employee
Krasnodar, Krasnodar, Russian Federation
Krasnodar, Krasnodar, Russian Federation
employee from 01.01.2006 to 01.01.2025
Krasnodar, Krasnodar, Russian Federation
employee
Krasnodar, Krasnodar, Russian Federation
UDC 61
CSCSTI 76.29
Infraorbital anesthesia is a key method of conduction anesthesia in the maxilla. However, the classic manual technique demonstrates limited efficacy and a high complication risk of up to 25 %, due to the anatomical variability of the infraorbital foramen (IFO) and the lack of a personalized approach. Study objective: To compare the clinical effectiveness of traditional manual technique and an optimized approach to conduction anesthesia in the infraorbital foramen during maxillary cystectomy based on digital preoperative planning and the use of a personalized navigation template. Materials and Methods: This randomized clinical trial included 40 patients (25–45 years old) with chronic apical periodontitis (K04.5) requiring cystectomy. In the study group (n = 20), anesthesia and surgery were performed using a customized navigation template designed using digital and additive technologies. In the control group (n = 20), cystectomy was performed using a classic manual infraorbital block using anatomical landmarks. The onset of anesthesia (in seconds), the volume of anesthetic administered, and the incidence and pattern of complications were assessed. Statistical analysis was performed using StatTech v. 4.12.5. Results and Discussion. Using a template reduced the onset of anesthesia by 1.7 times and the volume of anesthetic by 2.3 times. Men required 2.4 times more anesthetic than women (p < 0.05). The complication rate decreased from 25 % in the control group to 5 % in the study group. The needle insertion angle using the template coincided with the direction of the root apices in 97 % of cases, allowing the use of the anesthesia navigation window and the upper edge of the navigation stand as incision guides during cystectomy. Conclusion. A digital protocol for planning and 3D-printing a custom navigation template for infraorbital anesthesia significantly improves the efficacy, safety, and reproducibility of anesthesia, reducing the onset time, anesthetic volume, and complication rate. This justifies its implementation in clinical practice for elective maxillary surgeries.
infraorbital anesthesia, infraorbital foramen, navigation template, digital planning, cone beam computed tomography, 3D-printing
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