05. Results. The study shows that the pterygomandibular space is difficult to detect on CT with a step of more than 3 mm. It was determined that the angle between the posterior surface of the mandible branch, formed by the injection plane with the sagittal plane passing through the posterior edge of the mandible branch, varies significantly and depends on many parameters: gender, age, shape of dental arches, orientation of the mandibular branches. In most cases, the correlation with age was weak or very weak. Only some parameters had a statistically significant correlation with age, namely the transverse cranial index (r= -0.282; p=0.033) and the distance from the nerve entry point to the inner edge of the lower jaw on the left (r= -0.266; p=0.045). From the comparative data of electrodontodiagnostics, it follows that the most rational option of anesthesia is combined, which gives the deepest and longest anesthesia (200 McA) and deep - above 170 McA for 150 minutes. Conclusion. It was found that the distance from the canine tooth to the injection point on the opposite side had an average positive correlation with the sex, the distance from the mesiobuccal surface of the first mandible molar and the contact point of the first and second maxilla molars (p<0.05).