Зависимость техники выполнения инфраорбитальной проводниковой анестезии внутриканальным способом от топографо-анатомических особенностей удвоенных подглазничных каналов

Abstract

Локалізація та напрямок додаткових (подвоєних, потроєних) підочноямкових каналів (ПОЯК) на верхній щелепі впливає на адекватність і якість інфраорбітальної провідникової анестезії внутрішньоканальним способом. Варіабельність напрямків подвоєних, і потроєних ПОЯК на верхній щелепі та їх кількості виявлені нами в 3-х формах черепа, склала 23,33% від загального числа і не мала прямої залежності від антропометричних показників черепа. Подвоєння і потроєння ПОЯК частіше зустрічається в брахіцефалічній формі черепа (в 13,33% випадків); Локализация и направление дополнительных (удвоенных, утроенных) подглазничных каналов на верхней челюсти влияет на адекватность и качество инфраорбитальной анестезии, выполненной внутриканальным способом у пациентов на стоматологическом приеме. Вариабельность направлений удвоенных и утроенных подглазничных каналов нами выявленная на верхней челюсти в 3-х формах черепа (23,33% от общего числа случаев) не имела прямой зависимости от антропометрических показателей черепа. Удвоение и утроение ПГК чаще встречается в брахицефалической форме черепа (в 13,33% случаев); Abstract. Localization of the аdditional (doubled, tripled) infraorbital canals of the skull as well as their direction have a significant effect on the adequacy and quality of the local anaesthesia performed in patients, especially when performing the intracanal method of block anaesthesia. The purpose of work is to study topographic and anatomical features of doubled infraorbital canals with different forms of the skull, which affect the technique of performing by intracanal and extraoral method of infraorbital block anesthesia. Object and methods of research. We conducted anthropometric studies on 30 skulls of corpses (20 male, 10 female) aged 30-60 years. Using the caliper and ruler, the transverse (width) and anteroposterior (length) diameters of the skull were measured by the ratio which was multiplied by 100 for determining the cranial index (CI). Localization and direction of the doubled infraorbital canals were studied after injecting needles of single-use of 2-component 5 ml syringes of the Luer type (d of needles = 0.7 mm) and 3-component 1 ml insulin syringes (d of needles = 0.3-0.5 mm). Results of the research and its discussion. Doubled and tripled infraorbital canals were detected in three forms of the skull after anthropometric studies (transverse and anteroposterior diameters in 30 skulls). Doubling and tripling of the infraorbital canal was detected (in 23.33% of cases) in three skull forms, but more often it occurs in the brachycephalic form of the skull – in 13.33% of cases. Conclusions. It was found that doubling of the infraorbital canals from the right and left side of the upper jaw was found in 23.33% of cases among 20 male and 10 female skulls of different forms. In the dolichocephalic form of the skull, doubled infraorbital canals w detected in 6.66% of cases, in the brachycephalic form of the skull – in 13.33% of cases and in the mesocephalic form of the skull – in 3.33% of cases. Additional (doubled, tripled) infraorbital canals with different forms of the skull in 23.33% of cases are passable for needles (d of needles = 0.3-0.7 mm) of disposable use of 2- and 3-component syringes of the «Luer» type. This affects the technique of performing the intracanal method of infraorbital anesthesia. The asymmetrical direction of doubled infraorbital canals (forward, downward, inside – in 20.0% of cases and forward, downwards, outward – in 3,33% of cases) is established with respect to the main infraorbital canal. The technique of performing the intracanal method of infraorbital anesthesia depends on the number, location and direction of additional infraorbital canals.