Актуальные вопросы хирургической стоматологии и дентальной имплантологии
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Таким образом, консервативное лечение ПНЧ с применением кортикальных винтов
позволило улучшить результаты лечения и сократить срокиункциональной и эстетической
реабилитации пациентов.
LOCAL ANESTHESIA WITH EPINEPHRINE IS SAFE AND EFFECTIVE FOR ORAL
SURGERY IN PATIENTS WITH TYPE 2 DIABETES MELLITUS AND CORONARY
DISEASE: A PROSPECTIVE RANDOMIZED STUDY
Rakhmatullaeva O.U., Nurillayev H.Sh.
Tashkent State Dental Institute
OBJECTIVE
: To investigate the variations in blood glucose levels, hemodynamic effects
and patient anxiety scores during tooth extraction in patients with type 2 diabetes mellitus T2DM
and coronary disease under local anesthesia with 2% lidocaine with or without epinephrine.
PATIENTS AND METHODS:
This prospective randomized study was conducted from
September 2009 to November 2012 in patients with T2DM and coronary disease from the Heart
Institute (InCor) of Hospital das Clı´nicas da Faculdade de Medicina da Universidade de Sa˜o
Paulo (HCFMUSP). The study was approved by the local ethics committee under the protocol no
1033/08, and informed consent was obtained from all patients before inclusion in the study. This
study was registered at clinicaltrials.gov (NCT02173067). We enrolled adult patients with
pharmacologically controlled T2DM (via the use of insulin and/or hypoglycemic agents) and
coronary disease who needed to have at least one posterior maxillary tooth extracted according
to an oral examination and panoramic radiography. To assess the levels of blood glucose, the
MiniMed Continuous Glucose Monitoring (CGMS, Medtronic Diabetes) was employed. This
device is able to monitor average glucose measurements taken every 5 minutes. The MiniMed
monitor was installed in the morning on the day before the surgery. The patient then went home
and returned to the hospital for the surgery 24 hours later. The same dentist carried out the
surgery in all patients and was not provided any information regarding the blood glucose levels
of the patients during the protocol. Therefore, in this sense, the study was double blind. Subjects
were randomly divided into 2 groups: the LCA group received 2% lidocaine with 1:100,000
epinephrine, and the LSA group received plain 2% lidocaine. The same volume of anesthetic
(5.4 mL) was applied using a standard technique (25). The MiniMed monitor was removed an
hour after the surgery, and the data were downloaded into a computer using vMonGluco Client
software
RESULTS:
A total of 400 patients were initially evaluated. Among these individuals, 179
were edentulous patients, 74 were partial edentulous patients, 46 did not require tooth extraction,
and 28 refused to participate, all of whom were excluded. The remaining 70 patients (50 male,
20 female) were included (mean age, 63.4¡8.3 years (44-83), div mass index, 28.0¡5.0 kg/m2).
The subjects were randomly divided into 2 groups: an LSA group (n = 35) and an LCA group (n
= 35). Table 1 shows the clinical characteristics of the 2 groups. There was no difference in
gender between the groups (p = 0.290). Prophylactic antibiotics were administered to 3 patients,
with no difference between groups (p = 1.000). Amoxicillin was administered over 7 days to 30
subjects, and clindamycin was administered to 1 individual; there was no significant difference
between the LSA and LCA groups for this parameter (p = 0.336). There was also no significant
difference between the groups (p = 0.207) according to the duration of the surgery.
CONCLUSION
: The administration of 5.4 mL of 2% lidocaine with epinephrine neither
caused hyperglycemia nor had any significant impact on hemodynamic or anxiety parameters.
However, lower blood glucose levels were observed. This is the first report using continuous
blood glucose monitoring to show the benefits and lack of side effects of local anesthesia with
epinephrine in patients with type 2 diabetes mellitus and coronary disease.
Международная научная-практическая конференция
73
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ОДОНТОГЕННЫЕ ИНФЕКЦИИ ГОЛОВЫ И ШЕИ В ХИРУРГИЧЕСКОЙ
СТОМАТОЛОГИИ
Рахматуллаева А.Х., Рысметова М.Р., Рахматуллаева О.У.
Ташкентский государственный стоматологический институт
Актуальность.
Частыми и потенциально опасными осложнениями в нелеченых
стоматологических патологий или неправильных вмешательств, в особенности
хирургических и терапевтических, являются одонтогенные инфекции (ОИ). Чаще всего
они поражают околоносовые пазухи и шейно-фасциальные пространства. Их диагностику
не всегда можно провести с точностью, так как клиническая картина не всегда очевидна и
может не иметь связи со стоматологией. Если их развитие вовремя не взять под контроль,
то они могут быстро распространиться в области головы и шеи, дать необратимые
осложнения и представить опасность для жизни пациента. ля развития ОИ имеют
значение не только отсроченная диагностика и неадекватное лечение , но и общие
