The dissertation presents a theoretical justification and a practical solution to the current problem - increasing the safety and effectiveness of local anesthesia in dentistry by creating a new concept of conductive anesthesia on the lower jaw, which is based on the main doctrine of pharmacotherapy regarding the use of the minimum amount and types of drugs to achieve the required effectiveness and consists in development of a new gel-like composition of a local anesthetic solution and preferential deposition of the anesthetic in the interpterygoid and pterygoid mandibular anatomical spaces using the proposed auxiliary device. New data were obtained, which made it possible to clarify and supplement statistics on complications and analysis of the reasons for failure during conduction anesthesia on the lower jaw. With the help of anatomical dissection and morphometry, the position of the target nerves and mandibular artery was clarified and the risk of their injury was assessed during the reproduction of mandibular anesthesia on anatomical preparations. For the first time, the area of spread of the anesthetic solution from the target point of mandibular anesthesia during the introduction of an X-ray contrast agent with subsequent tomographic visualization was studied. For the first time, stable interdependencies of bony landmarks on the lower jaw were established in order to increase the accuracy of reaching the target point of anesthesia. A number of factors and their prevalence have been established that complicate mandibular anesthesia: individual anatomical, physiological and behavioral characteristics of patients during dental treatment. A local anesthesia index has been developed and clinically tested, which has a numerical expression and is based on clinical criteria, which allows to evaluate the effectiveness of various anesthesia techniques and the clinical effectiveness of local anesthetics taking into account their pharmacological properties in relation to the amount. The number of patients at a dental appointment with an aggravated allergy history who are at risk of developing severe generalized complications during anesthesia was determined, and a retrospective data analysis was carried out over a 10-year period. The cause-and-effect relationships of the development of complications during conduction anesthesia on the lower jaw are systematized. A new concept of conductor anesthesia on the lower jaw was created, which consists in moving away from the direct dose-dependent effectiveness of the local anesthetic, replacing the principle of "aimed hitting" when performing conductor anesthesia and revising the postulated methods in the direction of their adaptation to anatomical variability and involves the use of a new technique of conducting anesthesia on the lower jaw jaws, development of a gel-like composition of a local anesthetic solution and an auxiliary device for its administration. The composition of the local anesthetic solution was developed without the use of vasoconstrictors and preservatives, by introducing a gel-like agent into its composition, which contributes to reducing the amount, speed of absorption and systemic toxicity of the local anesthetic. The optimal dose of the proposed local anesthetic composition has been clinically established. A method of conductive anesthesia on the lower jaw has been developed. An auxiliary device has been developed and clinically tested to ensure the accuracy of the injection needle to the target point of anesthesia. The understanding of the influence of local anesthetic solutions on the ultrastructure of the mucous membrane of the gums and muscles of rats has been deepened. For the first time, hematological and biochemical studies of the main parameters characterizing the acute toxicity of a gel-like anesthetic composition were conducted. For the first time, studies of the properties of the gel-like anesthetic composition against the background of experimental periodontitis in rats were conducted, which showed that the gel-like composition of the anesthetic, unlike the traditional anesthetic, revealed antioxidant properties, as evidenced by a decrease in the level of peroxide products in the blood serum and SOPR, activation of FAS enzymes in the gums and alveolar process, increasing the activity of glutathione peroxidase and sulfhydryl (SH-groups), as well as decreasing the level of disulfide compounds (SS-groups) in the mucous membrane of the gums and bone of the alveolar process. At the same time, enzyme activity was mostly observed locally, and practically did not have a systemic effect. For the first time, a reliable increase in the effectiveness of the proposed complex of innovations within the framework of a single concept of conductor anesthesia on the lower jaw has been clinically proven.
