Layosh N. Clinical and statistical justification of the effectiveness of local anesthesia in outpatient dental treatment of adolescents. - Qualifying scientific work as a manuscript.

The dissertation is aimed at solving an important task in pediatric dentistry - increasing the effectiveness of local anesthesia in providing outpatient dental care to adolescent population of the Transcarpathian region by determining and correcting their psychoemotional profile. When assessing the levels of reactive and personal anxiety in 384 teenagers living in Zakarpattia Oblast (233 girls and 151 boys), a high level of personal anxiety predominated in 63.6% of those examined; during a visit to the dentist, the percentage of high reactive anxiety increased to 85.4%. Significant differences in indicators between boys and girls were determined (p<0.05). There were no significant differences in caries prevalence (89.6±2.60%; 93.2±2.80%; 91.4±1.98%; p<0.05) and intensity in groups with different levels of anxiety caries (8.3±0.20; 8.6±0.23; 8.4±0.18; p<0.05); significant differences in the prevalence of the decompensated degree of caries activity were established (44.7%; 25.8%; 14.3%; p<0.05); subcompensated (37.7%; 23.8%; 25.7%; p<0.05); and compensated (12.3%; 29.5%; 34.3%; p<0.05). It was established that high anxiety is a predictor of gingivitis progression, significant differences in PMA index indicators between clinical groups were determined (63.0±5.84; 46.0±1.20; 39.5±1.39; p<0.05). Calculating dependences according to the Spearman indicator established the presence of an inverse correlation in the comparison between groups with high and low anxiety and in groups with high and moderate anxiety (r=-0.99, p<0.05), and in groups with moderate and low anxiety has a direct correlation with the Spearman value (r=-0.99, p<0.05). High personal anxiety is one of the etiological factors in the formation and progression of carious lesions of hard tissues and gingivitis in adolescents; a direct relationship was established between the level of personal anxiety and the course of caries in adolescents, with an increase in personal anxiety, the percentage of decompensated caries increases (44.7%; 25.8%; 14.3%; p<0.05) and the deterioration of hygiene is noted. Among adolescents of the first group, the indicator of 3.53±0.2 points corresponds to very poor hygiene, in the second group 1.73±0.73 points corresponds to satisfactory hygiene, in the third group 1.42±0.16 points corresponds to good hygiene. When comparing the effectiveness of local anesthesia in patients with a high level of anxiety without and after psycho-emotional correction in a comparative aspect, the following was established: in the treatment of acute medium severe pain syndrome was noted before analgesia in 22.8% of cases, significant differences were found after 5 minutes (15, 2%; 2.5%; p<0.05) and 10 minutes after anesthesia in 5.0% of cases without correction of the psycho-emotional state. . In the treatment of acute deep caries, a severe pain syndrome was noted before analgesia in 20.0% of cases, significant differences between the comparison groups were found after 5 minutes (6.3%; 1.3%; p<0.05), after 10 minutes (6 .3%; 0.0%; p<0.05), and after 15 minutes (2.5%; 0.0%; p<0.05). In the treatment of acute pulpitis, a severe pain syndrome was noted before analgesia in 45.2% of cases, significant differences between the comparison groups were found after 5 minutes (38.7%; 3.2%; p<0.05), after 10 minutes (9, 8%; 0.0%; p<0.05), and after 15 minutes (1.5%; 0.0%; p<0.05). Unbearable pain syndrome before treatment was noted in 12.8% of cases in patients with a high level of anxiety in acute pulpitis, after 5 minutes in 9.7% and after 10 minutes in 1.5% of patients without correction of the psycho-emotional state and was not noted after correction in 5 minutes. In the treatment of acute periodontitis, a severe pain syndrome was noted before analgesia in 39.1% of cases, significant differences between the comparison groups were found after 5 minutes (34.8%; 4.3%; p<0.05), after 10 minutes (17, 4%; 0.0%; p<0.05), and after 15 minutes (4.4%; 0.0%; p<0.05). Unbearable pain syndrome before analgesia was noted in 47.8% of cases, after 5 minutes 21.8% and after 10 minutes 4.4% in patients without correction, which is significantly different from similar indicators in patients after correction (p<0.05 ).